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VEGF and survival in lung cancer

VEGF and survival

VEGF score was measured by immunohistochemical staining. High- and low-immunohistochemical-expressing groups were defined relative to the median staining score (2.5) for the entire study population. For example, a tumour with an immunohistochemical staining score ≥2.5 was defined as having high VEGF expression.2

Adapted from Yuan 2000. Reproduced with permission from the International Journal of Cancer (Predictive Oncology).

VEGF is associated with decreased patient survival

Yuan and colleagues demonstrated that high VEGF expression is correlated with a decreased rate of survival in patients with NSCLC.

  • In their study of 72 patients with stage I–III NSCLC, patients whose tumours expressed high levels of VEGF had a significantly shorter median survival following surgical resection than patients with low-VEGF-expressing tumours (16.0 vs 45.0 months, p<0.001).
  • This relationship held true even after results were stratified for tumour stage (see figure above).2

MVD and survival in lung cancer

Like VEGF overexpression, microvessel count has also been correlated with a range of tumour characteristics and outcomes in lung cancer, including tumour size and metastasis, cancer recurrence and overall and disease-free survival.2,7,15,16

  • In one of the largest studies evaluating the relationship between angiogenesis and survival in lung cancer, Fontanini and colleagues prospectively assessed samples from 407 stage I–III NSCLC patients.
  • In a multivariate analysis that also assessed tumour size and regional lymph node status as prognostic variables, they found that increased MVD was strongly associated with poorer survival (p<0.00001).17
 

In 2006, Bremnes and colleagues conducted a meta-analysis of 16 studies of patients with either small cell lung cancer or NSCLC.

  • Their analysis confirmed that both VEGF expression and MVD are prognostic factors for poor survival, with a HR of 1.8–2.0 for MVD and 1.5 for tumoural VEGF expression.
  • Note that a HR >1 indicates a poorer prognosis.6