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Reviews

Prognostic and predictive factors in resected non-small-cell lung cancer

, MD &
Pages 373-381 | Published online: 29 Jul 2010
 

Abstract

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 (18F-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 18F-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.

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