A Systematic Review and Meta-Analysis of Gene Expression Prognostic Signatures in Lung Cancer

• Activity Number: 306
• Type: Contributed
• Date/Time: Tuesday, August 5, 2014 : 8:30 AM to 10:20 AM
• Sponsor: Biometrics Section
• Author(s): Hao Tang*+ and Guanghua Xiao and Joan Schiller and Vassiliki Papadimitrakopoulou and John Minna and Ignacio Wistuba and Yang Xie
• Companies: University of Texas Southwestern Medical Center and University of Texas Southwestern Medical Center and University of Texas Southwestern Medical Center and MD Anderson Cancer Center and University of Texas Southwestern Medical Center and MD Anderson Cancer Center and University of Texas Southwestern Medical Center
• Keywords: non-small-cell lung cancer ; prognostic gene signatures ; meta-analysis

Abstract

More precise diagnosis of non-small-cell lung cancer (NSCLC) could improve treatment plans for individual patients. The goal of this study is to identify the most promising mRNA expression prognostic signatures in NSCLC for further prospective clinical validation. We performed a systematic review and meta-analysis of 42 published prognostic signatures for resected NSCLC. The prognostic performance of each signature was evaluated via a meta-analysis of 1,927 early stage NSCLC patients collected from 15 studies using three metrics (hazard ratios, concordance scores, and time-dependent receiver operating characteristic curves). Among the 42 gene signatures, 35 can significantly separate the predicted high- and low-risk groups, 29 have prognostic power after adjusting for clinical risk factors and 22 perform significantly better than random signatures. When analyzing histology types separately, 19 and 10 signatures are prognostic for adenocarcinoma and squamous cell histology, respectively. Based on this large-scale meta-analysis together with practical considerations, we recommend a set of mRNA expression prognostic signatures for further validation in prospective clinical studies.