Biomarkers can predict recurrence risk

This study examined whether biomarkers were predictive of recurrence (return of the cancer) and overall survival rates in patients with lung cancer.

Treatment for stage 2 or 3 lung cancer generally includes the surgical removal (resection) of the tumor, followed by additional (adjuvant) therapies such as chemotherapy or radiation therapy. However, recurrences are often seen in this patient population, therefore it would be useful to be able to predict the risk of recurrence, so that the appropriate treatments could be offered. A biomarker is a substance in the body which indicates the presence of cancer. In lung cancer, one such biomarker is the ERCC1 protein, which if expressed (found), indicates good survival chances, and less need for chemotherapy. Another known biomarker is the RRM1 protein, which is also predictive of better survival rates. However, biomarkers are not yet routinely used in determining recurrence risk in lung cancer patients. The current study examined multiple other possible biomarkers and patient characteristics, to determine if they were predictive of recurrence and survival rates in patients with early-stage lung cancer.

This study followed 370 patients with early-stage non-small cell lung cancer (NSCLC), all of whom had had their tumors removed. 36% of patients also underwent adjuvant therapy, either chemotherapy or radiation therapy. Patients were followed for over 5 years, and recurrence-free survival or RFS (the time patients survived from resection to recurrence of the disease) and overall survival or OS (the time patients survived from resection) were measured. 21 different potential biomarkers were explored, and were correlated with RFS and OS rates, as were patient characteristics, such as age or disease stage. By the end of the follow-up period, there were 209 recurrences or deaths from the disease. The median RFS time was 4.1 years, and the median OS time was 6.4 years.

Patient age and disease stage were associated with RFS and OS. Compared to patients with stage 1 disease, stage 2 patients had nearly twice the risk of recurrence and 1.5 times the risk of death, while stage 3 patients had over 2.5 times the risk of both recurrence and death.

Three biomarkers were found to be predictive of a shorter time to recurrence: patients who expressed the insulin receptor, the CXCR2 protein, or the IGF1R protein were almost 1.5 times more likely to have a short RFS time. Patients who expressed the pAMPK, pmTOR, EpCAM, or the CASK proteins were all 25-30% more likely to have longer RFS times. The CXCR2 and FEN1 proteins were both found to be predictive of a shorter OS, as patients expressing these proteins had a 150% increase in the risk of death. Expression of the pAMPK, pmTOR, and EpCAM proteins, however, was associated with a 25–30% chance of longer OS.

This study concluded that several biomarkers were predictive of lung cancer recurrence and survival, and these could be useful in determining treatment and prognosis for these patients.

Consult with your physician regarding the appropriate risk management for your situation.