DNA Methylation Markers and Early Recurrence in Stage I Lung Cancer

Methylation of the promoter region of a gene is a mechanism that influences gene expression. In this study of patients with stage I non–small-cell lung cancer (NSCLC), methylation of seven genes — p16, CDH13, APC, RASSF1A, MGMT, ASC, and DAPK — from tumor and lymph-node specimens was studied. Four genes ( p16, CDH13, RASSF1A, and APC ), when methylated, were associated with recurrence after surgery with curative intent. In this study of patients with stage I non–small-cell lung cancer, methylation of seven genes from tumor and lymph-node specimens was studied. Four genes, when methylated, were associated with recurrence after surgery with curative intent. Surgery with curative intent is the standard of care for patients with stage I non–small-cell lung cancer (NSCLC), yet notwithstanding advances in treatment, the dissemination of tumor cells outside the area of curative resection is a leading cause of relapse. 1 – 3 Despite surgery, approximately 30 to 40% of patients with NSCLC who have discrete lesions and histologically negative lymph nodes (stage I cancer; T1–2N0, according to the tumor–node–metastasis [TNM] classification criteria) die of recurrent disease. 4 – 6 Many of these recurrences are systemic, making it likely that such patients had occult micrometastases beyond the margins of surgical resection. 4 Epigenetic gene silencing . . .