When patients present with early-stage non-small-cell lung cancer, doctors assess the tumors by looking at their size, location and appearance, and use this information to decide what to do after surgery--whether to use chemotherapy or watch and wait. Knowing who would benefit from extra treatment could improve their chance of survival, and a genetic test in development with researchers at the University of California-San Francisco in collaboration with Pinpoint Genomics may aid this process.
Around 35 percent to 45 percent of people with early stage lung cancer die within 5 years if the disease recurs, often because they harbor tiny and undetectable metastatic cancers. Being able to find these and treat them could improve their chance of survival. UCSF's 14-gene test detects the genetic biomarkers associated with these metastatic cancers.
In two large clinical trials, the researchers assessed the genetic test against tissue samples from 433 people in the U.S. and 1,006 people in China with early-stage lung cancer. The test was able to predict, correctly, the odds of death within 5 years of lung cancer surgery as low, medium or high, with 71 percent of people classified as low risk in both trials. The study in China was reported to be the first major clinical trial under the auspices of the China Clinical Trials Consortium (CCTC), which was founded with support from UCSF.
"It's quite exciting," said Dr. David Jablons, the Ada Distinguished Professor in Thoracic Oncology and leader of the Thoracic Oncology Program at the Helen Diller Family Comprehensive Cancer Center at UCSF. "This has the potential to help hundreds of thousands of people every year survive longer."
According to the researchers, these are the two largest clinical studies ever conducted on the molecular genetics of lung cancer. The next step is to conduct a large clinical trial, selecting people classified as high risk and assigning them to either treatment or the watch and wait method. This genetic test, if it makes it through to the market, could help physicians predict the outcome for patients and decide who might benefit from extra treatment after surgery, potentially saving lives.