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Prognostic and predictive factors in resected non-small-cell lung cancer
Kyoichi Kaira1, Nobuyuki Yamamoto
1Shizuoka Cancer Center, Division of Thoracic Oncology, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan +81 55 989 5222 ; +81 55 989 5634 ; kkaira1970@yahoo.co.jp.
Importance Of The Field:
Tumor staging is at present the most important prognostic factor for survival in resected non-small cell lung cancer (NSCLC). Recent studies in prognostic and predictive factors have focused on identifying molecular markers.
Areas Covered In This Review:
This paper review current known molecular markers as a prognostic and predictive value. The biomarkers included nucleotide excision repair system (ERCC1, RRM1, BRCA1), cell cycle regulators and apoptosis (p53, p27, bcl-2, KRAS), tumor proliferation (Ki-67), angiogenesis (VEGF, microvessel density), molecular imaging ((18)F-FDG-PET), AKT/mTOR signaling pathway (AKT, mTOR) and EGFR mutation.
What The Reader Will Gain:
Recent study has demonstrated that overexpression of nucleotide excision repair protein is predictive of the resistance of NSCLC to gemcitabine and platinum. Overexpression of p53 and p27 is also a predictive marker for predicting poor outcome after adjuvant chemotherapy. A meta-analysis indicated that VEGF, Ki-67 and (18)F-FDG uptake can be a prognostic factor. Although phospho-Akt and mTOR overexpression are associated with poor outcome, the prognostic significance is still controversial. EGFR mutation is described as being associated with a favorable prognostic factor in resected NSCLC, but it is not an independent factor.
Take Home Message:
Search for new prognostic/predictive markers remains an important task for lung cancer diagnosis and treatment.