Dr. Wakelee on Adjuvant Therapy Predictive Markers

Heather Wakelee, MD, assistant professor, Department of Medicine, Division of Oncology, Stanford University, Stanford Clinical Cancer Center, discusses markers currently under investigation that could be used to predict adjuvant chemotherapy benefit in lung cancer patients.

DNA repair enzymes receive the most attention as potential benefit predictors of postoperative therapy. The theory in place is that if these markers are high the tumor will be more likely to build up a resistance to chemotherapy, and contrive less of a benefit.

The most common marker currently being investigated is the ERCC1 DNA repair protein that is encoded by the ERCC1 gene. This marker is still under investigation, but could lead to a clearer understanding of which patients would respond the most to adjuvant cisplatin.

A retrospective examination of a prognostic trial looking at untreated resected non-small cell lung cancer patients showed that ERCC1-positive patients had an increased rate of survival compared to those that are ERCC1-negative. This information suggests that ERCC1-negative patients will benefit the most from cisplatin chemotherapy.