Posts Tagged ‘NSCLC’

Is there a Gene Signature to Predict Malignancy and Risk of Non-Small Cell Lung Cancer?

Friday, January 13th, 2012

New Research published in a recent issue of the Journal of the National Cancer Institute concluded that the malignancy-risk gene signature was associated with overall survival (OS) and was also a prognostic and predictive indicator for early stage non-small cell lung cancer (NSCLC). . The gene signature has also been useful in predicting breast cancer risk and consists of numerous proliferative genes.
In their research, they hypothesized that the malignancy-risk gene signature would have high prognostic and predictive value for early stage NSCLC. They studied the hypothesis by using 3 different NSCLC microarray datasets ranging in number from 117 to 442. An overall malignancy risk score was generated by principal component analysis to determine the prognostic and predictive value of the signature using 2 sided statistical tests.
The malignancy-risk gene signature was statistically associated with overall survival (OS) at the .001 level for the NSCLC patients. Validation with the two additional datasets demonstrated that the malignancy-risk score had prognostic and predictive values. Of the patients not receiving chemotherapy (ACT) those with a low malignancy-risk score had increased overall survival compared with those having a high malignancy-risk score at the .007 level of probability and at the .01 level for the two independent data sets.
The researchers concluded that “the malignancy-risk gene signature was associated with OS and was a prognostic and predictive indicator.”

Staging Lung Cancer Using Less Invasive Method Shows Promise

Wednesday, December 1st, 2010

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In a study reported in the November 24 issue of the Journal of the American Medical Association (see the reference below) researchers concluded that when using two interventions to determine the stage of suspected non-small cell lung cancer (NSCLC) the less invasive may be more effective and save the patient unnecessary surgery.

In the study the researchers compared the two recommended lung cancer staging strategies that are endosonography, untrasound using a fiberoptic endoscope, considered the less invasive and
surgery. Currently, endosonography may be followed by surgical staging if no nodal metastases are found. Surgical staging alone has limitations and mit is believed may result in unnecessary surgery.

Interventions in the study included either surgical staging or endosonography followed by surgical staging if no nodal metastases were found and thoracotomy (surgical procedure) with lymph node dissection when there was no evidence of mediastinal (space near the lungs in the thoracic cavity) spread of the tumor.

Two hundred forty one patients with suspected NSCLC in whom mediastinal staging was indicated were randomized into the two group during the period February 2007 to April 2009. Of these, 118 were in the surgical staging group, and 123 in the endosonography group. Of the later group 65 also underwent surgical staging. “Nodal metastases were found in 41 patients (35%) by surgical staging vs 56 patients by endosonography (46%) and in 62 patients (50%) by endosonography followed by surgical staging. This corresponded to sensitivity of 79% (41/52) vs 85% (56/66) and 94% (62/66).” Unnecessary thoracotomies were performed on 21 patients (18%) in the mediastinoscopy group vs 9 (7%) in the endosonography group.

The authors concluded that among suspect NSCLC patients a staging strategy combining endosonography and surgical staging resulted in greater sensitivity for mediastinal nodal metastases and fewer unnecessary thoracotomies than using surgical strategies alone.
See the full study below:
http://jama.ama-assn.org/cgi/content/full/304/20/2245