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Trimodality treatment in Stage III nonsmall cell lung carcinoma
Author(s) -
Broermann Petra,
Junker Klaus,
Brandt Burkhard H.,
Heinecke Achim,
Freitag Lutz,
Klinke Folker,
Berdel Wolfgang E.,
Thomas Michael
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10387
Subject(s) - medicine , carboplatin , etoposide , oncology , vindesine , chemotherapy , stage (stratigraphy) , carcinoma , radiation therapy , neoadjuvant therapy , cancer , gastroenterology , cisplatin , biology , paleontology , vincristine , breast cancer , cyclophosphamide
BACKGROUND In a trimodality treatment approach for Stage III nonsmall cell lung carcinoma (NSCLC), the prognostic impact of the ras mutation status in resection specimens was evaluated. METHODS Forty patients with Stage III NSCLC underwent tumor resection after neoadjuvant treatment with two cycles of chemotherapy (ifosfamide, carboplatin, and etoposide) and subsequent twice‐daily radiotherapy (45 grays [Gy]; 2 × 1.5 Gy/day) with concurrent carboplatin and vindesine. Assessment of K‐ ras codon 12 mutation status was performed in the paraffin embedded resection specimens by a two‐step polymerase chain reaction followed by restriction fragment length polymorphism analysis. RESULTS K‐ ras mutation status could be assessed in 28 cases. A K‐ ras codon 12 point mutation was found in 13 of 28 resection specimens (46%). The mutation was found independently of gender, age, tumor stage, and clinical response status and occurred more frequently in adenocarcinomas. Even after complete resection, the presence of a K‐ ras mutation was a significant predictor for a poor progression free survival ( P = 0.005). CONCLUSIONS These data suggest that further evaluation of the K‐ ras codon 12 mutation status in trials on neoadjuvant and adjuvant therapy is warranted. This may contribute to the identification of stratification variables for future treatment approaches. Cancer 2002;94:2055–62. © 2002 American Cancer Society. DOI 10.1002/cncr.10387