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LncRNA signatures predict ICI response and survival across cancers in systematic reviewlncRNA Signatures May Help Predict Response to Cancer Treatment

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Key Takeaway
Consider lncRNA signatures as promising but unvalidated biomarkers for ICI response and prognosis.

This systematic review of 31 studies evaluated the prognostic and predictive value of long non-coding RNA (lncRNA) expression in adult cancer patients treated with immune checkpoint inhibitors (ICIs). The review synthesized evidence across multiple cancer types, finding that lncRNA-based signatures consistently demonstrated prognostic value by stratifying patients into groups with significantly different survival outcomes. Additionally, these signatures were associated with variations in ICI response, suggesting potential as predictive biomarkers.

The authors note that the association between lncRNA expression and survival or response is derived from existing studies, but no pooled effect sizes were reported. Limitations include the need for prospective validation and standardized analytical approaches before clinical implementation. The review did not report on safety, adverse events, or specific cancer types.

While lncRNAs represent promising biomarkers for precision immuno-oncology, they are not yet clinically validated. Clinicians should interpret these findings cautiously, as the evidence remains associative and requires further rigorous study.

How this fits prior evidence

This systematic review extends prior coverage of immune checkpoint inhibitors by exploring molecular biomarkers that may refine patient selection. While previous reports focused on clinical outcomes and adverse events (e.g., acute kidney injury, synergistic effects with radiotherapy), this review addresses the gap in predictive biomarkers by synthesizing evidence on lncRNA signatures. It confirms the need for prospective validation, aligning with prior calls for cautious interpretation of biomarker data.

Researchers reviewed 31 studies to see if certain molecules, known as lncRNAs, could act as signs for cancer treatment success. These were studied in adult patients receiving immune checkpoint inhibitors, which are a type of immunotherapy used to treat various cancers.

The review found that these lncRNA signatures consistently showed prognostic value. This means they helped group patients into different categories based on their survival outcomes. Additionally, the study found that these markers were linked to variations in how well patients responded to treatment across several types of cancer.

While these findings are promising for personalized medicine, there is a major reason to be cautious. These results come from a review of existing studies and have not been confirmed in large, prospective clinical trials. Because the research lacks standardized testing methods, these markers are not yet ready to change standard medical practice.

What this means for you:
lncRNA signatures show promise as markers for cancer treatment response but need more validation before use.

Common questions

What are lncRNAs and how do they relate to cancer?

lncRNAs are a type of RNA that can serve as biomarkers. This review found that specific lncRNA signatures were associated with variations in how patients responded to immune checkpoint inhibitors across multiple types of cancer.

Can these markers tell doctors if a treatment will work?

The study showed that lncRNA-based signatures could stratify patients into groups with different survival outcomes. This suggests they may have value in predicting how well a patient might respond to certain cancer treatments.

Are these markers ready to be used in clinics today?

No, these markers are not yet clinically validated for use in precision oncology. The review noted that more prospective validation and standardized analytical approaches are needed before they can be used in routine practice.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
BackgroundImmune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, durable clinical benefit is limited to a subset of patients. Long non-coding RNAs (lncRNAs) have emerged as important regulators of tumor biology and immune responses and may serve as novel biomarkers to predict prognosis and response to ICIs.MethodsThe systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251030158). Databases were searched from January 2010 to July 2025 for studies evaluating lncRNA expression in adult cancer patients treated with ICIs. Eligible studies assessed associations between lncRNAs expression and survival outcomes after ICI treatment.ResultsAfter selection, 31 studies across multiple cancer types, were included. Most studies were retrospective bioinformatic analyses of public datasets and focused on ICI therapies. lncRNA-based signatures consistently demonstrated prognostic value by stratifying patients into groups with significantly different survival outcomes and were associated with variations in ICI response across multiple cancer types.ConclusionsLncRNAs represent promising prognostic and predictive biomarkers for ICI. Prospective validation and standardized analytical approaches are needed to support their clinical translation in precision immuno-oncology.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251030158.
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