Journal
JOURNAL OF THORACIC ONCOLOGY
Volume 5, Issue 6, Pages 810-817Publisher
ELSEVIER SCIENCE INC
DOI: 10.1097/JTO.0b013e3181d89f95
Keywords
Non-small cell lung cancer; prognostic factors; p53; mucin
Categories
Funding
- NCI NIH HHS [U10 CA012046-30, U10 CA060138-10, U10 CA025224, U10 CA047642, CA31946, U10 CA025224-26, U10 CA003927, CA47577, U10 CA011789-32, U10 CA086726, U10 CA059518-18, U10 CA041287, U10 CA008025-33, U10 CA047559, U10 CA077406-05, U10 CA047577, U10 CA032291, CA33601, U10 CA016450-28, U10 CA004326-44, U10 CA077658, U10 CA045564, CA41287, U10 CA032291-27, U10 CA045808, U10 CA007968, U10 CA047577-22, U10 CA031946, U10 CA033601, U10 CA086726-06, U10 CA021060, U10 CA180821, U10 CA047555-15, CA45808, U10 CA041287-23, U10 CA059518, U10 CA047642-21, U10 CA045808-23, U10 CA074811-08, U10 CA026806-23, U10 CA077440, CA16450, U10 CA077658-12, U10 CA031983-21, U10 CA077440-12, CA08025, CA21060, U10 CA031946-28, U10 CA045564-23, U10 CA021661, U10 CA077298-05, U10 CA074811, U10 CA033601-30, U10 CA021661-30, U10 CA003927-51, U10 CA021060-26] Funding Source: Medline
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Introduction: Cancer and Leukemia Group B 9633 was a phase III trial that randomized patients with stage IB non-small cell lung cancer to observation or four cycles of carboplatin and paclitaxel. A statistically significant effect in favor of adjuvant chemotherapy was seen for disease-free survival (DFS) and overall survival (OS) in the subgroup of patients with tumors >= 4 cm. A laboratory companion study was conducted to see whether molecular and clinical factors could provide additional prognostic information. Methods: Formalin-fixed, paraffin-embedded blocks were obtained for 250 of the 344 patients enrolled. Immunohistochemical staining for bcl-2, p53, blood group antigen A, and mucin was correlated with DFS and OS. Results: The prevalence of the markers was bcl-2, 17%; p53, 47%; blood group antigen A, 25%; and mucin, 45%. Univariate analysis for DFS showed a statistically significant effect for the presence of mucin (p = 0.0005) and p53 (p = 0.05) and for OS showed a significant effect for mucin (p = 0.0005). In the multivariate Cox model, there was a statistically significant association between shorter DFS and presence of mucin (p = 0.002; hazard ratio [HR] 2.05) and p53 (p = 0.003; HR 1.95) and between shorter OS and presence of mucin (p = 0.004; HR 2.03) and p53 (p = 0.0005; HR 2.30). Of the clinical factors, male gender and larger tumor volume were also significant adverse prognostic factors (p < 0.05). Conclusions: A statistically significant association between shorter DFS and OS was seen for the patients with p53 protein expression, mucin expression, male gender, and larger tumors in this cohort of patients with stage IB non-small cell lung cancer treated on Cancer and Leukemia Group B 9633.
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