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Lung Cancer

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POSTED: 12:23 pm EDT March 16, 2007

Lung cancer is the second most commonly diagnosed cancer in the U.S. and the leading cause of cancer death. This year, the American Cancer Society estimates 213,380 new cases of lung cancer will be diagnosed in this country. About 160,390 men and women will die from the disease.

There are two major types of lung cancer - non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer (NSCLC) accounts for 85 to 90 percent of all lung cancers. Small cell lung cancer (SCLC) is less common, but is much more aggressive.

Predicting Recurrence of Non-small Cell Lung Cancer

Generally, the earlier a cancer is detected, the better the chance for successful treatment and survival. The standard treatment for stage I (the earliest stage) NSCLC is surgery, or removal of a section or lobe of the lung. Chemotherapy may be recommended if doctors believe some of the cancer may still remain. But since chemo can cause significant side effects, it isn't typically offered to all patients with early stage cancer. Yet, research shows about 30 to 35 percent of patients with stage I NSCLC eventually experience a recurrence of the cancer.

On the other hand, not all patients with more advanced disease (stages Ib, II or IIIa) experience recurrence. But these patients are typically offered chemo as part of their treatment.

Using tumor size and spread to predict treatment needs is not necessarily a good indicator of outcome. Two people with the exact same size tumor and stage of cancer can have completely different outcomes because of differing patterns of gene expression. Doctors say having a better estimate of the risk of recurrence may help them decide which patients would benefit most from chemotherapy and which ones may potentially avoid having to undergo the treatment.

Researchers from the Duke Institute for Genome Sciences and Policy at Duke University Medical Center have recently developed a tool, called the Lung Metagene Score, to estimate risk of recurrence in patients with early stage NSCLC. The tool was developed by analyzing genetic activity in tissue samples from patients diagnosed with early-stage NSCLC, and comparing that information with the patients' outcomes. The investigators then used those genetic profiles to develop a scoring system of cancer recurrence.

In a recent study, the researchers analyzed tissue samples from a small group of patients with NSCLC. The results were "scored" based on the previous genetic profiles. The study was published in the August 10, 2006 issue of the New England Journal of Medicine. The investigators found the Lung Metagene Score had an overall prediction accuracy of 72 and 79 percent.

Now researchers want to confirm the usefulness of the Lung Metagene Score in a phase III trial. The study, which is expected to begin sometime this year, will take place at 60 sites across the U.S. and Canada. For more information, log onto Duke's information site at http://www.askbig.org/archives/Articles ... nt/lms_FAQ.

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