title: Thyroid transcription factor-1 expression in advanced non- small cell lung cancer: impact on survival outcome.
abstract: BACKGROUND
  The prognostic role of thyroid transcription factor-1 (TTF-1) expression in lung cancer has been assessed but with inconsistent results. The present study aimed to evaluate the prognostic value of TTF1 expression in advanced non-squamous non-small cell lung cancer (NSCLC).
  
  
  METHODS
  In this retrospective study, patients with stage IIIB-IV non-squamous NSCLC were enrolled. Progression free survival (PFS) and overall survival (OS) were assessed according to TTF1 expression status, age categories (≤60 vs >60 years), gender, performance status (PS) (0-2 vs 3-4), type of 1st line chemotherapy (pemetrexed containing vs others) and EGFR status.
  
  
  RESULTS
  A total of 120 patients were included. In univariate analysis, PFS was improved in patients with PS 0-2 (7.0 vs 2.0 months, p=0.002) and those who received pemetrexed-containing chemotherapy (9.2 vs 5.8 months, p=0.004). OS was improved in female patients (23.0 vs 8.7 months, p<0.0001), PS 0-2 (14.4 vs 2.0 months, p<0.0001), those with pemetrexed-containing chemotherapy (17.0 vs 11.0 months, p=0.019), TTF1-positive (12.8 vs 5.8 months, p=0.011) and EGFR- mutant patients (23.0 vs 11.7 months, p=0.006). In multivariate analysis, male gender (HR=2.34, p=0.025) and non-pemetrexed containing therapy (HR=2.24, p=0.022) were independent predictors of worse PFS. Wild EGFR status (HR=2.49, p=0.015) and male gender (HR=2.78, p=0.008) were predictors of worse OS.
  
  
  CONCLUSIONS
  Pemetrexed-containing therapy significantly improved PFS while OS was improved in EGFR mutant patients. Female patients had better PFS and OS. TTF1 expression was not a prognostic marker in advanced non-squamous NSCLC.
authors: Department of Medical Oncology, Oncology Centre, King Abdullah Medical City, Makkah, Saudi Arabia E-mail : shereefmohamad@yahoo.com.
authors: Shereef Ahmed
authors: SA
authors: Elsamany
authors: Turki M
authors: TM
authors: Al-Fayea
authors: Abdullah Said
authors: AS
authors: Alzahrani
authors: Waleed Nabeel
authors: WN
authors: Abozeed
authors: Waseem
authors: W
authors: Darwish
authors: Mian Usman
authors: MU
authors: Farooq
authors: Ahmed Salahuddin
authors: AS
authors: Almadani
authors: Esraa Ahmed
authors: EA
authors: Bukhari
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D004268:DNA-Binding Proteins / Q000235:genetics*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D011379:Prognosis; D012189:Retrospective Studies; D014157:Transcription Factors; D016896:Treatment Outcome
chemical_list: D004268:DNA-Binding Proteins; C504003:TTF1 protein, human; D014157:Transcription Factors; D000068437:Pemetrexed