Expression of Bcl-2 predicts outcome in locally advanced non-small cell lung cancer patients treated with cisplatin-based concurrent chemoradiotherapy

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 68; no. 2; pp. 288 - 294
• Main Authors: Jeong, Seong Hyun, Jung, Jae Ho, Han, Jae Ho, Kim, Jang Hee, Choi, Yong-Won, Lee, Hyun Woo, Kang, Seok Yun, Hwang, Yoon Ho, Ahn, Mi Sun, Choi, Jin-Hyuk, Oh, Young Taek, Chun, Mison, Kang, Seunghee, Park, Kwang Joo, Hwang, Sung Chul, Sheen, Seung Soo
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ireland Ltd 01-05-2010; Elsevier
• Subjects: Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Bcl-2; bcl-2-Associated X Protein - genetics; bcl-2-Associated X Protein - metabolism; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - physiopathology; Carcinoma, Non-Small-Cell Lung - therapy; Chemoradiotherapy; Cisplatin - administration & dosage; Cisplatin - adverse effects; Disease Progression; DNA-Binding Proteins - genetics; DNA-Binding Proteins - metabolism; Endonucleases - genetics; Endonucleases - metabolism; Female; Hematology, Oncology and Palliative Medicine; Humans; Lung Neoplasms - diagnosis; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - physiopathology; Lung Neoplasms - therapy; Male; Medical sciences; Middle Aged; Non-small cell lung cancer (NSCLC); Pneumology; Prognosis; Proto-Oncogene Proteins c-bcl-2 - genetics; Proto-Oncogene Proteins c-bcl-2 - metabolism; Pulmonary/Respiratory; Radiotherapy, Adjuvant; Treatment Outcome; Tumor Suppressor Protein p53 - genetics; Tumor Suppressor Protein p53 - metabolism; Tumors; Tumors of the respiratory system and mediastinum; Bcl-2; Prognosis; Chemoradiotherapy; Non-small cell lung cancer (NSCLC); Antineoplastic agent; Human; Lung disease; Respiratory disease; Concurrent; Malignant tumor; non-small cell lung carcinoma; Gene expression; Radiotherapy; Cisplatin; Chemotherapy; Cancerology; Treatment; Bronchus disease; Cancer; Non small cell carcinoma; Pneumology
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2009.06.003

Abstract Background Platinum-based concurrent chemoradiotherapy (CCRT) is a standard treatment for locally advanced unresectable non-small cell lung cancer (NSCLC). The determination of parameters that may predict the result of the treatment has strong clinical implications. Patients and methods Pretreatment tumor biopsy specimens from 39 patients with locally advanced NSCLC (stage IIIA: 5, stage IIIB: 34) were analyzed for p53, Bcl-2, Bax and ERCC1 expression by immunohistochemistry. All patients were treated with cisplatin-based CCRT. Twenty-four patients received induction chemotherapy followed by CCRT (60 Gy/30 fractions, 6 mg/m2 of cisplatin daily). The most commonly administered induction chemotherapy regimen was VIP (etoposide, ifosfamide, cisplatin; 20 patients). Fifteen patients received the same CCRT without induction chemotherapy. Results High expression of p53, Bcl-2, Bax and ERCC1 was observed in 15 (38%), 19 (49%), 17 (44%) and 12 (31%) patients, respectively. High expression of Bcl-2 was significantly associated with longer survival duration (20 months vs. 9 months, P = 0.008) and better response to the treatment (74% vs. 30%, P = 0.01). In multivariate analysis, Bcl-2 expression was the only significant independent prognostic factor of overall survival ( P = 0.007) among the pretreatment patients characteristics. Conclusions High expression of Bcl-2 may be a useful prognostic factor in locally advanced NSCLC patients treated with cisplatin-based CCRT.