Mesothelioma and Lung Cancer News - Return to Menu

Gene Signature Predicts Recurrence in Non–Small Cell Lung Cancer

According to an article recently published in the New England Journal of Medicine, a gene expression profile, referred to as the lung metagene model, can help predict which patients with early non–small cell lung cancer are at a high risk for recurrence. Ultimately, these patients may benefit from additional treatment or more aggressive therapies than those at a lower risk for a recurrence.

Lung cancer remains the leading cause of cancer-related deaths in the world. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer; “non–small cell” refers to the type of cell within the lung where the cancer originated. Early NSCLC refers to cancer that has not spread to distant sites in the body. Patients with early NSCLC have the best chances for long-term survival; however, a significant portion of these patients still experience a recurrence and succumb to their disease.

Researchers have been trying to identify specific patterns of gene expressions that may reveal characteristics of cancer.

Researchers from several institutions in the United States recently identified expressions of genes that predicted the risk of a cancer recurrence among 89 patients with early-stage NSCLC. To further validate these findings, the researchers evaluated the identified gene expression profile among patients with NSCLC who were involved in previous trials, the American College of Surgeons Oncology Group (ACOSOG) Z0030 study and the Cancer and Leukemia Group (CALGB) 9761 study.

The gene expression model identified, referred to as the lung metagene model, accurately predicted 72% of patients who experienced a recurrence in the ACOSOG Z0030 study, and 79% of patients who experienced a recurrence in the CALGB 9761 study.
Among patients with stage IA NSCLC, the earliest stage of the disease, the lung metagene model helped identify which patients had less than a 10% chance of survival at five years.
The researchers concluded that the lung metagene model provides significant improvement over standard clinical classifications of patients with early lung cancer when determining their risk of a recurrence. Large clinical trials further evaluating the lung metagene model have begun.

Patients diagnosed with early NSCLC may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating the lung metagene model or other models evaluating gene expression. Findings may help individualize their treatment.

Reference: Potti A, Mukherjee S, Petersen R, et al. A Genomic Strategy to Refine Prognosis in Early-Stage Non–SmallCell Lung Cancer. New England Journal of Medicine. 2006;355:570-580.

Related News: Molecular Profiles Help Predict Prognosis in Lung Cancer (3/15/2006)

Molecular Profiles Help Predict Prognosis in Lung Cancer

According to an article recently published in the journal Cancer Cell, molecular profiles from tissue of lung cancer can help predict prognosis, even among those with the earliest stages of lung cancer. Patients with a poor prognosis according to these results may benefit from additional therapy.

Lung cancer remains the leading cause of cancer-related deaths in the US. In fact, lung cancer is responsible for more deaths than the following three leading causes of cancer-related deaths combined: breast cancer, lung cancer, and colon cancer.

Non-small cell lung cancer (NSCLC) accounts for approximately 75%-80% of all lung cancers. “Non-small cell” refers to the type of cell within the lung where the cancer originated.

Staging of lung cancer determines of the extent of spread of the cancer. Accuracy in staging is crucial since treatment options and prognosis are primarily determined by stage.

Currently, the stage of NSCLC is typically defined by the size of the cancer and by areas within the body that the cancer has invaded. However, since survival rates among patients with the same stage of NSCLC vary widely, researchers continue to evaluate other prognostic factors that may improve staging accuracy.

Researchers from several medical institutions recently conducted a clinical study to evaluate molecular profiles referred to as microRNAs (miRNAs) and their potential to predict outcomes in patients with adenocarcinoma of the lung (a type of NSCLC).

This study included samples from 104 patients diagnosed with NSCLC. The researchers compared cancerous lung tissue to healthy lung tissue of the same patient.

The researchers identified two miRNAs, referred to as has-mir-155 and has-let-7a-2, that were associated with survival of patients.

Patients with high levels of has-mir-155 and/or low levels of has-let-7a-2 had significantly poorer survival than their counterparts. All clinical and molecular factors taken together, including stage, high levels of has-mir-155, and/or low levels of has-let-7a-2 were the most significant factors for a poor outcome.

The researchers concluded that these two miRNAs may provide value in individualizing treatment for patients with NSCLC since they appear highly predictive of outcomes for patients with this disease. Further study evaluating has-mir-155 and has-let-71-2 levels are warranted.

Reference: Yanaihara N, Caplen N, Bowman E, et al. Unique microRNA Molecular Profiles in Lung Cancer Diagnosis and Prognosis. Cancer Cell. 2006; 9: 189-198.