Benefits and Toxicities of Chemotherapy Among Patients with Advanced Lung Cancer
According to a study published in the American Journal of Clinical Oncology, gene expression profiling may predict how well patients with lung cancer will respond to chemotherapy, and how likely they are to experience toxic effects of chemotherapy. Refinement of results from gene expression profiling and their feasibility in the clinical setting will be established through future clinical trials in the hopes of ultimately providing individualized care for patients with cancer.
Lung cancer is characterized by the uncontrolled growth of abnormal cells in one or both lungs. The majority of lung cancers begin in the bronchial tubes, which conduct air in and out of the lungs. In the U.S., lung cancer is the leading cause of cancer mortality among both men and women.
Treatment of lung cancer (as well as other cancers) may be aided by a laboratory technique called gene expression profiling. This technique tests cancer cells for specific patterns in their gene activity or in proteins produced by the genes. The identified patterns tend to be strongly associated with a specific type of cancer and specific characteristics of the cancer, such as its aggressiveness or response to therapy.
In the current study, researchers evaluated gene expression levels in 47 patients with advanced lung cancer. All patients except three were treated with platinum-based chemotherapy. The objective of the study was to determine whether gene expression levels could be used to predict which patients would respond to chemotherapy and which patients would experience toxic effects of chemotherapy (these include low blood cell levels, diarrhea, infection, and high blood levels of creatinine). In each patient, the researchers determined the expression levels of over one thousand genes in cancer tissue collected from the lung before chemotherapy began.
The researchers identified three genes that predicted cancer resistance to chemotherapy as well as patient survival. In addition, they identified genes that were associated with a higher probability of toxic effects of chemotherapy.
The researchers conclude that both the benefits and toxicities of chemotherapy were predicted by gene expression profiling using tissue collected before chemotherapy. Gene expression profiling may help individualize cancer treatment by identifying in advance those patients who are most and least likely to benefit from a particular treatment. Patients who have been diagnosed with lung cancer may wish to speak with their physician about participating in a clinical trial further evaluating gene expression profiling. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Oshita F, Ikehara M, Sekiyama A et al. Genomewide cDNA microarray screening of genes related to benefits and toxicities of platinum-based chemotherapy in patients with advanced lung cancer. American Journal of Clinical Oncology. 2005;28:367-70.
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