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Updated: Jun 13, 2026
MicroRNA Based Liquid Biopsy: The Experience of the Plasma miRNA Signature Classifier (MSC) for Lung Cancer Screening
Published on: October 26, 2017
Biomarkers in lung oncology
Rafael Rosell1, Alain Vergnenegre, Baorui Liu
1Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona, Spain. rrosell@iconcologia.net
Abstract:
The survival of advanced non-small-cell lung cancer patients is short in spite of advances in new combination chemotherapy regimens. The benefit of adding antiangiogenic drugs and/or EGFR inhibitors is unclear. For the vast majority of patients without EGFR mutations, treatment approaches based on customization should be pursued. BRCA1 is central to the repair of DNA damage and is an important modulator of the differential effect of chemotherapy. Retrospective and prospective data indicate that low BRCA1 mRNA levels predict better response and survival when patients are treated with cisplatin, non-taxane combinations. For an important subgroup of patients with EGFR mutations, selective treatment with EGFR tyrosine kinase inhibitors is a major advance, with a dramatic impact on clinical outcomes. In a prospective study of customized erlotinib [1], overall response rate was 70% (including 12% complete responses), median progression free survival was 14 months (even longer in women and in patients with del 19), 20% of patients were disease-free at three years, and median survival was 27 months. Nonetheless, these clinical outcomes fall short of curability and continuous treatment with erlotinib or gefitinib is required. It is plausible that several genetically defined subclasses of EGFR mutations could help to improve current clinical outcomes by combining erlotinib or gefitinib with other targeted drugs.
Insights
Advanced non-small-cell lung cancer survival remains poor. Customizing treatment based on EGFR mutations and BRCA1 levels shows promise for improving patient outcomes in lung cancer care.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Advanced non-small-cell lung cancer (NSCLC) survival is limited despite chemotherapy advances.
- The efficacy of antiangiogenic drugs and EGFR inhibitors in NSCLC is not fully established.
- BRCA1 plays a key role in DNA repair and influences chemotherapy response.
Purpose of the Study:
- To explore customized treatment strategies for advanced NSCLC.
- To investigate the predictive value of BRCA1 mRNA levels for chemotherapy response.
- To evaluate the effectiveness of EGFR tyrosine kinase inhibitors in NSCLC patients with EGFR mutations.
Main Methods:
- Analysis of retrospective and prospective data on BRCA1 mRNA levels and chemotherapy response.
- Prospective study of customized erlotinib treatment in NSCLC patients with EGFR mutations.
- Evaluation of clinical outcomes including response rate, progression-free survival, and overall survival.
Main Results:
- Low BRCA1 mRNA levels predict better response to cisplatin and non-taxane combinations.
- Customized erlotinib yielded a 70% response rate and 27-month median survival in EGFR-mutated NSCLC.
- 20% of patients remained disease-free at three years with erlotinib treatment.
Conclusions:
- Treatment customization based on EGFR mutation status and BRCA1 levels is crucial for advanced NSCLC.
- EGFR tyrosine kinase inhibitors represent a significant advance for EGFR-mutated NSCLC.
- Further research into genetically defined subclasses of EGFR mutations may improve NSCLC treatment outcomes.
