Cancer Research Lab

As circulating levels of 25-hydroxyvitamin (OH) D increase, survival in patients with early-stage non-small-cell lung cancer (NSCLC) improves, new research shows.

In an earlier study, Dr. Wei Zhou, from Harvard School of Public Health in Boston, and colleagues showed that surgery in the summertime coupled with higher vitamin D intake seemed to improve survival in NSCLC patients. The focus of the present study was to investigate the role of vitamin D further by assessing the impact of circulating 25(OH)D levels on NSCLC survival.

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Elevated expression of two genes — one involved in DNA synthesis (RRM1) and the other in DNA repair (ERCC1) — are associated with prolonged survival among patients with completely resected, stage 1 non-small-cell lung cancer, investigators report in the New England Journal of Medicine for February 22.

However, translating this knowledge into development of practical markers for cancer outcomes “has not been possible … because of technical limitations,” the authors note.

So Dr. Gerold Bepler and his team, at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida, developed an automated, quantifiable, immunohistochemical technique, which they used to determine levels of RRM1 (ribonucleotide reductase M1) and ERCC1 (excision repair cross-complementation group 1).

They tested their system using tissue samples from 187 patients who had undergone complete surgical resection for stage 1 non-small-cell lung cancer at their institution. None of the patients had been treated with chemotherapy or radiotherapy.

For patients whose tumors had levels of RRM1 below the median, the median disease-free survival was 54.5 months. For those with higher levels, disease-free survival was 120 months (p = 0.004). The median overall survival was 60.2 months and > 120 months, respectively (p = 0.02).

The investigators observed that ERCC1 expression was significantly associated with overall survival, but not disease-free survival.

Dr. Bepler and his group then stratified patients according to level of expression of each gene. Results showed that, for those with high expression of one protein and those with low expression of both, overall survival ranged from 56.8 months to 80 months. For those with high levels of both proteins, disease-free and overall survival were > 120 months, significantly longer than in the other three groups.

“Although high expression of either protein alone was associated with a good prognosis, co-expression of the two proteins characterized the group with an excellent outcome,” the investigators write.

Dr. Bepler and his associates point out that RRM1 and ERCC1 expression is associated with poor response to gemcitabine and platinum chemotherapy. So it is possible that gene expression profiles could be used to determine treatment for patients with cancer.

Recent studies that have defined the benefits of chemotherapy in older patients with metastatic lung cancer indicate that the use of single agent therapy is well justified, according to a review by Minnesota-based researchers. However, more information is required on treatment for non-small cell lung cancer in this group of patients.

“Lung cancer is the leading cause of cancer-related death in the United States, and it is becoming a major cause of morbidity and mortality among older Americans,” study co-author Dr. Aminah Jatoi told Reuters Health. “There is a growing need for research on how best to treat lung cancer in the elderly.”

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Using exhaled breath, a colorimetric chemical sensory array (ChemSensing, Champagne, Illinois) can distinguish between patients with lung cancer and healthy subjects, according to research published ahead of print in Thorax.

Cancer cells undergo metabolic changes that alter the production and processing of volatile organic compounds, explain lead author Dr. Peter J. Mazzone and his colleagues at the Cleveland Clinic in Ohio.

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Advanced age and other factors predispose patients to respiratory infections after lung cancer surgery, according to a report in the January Journal of Thoracic Oncology.

“Although elderly patients have risk factors for postoperative infections in lung cancer surgery, preoperative rehabilitation may reduce the risk of postoperative complications,” Dr. Satoshi Shiono from National Cancer Center Hospital East, Kashiwa, Chiba, Japan said.

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Lobectomy may provide better survival than wedge resection for lung cancers < 3 cm in size (stage IA), according to a report in the January issue of Chest.

The best surgical approach for stage I primary lung cancer is controversial, lead author Dr. Alexander Kraev, from Oregon Health and Science University in Portland, and colleagues note. The focus of the present study was to compare the long-term outcomes (10 years) of lobectomy and wedge resection as treatments for stage I cancers of various sizes and types.

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Co-expression of the novel tumor suppressor gene FUS1 and the well-established p53 is associated with enhanced suppression of human non-small cell lung cancer (NSCLC) in mice, investigators report in the January 15th issue of Cancer Research.

The enhanced anti-oncogene expression was accomplished by nanoparticle-mediated gene transfer. Senior researcher Dr. Lin Ji told Reuters Health, “The synergistic antitumor effects observed by systemic delivery of nanoparticles combining two novel tumor suppressor genes in pre-clinical lung cancer animal models would offer a more effective molecular therapeutic strategy for lung cancer and other human cancers.”

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The presence of emphysema seen on low-radiation-dose CT images appears to be an independent risk factor for lung cancer, investigators report in the December issue of Chest.

“Lung cancer screening using low-radiation-dose CT (LDCT) is a promising strategy currently undergoing intensive research efforts,” note Dr. Javier J. Zulueta of the University of Navarra, Spain, and colleagues. “An important aspect of these strategies is the ability to identify patients at high risk for lung cancer who may benefit the most from smoking cessation treatments, early diagnosis, or chemoprevention.”

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The expression of three specific genes in microarray studies provides information on overall survival in non-small cell lung cancer (NSCLC), Canadian investigators report.

Dr. Ming-Sound Tsao of Princess Margaret Hospital in Toronto and colleagues analyzed 158 possible prognostic genes, identified in previous studies as being potentially linked to NSCLC, by reverse transcription quantitative polymerase chain reaction (RT-qPCR) in the tumors of 14 patients with NSCLC.

As reported in the December 10 issue of the Journal of Clinical Oncology, they identified a three-gene classifier, involving genes STX1A, HIF1A and CCR7, that was predictive of overall survival, with a hazard ratio of 3.8.

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First big study to find link between saturated fats and lung disease

WASHINGTON – People who eat a lot of red meat and processed meats have a higher risk of several types of cancer, including lung cancer and colorectal cancer, U.S. researchers reported.

The work is the first big study to show a link between meat and lung cancer. It also shows that people who eat a lot of meat have a higher risk of liver and esophageal cancer and that men raise their risk of pancreatic cancer by eating red meat.

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