Prognostic impact of insulin receptor expression on survival of patients with nonsmall cell lung cancer†
Article first published online: 22 SEP 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 9, pages 2454–2465, 1 May 2012
How to Cite
Kim, J.-S., Kim, E. S., Liu, D., Lee, J. J., Solis, L., Behrens, C., Lippman, S. M., Hong, W. K., Wistuba, I. I. and Lee, H.-Y. (2012), Prognostic impact of insulin receptor expression on survival of patients with nonsmall cell lung cancer. Cancer, 118: 2454–2465. doi: 10.1002/cncr.26492
This study was presented at the 102nd Annual Meeting of the American Association for Cancer Research, April 2-6, 2011, Orlando, Florida.
- Issue published online: 20 APR 2012
- Article first published online: 22 SEP 2011
- Manuscript Accepted: 18 JUL 2011
- Manuscript Revised: 26 JUN 2011
- Manuscript Received: 14 MAR 2011
- nonsmall cell lung;
- IGF type 1;
The purpose of this study was to characterize insulin receptor (IR) and insulin-like growth factor-1 receptor (IGF-1R) expression in patients with nonsmall cell lung cancer (NSCLC).
A total of 459 patients who underwent curative resection of NSCLC were studied (median follow-up duration, 4.01 years). Expression of the IR and IGF-1R protein in tumor specimens was assessed immunohistochemically using tissue microarrays.
The cytoplasmic IR score was higher in patients with adenocarcinoma (ADC) than in those with squamous cell carcinoma (SCC), whereas cytoplasmic IGF-1R score was higher in patients with SCC than those with ADC. Neither IR nor IGF-1R expression was associated with sex, smoking history, or clinical stage. Patients with positive IR or IGF-1R expression levels had poor recurrence-free (RFS) (3.8 vs 3.3 years; 3.8 vs 2.0 years, respectively), but similar overall survival (OS). Patients with high expression levels of IR and IGF-1R had shorter RFS and OS compared with those with low levels of IR and/or IGF-1R expression. Finally, a multivariate analysis revealed the impact of IR, but not of IGF-1R, as an independent predictive marker of NSCLC survival: hazard ratio (HR) for OS, 1.005 (95% confidence interval [CI], 1.001-1.010], HR for RFS, 1.005 (95% CI, 1.001-1.009), when IR score was tested as a continuous variable.
Overexpression of IR predicts a poor survival among patients with NSCLC, especially those with SCC. These results might serve as future guidance to the clinical trials involving IR or IGR-1R targeting agents. Cancer 2012;. © 2011 American Cancer Society.