According to results presented at the 2006 annual meeting of the American Society of Clinical Oncology (ASCO), individuals with early lung cancer who do not express the ERCC-1 protein gain significant survival benefit from chemotherapy. On the other hand, those who do express this protein do not appear to gain any survival benefit from chemotherapy.

Lung cancer remains the leading cause of cancer-related deaths in the U.S. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer. “Non–small cell” refers to the type of cell within the where lung the cancer originated.

Resectable lung cancer refers to lung cancer that is still in early stages and can be completely removed with surgery. Unfortunately, even among patients with resectable lung cancer, long-term survival is poor. There is ongoing debate over the benefits of chemotherapy following surgical removal of lung cancer.

Researchers recently evaluated data from patients involved in the International Adjuvant Lung Cancer Trial (IALT) in which patients with resected NSCLC either received additional chemotherapy or no further therapy following surgery (control group). Overall, there was a 4.1% improvement in overall survival at five years among patients treated with chemotherapy. Researchers evaluated the tissue from 761 patients involved in the trial in an effort to identify disease variables that may be associated with outcomes.

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  • At five years, patients who did not display the ERCC-1 protein on their cancer cells (ERCC1-negative) had a survival rate of 47% if they were treated with chemotherapy compared to only 39% in the control group.
  • Half of the patients with ERCC1-negative cancers were still alive at 56 months if treated with chemotherapy compared to only 42 months in the control group.
  • At five years, patients who did display the ERCC-1 protein on their cancer cells (ERCC1-positive) had a survival rate of 40% if they were treated with chemotherapy compared with 46% for those in the control group.
  • Half of the ERCC1-positive patients were alive at 50 months if they were treated with chemotherapy compared with 55 months for those not treated with chemotherapy.

The researchers concluded that patients with ERCC-1 negative NSCLC that has been resected gain significant survival benefit from the addition of chemotherapy; however, those with ERCC-1 positive NSCLC that has been resected do not appear to gain a survival benefit with the addition of chemotherapy. If these results can be confirmed, display of the ERCC-1 protein may play an important role in developing individualized therapeutic options for patients with resectable NSCLC.

Reference: Soria J, Haddad V, Olaussen KA, et al. Immunohistochemical Staining of the Excision Repair Cross Complementing 1 (ERCC1) Protein as Predictor for Benefit of Adjuvant Chemotherapy (CT) in the International Lung Cancer Trials (IALT). Proceedings from the 42nd annual meeting of the American Society of Clinical Oncology (ASCO). June 2006. Atlanta, GA. Abstract 7010.

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