Impact of the Deletion Polymorphism on Survival Among Patients With Completely Resected Non-Small-Cell Lung Carcinoma.

PURPOSE

A deletion polymorphism of the gene has been reported to be a prognostic factor for patients with non-small-cell lung cancer (NSCLC) treated with epidermal growth factor receptor-tyrosine kinase inhibitors in the Asian population. We investigated the impact of the deletion polymorphism on survival among patients with completely resected NSCLC.

PATIENTS AND METHODS

The polymorphism was detected by polymerase chain reaction analysis. We measured overall survival (OS) and recurrence-free survival rates in 411 patients and postrecurrence survival (PRS) in 94 patients who experienced recurrence and received additional anticancer therapy.

RESULTS

The deletion polymorphism was detected in 61 patients (14.8%). OS rates were significantly lower for patients with the deletion polymorphism than for those with the wild-type sequence. On multivariable analysis, the deletion polymorphism was identified as an independent prognostic factor for OS (hazard ratio, 1.98; 95% CI, 1.17 to 3.36; = .011). Among the 94 patients who experienced recurrence and were treated with anticancer therapy, patients with the deletion polymorphism showed significantly poorer PRS than those with the wild-type sequence (median, 9.8 months 26.9 months, respectively; < .001). Multivariable analysis revealed that the deletion polymorphism was an independent predictor of PRS (hazard ratio, 3.36; 95% CI, 1.75 to 6.47; < .001). This trend remained apparent in subgroup analyses stratified by status, histology, and therapeutic modality.

CONCLUSION

The deletion polymorphism is a novel indicator of shortened PRS among patients with recurrent NSCLC treated with anticancer therapy in the Asian population.