An analysis of genetic and clinical data for nearly 800 patients with non-small cell lung cancer has identified differences in genetic characteristics that are associated with age and sex specific patterns of increased or decreased recurrence-free survival, according to a study in the February 10 issue of JAMA.
The five-year overall survival rate for lung cancer is only 15 percent, and it remains the leading cause of cancer-related death in the United States. An estimated 159,000 lung cancer deaths occurred in 2009, and more than 219,000 new cases were diagnosed. Almost half of these new cases are diagnosed in women, with approximately 30 percent to 40 percent of cases diagnosed in patients older than 70 years, with the majority of these cases (greater than 85 percent) non-small cell lung cancer (NSCLC), according to background information in the article.
"Despite evidence that clinical and pathologic factors (e.g., age, histology, smoking status, sex) are clinically relevant, little is known regarding the underlying biological differences in lung tumor gene expression among patients with different clinicopathologic characteristics. A deeper understanding of molecular abnormalities at a pathway level [involving gene expression and biochemical reactions that transmit information within and between cells] may help dissect the complex mechanisms of lung cancer oncogenesis [development of tumors], shed light on the biological underpinnings contributing to survival differences in NSCLC that are age- and sex-based, and further help identify specific cohorts of patients that may be more susceptible to novel individualized therapeutic strategies," the authors write.
William Mostertz, M.S., of Duke University, Durham, N.C., and colleagues examined clinically relevant differences in the underlying biology of NSCLC based on patient age and sex. The study consisted of an analysis, performed from July 2008 to June 2009, of 787 patients with predominantly early stage NSCLC. Lung tumor samples with corresponding microarray (genetic analysis of biological material) and clinical data were used. All patients were divided into subgroups based on age (less than 70 vs. 70 years or older) or sex.