Predicting the Outcome of Chemotherapy for Lung Cancer

Curr Opin Pharmacol. 2006 Aug;6(4):323-31. doi: 10.1016/j.coph.2006.01.011. Epub 2006 Jun 12.

Abstract

Lung cancer is a worldwide problem. At the time of diagnosis, 50% of patients have advanced incurable disease. Different chemotherapy combinations--with or without targeted therapies--yield similar results despite the continuous efforts of clinicians. However, molecular biological studies have already shed a great deal of light on the existence of multiple genetic aberrations that can be useful for customizing treatment. mRNA transcripts involved in DNA repair pathways, such as ERCC1 and BRCA1, confer selective resistance to cisplatin or taxanes, whereas thioredoxin confers a broad spectrum of chemoresistance. Polymorphisms in DNA repair genes and methylation of checkpoint genes in circulating serum DNA could become important predictive markers of survival in certain cisplatin-based regimens. Epidermal growth factor receptor tyrosine kinase mutations are the crux of targeted therapies, whereas epithelial-mesenchymal transitions and HER3 mRNA levels are promising ancillary markers for treatment with epidermal growth factor receptor tyrosine kinase inhibitors.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • 14-3-3 Proteins / genetics
  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Agents / therapeutic use*
  • Cell Transformation, Neoplastic / genetics
  • Cell Transformation, Neoplastic / pathology
  • Clinical Trials as Topic
  • DNA Repair Enzymes / genetics
  • DNA-Binding Proteins / genetics
  • Drug Resistance, Neoplasm / genetics
  • Epigenesis, Genetic
  • Epithelial Cells / pathology
  • ErbB Receptors / antagonists & inhibitors
  • ErbB Receptors / genetics
  • Erlotinib Hydrochloride
  • Gefitinib
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / etiology
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology
  • Mesoderm / pathology
  • Mutation
  • Nuclear Proteins
  • Polymorphism, Genetic
  • Protein Kinase Inhibitors / pharmacology*
  • Protein Kinase Inhibitors / therapeutic use*
  • Quinazolines / pharmacology
  • Quinazolines / therapeutic use
  • Smoking / adverse effects
  • Thioredoxins / genetics
  • Treatment Outcome
  • Y-Box-Binding Protein 1

Substances

  • 14-3-3 Proteins
  • Antineoplastic Agents
  • DNA-Binding Proteins
  • Nuclear Proteins
  • Protein Kinase Inhibitors
  • Quinazolines
  • Y-Box-Binding Protein 1
  • YBX1 protein, human
  • Thioredoxins
  • Erlotinib Hydrochloride
  • ErbB Receptors
  • DNA Repair Enzymes
  • Gefitinib