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Noro R, Honda K, Nagashima K, Motoi N, Kunugi S, Matsubayashi J, Takeuchi S, Shiraishi H, Okano T, Kashiro A, Meng X, Yoshida Y, Watanabe S, Usuda J, Inoue T, Wilber H, Ikeda N, Seike M, Gemma A, Kubota K. ACTN4 gene amplification is a predictive biomarker for adjuvant chemotherapy with UFT in stage I lung adenocarcinomas. Cancer Sci 2021; 113:1002-1009. [PMID: 34845792 PMCID: PMC8898703 DOI: 10.1111/cas.15228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 11/27/2022] Open
Abstract
Although adjuvant tegafur/uracil (UFT) is recommended for patients with completely resected stage I non‐small‐cell lung cancer (NSCLC) in Japan, only one‐third of cases has received adjuvant chemotherapy (ADJ) according to real‐world data. Therefore, robust predictive biomarkers for selecting ADJ or observation (OBS) without ADJ are needed. Patients who underwent complete resection of stage I lung adenocarcinoma with or without adjuvant UFT were enrolled. The status of ACTN4 gene amplification was analyzed by FISH. Statistical analyses to determine whether the status of ACTN4 gene amplification affected recurrence‐free survival (RFS) were carried out. Formalin‐fixed, paraffin‐embedded samples from 1136 lung adenocarcinomas were submitted for analysis of ACTN4 gene amplification. Ninety‐nine (8.9%) of 1114 cases were positive for ACTN4 gene amplification. In the subgroup analysis of patients aged 65 years or older, the ADJ group had better RFS than the OBS group in the ACTN4‐positive cohort (hazard ratio [HR], 0.084, 95% confidence interval [CI], 0.009‐0.806; P = .032). The difference in RFS between the ADJ group and the OBS group was not significant in ACTN4‐negative cases (all ages: HR, 1.214; 95% CI, 0.848‐1.738; P = .289). Analyses of ACTN4 gene amplification contributed to the decision regarding postoperative ADJ for stage I lung adenocarcinomas, preventing recurrence, improving the quality of medical care, preventing the unnecessary side‐effects of ADJ, and saving medical costs.
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Affiliation(s)
- Rintaro Noro
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazufumi Honda
- Department of Biomarkers for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan.,Department of Bioregulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kengo Nagashima
- Research Center for Medical and Health Data Science, Keio University Hospital, Tokyo, Japan
| | - Noriko Motoi
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.,Department of Pathology, Saitama Cancer Center, Saitama, Japan
| | - Shinobu Kunugi
- Department of Analytic Human Pathology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Matsubayashi
- Department of Anatomical Pathology, Tokyo Medical University, Tokyo, Japan
| | - Susumu Takeuchi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.,Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Hideaki Shiraishi
- Department of Biomarkers for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan
| | - Tetsuya Okano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.,Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Ayumi Kashiro
- Department of Biomarkers for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan.,Department of Bioregulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Xue Meng
- Department of Biomarkers for Early Detection of Cancer, National Cancer Center Research Institute, Tokyo, Japan.,Department of Bioregulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yukihiro Yoshida
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Shunichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Jitsuo Usuda
- Department of Thoracic Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Tatsuya Inoue
- Department of Thoracic Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Huang Wilber
- Abnova, 9th Floor, No. 108, Jhouzih Street, Neihu District, Taipei City, 114, Taiwan
| | - Norihiko Ikeda
- Department of Surgery, Tokyo Medical University, Tokyo, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Akihiko Gemma
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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