Trimodality therapy in stage III non-small cell lung cancer: prediction of recurrence by assessment of p185neu

• Published in: The European respiratory journal Vol. 13; no. 2; pp. 424 - 429
• Main Authors: Thomas, M, Rube, C, Semik, M, von Eiff, M, Klinke, F, Macha, HN, Freitag, L, Scheld, HH, Willich, N, Berdel, WE, Junker, K
• Format: Journal Article
• Language: English
• Published: Leeds Eur Respiratory Soc 01.02.1999; Maney
• Subjects: Adult; Aged; Biological and medical sciences; Biomarkers, Tumor - analysis; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Non-Small-Cell Lung - therapy; Combined Modality Therapy; Disease-Free Survival; Female; Humans; Immunohistochemistry; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local; Pneumology; Prognosis; Receptor, ErbB-2 - analysis; Survival Rate; Tumors of the respiratory system and mediastinum; Antineoplastic agent; Human; Lung disease; Respiratory disease; Mediastinum; Exploration; Tumoral marker; Malignant tumor; Metastasis; Gene expression; Radiotherapy; Bronchopulmonary; Lymphatic vessel disease; Chemotherapy; Treatment; Biopsy; Adenopathy; Surgery; Predictive value; Bronchus disease; Combined treatment; Preoperative; Non small cell carcinoma
• ISSN: 0903-1936; 1399-3003
• DOI: 10.1183/09031936.99.13242499

In a trimodality treatment approach for stage III non-small cell lung cancer the prognostic impact of pretherapeutic p185neu assessment was evaluated. Fifty-four patients were admitted to chemotherapy followed by twice-daily radiation with concomittant low-dose chemotherapy and subsequent surgery. Immunohistochemical assessment of p185neu expression was performed in paraffin-embedded mediastinal lymph node metastases, by mediastinoscopy biopsy prior to therapy. Paraffin-embedded biopsies of mediastinal lymph node metastases were available in 33 cases. Seven out of eight patients with positive p185neu staining developed distant metastases, in contrast to seven out of 25 negative cases. Expression of p185neu in mediastinal lymph node metastases was a significant predictor for progression-free survival (p=0.047) and resulted mainly from significant differences in metastases-free survival (p185neu-positive versus p185neu-negative: median, 11 versus 19 months; 2- and 3-yr rates, 13% and 0% versus 40% and 32%; p=0.04). On the basis of these preliminary results it was concluded that further evaluation of p185neu expression in trials on neoadjuvant and adjuvant therapy is warranted. When the prognostic impact of p185neu in such trials with larger patient numbers is confirmed, this may contribute to the identification of stratification variables for future treatment approaches of non-small cell lung cancer.