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Journal of Thoracic Oncology:
doi: 10.1097/JTO.0b013e3181a1099a
Letters to the Editor

Validation of a Reverse Transcription-Polymerase Chain Reaction-Based Five-Gene Signature in Non-small Cell Lung Cancer

Ruco, Luigi MD; Scarpino, Stefania PhD; Natoli, Guido MD

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Author Information

University “La Sapienza”; 00139 Rome; Italy;

Disclosure: The authors declare no conflict of interest.

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To the Editor:

Last year in the New England Journal of Medicine Chen et al.1 stated that a five-gene quantitative polymerase-chain-reaction assay stratified patients with early-stage lung cancer into low-risk and high-risk groups. Indeed, they concluded that patient with surgically resected non-small cell lung cancer that were classified as first group might be spared from adjuvant treatment. In contrast, Michiels and Hill2 observed that to correctly validate such signature a different and independent group of patients needed to be used. In addition, Dobbin3 noted that the reuse of survival data to identify a predictor genes provide substantial bias. Taken together, these observations provide a rationale for an independent validation of such molecular signature. To do that, we analyzed a population of 38 non-small cell lung cancer patients with stage I disease and untreated after lobar resection. Using methods as described,1 we did not find difference among 19 patients who had cancer-related death within 30months after resection and 19 patients who were alive within 40 months after resection (5-gene high risk = 7/12 versus 8/11; Fisher’s exact test p = 1).

Luigi Ruco, MD

Stefania Scarpino, PhD

Guido Natoli, MD

University “La Sapienza”

00139 Rome


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1. Chen HY, Yu SL, Chen CH, et al. A five-gene signature and clinical outcome in non–small-cell lung cancer. N Engl J Med 2007;356:11–20.

2. Michiels S, Hill C. Five-gene signature in non-small-cell lung cancer. N Engl J Med 2007;356:1581–1582.

3. Dobbin KK. Five-gene signature in non-small-cell lung cancer. N Engl J Med 2007;356:1582.

© 2009International Association for the Study of Lung Cancer


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