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Updated: May 19, 2026
Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Tissue platinum concentration and tumor response in non-small-cell lung cancer
Eric S Kim1, J Jack Lee, Guangan He
1The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 463, Houston, TX 77030, USA. esy_kim@yahoo.com
Purpose:
Platinum resistance is a major limitation in the treatment of advanced non-small-cell lung cancer (NSCLC). Reduced intracellular drug accumulation is one of the most consistently identified features of platinum-resistant cell lines, but clinical data are limited. We assessed the effects of tissue platinum concentrations on response and survival in NSCLC.
Patients And Methods:
We measured total platinum concentrations by flameless atomic absorption spectrophotometry in 44 archived fresh-frozen NSCLC specimens from patients who underwent surgical resection after neoadjuvant platinum-based chemotherapy. Tissue platinum concentration was correlated with percent reduction in tumor size on post- versus prechemotherapy computed tomography scans. The relationship between tissue platinum concentration and survival was assessed by univariate and multicovariate Cox proportional hazards regression model analysis and Kaplan-Meier analysis.
Results:
Tissue platinum concentration correlated significantly with percent reduction in tumor size (P < .001). The same correlations were seen with cisplatin, carboplatin, and all histology subgroups. Furthermore, there was no significant impact of potential variables such as number of cycles and time lapse from last chemotherapy on platinum concentration. Patients with higher platinum concentration had longer time to recurrence (P = .034), progression-free survival (P = .018), and overall survival (P = .005) in the multicovariate Cox model analysis after adjusting for number of cycles.
Conclusion:
This clinical study established a relationship between tissue platinum concentration and response in NSCLC. It suggests that reduced platinum accumulation might be an important mechanism of platinum resistance in the clinical setting. Further studies investigating factors that modulate intracellular platinum concentration are warranted.
Insights
Higher platinum concentration in non-small cell lung cancer (NSCLC) tissue correlates with better treatment response and survival. This finding suggests platinum accumulation is key to overcoming platinum resistance in NSCLC patients.
Area of Science:
- Oncology
- Pharmacology
- Cancer Research
Background:
- Platinum-based chemotherapy is a cornerstone for advanced non-small-cell lung cancer (NSCLC).
- Platinum resistance significantly limits treatment efficacy in NSCLC.
- Reduced intracellular platinum accumulation is a known mechanism in resistant cell lines, but clinical data are scarce.
Purpose of the Study:
- To investigate the clinical correlation between platinum concentration in NSCLC tumor tissue and treatment response.
- To assess the impact of tissue platinum levels on survival outcomes in NSCLC patients.
Main Methods:
- Platinum concentrations were measured in 44 NSCLC specimens post-neoadjuvant chemotherapy using atomic absorption spectrophotometry.
- Tumor size reduction was quantified using CT scans and correlated with platinum levels.
- Survival analyses (univariate, multivariate Cox, Kaplan-Meier) were performed to evaluate the relationship between platinum concentration and patient outcomes.
Main Results:
- A significant positive correlation was observed between tissue platinum concentration and tumor size reduction (P < .001).
- Higher platinum concentrations were associated with longer time to recurrence, progression-free survival, and overall survival (P = .034, P = .018, P = .005, respectively).
- No significant impact of chemotherapy cycles or time since last treatment on platinum concentration was found.
Conclusions:
- This study clinically validates the link between tissue platinum concentration and treatment response in NSCLC.
- Diminished platinum accumulation appears to be a significant clinical mechanism driving platinum resistance.
- Further research into factors influencing intracellular platinum levels is recommended.
