<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2017-0020_s_015_w2aab3b8c82b1b7b1aab1c16b1Aa"><h3>Background</h3><p>The insulin-like growth factor 1 receptor (IGF1R) expression has been addressed as a potential prognostic marker in non-small-cell lung cancer (NSCLC) in various studies; however, the associations between IGF1R expression and prognosis of advanced NSCLC patients is still controversial. The aim of our observational, cohort study was to evaluate the expression of IGF1R in advanced NSCLC and its prognostic role. A subgroup analysis was performed to address the influence of pre-existing type 2 diabetes mellitus (T2DM) status on IGF1R expression and overall survival (OS).</p></sec><sec id="j_raon-2017-0020_s_016_w2aab3b8c82b1b7b1aab1c16b2Aa"><h3>Patients and methods</h3><p>IGF1R expression was evaluated in 167 consecutive advanced NSCLC patients (stage IIIB and IV), diagnosed and treated at one university institution, between 2005 and 2010. All patients received at least one line of standard cytotoxic therapy and 18 of them had pre-existing T2DM. IGF1R expression was determined by immunohistochemical (IHC) staining, with score ≥ 1+ considered as positive. Information on baseline characteristics, as well as patients’ follow-up data, were obtained from the hospital registry. Associations of IGF1R expression with clinical characteristics and overall survival were compared.</p></sec><sec id="j_raon-2017-0020_s_017_w2aab3b8c82b1b7b1aab1c16b3Aa"><h3>Results</h3><p>IGF1R expression was positive in 79.6% of patients, significantly more often in squamous-cell carcinoma (SCC) compared to non-squamous-cell (NSCC) histology (88.7% vs. 74.3%; P = 0.03). IGF1R positivity did not correlate with T2DM status or with other clinical features (sex, smoking status, performance status). Median OS was similar between IGF1R positive and IGF1R negative group (10.2 vs. 8.5 months, <italic>P</italic> = 0.168) and between patients with or without T2DM (8.7 vs. 9.8 months, <italic>P =</italic> 0.575). Neither IGF1R expression nor T2DM were significant predictors of OS.</p></sec><sec id="j_raon-2017-0020_s_018_w2aab3b8c82b1b7b1aab1c16b4Aa"><h3>Conclusions</h3><p>IGF1R or T2DM status were not significantly prognostic in described above collective of advanced NSCLC treated with at least one line of chemotherapy. In addition, no association between T2DM status and IGF1R expression was found. Further studies on IGF1R expression and its prognostic as well as therapeutic consequences in a larger collective of advanced NSCLC patients, with or without T2DM, are needed.</p></sec></abstract>

BackgroundThe insulin-like growth factor 1 receptor (IGF1R) expression has been addressed as a potential prognostic marker in non-small-cell lung cancer (NSCLC) in various studies; however, the associations between IGF1R expression and prognosis of advanced NSCLC patients is still controversial. The aim of our observational, cohort study was to evaluate the expression of IGF1R in advanced NSCLC and its prognostic role. A subgroup analysis was performed to address the influence of pre-existing type 2 diabetes mellitus (T2DM) status on IGF1R expression and overall survival (OS).Patients and methodsIGF1R expression was evaluated in 167 consecutive advanced NSCLC patients (stage IIIB and IV), diagnosed and treated at one university institution, between 2005 and 2010. All patients received at least one line of standard cytotoxic therapy and 18 of them had pre-existing T2DM. IGF1R expression was determined by immunohistochemical (IHC) staining, with score ≥ 1+ considered as positive. Information on baseline characteristics, as well as patients’ follow-up data, were obtained from the hospital registry. Associations of IGF1R expression with clinical characteristics and overall survival were compared.ResultsIGF1R expression was positive in 79.6% of patients, significantly more often in squamous-cell carcinoma (SCC) compared to non-squamous-cell (NSCC) histology (88.7% vs. 74.3%; P = 0.03). IGF1R positivity did not correlate with T2DM status or with other clinical features (sex, smoking status, performance status). Median OS was similar between IGF1R positive and IGF1R negative group (10.2 vs. 8.5 months, P = 0.168) and between patients with or without T2DM (8.7 vs. 9.8 months, P = 0.575). Neither IGF1R expression nor T2DM were significant predictors of OS.ConclusionsIGF1R or T2DM status were not significantly prognostic in described above collective of advanced NSCLC treated with at least one line of chemotherapy. In addition, no association between T2DM status and IGF1R expression was found. Further studies on IGF1R expression and its prognostic as well as therapeutic consequences in a larger collective of advanced NSCLC patients, with or without T2DM, are needed.

Insulin-like growth factor 1 receptor expression in advanced non-small-cell lung cancer and its impact on overall survival

Radiology and Oncology

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BackgroundThe insulin-like growth factor 1 receptor (IGF1R) expression has been addressed as a potential prognostic marker in non-small-cell lung cancer...

Variable	IGF1R positive No (%)	IGF1R negative No (%)	P value
All patients	133 (79.6%)	34 (20.4%)
Histology			0.03
- NSCC	78 (74.3%)	27 (25.7%)
- SCC	55 (88.7%)	7 (11.3%)
Sex			0.17
- Male	98 (82.4%)	21 (17.6%)
- Female	35 (72.9%)	13 (27.1%)
Smoking status			0.77
- Current/former smoker	116 (80.0%)	29 (20.0%)
- Never smoker	17 (77.3%)	5 (22.7%)
ECOG - PS			0.97
- 0–1	121 (79.6%)	31 (20.4%)
- ≥ 2	12 (80.0%)	3 (20.0%)
Diabetes mellitus type 2			0.84
- No	119 (79.9%)	30 (20.1%)
- Yes	14 (77.8%)	4 (22.2%)

Variable	No (%)
All patients	167 (100%)
Histology
- NSCC	105 (62.9%)
- SCC	62 (37.1%)
Sex
- Male	119 (71.3%)
- Female	48 (28.7%)
Smoking status
- Current/former smoker	145 (86.8%)
- Never smoker	22 (13.2%)
ECOG-PS
- 0-1	152 (91.0%)
- ≥ 2	15 (9.0%)
Diabetes mellitus type 2
- No	149 (89.2%)
- Yes	18 (10.8%)
IGF1R expression
- Positive	133 (79.6%)
- Negative	34 (20.4%)

Variable	Univariate Analysis			Multivariate Analysis

	HR	95%CI	P value	HR	95%CI	P value
Histology
SCC vs NSCC	1.097	0.798–1.509	0.569	1.249	0.885–1.763	0.206
Sex
Male vs female	1.396	0.994–1.961	0.054	1.390	0.939–2.057	0.100
Smoking status
Current/former smoker vs. non-smoker	1.692	1.064–2.689	0.026	1.509	0.908–2.510	0.113
ECOG-PS
0.1 vs ≥ 2	0.600	0.351–1.025	0.061	0.589	0.341–1.015	0.057
Diabetes mellitus type 2
Yes vs No	0.869	0.531–1.423	0.576	0.828	0.498–1.378	0.468
IGF1R
Positive vs negative	0.766	0.523–1.121	0.170	0.776	0.518–1.162	0.219

Insulin-like growth factor 1 receptor expression in advanced non-small-cell lung cancer and its impact on overall survival

Article Category: Research Articles

Published Online: Apr 26, 2017

Page range: 195 - 202

Received: Oct 16, 2016

Accepted: Nov 08, 2016

DOI: https://doi.org/10.1515/raon-2017-0020

© 2017 Mojca Humar, Izidor Kern, Gregor Vlacic, Vedran Hadzic, Tanja Cufer

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

IHC IGF1R expression by histological/clinical characteristics and diabetes mellitus

Patient and tumour characteristics

Univariate and multivariate analysis of overall survival