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SPARC is a possible predictive marker for albumin-bound paclitaxel in non-small-cell lung cancer

Authors Komiya K, Nakamura T, Nakashima C, Takahashi K, Umeguchi H, Watanabe N, Sato A, Takeda Y, Kimura S, Sueoka-Aragane N

Received 7 June 2016

Accepted for publication 13 September 2016

Published 27 October 2016 Volume 2016:9 Pages 6663—6668

DOI https://doi.org/10.2147/OTT.S114492

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Yao Dai


Kazutoshi Komiya,1 Tomomi Nakamura,1 Chiho Nakashima,1 Koichiro Takahashi,1 Hitomi Umeguchi,1,2 Naomi Watanabe,1 Akemi Sato,1 Yuji Takeda,1,3 Shinya Kimura,1 Naoko Sueoka-Aragane1

1Department of Internal Medicine, Division of Hematology, Respiratory Medicine and Oncology, Faculty of Medicine, Saga University, 2Japanese Red Cross Karatsu Hospital, 3Department of Thoracic Surgery, Faculty of Medicine, Saga University, Saga, Japan

Objectives: Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) produced good tumor response in cases with lung squamous cell carcinoma, one of the most difficult cancers to treat. Secreted protein acidic and rich in cysteine (SPARC) binds to albumin, suggesting that SPARC plays an important role in tumor uptake of nab-paclitaxel. There is as yet no predictive marker for cytotoxic agents against non-small-cell lung cancer (NSCLC), and hence we believed that SPARC expression might be associated with tumor response to nab-paclitaxel.
Patients and methods: We studied stromal SPARC reactivity and its association with clinicopathological characteristics in 200 cases of NSCLC using a custom tissue microarray fabricated in our laboratory by immunohistochemical staining. We also investigated the relationship between stromal SPARC reactivity and tumor response to nab-paclitaxel using biopsy or surgical specimens obtained from advanced or recurrent lung cancer patients.
Results: High SPARC stromal reactivity (>50% of optical fields examined) was detected in 16.5% of cases and intermediate SPARC reactivity (10%–50%) in 56% of cases. High expression in cancer cells was rare (five cases). Stromal SPARC level was correlated with smoking index, squamous cell carcinoma, and vessel invasion. Furthermore, patients with high stromal SPARC reactivity in biopsy specimens such as transbronchial lung biopsy or surgical specimens tended to respond better to nab-paclitaxel.
Conclusion: Stromal SPARC was detected by immunohistochemical staining in ~70% of NSCLC cases, and good tumor response to nab-paclitaxel was correlated with high stromal SPARC reactivity. SPARC may be a useful predictive marker for selecting patients likely to respond favorably to nab-paclitaxel treatment.

Keywords: lung cancer, nab-paclitaxel, SPARC, predictive marker, squamous cell carcinoma

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