IDENTIFICATION OF NOVEL BIOMARKERS FOR LUNG CANCER RISK IN HIGH LEVELS OF RADON BY PROTEOMICS: A PILOT STUDY.

Radon is the second most important risk factor for lung cancer after tobacco smoking. In Chiang Mai, Thailand, the values of indoor radon activity concentrations are considerably higher than global average values and it is a highest level among East Asian countries. The aim of our study is to identify novel biomarkers for lung cancer risk in high radon areas using a proteomic approach. In our transitional study, a total of 81 participants of non-smokers were examined, consist of 25 lung cancer patients (LC), 16 healthy controls from low levels of natural radiation areas (LLNRA) and 40 healthy controls from high levels of natural radiation areas (HLNRA). The results showed that a total of 799 differentially expressed proteins were identified. Among these, a total of 25 proteins were observed in both LC and HLNRA, but not in LINRA. Owing to the results obtained from this study, we also point out the research direction regarding the validation of some new candidate protein as a biomarker to screen population with high risk for lung cancer in the area with high levels of radon.

Preliminary study of efficacy of intravenous cisplatin plus oral etoposide in small cell lung cancer.

Twenty-three patients with small cell lung cancer were treated with combination chemotherapy consisting of Cisplatin at 100 mg/m2 given by 2 hours intravenous infusion on day 1 and oral etoposide 25 mg/caplet given twice a day for 21 days repeated every 28 days for 6 cycles. Of 23 cases, four cases were not evaluable due to early death (three of them died from febrile neutropenia). Median age of the patients was 59 years (range = 45-76 years). Five cases were female and eighteen cases were male. Median Karnofsky performance status was 70 per cent (range = 50-90%). Five cases were extensive disease and eighteen cases were limited disease. Of 5 extensive disease cases, 1 complete response (20%) and 3 partial responses (60%) were achieved. Of 14 limited disease patients, 1 complete response (7.1%) and 11 partial responses (78.6%) were achieved. Hematologic toxicities were severe causing three patients to die because of febrile neutropenia, nine cases (10.7%) had grade 3 and 4 neutropenia. Grade 3 and 4 anemia and thrombocytopenia were seen in 28.6 per cent and 8.3 per cent respectively. Median survival time of all cases was 7 months. Thus, the combination of intravenous cisplatin and prolonged administration of oral etoposide could be administered to small cell lung cancer patients with high response rate, however, because of its severe toxicities, special caution should be considered and the optimal duration of oral etoposide should be evaluated.

Combination of gemcitabine and cisplatin in advanced non-small cell lung cancer.

A prospectively designed phase II study of non-small cell lung cancer stage IIIb and IV treated by gemcitabine and cisplatin was studied. The dosage of gemcitabine was 1 g/m2 weekly on day 1, 8 and 15. Cisplatin 100 mg/m2 was given on day 15 of each 28 day cycle. Twenty-eight patients were treated and all cases were evaluated for response. Survival and toxicity were determined in all enrolled patients. Thirteen (46.4%) achieved partial response (PR). By using Kaplan Meier's method the mean survival time was 19.8 months. One year survival was 66.6 per cent. Non hematologic toxicity consisted of mild nausea, vomiting, alopecia and hyperpigmentation of the skin. Rising creatinine of grade I was seen in 1.6 per cent. Anemia and leukopenia were common hematologic side effects with 27.5 per cent and 14.2 per cent of patients experiencing grade III and IV toxicity respectively. Both side effects were usually short lived and responsible for the delay of gemcitabine administration on day 8 and 15 in 18.3 per cent and 23.3 per cent on day 15 alone of chemotherapeutic courses respectively. We conclude that the combination of gemcitabine and cisplatin at this dosage achieved good response with moderate side effects.