Genomics of lung cancer progression varies widely among patients, offering clues to predictive biomarkers

A new Mayo Clinic study published online in Cancer Research has complicated the prevailing theory of linear lung cancer progression and offers new insights for management of this deadly cancer. According to the study, sequencing results provide, for the first time, strong molecular evidence of progression from phenotypically indolent components to more aggressive disease and also show that both components can progress independently, even if they arise from the same precursor.

Treatment of early-stage cancers may be tailored according to the type of genomic alterations observed, says George Vasmatzis, PhD, senior author of the study and co-director of the Biomarker Discovery Program in the Mayo Clinic Center for Individualized Medicine. In some cases, this could mean less aggressive treatment and periods of close observation, while other situations may call for more immediate interventions, such as surgery or radiation.

“As suggested by clinical studies demonstrating improved disease-free and overall survival for treatment of lesions containing components of adenocarcinoma in situ [noninvasive lung cancer], it may be that this represents a distinct clinical entity that can be treated less aggressively by either sub-lobar resection or even periods of watchful waiting with close imaging follow-up prior to any treatment,” says Dr. Vasmatzis.

Future studies of lung cancer genomics and tumor progression are underway from Dr. Vasmatzis’ team in the Biomarker Discovery Program. Their goal is to develop a series of predictive biomarkers that can help patients and physicians separate potentially aggressive and life-threatening lung cancers from indolent ones based on the molecular signatures found within the individual patient’s tissue. Read the study abstract.