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Lung Cancer Survival Affected by Age, Gender
Reported February 15, 2010
(Ivanhoe Newswire) -- The biology of lung cancer differs from one
patient to the next, depending on age and gender, which may help explain why
certain groups of patients do better than others even though they appear to
have the same disease.
Senior author Anil Potti, M.D., oncologist in the Duke Institute for Genome
Sciences & Policy (IGSP), was quoted as saying, "Our study supports two key
findings: First, the biology of lung cancer in women is dramatically
different from what we see in men. Women, in general, have a less complex
disease, at least in terms of the numbers of molecular pathways involved. We
also discovered that there is a subset of elderly patients who would
probably benefit from treatments that we've normally reserved for younger
patients."
Potti said that in the past, physicians have had to rely on very rough
measures to categorize patients' lung cancers, factors such as the size of
the tumor, the tissue type and the degree to which the cancer had spread.
"But this new information tells us that we can analyze patients' disease
much more discretely," said Potti.
Potti and a team of researchers in the IGSP studied clinical data and
accompanying genomic information obtained from tumors of 787 patients with
predominantly early stage non-small cell lung cancer (NSCLC), the most
common form of the disease. They gathered tumor samples and corresponding
microarray data showing which genes were activated in the tumors, then
selected twelve of the most common molecular pathways that become
dysregulated in NSCLC. The goal was to identify any patterns linking the
pathways to age, gender and time to recurrence. They sorted the patients by
age and gender and then again into low- and high-risk groups, based on
five-year, recurrence-free survival.
They found that certain molecular pathways were more frequently activated in
some groups than in others and that certain pathway patterns were associated
with better long-term survival in lung cancer patients.
Specifically, they found that high-risk patients – those with the shortest
time to recurrence – were significantly more likely to have increased
activation of the pathways responsible for tumor metastasis and necrosis,
when compared with low-risk patients.
High-risk patients 70 or older were found to have higher activation of
pathways regulating blood supply and invasiveness. In comparing high-risk
women to high-risk men, the researchers found that men were more likely to
have a much more complex pattern of multiple pathways being activated than
women with the same type of lung cancer.
The study also identified a subset of patients over age 70 who had a
low-risk profile. Potti said that is important because people over age 70
are generally not included in many clinical trials, and physicians often
hesitate to offer them the option of conventional chemotherapy. "The
thinking has been that they may not withstand the treatment or benefit from
it much,” said Potti. “But now we know that it probably makes sense to
consider treating this population by risk-stratifying the disease."
Study co-author Jeffrey Crawford, M.D., chief of medical oncology at Duke,
was quoted as saying, "People still don't realize how bad a disease this is.
Lung cancer kills more than 150,000 patients each year in the U.S. – more
than breast, prostate, colon and ovarian cancer combined. Unfortunately,
there is a patient dying from lung cancer every three minutes in this
country. So being able to better understand the disease and stratify
patients by their individual molecular profiles means we can do a much
better job pairing the right drug with the right patient."
SOURCE: Duke University Medical Center, February 9, 2010 |
