Chromosome instability within lung cancer tumors increases the risk of recurrence or death and may help forecast recurrence long before standard tests, according to a study published online April 26 in the New England Journal of Medicine and Nature.
In this study, tumor samples from 100 patients with non-small-cell lung cancer who had not previously received systemic therapy were collected and sequenced. 327 tumor regions to define evolutionary histories were analyzed, obtaining a census of clonal and subclonal events, and assessing the relationship between intratumor heterogeneity and recurrence-free survival.
The researchers found that patients with a high proportion of unstable chromosomes in their tumors had an increased risk of recurrence or death within two years (hazard ratio, 4.9). They also found that blood tests for chromosome instability could identify patients at high risk for relapse up to a year before imaging could confirm recurrence.
The study offers new insights into how tumors evolve and evade treatment, a leading cause of cancer death.
http://www.nejm.org/doi/full/10.1056/NEJMoa1616288#iid=f01
