In the future, many cancer scientists and physicians believe, a "molecular fingerprint" of an individual´s cancer may be used to diagnose that patient´s disease and tailor therapy.
Researchers at Vanderbilt have moved a step closer to that scenario with the identification of a distinct pattern of expression of 15 proteins in lung cancers that can predict a poor prognosis or a good prognosis. All patients in the poor prognosis group had died one year after diagnosis, while all patients in the good prognosis group were still alive. Median survival, the point at which half the patients were still alive, was six months for the poor prognosis group, compared to 33 months for the good prognosis group. "If this pattern is confirmed in larger studies, its prognostic power exceeds that of virtually any previously published standard molecular marker," the authors write in the August 9 issue of The Lancet.
The scientists also demonstrate that protein profiles obtained from a tiny amount of tumor tissue – only 1 millimeter in diameter and only 1/1000 of a millimeter in thickness - can be used to predict risk that the cancer has spread to nearby lymph nodes.
Predictions based on protein profiles were confirmed by pathological evaluation under a microscope. In one case, a large cell carcinoma may have been misclassified based on protein patterns as an adenocarcinoma, but the investigators report that this tumor may actually be an adenocarcinoma that is too poorly differentiated to identify as such under the microscope.
The investigators note that using protein profiles to make distinctions that are already apparent under the microscope offers little use in clinical care, although the approach is potentially useful in identifying novel therapeutic targets. However, the ability to use protein profiles to predict node involvement or to identify patients as high- or low-risk could have great implications for treatment strategies, Carbone said.
"Because such small tissue samples are needed, it would be of great interest to analyze protein expression patterns of tissue samples from needle aspirations or from different cell subtypes within the lung," Carbone said. "It also would be interesting to look for patterns associated with response to specific therapies, with smoking exposure, or with preneoplasia and the progression to cancer.
"If these data are confirmed using larger numbers of patients, this technology could have significant implications for the clinical management of non-small cell lung cancer."
Contact: Cynthia Floyd Manley, firstname.lastname@example.org
Cynthia Floyd Manley | EurekAlert!
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