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An Evidence-Based Approach to the Use of Predictive Biomarkers in the Treatment of Non- Small Cell Lung Cancer (NSCLC)
Juravinski Cancer Centre, 699 Concession, St Hamilton, Hamilton, ON L8V 5C2, Canada
Department of Oncology, McMaster University Hamilton, ON L8S 4L8, Canada
* Author to whom correspondence should be addressed.
Received: 9 August 2011; in revised form: 30 August 2011 / Accepted: 5 September 2011 / Published: 13 September 2011
Abstract: Recent advances in the treatment of non-small cell lung cancer (NSCLC) have led to improvements in patient survival and quality of life. It is unclear whether molecular abnormalities associated with NSCLC cell survival, growth and proliferation are useful in predicting treatment benefit. We conducted a systematic review to establish which biomarkers contribute meaningfully to the management of NSCLC. A team of researchers searched PubMed and conference proceedings (ASCO, ESMO, IASLC, USCAP) using MESH terms for NSCLC and randomized trials (RCT), plus keywords for variables of interest. Evidence from multiple RCTs confirmed that histologic subtype is prognostic for survival and predictive of treatment efficacy and/or toxicity in NSCLC. Likewise, activating mutations of the epidermal growth factor receptor (EGFR) are associated with benefit from EGFR tyrosine kinase inhibitors in patients with advanced non-squamous NSCLC and should be assessed routinely. No biomarkers to date reliably predict response to anti-Vascular Endothelial Growth Factor (VEGF) therapies. There are inconsistent data on the role of ERCC1, BRCA, Beta tubulin III, RRM1, K-RAS, or TP-53 in treatment decisions. These tests should not be routinely used in selecting treatment at this time, whereas EML4/ALK translocations predict responses to specific targeted agents, the optimal assessment of this molecular abnormality has yet to be established. Personalized care of patients with NSCLC based on biomarkers is increasingly important to both clinical practice and research.
Keywords: Non-small-cell lung cancer; targeted therapy; epidermal growth factor receptor; tyrosine kinase inhibitor; molecular marker; biomarker
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Cite This Article
MDPI and ACS Style
Quinton, C.; Ellis, P.M. An Evidence-Based Approach to the Use of Predictive Biomarkers in the Treatment of Non- Small Cell Lung Cancer (NSCLC). Cancers 2011, 3, 3506-3524.
Quinton C, Ellis PM. An Evidence-Based Approach to the Use of Predictive Biomarkers in the Treatment of Non- Small Cell Lung Cancer (NSCLC). Cancers. 2011; 3(3):3506-3524.
Quinton, Cindy; Ellis, Peter M. 2011. "An Evidence-Based Approach to the Use of Predictive Biomarkers in the Treatment of Non- Small Cell Lung Cancer (NSCLC)." Cancers 3, no. 3: 3506-3524.