[Press & Publications] PREDICTING CANCER RECURRENCE [Medical]



May 2000

No 106

STRICTLY EMBARGOED UNTIL TUESDAY MAY 23 5.30PM

Dr Giles Cox, interviewee for this study, is available to talk to the media TODAY Friday May 19 ONLY. Contact numbers below. Please observe the embargo.

Scientists at the University of Leicester have achieved a major breakthrough in being able to predict recurrence of lung cancer in patients.

This finding is important because patients at risk of a relapse can be offered appropriate follow-up therapy.

The discovery has been made by Giles Cox, Louise Jones and Ken O'Byrne from the Departments of Oncology and Pathology at the University of Leicester. It was announced today (TUESDAY MAY 23) at the American Society of Clinical Oncology meeting held in New Orleans.

They found that by studying certain biological characteristics of a tumour, they are able to predict which patients will have a recurrence of non-small cell lung cancer following surgery.

At present, physicians look at the size, site and spread of a lung cancer to predict the likelihood of the disease recurring after potentially curative surgery. Despite this, tumours with a similar pattern of spread can vary considerably in their behaviour.

By studying the underlying biological characteristics of a cancer, it may be possible to more accurately predict which patients will have a recurrence of their disease.

The researchers stained cancers taken from 168 patients to look for several markers:

  • Enzymes known as MMP-2 and MMP-9 that facilitate tumour invasion into tissue
  • The levels of two epidermal growth factor receptors (EGFR and c-erbB-2) on the surface of cancer cells
  • The number of blood microvessels in the tumour (angiogenesis)
  • These factors are thought to be associated with the growth of a tumour and its ability to invade a spread to distant sites. The staining could be carried out easily on routinely processed tissue.

    Dr Cox, who led the research, said: The presence of MMP-9 in tumour cells predicted poor outcome and the prognosis was worse when both EGFR and MMP-9 are found in the same tumour. High numbers of blood vessels in a tumour also predicted relapse.

    These biological markers were significantly better predicators of recurrence and death than the traditional method of looking at the spread of the disease. If EGFR, MMP-9 and angiogenesis were all present, it was highly likely that the cancer would recur after surgery.

    The cancer-related mortality in this group of patients, excluding other causes of death, was 84% compared to only 36% when none of these were present.

    Scientists say further treatment after surgery could be targeted to these patients. Dr Cox added: More exciting is the development of novel treatments such as receptor blockers, MMP-inhibitors and anti-angiogenesis agents.

    Many of these experimental drugs are currently undergoing clinical trials. Their use could be targeted to the individual patients in whose cancers these systems appear to be activated. An additional benefit of these novel treatments is their comparative lack of side-effects compared to chemotherapy.

    The prospect of treatment tailored to the individual patient and tumour characteristics may be nearing reality.

    NOTE TO NEWDESK:

    Dr Giles Cox, Research Fellow in Respiratory Medicine, University of Leicester based at Glenfield Hospital: 0116 256 3456 (dir) or 0116 287 1471 and ask to bleep 713

    Dr Ken O'Byrne, Senior Lecturer, Department of Oncology, University of Leicester based at Leicester Royal Infirmary: 0116 258 7606

    Dr Louise Jones, Senior Lecturer, University of Leicester email lj17@le.ac.uk

    Giles is available for interview only on Friday May 19. Thereafter, please note that Giles and Ken will be back in Leicester on Friday 26 May.


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