While adjuvant chemotherapy (ACT) after surgical removal of non-small cell lung cancer (NSCLC) can help prevent cancer recurrence and improve survival, the average benefits are small and the treatment can have serious side effects. A study of patients with adenocarcinoma identified 12 genes that together predicted the likelihood of better (low-risk) or worse (high-risk) long-term outcomes in these patients. Patients with a high-risk “gene signature” benefitted significantly from ACT, while low-risk patients gained no additional benefit, suggesting that the gene set can be used to pinpoint patients for whom ACT treatment would be worth the risk of side effects.
Forty patients with non-small cell lung cancer (NSCLC) with brain metastases (cancer that had spread to the brain) were treated with the EGFR inhibitor Tarceva (erlotinib) and whole-brain radiation therapy (WBRT). Tarceva plus WBRT was relatively well tolerated and resulted in median survival rates (10.9 months) that were higher than in a previous trial of WBRT alone (3.9 months). The fact that many NSCLC patients carry mutations in the EGFR gene may contribute to the beneficial effects of adding Tarceva treatment to WBRT in NSCLC with brain metastases.