A Threshold of Systemic MAGE-A Gene Expression Predicting Survival in Resected Non–Small Cell Lung Cancer

Abstract

Quantitative measurement of minimal residual disease predicting recurrence in individual cancer patients is available only in very few indications, such as acute lymphoblastic leukemia, but is still missing in most solid tumors, including non-small cell lung cancer (NSCLC). MAGE-A expression levels in blood and bone marrow determined as calibrator-normalized relative ratios by quantitative multimarker real-time RT-PCR for transcript amplification of -A1, -A2, -A3/6, -A4, -A10, and -A12 in 94 patients with completely resected NSCLC were correlated with survival in a clinical study. Patients with MAGE-A expression levels ≥0.2 in at least one sample of bone marrow or blood at tumor surgery had a significantly reduced overall ( = 0.007), cancer-free ( = 0.002), and distant metastasis-free survival ( < 0.001) versus patients below 0.2 in all samples without significant difference in locoregional recurrence-free survival. The corresponding HRs (≥0.2 vs. <0.2) for death, cancer-related death, and development of distant metastasis were 2.56 [95% confidence interval (CI), 1.42-4.63], 3.32 (95% CI, 1.66-6.61), and 4.03 (95% CI, 1.77-9.18), respectively. Five-year Kaplan-Meier estimates of distant metastasis-free survival were 43% (MAGE-A ≥ 0.2) versus 87% (MAGE-A < 0.2). MAGE-A expression in blood or bone marrow at tumor surgery is an independent predictor of survival in resected NSCLC. The reliable prediction of distant metastasis in individual patients with a statistically proven impact on overall survival may help to refine patient selection for adjuvant therapy urgently needed, especially in the clinical management of elderly patients. .

A molecular and staging model predicts survival in patients with resected non-small cell lung cancer

“…At present, the TNM staging system has limited power to predict survival. During the past decades, considerable efforts have been made toward the development of gene-expression-based prognostic biomarkers for NSCLC [ 14 – 17 ]. As a result, well combination of molecular markers and traditional staging system may improve the predictive power.…”

Prognostic significance of TCF21 mRNA expression in patients with lung adenocarcinoma

“…However, the expression level of mRNA detected by polymerase chain reaction also performed reliable prognostic value for lung cancer patients 23, 24 . In this study, we extracted gene expression array data from GEO datasets using the GCBI bioinformatics analysis platform and further assessed these data using the comprehensive survival analysis platform Kaplan-Meier plotter and PrognoScan.…”

MAGE‐A gene expression in peripheral blood serves as a poor prognostic marker for patients with lung cancer

“…MAGE‐A antigens are strictly tumor‐specific, include 12 family members (MAGE‐A1–MAGE‐A12) and are expressed in various tumor tissues, including NSCLC,9, 10 laryngeal squamous cell carcinoma,11 breast cancer,12 bladder carcinoma13 and glioma 14. The expression of MAGE‐A in blood and bone marrow has been detected using real‐time reverse transcriptase (RT)‐PCR analysis 9, 10. The prognostic significance of MAGE‐A expression in the CTCs of patients with lung cancer is unknown.…”