Recent Outcomes for Patients with Carcinoma of the Lung

Dillman, Robert O.; Berry, Charles C.; Ryan, Kevin; Green, Mark R.; Seagren, Stephen L.

doi:10.3109/07357909109032795

Cited by 13 publications

(3 citation statements)

References 29 publications

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“…Survival analysis showed that tumour stage, grade and nodal status were strongly associated with prognosis, as seen in several earlier studies [5,10,23], and provides indirect evidence of the validity of our survival data although overall survival data were used. To evaluate the prognostic significance of DNA ploidy alterations, tumours were categorized into those with minor and those with major ploidy aberrations.…”

Section: Discussionmentioning

confidence: 70%

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DNA Aneuploidy, S-phase fraction, nuclear p53 positivity, and survival in non-small-cell lung carcinoma

et al. 1997

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Inactivation of the p53 gene plays a key role in tumour biology, probably through a disturbed cell cycle control and an increased genetic instability in p53-inactivated tumours. To learn more about the relationship between p53 alterations, proliferation and genetic instability (DNA aneuploidy) in lung cancer patients, specimens of 220 surgically resected lung carcinomas with clinical follow-up information were examined by immunohistochemistry (p53; CM1) and flow cytometry. Nuclear p53 positivity--found in 49.5% of the tumours--was associated with both high S-phase fraction (SPF) and DNA ploidy aberrations. SPF was higher in p53-positive tumours (15.9 +/- 10.2) than in p53-negative tumours (10.3 +/- 8.7; P = 0.03). The rate of p53 positivity was higher in 101 DNA-aneuploid and DNA-multiploid tumours (55%) than in 27 diploid and peridiploid carcinomas (33%; P = 0.0512). These results are consistent with an in vivo role of p53 inactivation for increased proliferative activity and development of genomic instability in lung cancer. There was no association between SPF and prognosis. Although prognosis was worse in DNA-aneuploid and multiploid tumours than in diploid, peridiploid and tetraploid carcinomas (P = 0.029), DNA ploidy was not an independent predictor of poor prognosis in multivariate analysis. These data show that DNA-flow cytometry has little prognostic value for patients with resected non-small-cell lung carcinoma.

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Section: Discussionmentioning

confidence: 70%

“…The prognosis of patients with lung cancer is generally poor [5,23,31]. Some 30% are still operable at the time of diagnosis, and only a minority of them will be definitely cured by surgery.…”

Section: Introductionmentioning

confidence: 99%

DNA Aneuploidy, S-phase fraction, nuclear p53 positivity, and survival in non-small-cell lung carcinoma

et al. 1997

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“…Radiotherapy is a versatile intervention, as it does not require fitness for surgery or the ability to tolerate chemotherapy, can be tailored to the patient by dose modification, and can be integrated with other treatment options. However, median overall survival with radiotherapy alone is 9 to 11 months, and the 5-year survival rate is disappointingly low, at 3% to 10% [7][8][9][10]. Furthermore, radiotherapy cannot treat the distant micrometastases that are often present at the time of diagnosis.…”

Section: Introductionmentioning

confidence: 94%

Advanced non-small cell lung cancer therapy: historical and future perspectives

Reck

Gatzemeier

2008

Targ Oncol

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Before the 1980s, radiotherapy was the principal treatment for advanced non-small cell lung cancer (NSCLC). Radiotherapy is primarily effective for local disease control and in early stage disease, or as palliative therapy in inoperable disease. Prior to 1990, only a few cytotoxic drugs had confirmed activity against NSCLC, but a series of trials had established platinum-based chemotherapy as the most effective treatment regimen. Since then, newer chemotherapeutic agents have been found to be effective, and superior to traditional platinum combinations. Recently, chemotherapy-based regimens appear to have reached a therapeutic plateau, and effective, better-tolerated treatments are needed. Improved understanding of the molecular biology and genetics of the tumor has led to the development of more selective, less toxic, targeted therapies. Vascular endothelial growth factor (VEGF) and the epidermal growth factor receptor both play a key role in tumor growth and proliferation, and are logical targets for therapy. Bevacizumab, a monoclonal antibody against VEGF, has demonstrated significant improvements in survival and response rates when combined with chemotherapy (versus chemotherapy alone) as first-line therapy. In the second-line setting, the tyrosine kinase inhibitor erlotinib has demonstrated improved survival compared with placebo. This paper reviews the principal treatments used for NSCLC in the past two decades, provides an overview of current treatment options and considers future challenges. Prolongation of survival, reduced toxicity and improved quality of life are the main objectives. Key challenges for the future are patient-specific tailored therapy and expansion of the eligible patient population for novel therapies.

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NUCLEAR p53 OVEREXPRESSION IS AN INDEPENDENT PROGNOSTIC PARAMETER IN NODE-NEGATIVE NON-SMALL CELL LUNG CARCINOMA

et al. 1996

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The prognosis of operated patients with non‐small cell lung cancer (NSCLC) is poor despite thorough pre‐operative staging. An improved preselection is needed of patients likely to profit from surgery. This study was undertaken to evaluate the prognostic significance of nuclear p53 overexpression in a cohort of 247 surgically treated patients with NSCLC. It showed that the prevalence of immunohistochemically detectable p53 overexpression varied between different tumour types. p53 overexpression was equally frequent in large cell carcinoma (53 per cent) and in squamous cell carcinoma (54 per cent), but significantly less frequent in adenocarcinoma (34 per cent;P=0·009). p53 overexpression was particularly rare in bronchioloalveolar carcinoma (positivity in 1 of 17 cases). These variations may reflect aetiological differences between the histological subtypes. p53 overexpression was also associated with high tumour grade (P=0·0157) and the presence of lymph node metastasis (P=0·0259), but not with advanced tumour stage. Survival analysis showed no difference in clinical outcome between p53‐positive and p53‐negative tumours within 101 node‐positive tumours. In contrast, survival time was significantly better in p53‐negative tumours than in p53‐positive tumours within the group of 113 node‐negative tumours (P=0·032). Stepwise regression analysis showed that p53 overexpression is an independent prognostic factor in node‐negative NSCLC.

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Recent Outcomes for Patients with Carcinoma of the Lung

Cited by 13 publications

References 29 publications

DNA Aneuploidy, S-phase fraction, nuclear p53 positivity, and survival in non-small-cell lung carcinoma

DNA Aneuploidy, S-phase fraction, nuclear p53 positivity, and survival in non-small-cell lung carcinoma

Advanced non-small cell lung cancer therapy: historical and future perspectives

NUCLEAR p53 OVEREXPRESSION IS AN INDEPENDENT PROGNOSTIC PARAMETER IN NODE-NEGATIVE NON-SMALL CELL LUNG CARCINOMA

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