Prognostic and predictive markers of benefit from adjuvant chemotherapy in early-stage non-small cell lung cancer.
Lung cancer-predominantly non-small cell lung cancer (NSCLC)-is the leading cause of death from cancer in most industrialized countries. Patients with early-stage NSCLC are at substantial risk for recurrence and death even after potentially curative surgery. Multiple large randomized trials have demonstrated that adjuvant chemotherapy using modern cisplatin-based regimens can significantly improve 5-year survival in carefully selected patients with NSCLC.The current staging system is inadequate for predicting the outcome of treatment and the prognosis in an individual patient. Molecular markers may provide additional information about the likelihood of relapse beyond that obtained from pathologic staging. They may also have value in determining which patients will benefit from adjuvant platinum-based chemotherapy.This is a review focused on approaches and specific markers under study, including gene expression profiles, DNA repair pathways, class III beta-tubulin expression, abnormalities in the k-ras oncogene and p53 tumor suppressor gene, and DNA methylation markers. Additional studies will be required to determine whether these markers are useful in selecting patients for adjuvant platinum-based chemotherapy.
Medical Oncology Department, Hospital Universitario Clínico San Carlos, Center affiliate to the Red Temática de Investigación Cooperativa (RD06/0020/0021, Instituto de Salud Carlos III (ISCIII), Madrid, Spain. anabelencustodio@hotmail.com
Ana Belén
AB
Custodio
José Luis
JL
González-Larriba
Jana
J
Bobokova
Antonio
A
Calles
Rafael
R
Alvarez
Eugenio
E
Cuadrado
Aranzazu
A
Manzano
Eduardo
E
Díaz-Rubio
D015415:Biomarkers / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D019175:DNA Methylation; D004260:DNA Repair; D020869:Gene Expression Profiling; D011905:Genes, ras; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D014404:Tubulin / Q000032:analysis
D015415:Biomarkers; D014404:Tubulin