Prognostic significance of NSE mRNA in advanced NSCLC treated with gefitinib
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RESEARCH ARTICLE
Prognostic significance of NSE mRNA in advanced NSCLC treated with gefitinib Y. Wang • D. Tang • A. Sui • W. Jiao • Y. Luo M. Wang • R. Yang • Z. Wang • Y. Shen
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Received: 31 July 2012 / Accepted: 30 August 2012 / Published online: 11 October 2012 Ó Federacio´n de Sociedades Espan˜olas de Oncologı´a (FESEO) 2012
Abstract Purpose Current knowledge of the prognostic biomarkers of advanced non-small cell lung cancer (NSCLC) treated with gefitinib is poor. NSE mRNA as a potential prognostic biomarker of the effectiveness of gefitinib treatment in NSCLC, especially in the Chinese population, needs to be further validated. Patients and Methods We retrospectively reviewed 168 advanced NSCLC patients treated with gefitinib between May 2006 and July 2010. NSE mRNA was measured using quantitative RT-PCR analysis for correlation with the clinical outcomes. Results We found that NSE mRNA expression was inversely correlated with sensitivity to gefitinib in NSCLC patients. Patients without elevated NSE mRNA had a more RR (CR ? RR) 45.1 % than elevated 18.9 % (P = 0.0005). Moreover, the time to progression was 6.0 versus 4.2 months, respectively. Log-rank test was marginally significant (v2 = 12.11, P = 0.0007) and Cox multivariate analysis revealed that NSE mRNA (HR = 3.076; 95 % CI 1.943–4.870; P \ 0.0001) was an independent prognostic factor of NSCLC patients in the Chinese population. Conclusion For NSCLC patients treated with gefitinib, patients without elevated NSE mRNA had a better prognosis than those with elevated NSE mRNA. Pretreatment NSE mRNA holds great potential as a prognostic Y. Wang D. Tang W. Jiao Y. Luo M. Wang R. Yang Z. Wang Y. Shen (&) Thoracic Surgery of the Affiliated Hospital of Medical College Qingdao University, 16 Jiangsu Road, Qingdao 266003, China e-mail: [email protected] A. Sui Central Laboratory of the Affiliated Hospital of Medical College Qingdao University, Qingdao, China
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biomarker in advanced NSCLC. Therefore, it is proposed that NSE mRNA should be routinely detected to screen patients who are more likely to benefit from gefitinib-based treatment. Keywords NSE mRNA Prognosis Non-small cell lung cancer (NSCLC) Gefitinib
Introduction Lung cancer is the most common cause of cancer-related death worldwide. Non-small cell lung cancer (NSCLC) represents 75–80 % of lung cancer cases and accounts for approximately 1.2 million new cases each year [1]. Despite extensive pre-clinical and clinical research, the prognosis for patients with NSCLC remains poor, with a 5-year survival rate of only about 15 % due to the high rate of unresectable cancer at diagnosis and the inability of chemotherapy to cure metastasizing disease. Therefore, the identification of predictive and prognostic factors could help clinicians to optimize therapeutic strategies and to better assess survival probabilities. Epidermal growth factor receptor (EGFR) is a promising target in the treatment of advanced NSCLC due to its frequent over-expression in NSCLC tumor. Gefitinib, an EGFR
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