Platinum-based chemotherapy in lung cancer affects the expression of certain biomarkers including ERCC1.

Chemotherapies are widely used in the treatment of lung cancer. However, little is known about their effect in the expression of different tissue markers. Seventeen lung cancer tissue blocks obtained by bronchoscopic biopsies together with their corresponding surgical biopsies after neoadjuvant chemotherapy were studied. They included 9 adenocarcinomas (ADC) and 8 squamous cell carcinomas (SCC). Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissues to study the expression of Ki-67, p53, Bcl-2, Bax, Fas-ligand and ERCC1 (excision repair cross-complementation group 1). Out of 17 NSCLC 6 expressed proapoptotic markers and 4 expressed antiapoptotic markers, while in 7 cases the apoptotic markers did not show detectable changes after neoadjuvant chemotherapy. Six of 17 bronchoscopic NSCLC cases expressed increased level of Ki-67 after neoadjuvant treatment. Eight bronchoscopic NSCLC tissues (6 SCC, 2 ADC) expressed ERCC1. All but one ADC became ERCC1 negative after neoadjuvant therapy. There was no newly expressed ERCC1 positive case in the surgical biopsy group. Platinum-based neoadjuvant chemotherapy had no effect on the apoptotic activity of 17 patients' tumor specimen, however, 6 of 17 bronchoscopic NSCLC cases expressed increased level of Ki-67 after neoadjuvant treatment, in 3 cases the level of Ki-67 became decreased, while 8 cases had no detectable change of proliferation activity. The results of the present study suggest that platinum-based chemotherapy probably induces a selection of tumor cells with more aggressive phenotype, and also affects the expression of tissue marker (ERCC1) that could have predictive value.

[The role of adjuvant chemotherapy in the treatment of non-small cell lung cancer]. / Az adjuváns kemoterápia helye a nem kissejtes tüdorák kezelésében.

UNLABELLED: Postoperative treatments for lung cancer have been evaluated for more than two decades, but in the majority of the studies (especially until 1990) no significant effect on survival has been shown. In 1995, a meta-analysis of eight cisplatin-based adjuvant chemotherapy trials with NSCLC showed a 13% reduction in the risk of death (P=0.08) and 5% benefit in 5-year survival. Among four positive trials (IALT, JBR10, ANITA and CALGB study) the absolute increase in the 5-year survival rates by adjuvant chemotherapy ranged from 4% to 15%, and the hazard ratios for death ranged from 0.6 to 0.86. The author analyzes the most important studies. CONCLUSION: adjuvant chemotherapy after complete resection of NSCLC can be considered as a new standard of care in patients with good performance status. Patients should receive 4 cycles of platina-based chemotherapy beginning 4-8 weeks after surgery. FUTURE PERSPECTIVES: optimization of chemotherapy regimens including targeted therapy (such as EGFR inhibitors, angiogenesis inhibitors, anti-EGFR monoclonal antibodies). Further progress is anticipated through the integration of chemopreventive agents into the adjuvant treatment.

Elevated anti-cholesterol antibody levels in the sera of non-small cell lung cancer patients.

There have been no published data yet on the serum level of antibodies against cholesterol (anti-cholesterol antibodies) in oncological patients. We decided to examine these levels in the sera of non-small cell lung cancer (NSCLC) patients. Measurements were performed by ELISA technique in the sera of 44 NSCLC patients and the results were compared to the anti-cholesterol antibody levels of 34 non-tumorous control subjects. Serum anti-cholesterol antibody levels were found to be significantly higher in NSCLC patients than in non-tumorous controls (40.35 arbitrary units/ml (AU/ml) versus 26.00 AU/ml, P=0.0003). The elevated anti-cholesterol antibody values were observable at different percentile values as well (25 percentile: 27.01 AU/ml in NSCLC patients, versus 17.33 AU/ml in controls; 75 percentile: 60.90 AU/ml in NSCLC patients versus 32.90 AU/ml in controls). These results suggest that anti-cholesterol antibodies might be applicable for the serodiagnosis of NSCLC. We emphasize the need for the collection of more data on anti-cholesterol antibody levels in NSCLC patients and in patients with different other malignant tumours in order to investigate the possible benefit anti-cholesterol antibodies might offer in clinical work.

The immunodiagnosis of lung cancer with monoclonal antibodies.

Lung cancer is responsible for much suffering and death worldwide. The only hope for cure is therapy applied in an early phase, and all methods of diagnosis should be aimed at this goal. This paper reviews the development of the use of monoclonal antibodies in the diagnosis of lung cancer. Relevant data since the publication of the technology of producing monoclonal antibodies in 1975 to the present are summarized. The authors evaluate the progress of the immunodiagnosis of lung cancer by monoclonal antibodies from pleural effusion, bone marrow, sputum, bronchial lavage, and bronchial brush (immunocytochemistry). They collect recent data on the immunohistochemistry of biopsy materials and of removed tissues. They evaluate radioimmuno-imaging (radioimmuno-scintigraphy) and immuno-PET as in vivo macroscopic diagnostic methods of lung cancer by monoclonal antibodies as well as the help monoclonal antibodies provide in radioimmuno-guided surgery or immunoimage-guided, focally ablative therapy of this disease.

[Our experience with patients operated after neoadjuvant therapy]. / Neoadjuváns kezelést követoen végzett reszekciós mutétekkel szerzett tapasztalataink.

The authors performed thoracotomies on 47 patients because of NSCLC between 1 January 2000 and 31 December 2003. All patients had neoadjuvant therapy which was indicated by IIIA stage NSCLC with N2 nodal status. After the neoadjuvant therapy almost all tumors (92.7%) became resectable. The combinations of therapy types, the operations type and the surgical complications are analysed. Long term outcome proves, that multimodal therapy of NSCLC (in IIIA stage) is an effective treatment method.