The Predictive Value of Fragile-site Associated Tumor Suppressor (FATS) Gene Expression on the Sensitivity of Cisplatin in Advanced Non-Small Cell Lung Cancer

Background Cisplatin based chemotherapy regimens have been the standard of care for the treatment of advanced stage non-small cell lung cancer, however not all patients respond adequately to the treatment. We therefore assessed the expression of Fragile-site Associated Tumor Suppressor (FATS) gene and the response to cisplatin.
Patients and methods: A prospective longitudinal study will be conducted in NCI (National Cancer Institute) medical oncology department in outpatient setting, in the period between June 2012 and July 2014. The study included 70 patients with pathologically proven advanced (stage IIIB and IV) non-small cell lung cancer treated with Cisplatin-based regimens. The primary end point was progression free survival (PFS) while the secondary end points were overall survival (OS) and overall response rate (ORR).
Results: Seventy patients were assessed and only 57 patients were evaluated for the trial. Ten patients achieved partial response while 6 patients achieved stable disease and rest had a progressive disease. Median PFS was 4.1 months (95% CI 2.1-6.2) in the low expression group which was not statistically different compared to 3.8 months (95% CI 3.3-4.3) in the high expression group (p= 0.442) while the median OS was statistically significant in high expression group [6.9 months (95% CI 5.4-8.3) compared to low expression group [4.5 months (95% CI 3.7-5.3)] (p= 0.031).
Conclusion: The expression of the FATS gene can have an implication on the response to cisplatin and the overall survival. This opens the opportunity that FATS gene can be used as a predictive marker for NSCLC patients receiving cisplatin-based chemotherapy.