Abstract
Introduction
Class-III-beta-tubulin (TUBB3) expression may be a potential predictive factor for treatment with microtubule interfering cytotoxic drugs in non-small cell lung cancer (NSCLC). Potential changes in TUBB3 expression during chemotherapy may be of interest if future choice of chemotherapy is to be based on TUBB3 expression. If the biomarker expression changes during chemotherapy, biopsies before initiation of chemotherapy beyond first line may be needed if treatment decision is to be based on TUBB3 expression. Thus, the aim was to explore TUBB3 expression heterogeneity and changes during chemotherapy.
Materials and methods
TUBB3 expression was investigated by immunohistochemistry performed on diagnostic biopsies and on available subsequent resection specimens in 65 NSCLC patients stage T1-3N0-2 who received neoadjuvant carboplatin and paclitaxel (NAC-group). Another group of 53 NSCLC patients stage T1-4N0-1 was treated with surgery alone without preceding chemotherapy (OP-group). Paired repeated samples were compared in order to evaluate for changes in TUBB3 expression.
Results
No statistically significant change in TUBB3 expression was observed between initial diagnostic biopsies and subsequent surgical resections of primary tumors in either the OP-group (p = 0.124) or the NAC-group (p = 0.414). When dichotomized into high and low TUBB3 expression, discordance between diagnostic biopsies and resection specimens of the primary tumors occurred in 22 % and 40 % in the OP-group and NAC-group, respectively (p = 0.169). Significantly more patients having low TUBB3 expression experienced down-staging during neoadjuvant chemotherapy compared to patients having high TUBB3 expression (p = 0.022).
Conclusion
A high degree of discordance of TUBB3 expression between paired repeated tumor samples was observed, which likely reflects intratumoral heterogeneity. This emphasizes a need for optimal tumor tissue samples in order to stratify patients based on TUBB3 expression. No significant changes in TUBB3 expression after neoadjuvant carboplatin and paclitaxel chemotherapy occurred, suggesting no need for rebiopsy in case second-line chemotherapy with microtubule interfering cytotoxic treatments is necessary.
Similar content being viewed by others
References
Vilmar A, Santoni-Rugiu E, Sørensen JB (2010) ERCC1, toxicity and quality of life in advanced NSCLC patients randomized in a large multicentre phase III trial. Eur J Cancer 46(9):1554–1562
Takezawa K, Okamoto I, Okamoto W, Takeda M, Sakai K, Tsukioka S, Kuwata K, Yamaguchi H, Nishio K, Nakagawa K (2011) Thymidylate synthase as a determinant of pemetrexed sensitivity in non-small cell lung cancer. Br J Cancer 104(10):1594–1601
Vilmar AC, Santoni-Rugiu E, Sorensen JB (2012) Predictive impact of RRM1 protein expression on vinorelbine efficacy in NSCLC patients randomly assigned in a chemotherapy phase III trial. Ann Oncol 24(2):309–314
Vilmar AC, Santoni-Rugiu E, Sørensen JB (2011) Class III β-tubulin in advanced NSCLC of adenocarcinoma subtype predicts superior outcome in a randomized trial. Clin Cancer Res 17(15):5205–5214
Hwang IG, Ahn MJ, Park BB, Ahn YC, Han J, Lee S, Kim J, Shim YM, Ahn JS, Park K (2008) ERCC1 expression as a prognostic marker in N2(+) non small-cell lung cancer patients treated with platinum-based neoadjuvant concurrent chemoradiotherapy. Cancer 113(6):1379–1386
Koh Y, Jang B, Han SW, Kim TM, Oh DY, Lee SH, Kang CH, Kim DW, Im SA, Chung DH, Kim YT, Kim TY, Kim YW, Kim JH, Heo DS, Bang YJ (2010) Expression of class III beta-tubulin correlates with unfavorable survival outcome in patients with resected non-small cell lung cancer. J Thorac Oncol 5(3):320–325
Ferlini C, Raspaglio G, Cicchillitti L, Mozzetti S, Prislei S, Bartollino S, Scambia G (2007) Looking at drug resistance mechanisms for microtubule interacting drugs: does TUBB3 work? Curr Cancer Drug Targets 7(8):704–712
Levallet G, Bergot E, Antoine M, Creveuil C, Santos AO, Beau-Faller M, de Fraipont F, Brambilla E, Levallet J, Morin F, Westeel V, Wislez M, Quoix E, Debieuvre D, Dubois F, Rouquette I, Pujol JL, Moro-Sibilot D, Camonis J, Zalcman G (2012) Intergroupe Francophone de CancérologieThoracique (IFCT): high TUBB3 expression, an independent prognostic marker in patients with early non-small cell lung cancer treated by preoperative chemotherapy, is regulated by K-Ras signaling pathway. Mol Cancer Ther 11(5):1203–1213
Yuan SF, Zhu LJ, Zheng WE, Chen H, Wu LL, Zhang W, Sun HY, Chen WJ (2012) Expression of β-tubulin III and survivin in advance stage breast cancer correlates with chemotherapeutic effects of docetaxel. Asian Pac J Cancer Prev 13(1):361–365
Gao S, Zhao X, Lin B, Hu Z, Yan L, Gao J (2012) Clinical implications of REST and TUBB3 in ovarian cancer and its relationship to paclitaxel resistance. Tumour Biol 33(5):1759–1765
Vilmar AC, Santoni-Rugiu E, Sørensen JB (2010) ERCC1 and histopathology in advanced NSCLC patients randomized in a large multicenter phase III trial. Ann Oncol 21(9):1817–1824
Olaussen KA, Dunant A, Fouret P, Brambilla E, André F, Haddad V, Taranchon E, Filipits M, Pirker R, Popper HH, Stahel R, Sabatier L, Pignon JP, Tursz T, Le Chevalier T, Soria JC (2006) IALT bio investigators: DNA repair by ERCC1 in non-small-cell lung cancer and cisplatin-based adjuvant chemotherapy. N Engl J Med 355(10):983–991
Nicolson MC, Fennell DA, Ferry D, O’Byrne K, Shah R, Potter V, Skailes G, Upadhyay S, Taylor P, André V, Nguyen TS, Myrand SP, Visseren-Grul C, Das M, Kerr KM (2013) Thymidylate synthase expression and outcome of patients receiving pemetrexed for advanced nonsquamous non-small-cell lung cancer in a prospective blinded assessment phase II clinical trial. J Thorac Oncol 8(7):930–939
Bepler G, Williams C, Schell MJ, Chen W, Zheng Z, Simon G, Gadgeel S, Zhao X, Schreiber F, Brahmer J, Chiappori A, Tanvetyanon T, Pinder-Schenck M, Gray J, Haura E, Antonia S, Fischer JR (2013) Randomized international phase III trial of ERCC1 and RRM1 expression-based chemotherapy versus gemcitabine/carboplatin in advanced non-small-cell lung cancer. J Clin Oncol 31(19):2404–2412
Ferlini C, Raspaglio G, Mozzetti S, Cicchillitti L, Filippetti F, Gallo D, Fattorusso C, Campiani G, Scambia G (2005) The seco-taxane IDN5390 is able to target class III beta-tubulin and to overcome paclitaxel resistance. Cancer Res 65(6):2397–2405
Lee SC, Xu X, Chng WJ, Watson M, Lim YW, Wong CI, Iau P, Sukri N, Lim SE, Yap HL, Buhari SA, Tan P, Guo J, Chuah B, McLeod HL, Goh BC (2009) Post-treatment tumor gene expression signatures are more predictive of treatment outcomes than baseline signatures in breast cancer. Pharmacogenet Genomics 19(11):833–842
Chuah BYS, Putti T, Salto-Tellez M, Charlton A, Iau P, Buhari SA, Wong CI, Tan SH, Wong ALA, Chan CW, Goh BC, Lee SC (2011) Serial changes in the expression of breast cancer-related proteins in response to neoadjuvant chemotherapy. Ann Oncol 22(8):1748–1754
Jakobsen J, Santoni-Rugiu E, Ravn J, Sorensen J (2013) Intratumor variation of biomarker expression by immunohistochemistry in resectable non-small cell lung cancer. Eur J Cancer 49:2494–2503
Meert AP, Martin B, Verdebout JM, Paesmans M, Berghmans T, Ninane V, Sculier JP (2004) Correlation of different markers (p53, EGF-R, c-erbB-2, Ki-67) expression in the diagnostic biopsies and the corresponding resected tumors in non-small cell lung cancer. Lung Cancer 44(3):295–301
Taillade L, Penault-Llorca F, Boulet T, Fouret P, Michiels S, Taranchon E, Mountzios G, Validire P, Domont J, Girard P, Grunenwald D, Le Chevalier T, Soria JC (2007) Immunohistochemical expression of biomarkers: a comparative study between diagnostic bronchial biopsies and surgical specimens of non-small-cell lung cancer. Ann Oncol 18(6):1043–1050
Pápay J, Sápi Z, Egri G, Gyulai M, Szende B, Losonczy G, Tímár J, Moldvay J (2009) Platinum-based chemotherapy in lung cancer affects the expression of certain biomarkers including ERCC1. Pathol Oncol Res 15(3):445–450
De Pas T, Pelosi G, de Braud F, Veronesi G, Curigliano G, Leon ME, Danesi R, Noberasco C, d’Aiuto M, Catalano G, Viale G, Spaggiari L (2004) Modulation of epidermal growth factor receptor status by chemotherapy in patients with locally advanced non-small-cell lung cancer is rare. J Clin Oncol 22(24):4966–4970
Junker K, Stachetzki U, Rademacher D, Linder A, Macha HN, Heinecke A, Müller KM, Thomas M (2005) HER2/neu expression and amplification in non-small cell lung cancer prior to and after neoadjuvant therapy. Lung Cancer 48(1):59–67
Bai H, Wang Z, Chen K, Zhao J, Lee JJ, Wang S, Zhou Q, Zhuo M, Mao L, An T, Duan J, Yang L, Wu M, Liang Z, Wang Y, Kang X, Wang J (2012) Influence of chemotherapy on EGFR mutation status among patients with non-small-cell lung cancer. J Clin Oncol 30(25):3077–3083
Taniguchi K, Okami J, Kodama K, Higashiyama M, Kato K (2008) Intratumor heterogeneity of epidermal growth factor receptor mutations in lung cancer and its correlation to the response to gefitinib. Cancer Sci 99(5):929–935
Ferrandina G, Zannoni GF, Martinelli E, Paglia A, Gallotta V, Mozzetti S, Scambia G, Ferlini C (2006) Class III beta-tubulin overexpression is a marker of poor clinical outcome in advanced ovarian cancer patients. Clin Cancer Res 12(9):2774–2779
Okuda K, Sasaki H, Dumontet C, Kawano O, Yukiue H, Yokoyama T, Yano M, Fujii Y (2008) Expression of excision repair cross-complementation group 1 and class III beta-tubulin predict survival after chemotherapy for completely resected non-small cell lung cancer. Lung Cancer 62(1):105–112
Reiman T, Lai R, Veillard AS, Paris E, Soria JC, Rosell R, Taron M, Graziano S, Kratzke R, Seymour L, Shepherd FA, Pignon JP, Sève P (2012) LACE-Bio group: cross-validation study of class III beta-tubulin as a predictive marker for benefit from adjuvant chemotherapy in resected non-small-cell lung cancer: analysis of four randomized trials. Ann Oncol 23(1):86–93
Azuma K, Sasada T, Kawahara A, Takamori S, Hattori S, Ikeda J, Itoh K, Yamada A, Kage M, Kuwano M, Aizawa H (2009) Expression of ERCC1 and class III beta-tubulin in non-small cell lung cancer patients treated with carboplatin and paclitaxel. Lung Cancer 64(3):326–333
Ikeda S, Takabe K, Suzuki K (2009) Expression of ERCC1 and class III beta tubulin for predicting effect of carboplatin/paclitaxel in patients with advanced inoperable non-small cell lung cancer. Pathol Int 59(12):863–867
Acknowledgments
We thank Camilla Cordua Mortensen, Heidi Ugleholdt, and Lone Svendstrup for expert technical assistance. This study was supported by the Danish Cancer Research Foundation, Arvid Nillsons Foundation, Torben and Alice Frimodts Foundation, Aase and Ejnar Danielsens Foundation, Eva and Henry Fraenkels Foundation, The Danish Research Foundation, Snedkermester Sophus Jacobsen and Hustru Astrid Jacobsens Foundation, The Foundation for the Promotion of Medical Cancer Treatment, and The Research Foundation of the Department of Oncology, Rigshospitalet.
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Jakobsen, J.N., Santoni-Rugiu, E. & Sørensen, J.B. Longitudinal assessment of TUBB3 expression in non-small cell lung cancer patients. Cancer Chemother Pharmacol 73, 43–51 (2014). https://doi.org/10.1007/s00280-013-2315-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00280-013-2315-6