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Among patients with operable Stage IB to Stage II non–small cell lung cancer, those who have higher levels of a particular protein in tumor tissue may derive greater benefit from adjuvant chemotherapy. These results were published in the journal Clinical Cancer Research.

Cancers of the lung are classified by how they appear under a microscope. While there are more than a dozen different kinds of lung cancer, the two main types of lung cancer are non–small cell and small cell, which together account for over 90% of all lung cancers. Non–small cell lung cancer (NSCLC) accounts for approximately 75% of these cancers and consists of squamous cell, adenocarcinoma, and large cell types.

For patients with operable, Stage IB to Stage II NSCLC, recent studies have suggested that the addition of adjuvant (post-surgery) chemotherapy with cisplatin and vinorelbine results in better survival than surgery alone. Because the benefit of adjuvant chemotherapy is likely to vary across patients, researchers are evaluating different characteristics of patients or tumors that may help guide chemotherapy use. If certain patients are found to be unlikely to benefit from chemotherapy, these patients could be spared the side effects of this treatment.

In samples of lung cancer tissue from patients with advanced disease, levels of a protein known as class III b-tubulin have been linked with both survival and response to chemotherapy. Specifically, higher levels have been linked with both worse survival and a worse response to chemotherapy.

To evaluate class III b-tubulin levels in patients with earlier stage cancer, researchers assessed 256 patients with Stage IB to Stage II NSCLC. Some of the patients had been treated with surgery alone, and some had been treated with surgery plus chemotherapy (cisplatin and vinorelbine).

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  • In patients treated with surgery alone, higher tubulin levels were linked with worse survival.
  • In patients treated with surgery plus chemotherapy, tubulin level did not influence survival.
  • There was some suggestion that patients with higher tubulin levels may be more likely to benefit from adjuvant chemotherapy than patients with lower tubulin levels.

The researchers conclude that in patients with operable NSCLC, those with higher levels of tubulin in tumor tissue may be more likely than those with lower levels of tubulin to benefit from adjuvant chemotherapy. These results differ from what has been observed among patients with more advanced NSCLC and will need to be further evaluated in a larger study.

Reference: Seve P, Lai R, Ding K et al. Class III b-tubulin expression and benefit from adjuvant cisplatin/vinorelbine chemotherapy in operable non–small cell lung cancer: analysis of NCIC JBR.10. Clinical Cancer Research. 2007;13:994-999.

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