Trimodality therapy in stage III non-small cell lung cancer: prediction ofrecurrence by assessment of p185(neu)

In a trimodality treatment approach for stage III non-small cell lung cance r the prognostic impact of pretherapeutic p185(neu) assessment was evaluate d. Fifty-four patients were admitted to chemotherapy followed by twice-daily r adiation with concomittant low-dose chemotherapy and subsequent surgery, Im munohistochemical assessment of p185(neu) expression was performed in paraf fin-embedded mediastinal lymph node metastases, by mediastinoscopy biopsy p rior to therapy. Paraffin-embedded biopsies of mediastinal lymph node metastases were availa ble in 33 cases. Seven out of eight patients with positive p185(neu) staini ng developed distant metastases, in contrast to seven out of 25 negative ca ses. Expression of p185(neu) in mediastinal lymph node metastases was a sig nificant predictor for progression-free survival (p=0.047) and resulted mai nly from significant differences in metastases-free survival (p185(neu)-pos itive versus p185(neu)-negative: median, II versus 19 months; 2- and 3-yr r ates, 13% and 0% versus 40% and 32%; p=0.04), On the basis of these preliminary results it was concluded that further eva luation of p185neu expression in trials on neoadjuvant and adjuvant therapy is warranted. When the prognostic impact of p185(neu) in such trials with larger patient numbers is confirmed, this may contribute to the identificat ion of stratification variables for future treatment approaches of non-smal l cell lung cancer.