Biomarkers in Early-Stage Non–Small-Cell Lung Cancer: Current Concepts and Future Directions

Abstract

Advances in molecular biology and bioinformatics have resulted in the identification of a number of potential biomarkers that could be relevant in the management of patients with non-small cell lung cancer (NSCLC). Although there is an increasing amount of literature related to these biomarkers, major issues need to be resolved including validity and reproducibility of results. Additionally, in order to interpret the existing literature accurately a clear distinction must be made between the prognostic and predictive value of biomarkers. The practical applicability of biomarker discovery for patients with lung cancer includes the identification of patients with early-stage NSCLC who are most likely to benefit from adjuvant therapy. Information gleaned from biomarkers has the potential to help in evaluating the role of targeted therapies including immunotherapy in the neoadjuvant and adjuvant setting. The role of gene signatures and the use of newer platforms such as RNA, methylation and protein signatures is being explored in patients with early stage NSCLC. This review focuses on the applications of biomarker discovery in patients with early stage NSCLC

miR-330-3p controls cell proliferation by targeting early growth response 2 in non-small-cell lung cancer

“…There are some well-identified biomarkers that could potentially yield new treatment options [31][32][33]. Increased miR-330-3p expression in NSCLC patient samples was reported previously [23], and recent studies have indicated that miRNAs are involved in NSCLC pathogenesis [34][35][36].…”

CACNA1B (Cav2.2) Overexpression and Its Association with Clinicopathologic Characteristics and Unfavorable Prognosis in Non-Small Cell Lung Cancer

“…However, despite a complete and presumably curative resection, approximately 40–50% of patients with resected NSCLC die of recurrent disease [9]. Molecular prognostic markers are needed to identify subset of patients that would benefit from aggressive treatment after surgical resection [10]. …”

Independent Validation Test of the Vote-Counting Strategy Used to Rank Biomarkers From Published Studies

“…All too often, however, these studies present a confusing picture of which biomarkers would perform best in an independent validation test. The results are frequently conflicting and difficult to interpret due to differences in patient demographics, biospecimen type, sample processing and storage, assay method, normalization and data analysis method and the criteria used to assign significance [1–4]. The results can also be difficult to have confidence in due to small effect sizes, small numbers of subjects relative to number of markers tested, multiple clinical endpoints and the absence of a test cohort [1–6].…”