Sir,
We would like to thank Gianluigi Ferreti and his colleagues for their interest in our systematic review.
In their letter, Ferreti et al. interrogated on the prognostic role of Ras in NSCLC. They cited seven studies with apparent conflicting results. Some comments have to be made. First, we discussed in our articles the controversial results of the literature relative to biological prognostic factors, justifying the need for meta-analyses, as we reported with K-Ras (Mascaux et al, 2005) and other biomarkers previously such as p53, bcl2, VEGF, Neu, Ki-67 or EGFR.
Secondly, we have some concerns with the studies cited by Ferreti et al. Some of these articles were not included in our systematic review for the following reasons:
-
no prognostic analysis (Ferretti et al, 2000);
-
no survival prognostic analysis but assessment of the predictive role of K-Ras for response to chemotherapy (Eberhard et al, 2005; Winton et al, 2005);
-
assessment of K-Ras mutation on resected tumours after induction chemotherapy (Broermann et al, 2002);
-
publication after the deadline for the selection of the studies to be included in the meta-analysis (Zhu et al, 2004).
The last two studies that Ferreti et al commented (Moldvay et al, 2000; Schiller et al, 2001) were included in our systematic review and were aggregated with the 26 other evaluable studies for meta-analysis.
In conclusion, our systematic review showed that K-Ras is a potential prognostic factor for survival in lung cancer according to the literature published on this topic till end of 2003. The predictive role of K-Ras for response to chemotherapy and the impact of K-Ras mutation on survival in patients receiving induction chemotherapy before surgery were not the subjects of our meta-analysis and need further investigations.
Change history
16 November 2011
This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication
References
Broermann P, Junker K, Brandt BH, Heinecke A, Freitag L, Klinke F, Berdel WE, Thomas M (2002) Trimodality treatment in Stage III nonsmall cell lung carcinoma: prognostic impact of K-ras mutations after neoadjuvant therapy. Cancer 94: 2055–2062
Eberhard DA, Johnson BE, Amler LC, Goddard AD, Heldens SL, Herbst RS, Ince WL, Janne PA, Januario T, Johnson DH, Klein P, Miller VA, Ostland MA, Ramies DA, Sebisanovic D, Stinson JA, Zhang YR, Seshagiri S, Hillan KJ (2005) Mutations in the epidermal growth factor receptor and in KRAS are predictive and prognostic indicators in patients with non-small-cell lung cancer treated with chemotherapy alone and in combination with erlotinib. J Clin Oncol 23: 5900–5909
Ferretti G, Curigliano G, Pastorino U, Cittadini A, Flamini G, Calabro MG, De PT, Orlando L, Mandala M, Colleoni M, Spaggiari L, Granone PL, Pagliari G, de BF, Fazio N, Goldhirsch A (2000) Detection by denaturant gradient gel electrophoresis of tumor-specific mutations in biopsies and relative bronchoalveolar lavage fluid from resectable non-small cell lung cancer. Clin Cancer Res 6: 2393–2400
Mascaux C, Iannino N, Martin B, Paesmans M, Berghmans T, Dusart M, Haller A, Lothaire P, Meert AP, Noel S, Lafitte JJ, Sculier JP (2005) The role of RAS oncogene in survival of patients with lung cancer: a systematic review of the literature with meta-analysis. Br J Cancer 92: 131–139
Moldvay J, Scheid P, Wild P, Nabil K, Siat J, Borrelly J, Marie B, Farre G, Labib T, Pottier G, Sesboue R, Bronner C, Vignaud JM, Martinet Y, Martinet N (2000) Predictive survival markers in patients with surgically resected non-small cell lung carcinoma. Clin Cancer Res 6: 1125–1134
Schiller JH, Adak S, Feins RH, Keller SM, Fry WA, Livingston RB, Hammond ME, Wolf B, Sabatini L, Jett J, Kohman L, Johnson DH (2001) Lack of prognostic significance of p53 and K-ras mutations in primary resected non-small-cell lung cancer on E4592: a Laboratory Ancillary Study on an Eastern Cooperative Oncology Group Prospective Randomized Trial of Postoperative Adjuvant Therapy. J Clin Oncol 19: 448–457
Winton T, Livingston R, Johnson D, Rigas J, Johnston M, Butts C, Cormier Y, Goss G, Inculet R, Vallieres E, Fry W, Bethune D, Ayoub J, Ding K, Seymour L, Graham B, Tsao MS, Gandara D, Kesler K, Demmy T, Shepherd F (2005) Vinorelbine plus cisplatin vs observation in resected non-small-cell lung cancer. N Engl J Med 352: 2589–2597
Zhu CQ, Blackhall FH, Pintilie M, Iyengar P, Liu N, Ho J, Chomiak T, Lau D, Winton T, Shepherd FA, Tsao MS (2004) Skp2 gene copy number aberrations are common in non-small cell lung carcinoma, and its overexpression in tumors with ras mutation is a poor prognostic marker. Clin Cancer Res 10: 1984–1991
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/
About this article
Cite this article
Mascaux, C., on behalf of the authors. Reply: K-Ras: a prognostic factor for survival in non-small cell lung cancer. Br J Cancer 94, 1549 (2006). https://doi.org/10.1038/sj.bjc.6603113
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bjc.6603113
