Test Might Predict Risk of Lung Cancer's Return

But it's not clear yet how helpful the molecular exam will be, experts say

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121244.html
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Thursday, January 26, 2012

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Lung Cancer

THURSDAY, Jan. 26 (HealthDay News) -- A new industry-funded study suggests that a molecular test can provide insight into whether patients are at high risk of a relapse after surgical treatment for a form of lung cancer.

The test, which is currently available, could help doctors decide whether the patients should undergo chemotherapy to prevent the cancer from returning.

There are caveats: The test is expensive, and researchers don't yet know whether patients determined to be at high risk will live longer if they undergo chemotherapy.

Still, "this may be one of the very first examples of where we understood enough about the molecular biology of a cancer to truly personalize the treatment of patients and actually improve the cure rate for that cancer," said study co-author Dr. Michael Mann, an associate professor of surgery at the University of California, San Francisco.

At issue is non-small-cell lung cancer, by far the most common kind of lung cancer. Even if tumors are diagnosed early and removed, the cancer will spread and kill 35 percent to 50 percent of patients.

In these cases, "even when the tumor is small and they got it all, microscopic disease has spread around the body," said Dr. John Minna, co-author of a commentary accompanying the study. He is a cancer researcher and professor of medicine at the University of Texas Southwestern Medical Center in Dallas.

Scientists are trying to find a way to predict what will happen to patients after surgery so they can figure out if chemotherapy treatment is a good idea.

In the new study, researchers gave the molecular test to 433 lung cancer patients in California and 1,006 patients in China. The researchers found that the test helped them to predict the likelihood that patients would survive for five years.

Conceivably, physicians could adjust the treatment of patients after surgery to coincide with the risk of a recurrence of their cancer. For now, though, that's not proven. The research "doesn't tell you that if you had a bad prognosis and you were treated with chemotherapy, then you'd do better," Minna said.

Still, information about the risks faced by a patient could help doctors make choices about treatments, said Minna, who called the test "promising."

Study co-author Mann agreed: "There may be an important conversation that you can have with your oncologist about potential benefit from additional therapy to reduce the likelihood of the cancer coming back."

Mann said the test -- which is currently available -- could cost several thousand dollars. Minna, the commentary co-author, said any cost over a few hundred dollars could be an issue for insurors.

The research was funded by the firm that developed the molecular test, and several of the study authors serve as consultants to the firm.

The study appears in the Jan. 27 online issue of The Lancet.

SOURCES: Michael J. Mann, M.D., associate professor, surgery, University of California, San Francisco; John D. Minna, M.D., professor, medicine, University of Texas Southwestern Medical Center, Dallas; Jan. 27, 2012, The Lancet

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