By: Susan Aldridge, medical journalist, PhD
There is an increasing research and clinical interest in the influence of genetics on a patient’s prognosis in cancer, including non-small cell lung cancer. The five year overall survival rate in lung cancer is only 15% and it is the leading cause of cancer death in the United States. There were around 159,000 lung cancer deaths in the US in 2009 and more than 219,000 new cases of the disease. Around half of the cases of lung cancer occur among women and 30-40% are among patients over 70 years. Most of these cases are non-small cell lung cancer.
Not much is yet known of underlying lung tumor gene expression differences in lung cancer. However, researchers at Duke University, Durham, North Carolina, now report on a study of gene expression profiles in a group of nearly 800 patients with non-small cell lung cancer. The profiles were obtained using microarray (‘gene chip’) technology on lung tumor samples. High and low risk patients had different gene expression profiles. High risk patients, with the shortest survival times, had increased activation of a gene called Src compared to low risk patients, who survived for longer. They also had increased activation of the tumor necrosis gene which is involved in tissue death. High risk patients also had higher activation of their wound healing and invasiveness molecular pathways. There were also differences in gene expression profiles between women and men with lung cancer. The study suggests that gene expression studies can have real clinical benefit in lung cancer, both in predicting outcome (and directing treatment to be more, or less, aggressive) and in pointing the way towards new and more precisely targeted therapies.
Mostertz W et al Age and sex specific genomic profiles in non-small cell lung cancer Journal of the American Medical Association February 10 2010;303:535-543