Prognostic impact of TTF-1 expression in patients with stage IV lung adenocarcinomas Journal Article


Authors: Schilsky, J. B.; Ni, A.; Ahn, L.; Datta, S.; Travis, W. D.; Kris, M. G.; Chaft, J. E.; Rekhtman, N.; Hellmann, M. D.
Article Title: Prognostic impact of TTF-1 expression in patients with stage IV lung adenocarcinomas
Abstract: Objectives Thyroid transcription factor 1 (TTF-1) is routinely tested in the diagnostic evaluation of suspected lung cancers, is commonly expressed by lung adenocarcinomas, and may modulate lung cancer biology. We examined the role of TTF-1 as a predictive and prognostic marker in patients with advanced lung adenocarcinomas. Materials and methods We analyzed clinical, pathologic, and molecular features, treatments received, and overall survival obtained from the medical records of 479 consecutive patients at a single site with stage IV lung adenocarcinomas and evaluable TTF-1 expression. TTF-1 expression was determined by immunohistochemistry using antibody 8G7G3/1. Results and conclusion TTF-1 expression was evaluable in 479 (75%) of all patients reviewed, and was positive in 383 (80%, 95% CI 76–83%). Clinicopathologic features were similar between TTF-1 positive and TTF-1 negative tumors, except EGFR mutations were more common in TTF-1 positive cases (24% vs 6%, p < 0.001). In univariate analysis, overall survival was significantly longer in patients with TTF-1 positive versus TTF-1 negative tumors (18 months vs 9 months, p < 0.0001). In multivariate analysis, TTF-1 positivity remained associated with better overall survival (HR = 0.38, p < 0.0001), exceeding the prognostic impact of Karnofsky performance status >/= 80% (HR 0.62, p = 0.0003) and receipt of first-line combination chemotherapy or targeted therapy (HR relative to first-line single agent chemotherapy 0.59, p = 0.05 and 0.51, p = 0.05 respectively). Both patients with TTF-1 positive and TTF-1 negative cancers had longer durations of initial therapy when treated with pemetrexed-based chemotherapy. In patients with advanced lung adenocarcinomas, TTF-1 expression is associated with better survival but is not predictive of distinct benefit from pemetrexed-based chemotherapy. © 2017 Elsevier B.V.
Keywords: chemotherapy; lung adenocarcinoma; biomarker; non-small-cell lung cancer; thyroid transcription factor 1
Journal Title: Lung Cancer
Volume: 108
ISSN: 0169-5002
Publisher: Elsevier Ireland Ltd.  
Date Published: 2017-06-01
Start Page: 205
End Page: 211
Language: English
DOI: 10.1016/j.lungcan.2017.03.015
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 2 June 2017 -- Source: Scopus
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MSK Authors
  1. Natasha Rekhtman
    210 Rekhtman
  2. Jamie Erin Chaft
    127 Chaft
  3. William D Travis
    548 Travis
  4. Linda Su Hyun Ahn
    7 Ahn
  5. Mark Kris
    605 Kris
  6. Matthew David Hellmann
    168 Hellmann
  7. Ai   Ni
    48 Ni
  8. Sutirtha Datta
    2 Datta