According to an article recently published in the New England Journal of Medicine, a gene expression profile, referred to as the lung metagene model, can help predict which patients with early non–small cell lung cancer are at a high risk for recurrence. Ultimately, these patients may benefit from additional treatment or more aggressive therapies than those at a lower risk for a recurrence.

Lung cancer remains the leading cause of cancer-related deaths in the world. 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 lung where the cancer originated. Early NSCLC refers to cancer that has not spread to distant sites in the body. Patients with early NSCLC have the best chances for long-term survival; however, a significant portion of these patients still experience a recurrence and succumb to their disease.

Researchers have been trying to identify specific patterns of gene expressions that may reveal characteristics of cancer.

Researchers from several institutions in the United States recently identified expressions of genes that predicted the risk of a cancer recurrence among 89 patients with early-stage NSCLC. To further validate these findings, the researchers evaluated the identified gene expression profile among patients with NSCLC who were involved in previous trials, the American College of Surgeons Oncology Group (ACOSOG) Z0030 study and the Cancer and Leukemia Group (CALGB) 9761 study.

  • The gene expression model identified, referred to as the lung metagene model, accurately predicted 72% of patients who experienced a recurrence in the ACOSOG Z0030 study, and 79% of patients who experienced a recurrence in the CALGB 9761 study.
  • Among patients with stage IA NSCLC, the earliest stage of the disease, the lung metagene model helped identify which patients had less than a 10% chance of survival at five years.

The researchers concluded that the lung metagene model provides significant improvement over standard clinical classifications of patients with early lung cancer when determining their risk of a recurrence. Large clinical trials further evaluating the lung metagene model have begun.

Patients diagnosed with early NSCLC may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating the lung metagene model or other models evaluating gene expression. Findings may help individualize their treatment.

Reference: Potti A, Mukherjee S, Petersen R, et al. A Genomic Strategy to Refine Prognosis in Early-Stage Non–SmallCell Lung Cancer*. New England Journal of Medicine.* 2006;355:570-580.

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