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A genetic test performed on a sample of tumor tissue helps predict survival among patients with early, non-squamous, non-small cell lung cancer (NSCLC) who are treated with surgery only. Patients with low predicted survival may benefit from the addition of chemotherapy. These results were recently presented at the 14th World Conference on Lung Cancer meeting sponsored by the International Association for the Study of Lung Cancer (IASLC).

Lung cancer remains the greatest cause of cancer-related deaths in the United States and worldwide.  Patients with early-stage NSCLC have cancer that is not detected outside the lung. However, the majority of these patients ultimately die from the disease due to its spread to distant sites in the body (metastasis). This underscores the limited accuracy of currently available methods for the detection of metastasis, resulting in incorrect staging and under-treatment of many patients with a diagnosis of early NSCLC.

An international clinical trial was recently conducted to evaluate the effectiveness of a genetic assay in determining overall survival among patients who were diagnosed with early NSCLC.  The trial included tumor samples from over 1,100 patients who underwent the surgical removal of their cancer without chemotherapy. Based on genetic analysis, patients were categorized as high-risk, intermediate-risk, or low-risk for the return of cancer following surgery.

  • At 5 years following surgery, overall survival was 78%, 60%, and 30%, for low-, intermediate-, and high-risk groups, respectively.
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The researchers stated that this genetic assay helps to identify patients who may be at a high risk of developing progression of their cancer following surgery alone. Ultimately, these patients may benefit from chemotherapy following surgery while those at a low risk of cancer progression may be spared unnecessary side effects of chemotherapy.  This is the largest validation trial to date to test a genetic assay in patients with this disease. Further trials are necessary to determine if patients at a high risk of death according to the test would ultimately demonstrate a benefit from chemotherapy following surgery.

Reference: Kratz J, Van Den Eeden S, He J, et al. Large-scale international validation of a qPCR-based genetic assay prognostic of survival in resected non-squamous cell lung cancer. (Conference President’s selection).  Paper presented at the 14th World Conference on Lung Cancer. July 3-7, 2011. Amsterdam, Netherlands. Abstract #01.07

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