ESMO 2025 Tumor-infiltrating clonal hematopoiesis may be a target for cancer treatment

MedNet.nl: Clonal hematopoiesis is the presence of clones of blood cells that originate from a mutated hematopoietic stem cell. If these (immune) cells are found in a tumor, this is referred to as tumor-infiltrating clonal hematopoiesis (TI-CH). The latest insights on this topic were discussed during ESMO, including a study recently published in The New England Journal of Medicine showing that TI-CH increases the risk of recurrence in patients with non-small-cell lung cancer.

The prevalence of clonal hematopoiesis increases with age and is approximately 10–15% in people over the age of 60 years. Clonal hematopoiesis increases the risk of hematologic malignancy, but is not in itself evidence of a hematologic disorder. Its occurrence is also associated with various nononcologic conditions, such as ischemic heart failure, atherosclerosis, type 2 diabetes, venous thrombosis, and COPD. Clonal hematopoiesis also occurs in approximately 25% of patients with solid tumors and is associated with poorer survival in these patients. This condition is also associated with an increased risk of lung cancer.

A recently published study examined the incidence of clonal hematopoiesis and TI-CH in 421 patients with lung cancer and in 49,351 patients with other types of tumors. The aim was to gain more insight into the role of clonal hematopoiesis in tumor progression. The study showed that 42% of lung cancer patients with clonal hematopoiesis had TI-CH and that its presence significantly increased the risk of recurrence or death (HR=1.80). In the total cohort of patients with solid tumors and clonal hematopoiesis, 26% of patients had TI-CH.

The growing understanding of the role of TI-CH in (hemato-)oncologic malignancies means that various therapeutic strategies are currently being investigated.

Bernard E. ESMO 2025, Premalignant states in haematology; clonal haematopoiesis and cancer. Educational session, Sunday, October 19, 5:20-5:45 p.m.

Pich O, et al. Tumor-Infiltrating Clonal Hematopoiesis. N Engl J Med 2025;392:1594-608.

This article was originally published in Dutch on MedNet.nl