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According to a study published in the journal Cancer, the levels of two different types of T-cells (cells that play a role in immune responses) in cancer tissue may help predict the probability of recurrence in patients with Stage I non–small cell lung cancer.

Lung cancer remains the leading cause of cancer-related deaths in the United States. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, comprising approximately 75–85% of all lung cancers.

Stage I NSCLC is located in only one lung and has not spread to the adjacent lymph nodes or outside the chest.

The mainstay of treatment for patients diagnosed with a Stage I NSCLC has been surgical removal of the cancer. In general, surgical removal of Stage I cancers results in over 60% of patients surviving without evidence of cancer recurrence within five years of treatment. The size and specific location of the cancer may improve or diminish an individual patient’s chance of cure.

Although many patients with early-stage NSCLC will eventually experience a cancer recurrence, it is difficult to predict which patients are most at risk. More accurate assessment of recurrence risk may allow for more individualized cancer treatment.

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A factor that may influence cancer control and cancer recurrence is the immune system. Researchers have long suspected that the immune system plays a role in destroying cancer cells. It’s possible, therefore, that a reduction in the immune system’s response to a cancer may allow for cancer growth and recurrence.

To explore the link between two types of immune cells and lung cancer recurrence, researchers evaluated information from 64 patients with Stage I NSCLC. The levels of two different cell types were assessed in cancer tissue. These cell types were tumor-infiltrating T-cell lymphocytes (TIL) and tumor-regulatory T-cells (Treg). These two types of cells have opposing actions-TIL are involved with an active immune response and Treg cells down-regulate the immune response.

  • Treg cells were detected in 51% of cancers and TIL were detected in 83% of cancers.
  • Patients with no TIL, or with a high proportion of Treg cells relative to TIL, had an increased risk of cancer recurrence. Compared to the patients at lowest risk of recurrence (those with abundant TIL and no Treg cells), these patients were eight times more likely to experience a cancer recurrence.

The researchers conclude that Stage I NSCLC patients whose cancers have a higher proportion of Treg cells relative to other types of T-cells may have a higher risk of cancer recurrence. Combination of this marker with other markers of prognosis may eventually help guide treatment decisions.

Reference: Petersen RP, Campa JM, Sperlazza J et al. Tumor Infiltrating Foxp3+ Regulatory T-cells are Associated with Recurrence in Pathologic Stage I NSCLC Patients. Cancer [early online publication]. November 10, 2006.

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