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Aromatase Expression Predicts Survival in Women with Early-Stage Non–Small Cell Lung Cancer

Departments of ¹ Pathology and Laboratory Medicine, and ² Medicine, ³ Jonsson Comprehensive Cancer Center, ⁴ Department of Biostatistics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; and ⁵ Departments of Thoracic/Head and Neck Medical Oncology and Pathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas

Requests for reprints: Lee Goodglick, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, 10833 Le Conte Avenue, Box 951732, CHS, Los Angeles, CA 90095-1747. Phone: 310-825-9134; Fax: 310-267-2104; E-mail: lgoodglick{at}mednet.ucla.edu.

Estrogen signaling is critical in the progression of tumors that bear estrogen receptors. In most patients with breast cancer, inhibitors that block interactions of estrogen with its receptors or suppress the production of endogenous estrogens are important interventions in the clinic. Recent evidence now suggests that estrogen also contributes to the pathogenesis of non–small cell lung cancer (NSCLC). We used a human lung cancer xenograph model system to analyze the effect of aromatase or estradiol on tumor growth. We further examined the level of protein expression of aromatase in 422 patients with NSCLC using a high-density tissue microarray. Results were confirmed and validated on an independent patient cohort (n = 337). Lower levels of aromatase predicted a greater chance of survival in women 65 years and older. Within this population, the prognostic value of aromatase was greatest in earlier stage lung cancer (stage I/II). In addition, for women with no history of smoking, lower aromatase levels were a strong predictor of survival. Our findings implicate aromatase as an early-stage predictor of survival in some women with NSCLC. We predict that women whose lung cancers have higher levels of aromatase might be good candidates for targeted treatment with aromatase inhibitors. [Cancer Res 2007;67(21):10484–90]

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