Navigation Links
Molecular pathways linked to sex, age affect outcomes in lung cancer

DURHAM, N.C. The biology of lung cancer differs from one patient to the next, depending on age and sex, according to scientists at Duke University Medical Center. The findings may help explain why certain groups of patients do better than others, even though they appear to have the same disease.

"Our study supports two key findings: First, the biology of lung cancer in women is dramatically different from what we see in men. Women, in general, have a less complex disease, at least in terms of the numbers of molecular pathways involved. We also discovered that there is a subset of elderly patients would probably benefit from treatments that we've normally reserved for younger patients," says Anil Potti, M.D., an oncologist in the Duke Institute for Genome Sciences & Policy (IGSP) and the senior author of the study.

Potti says that in the past, physicians have had to rely on very rough measures to categorize patients' lung cancers, factors such as the size of the tumor, the tissue type and the degree to which the cancer had spread. "But this new information tells us that we can analyze patients' disease much more discretely," says Potti. He says the information could also be used to enrich the selection process in clinical trials designed to evaluate new drugs aimed at specific molecular targets.

Physicians have long observed that over time, women with lung cancer tend to do a little better than men, and that younger patients do better than older ones. Potti found that women tend to have only a few cancer-promoting pathways activated in their tumors, where men may have twice as many.

Potti and a team of researchers in the IGSP studied clinical data and accompanying genomic information obtained from tumors of 787 patients with predominantly early stage non-small cell lung cancer (NSCLC), the most common form of the disease. They gathered tumor samples and corresponding microarray data showing which genes were activated in the tumors, then selected twelve of the most common molecular pathways that become dysregulated in NSCLC. The goal was to identify any patterns linking the pathways to age, sex and time to recurrence. They sorted the patients by age and sex and then again into low- and high-risk groups, based on five-year, recurrence-free survival.

They found that certain molecular pathways were more frequently activated in some groups than others and that certain pathway patterns were associated with better long-term survival in patients with lung cancer. Specifically, they found that:

  • High-risk patients those with the shortest time to recurrence were significantly more likely to have increased activation of the pathways responsible for tumor metastasis and necrosis, when compared with low-risk patients.
  • High-risk patients 70 or older were found to have higher activation of pathways regulating blood supply and invasiveness.
  • In comparing high-risk women to high-risk men, they found that men were more likely to have a much more complex pattern of multiple pathways being activated than women with the same type of lung cancer.

The study also identified a subset of patients over age 70 who had a low-risk profile, meaning the molecular pathways activated in their tumors would likely give them a better chance at long-term survival. Potti says that's important because people over age 70 are generally not included in many clinical trials and physicians often hesitate to offer them the option of conventional chemotherapy. "The thinking has been that they may not withstand the treatment or benefit from it much. But now we know that it probably makes sense to consider treating this population, by risk-stratifying the disease," says Potti.

Potti says it is likely that there are additional cancer-promoting pathways that are involved in the development and progression of NSCLC and adds that these findings must be validated in other studies. But he said the set of 12 known oncogenic pathways they chose to study are significant "because we already have drugs that can regulate many of them."

"People still don't realize how bad a disease this is," says Jeffrey Crawford, M.D., a study co-author and the chief of medical oncology at Duke. "Lung cancer kills more than 150,000 patients each year in the U.S. more than breast, prostate, colon and ovarian cancer combined. Unfortunately, there is a patient dying from lung cancer every three minutes in this country. So being able to better understand the disease and stratify patients by their individual molecular profiles means we can do a much better job pairing the right drug with the right patient."


Contact: Michelle Gailiun
Duke University Medical Center

Related medicine news :

1. Ground Breaking Molecular Diagnostics Business Appoints New CEO
2. Select Topics in ALL: Molecular Characterization, Approaches to CNS Disease, and Post-remission Transplantation
3. Scientists show how molecular switch helps pancreatic cancer beat drugs
4. News from the Latest Issue of Molecular Medicine
5. The Institut Curie and Ipsogen Sign a Scientific Collaboration Agreement Relating to the Genomic Grade, a Molecular Diagnostic Tool for Breast Cancer
6. Scientists Find Molecular Switch Related to Huntingtons
7. Seven World Leading IT Companies to Sponsor and Speak at CHI's Adopting R&D Informatics Systems, part of 17th International Molecular Medicine Tri-Conference
8. New England Journal of Medicine publishes CWRU review of the molecular basis of colorectal cancer
9. Scientists find molecular trigger that helps prevent aging and disease
10. CHI's Molecular Medicine Tri-Conference Keynote John Crowley Inspires Feature Film Starring Harrison Ford
11. News from the November/December Issue of Molecular Medicine
Post Your Comments:
(Date:11/27/2015)... ... , ... MPWH, the No.1 Herpes-only dating community in the world, revealed that over 50% of ... than 3.7 billion people under the age of 50 – or 67% of the population ... global estimates of HSV-1 infection . , "The data shocks us highly!" said Michelle ...
(Date:11/27/2015)... DE (PRWEB) , ... November 27, 2015 , ... ... member of the well-respected Microsoft Dynamics SL User Group (MSDSLUG). Recognized as Microsoft’s ... an independent group of Microsoft Dynamics SL software users, partners, industry experts and ...
(Date:11/27/2015)... MINNEAPOLIS, Minn. (PRWEB) , ... November 27, 2015 ... ... you start failing. Secura Consultants has prided itself for not only fulfilling the ... best income protection solutions at an affordable price and providing top-tier customer service. ...
(Date:11/27/2015)... ... ... CBD College is proud to announce that on November 20th, ... its Diagnostic Medical Sonography program. CBD College is honored to join this very short ... universities in the state of California make the cut. CBD College is officially the ...
(Date:11/27/2015)... ... November 27, 2015 , ... Dr. Thomas Dunlap ... and Dr. Tucker Bierbaum with Emergency Medicine at St., Joseph Health System’s ... STEMI and Sepsis conditions present in similar ways and require time-critical intervention to avoid ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... , November 26, 2015 /PRNewswire/ ... announced the addition of the  "2016 ... the Global Cell Surface Testing Market: ... report to their offering.  --> ... addition of the  "2016 Future Horizons ...
(Date:11/26/2015)... , Nov. 26, 2015 Research and ... the "Advanced Wound Care Market by Type (Dressings, ... End User (In-Patient Facility, Out-Patient Facility), and Geography - ... --> --> ... description, definition and forecast of the global advanced wound ...
(Date:11/26/2015)... , November 26, 2015 ... the "Self Administration of High Viscosity Drugs" ... ) has announced the addition of the ... report to their offering. --> Research ... addition of the "Self Administration of High ...
Breaking Medicine Technology: