Trimodality therapy in stage III non-small cell lung cancer: Prediction of recurrence by assessment of p185(neu)

Abstract

In a trimodality treatment approach for stage III non-small cell lung cancer the prognostic impact of pretherapeutic p185(neu) assessment was evaluated. Fifty-four patients were admitted to chemotherapy followed by twice-daily radiation with concomittant low-dose chemotherapy and subsequent surgery. Immunohistochemical assessment of p185(neu) expression was performed in paraffin-embedded mediastinal lymph node metastases, by mediastinoscopy biopsy prior to therapy. Paraffin-embedded biopsies of mediastinal lymph node metastases were available in 33 cases. Seven out of eight patients with positive p185(neu) staining developed distant metastases, in contrast to seven out of 25 negative cases. Expression of p185(neu) in mediastinal lymph node metastases was a significant predictor for progression-free survival (p=0.047) and resulted mainly from significant differences in metastases- free survival (p185(neu)-positive versus p185(neu)-negative: median, 11 versus 19 months; 2- and 3-yr rates, 13% and 0% versus 40% and 32%; p=0.04). On the basis of these preliminary results it was concluded that further evaluation of p185(neu) expression in trials on neoadjuvant and adjuvant therapy is warranted. When the prognostic impact of p185(neu) in such trials with larger patient numbers is confirmed, this may contribute to the identification of stratification variables for future treatment approaches of non-small cell lung cancer.