Diagnostic methods for determining prognosis of non-small cell lung cancer

摘要

The invention provides methods for identifying early stage non-small cell lung cancer (NSCLC) patients who will have a favorable prognosis for the recurrence of lung cancer after surgical resection. The invention is based on the discovery that assessment of chromosomal copy number abnormalities at two or more of chromosome 5p15, 7p12, 8q24 and centromere 6 can be used for prognostic classification. The invention preferably uses fluorescence in situ hybridization with fluorescently labeled nucleic acid probes to hybridize to patient samples to quantify the chromosomal copy number of the these genetic loci. Assessment of the copy number abnormality patterns using four classifiers produced statistically significant prognostic classification for NSCLC: (i) the Range3 pattern of cells showing a difference on a cell by cell basis, of at least three FISH probe signals between the FISH signals at the chromosomal locus with the largest number of FISH signals minus the FISH signals at the chromosomal locus with the lowest number of FISH signals; (ii) the MYC/EGFR % loss pattern assessing the percentage of cells showing fewer MYC FISH probe signals than EGFR FISH probe signals; (iii) a combination of the Range3 pattern and the MYC/CEP6 ratio pattern of a percentage of cells showing a relative loss of MYC FISH probe signals to the FISH probe signal for CEP6; (iv) the combination of the MYC/5p15 ratio pattern showing the relative ratio of MYC and 5p15 locus signals of ≧0.80 and the 5p15/CEP6 ratio pattern assessing percentage of cells having a relative ratio of 5p15 FISH probe signals to CEP6 FISH probe signals ≧1.1 versus MYC/5p15 ratio of <0.80 or 5p15/CEP6<1.1; and (v) a combination of the average range of probe signal differences of equal to or greater than about 2.5 with the Range3 pattern in a percentage of the cells. The invention can be used to identify those early stage NSCLC patients at higher risk of recurrence who should be treated with neoadjuvant chemotherapy before surgery or with adjuvant chemotherapy after surgery.

主权项

1. A method of determining prognosis of lung cancer in a human patient, the method comprising:
(a) obtaining a biological sample comprising malignant lung cells from a human patient classified as having Stage IB, IIA, or IIB non-small cell lung cancer; (b) contacting the biological sample with a set of chromosomal probes comprising at least two probes selected from a group consisting of a chromosome 5p15.2 locus specific probe, a chromosome 8q24 locus specific probe that includes the C-MYC gene, a chromosome 6 enumeration probe, and a chromosome 7p12 locus specific probe that includes the EGFR gene under conditions sufficient to enable hybridization of probes in the set to chromosomes in the sample, if any, wherein each of the chromosomal probes is directly labeled with a fluorescent label that can be separately detected; (c) detecting in a population of said malignant lung cells a hybridization pattern of the set of chromosomal probes, wherein the hybridization pattern indicates the percentage of cells in which the difference between the number of probe signals in the locus with the greatest number of probes and the number of probe signals in the locus with the lowest number of probe signals is greater than three; (d) providing a prognosis of lung cancer in the patient based upon the hybridization pattern detected in step (c), wherein said percentage of cells is at least 42% and the prognosis is an increased time to recurrence (TTR) after surgical resection, or said percentage of cells is less than 42% and the prognosis is a decreased TTR after surgical resection, and (e) administering adjuvant chemotherapy post-surgery or administering neoadjuvant chemotherapy before surgery when the percentage of cells in step (c) is less than 42%.