Lung Cancer Gene Test Predicts Who Needs Chemotherapy – Tumor Profiles Determines High Risk Patients

Scientists at Duke University have developed a genomic test to determine which patients with early-stage lung cancer need chemotherapy and which do not. They describe the chemotherapy as a “toxic regimen of drugs”.

The test could potentially save thousands of lives each year by allowing doctors to make the important recommendation for chemotherapy. The developers of the test, at Dukes Institute for Genome Sciences & Policy, say that some patients should receive it, but are currently advised against it.

The Lung Metagene Predictor test scans thousands of genes to identify patterns of gene activity in individual tumors that indicate a patient is likely to suffer a recurrence of disease. Currently, chemotherapy is only prescribed to patients with relatively large and aggressive tumors. The recurrent tumors are usually fatal and it is critical to treat those patients that are susceptible to them.

Dr. Anil Potti said "Using the unique genomic signatures from each tumor, our new test predicted with up to 90 percent accuracy which early-stage lung cancer patients would suffer a recurrence of their cancer and which patients would not. We now have a tool that can be used to move these high-risk patients from the 'no chemotherapy' group into the aggressive treatment group." Potti is an assistant professor of medicine and lead author of the study.

Scientists believe that the genomic test can be used for any cancer, but the Duke team focused its effort on lung cancer because the survival rate is just 15 percent. Potti says the dilemma is that a third or more of early-stage patients who appear to be at low risk will experience a recurrent tumor.

"Until now, there simply has been no way to identify the 30 percent to 40 percent of early-stage lung cancer patients who would experience a recurrence," Potti said. "Now, with our test, we can say with confidence that we can identify this group of patients so they can be treated accordingly."

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