Prognostic factors in non‐small cell lung cancer

Abstract

Identification of prognostic factors is critical in optimizing treatment for patients with cancer. The purpose of this work is to review the modern literature with regard to prognostic factors for patients with non-small-cell lung cancer (NSCLC) taking into account ongoing advances in clinical evaluation, staging, surgery, radiation therapy, chemotherapy, and molecular biology in this widely heterogeneous patient population.

Expression of excision repair cross-complementation group 1 protein predicts poor outcome in advanced non-small cell lung cancer patients treated with platinum-based doublet chemotherapy

“…Although further prospective studies with large numbers of patients are warranted to confirm the role of ERCC1 as a prognostic factor, the present results may have significant clinical implications, since there is no established prognostic marker except pretreatment performance status or disease control in palliative chemotherapy for NSCLC [22,23]. Because the standard treatment for patients with stage IIIB with malignant effusion or stage IV is platinum and third generation doublet chemotherapy, patients with high expression of ERCC1 might benefit from alternative platinum non-containing regimens such as third generation doublets.…”

“…The most important finding of the current study was the prognostic significance of high ERCC1 expression. That is, high expression of ERCC1 was an independent prognostic marker of poor OS in multivariate analysis, along with poor performance status and lack of disease control, which have been suggested as important prognostic factor in palliative chemotherapy for NSCLC [22,23].…”

Expression of Bcl-2 predicts outcome in locally advanced non-small cell lung cancer patients treated with cisplatin-based concurrent chemoradiotherapy

“…Although further prospective studies with large numbers of patients are necessary to confirm the prognostic significance of Bcl-2 as a prognostic factor, the present results may have significant clinical implications, since there is no established prognostic marker except for pretreatment performance status or weight loss in CRT for locally advanced unresectable NSCLC [47]. Because low expression of Bcl-2 was associated with poor survival and low response rate to cisplatin-based CCRT in the present study, patients with low expression of Bcl-2 might benefit from CCRT incorporating non-platinum drugs such as taxanes and vinorelbine.…”

Individualized therapy in non-small-cell lung cancer: future versus current clinical practice

“…Factors such as disease stage, performance status, weight loss and female gender, as well as biological factors such as epidermal growth factor receptor (EGFR) mutations, mutations of the tumor suppressor gene p53 and activation of the Kirsten rat sarcoma (KRAS) oncogenes have significant prognostic and predictive value (Solan and Werner-Wasik, 2003;National Comprehensive Cancer Network, 2008).…”

“…Rather, a multigenetic approach to determining the optimal treatment for individual patients is more likely to be successful. However, this remains a challenge because of the complexity of simultaneously analysing multiple independent parameters (Solan and Werner-Wasik, 2003). recurrent NSCLC; however, they are most likely to have substantial efficacy only in a small population of patients (Lynch et al, 2004;Shepherd et al, 2005;Reckamp et al, 2008).…”