According to a recent article published in
The Lancet, proteomic patterns may provide improved diagnostic precision in patients with NSCLC. Greater diagnostic precision could potentially lead to individualized treatment regimens and ultimately improved outcomes in the near future for patients with NSCLC.
Lung cancer continues to remain the number one cause of cancer deaths in the United States. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and refers to the type(s) of cell within the lung that the cancer originated. There are several classifications of NSCLC, depending upon the specific type of cell that has become cancerous. Treatment strategies for NSCLC are presently dictated by the extent (stage) and location to which the cancer has spread. However, current staging methods are often not sensitive enough to provide great accuracy in determining the extent of cancer spread which may lead to suboptimal treatment strategies. Patients with early-stage NSCLC, or cancer that has not spread from its site of origin, may ultimately be cured with the surgical removal of the cancer. However, the majority of patients diagnosed with NSCLC have cancer that has spread from its site of origin, a point at which NSCLC is difficult to cure.
Patients with NSCLC whose cancer has spread to lymph nodes are often treated more aggressively than those without spread. In addition, differing biological variables between patients with NSCLC ultimately impact responses to therapy. Furthermore, researchers are only beginning to uncover associations between biological or genetic variability of patients and associated responses to therapy. As research involving biologic differences and associated responses to treatment matures, standard practice will undoubtedly become more individualized, enabling physicians to provide specific treatment regimens matched with a patient’s biological variations to ensure optimal outcomes.
Proteomics is the measure of different proteins that are produced by a cell. Proteomics is quickly gaining acceptance in the medical field as a promising tool to differentiate protein expression of a cell and biological variables (including responses to therapy) associated with the found protein expressions of the cell. Researchers from Vanderbilt University and Cancer Center recently conducted a clinical study to evaluate the accuracy of proteomics in determining specific disease characteristics in patients diagnosed with NSCLC. The object of the study was to determine if proteomics could distinguish between NSCLC that had originated in the lung or cancer that had originated elsewhere in the body and spread to the lung (metastasis), or NSCLC that had recurred in the lung. In addition, researchers tested the accuracy of proteomics in determining if NSCLC had spread to lymph nodes, compared to NSCLC that was confined within the lung. Initially, proteomic spectra, or a “fingerprint” of the quantity of different expressed proteins from a cell, were obtained from samples of lung tissue from patients with lung tumors, either original NSCLC, recurrence of NSCLC, cancer metastasis to the lung, pulmonary carcinoid (lung cancer that is not NSCLC) and healthy individuals. These results were used to determine if consistent patterns of expression correlated with NSCLC, compared to healthy lung tissue. Next, researchers tested these differences on lung tissue samples from an additional 37 patients diagnosed with NSCLC and 6 healthy individuals. The results were compared with laboratory results involving tissue samples from the patients.
With nearly 100% accuracy, researchers identified different types of NSCLC using proteomic spectra and were able to distinguish between NSCLC, carcinoid and normal lung tissue. In addition, researchers were able to distinguish between NSCLC, a recurrence of NSCLC or metastasis of cancer to the lung with 100% accuracy. Researchers were also able to identify cancer spread to the lymph nodes with 75% accuracy.
The researchers concluded that proteomic analysis appears to provide diagnostic information for patients with NSCLC with great accuracy. Larger clinical trials are necessary in order to confirm this finding; however, these results provide important implications to the direction of novel techniques that may become incorporated into standard clinical practice for patients with cancer in the near future. Patients diagnosed with NSCLC may wish to speak with their physician about the risks and benefits of participating in a clinical trial further evaluating proteomic analysis. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (
www.cancerconsultants.com. Personalized clinical trial searches are also performed on behalf of patients by cancerconsultants.com
Reference: Yanagisawa K, Shyr Y, Baogang X, et al. Proteomic patterns of tumour subsets in non-small-cell lung cancer.
The Lancet. 2003;362:433-439.
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