title: Histology as a potential clinical predictor of outcome in advanced non-small-cell lung cancer treated with vinorelbine and mitomycin combination chemotherapy.
abstract: BACKGROUND
  The importance of clinical predictors in the treatment of non-small-cell lung cancer (NSCLC) has increased during the last decade. This retrospective study analyzed the combined patient-level data from two phase II trials that investigated the efficacy and safety of combination chemotherapy with vinorelbine and mitomycin in patients with locally advanced or metastatic NSCLC. The aim of this analysis was to determine if patients' baseline and disease characteristics, including histology, gender, smoking history, and expression of TTF-1, might be potential predictors of outcome.
  
  
  METHODS
  Response rates, unadjusted survival times, and Cox covariate-adjusted hazard ratios (HRs) were calculated. Results were reported separately for each subgroup in each individual trial and in the pooled data set.
  
  
  RESULTS
  A total of 175 patients were included in this analysis. Adjusted HRs for both overall survival (OS) and progression free survival (PFS) favored the nonadenocarcinoma histology subgroup, achieving a statistical significance for OS in the pooled data (n = 175; HR 0.68; 95 % CI 0.49-0.94; p = 0.019). TTF-1-negative immunohistochemistry was associated with a significantly higher response rate (25 vs. 0 %; p = 0.04) and with a nonsignificant advantage in OS (n = 33; HR 1.23; 95 % CI 0.56-2.73; p = 0.608). Gender and smoking history were not strongly related to outcome.
  
  
  CONCLUSIONS
  The results of this analysis indicate that patients with nonadenocarcinoma histology might get superior benefit from combination chemotherapy with vinorelbine and mitomycin. These results should be confirmed in a prospective study.
authors.affiliation: Department of Internal Medicine II, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wibmer
authors.forename: Thierry
authors.initials: T
authors.lastname: Berghmans
authors.forename: Cornelia
authors.initials: C
authors.lastname: Kropf-Sanchen
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lafitte
authors.forename: Stefan
authors.initials: S
authors.lastname: Rüdiger
authors.forename: Marianne
authors.initials: M
authors.lastname: Paesmans
authors.forename: Ioanna
authors.initials: I
authors.lastname: Blanta
authors.forename: Arnaud
authors.initials: A
authors.lastname: Scherpereel
authors.forename: Kathrin M
authors.initials: KM
authors.lastname: Stoiber
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rottbauer
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Sculier
authors.forename: Christian
authors.initials: C
authors.lastname: Schumann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000737:chemistry / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D017322:Clinical Trials, Phase II as Topic; D004268:DNA-Binding Proteins / Q000032:analysis; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000737:chemistry / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014157:Transcription Factors; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; C504003:TTF1 protein, human; D014157:Transcription Factors; D016685:Mitomycin; D014747:Vinblastine; D000077235:Vinorelbine
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