Biomarkers and the future of chemotherapy in non-small cell lung cancer


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Jean-Charles Soria

Institut de Cancrologie Gustave Roussy, Paris, France

Abstract

Lung cancer is the leading cause of cancer death in men and also increasingly in women. Novel therapeutic strategies need to be developed and existing therapies optimised in order to raise the survival rate of lung cancer patients. In this regard, rational treatment decision-making based on an analysis of biomarkers of response and resistance to cytotoxic appears to be a promising approach.

The application of pharmacogenetics to cytotoxic chemotherapy could lead to the development of individualised drugs for patients with cancer. Numerous studies have reported the role of ERCC1 expression in the repair mechanism of cisplatin-induced DNA adducts in cancer. These studies suggest that ERCC1 is a potentially useful marker to predict resistance to cisplatin, carboplatin and oxaliplatin. RRM1 as well as BRCA1 may also be potential indicators that may help select those patients with the highest probability of response to cisplatin and/or gemcitabine. Other markers have also being suggested as potential predictors of the efficacy or toxicity of pemetrexed (eg TS, homocysteine levels), paclitaxel (eg Map-tau), docetaxel (eg bcl2) or navelbine (beta tubulin III).

Biomarker work which helps pave the way towards providing individualised anti-cancer therapy based on tumour characteristics, should be strongly encouraged. This is one of the strongest expectations not only of the medical community but mostly of our fellow citizens.