Gene Signature May Predict Recurrence of Lung Cancer

ByABC News
May 16, 2008, 5:04 PM

May 17 -- FRIDAY, May 16 (HealthDay News) -- A panel of 15 genes may help determine which patients with early-stage non-small cell lung cancer will experience a recurrence and, therefore, benefit the most from chemotherapy, a new study shows.

By extension, the same genetic signature may also identify patients with less aggressive forms of the cancer who would be able to forego chemotherapy.

"Using this signature, we can identify up to 30 to 40 percent of stage I patients who might benefit from post-surgery chemotherapy and maybe up to 30 to 40 percent who might not benefit," said study author Dr. Ming Tsao, who will present the finding June 1 at the American Society of Clinical Oncology (ASCO) annual meeting, in Chicago. "The idea is that this could potentially supercede staging, although we definitely need more studies. [The information] is not immediately useful."

Previous trials have shown a benefit for stage I and II non-small cell lung cancer patients who received chemo after surgery. But, so far, the benefit has been confined mostly to stage II patients.

Even so, the distinction is not clear-cut. Some 30 percent of stage I patients who don't get added chemotherapy will die of a disease recurrence, and it's also possible that some stage II patients might not need chemotherapy after surgery.

"The goal of this study was to identify the genetic characteristics that could potentially be used to predict more precisely the likelihood of clinical outcomes, so those who need post-surgery chemo should get it and those who do not need it do not get it," explained Tsao, who is professor of laboratory medicine at the University of Toronto and a senior scientist at Princess Margaret Hospital in Toronto.

Gene expression profiling was performed on frozen tumor tissues from 64 patients as part of a follow-up analysis of a National Cancer Institute of Canada trial. Researchers then identified a group of 15 genes that divided the patients into high-risk (33 patients) and low-risk (31 patients) categories.