Prognostic implications of glucocorticoid receptor expression in non-small cell lung cancer patients treated with pemetrexed

Purpose: This study aimed to evaluate whether the GRα/GRβ expression ratio can serve as a predictive biomarker for treatment response and survival outcomes in patients with non-squamous non-small cell lung cancer (NSCLC) receiving pemetrexed-based chemotherapy. Methods: A total of 35 patients with confirmed non-squamous NSCLC were enrolled and treated with pemetrexed plus dexamethasone. Quantitative PCR was used to measure GRα and GRβ mRNA levels, and patients were categorized into high and low GRα/GRβ ratio groups. Tumor response was assessed using RECIST criteria. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan–Meier analysis. Results: The low GRα/GRβ group showed a significantly higher response rate (52.9% vs. 44.4%, p = 0.04), greater tumor shrinkage (55% vs. 42%, p = 0.03), and improved lymph node regression. Median PFS and OS were also longer in the low-ratio group (5.5 vs. 4.0 months, p = 0.035; 14.0 vs. 11.6 months, p = 0.025, respectively). Conclusion: The GRα/GRβ expression ratio appears to be a promising predictive marker for clinical response and survival in non-squamous NSCLC. Incorporating this biomarker into treatment planning may enhance patient stratification and therapeutic decision-making.