Treatment based On BRCA1 level does not increase survival of stage II/III NSCLC N+ resected patients

October 16, 2017

Yokohama, Japan - Oct. 17, 2017 - New research shows that treating stage II and III non-small cell lung cancer (NSCLC) N+ resected patients with customized chemotherapy (CT) treatment based on their specific BRCA1 expression levels, as opposed to providing the standard treatment, did not increase overall survival rates among those patients who received individualized CT treatment. However, BRCA1 expression levels could be prognostic and treatment could achieve different outcomes. Dr. Bartomeu Massuti of Alicante University Hospital in Spain on behalf the Spanish Lung Cancer Cooperative Group (GECP-SCLG) presented his findings today at the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer (WCLC) in Yokohama, Japan.

For patients with resected NSCLC with lymph node involvement, postoperative platinum-based CT is the standard of care. BRCA1 is a DNA repair factor that is mainly involved in the repair of double strand DNA breaks and may also act as a differential regulator of response to cisplatin (Cis) and antimicrotubule agents. BRCA1 efficiency enhances resistance to Cis, and loss of BRCA1 function is associated with sensitivity to DNA-damaging CT. Therefore, the research team sought to determine if differential CT treatment based on knowledge of patients' BRCA1 levels could lead to higher survival rates and if cisplatin could be avoided in a pre-defined subgroup.

The researchers hypothesized that the five year survival rate of the standard care control group (45%) could increase by 20% in an intervention group that received CT compatible with either their low, medium or high BRCA1 expression levels. While those in the control group received the standard Cis-Docetaxel, those in the experimental group either received Cis-Gemcitabine (low BRCA1), Cis-Doc (intermediate BRCA1) or Docetaxel (high BRCA 1).

After median follow-up of 53 months, the OS among the control group was 69.3 months and among the experimental group 82.3 months, ranging from 74 months (low BRCA) to 80.5 months (intermediate BRCA) and 80.2 months (high BRCA).

Their findings suggest that survival rates do not increase among patients who receive chemotherapy (CT) treatment based on their BRAC1 levels. However, the researchers did find higher rates of survival than expected in patients with lymph node involvement, and also determined that in the case of high levels of BRCA1, CT treatment with Docetaxel (but without cisplatin) is not detrimental. Also for patients with low BRCA1 levels, Cisplatin-Gemcitabine could be superior to Cisplatin-Docetaxel.

"The findings from our study do not allow changing the current standard of treatment, but this trial validates BRCA1 as a prognostic factor and selection of chemotherapy treatment based on BRCA1 expression levels could be an option to improve outcomes, avoiding in some cases the use of cisplatin and its toxicity," said Dr. Massuti. "Having this evidence to back up our treatment decisions is essential to providing the best care possible and also opens new opportunities for research in this setting."
-end-
About the WCLC

The World Conference on Lung Cancer (WCLC) is the world's largest meeting dedicated to lung cancer and other thoracic malignancies, attracting over 6,000 researchers, physicians and specialists from more than 100 countries. The goal is to disseminate the latest scientific achievements; increase awareness, collaboration and understanding of lung cancer; and to help participants implement the latest developments across the globe. Organized under the theme of "Synergy to Conquer Lung Cancer," the conference will cover a wide range of disciplines and unveil several research studies and clinical trial results. For more information, visit http://wclc2017.iaslc.org/.

About the IASLC

The International Association for the Study of Lung Cancer (IASLC) is the only global organization dedicated to the study of lung cancer and other thoracic malignancies. Founded in 1974, the association's membership includes more than 6,500 lung cancer specialists across all disciplines in over 100 countries, forming a global network working together to conquer lung and thoracic cancers worldwide. The association also publishes the Journal of Thoracic Oncology, the primary educational and informational publication for topics relevant to the prevention, detection, diagnosis and treatment of all thoracic malignancies. Visit http://www.iaslc.org for more information.

International Association for the Study of Lung Cancer

Related Lung Cancer Articles from Brightsurf:

State-level lung cancer screening rates not aligned with lung cancer burden in the US
A new study reports that state-level lung cancer screening rates were not aligned with lung cancer burden.

The lung microbiome may affect lung cancer pathogenesis and prognosis
Enrichment of the lungs with oral commensal microbes was associated with advanced stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.

New analysis finds lung cancer screening reduces rates of lung cancer-specific death
Low-dose CT screening methods may prevent one death per 250 at-risk adults screened, according to a meta-analysis of eight randomized controlled clinical trials of lung cancer screening.

'Social smokers' face disproportionate risk of death from lung disease and lung cancer
'Social smokers' are more than twice as likely to die of lung disease and more than eight times as likely to die of lung cancer than non-smokers, according to research presented at the European Respiratory Society International Congress.

Lung cancer therapy may improve outcomes of metastatic brain cancer
A medication commonly used to treat non-small cell lung cancer that has spread, or metastasized, may have benefits for patients with metastatic brain cancers, suggests a new review and analysis led by researchers at St.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Lung transplant patients face elevated lung cancer risk
In an American Journal of Transplantation study, lung cancer risk was increased after lung transplantation, especially in the native (non-transplanted) lung of single lung transplant recipients.

Proposed cancer treatment may boost lung cancer stem cells, study warns
Epigenetic therapies -- targeting enzymes that alter what genes are turned on or off in a cell -- are of growing interest in the cancer field as a way of making a cancer less aggressive or less malignant.

Are you at risk for lung cancer?
This question isn't only for people who've smoked a lot.

Read More: Lung Cancer News and Lung Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.