Analysis of Brain Metastasis in Patients With Lung Cancer

Introduction: The molecular and genetic events that permit tumor metastasis are not well understood. The process whereby tumor cells escape the primary, local tumor, spread to distant sites in the body and find and create conditions conducive to growth in these disparate tissues remains an area of intense investigation. Metastasis of epithelial tumors, such as lung cancer, to the brain is a common problem, with significant consequences with respect to neurological dysfunction and shortening of survival. Objective: To study two subset of patients with non small cell lung cancer (NSCLC) metastatic to the brain, to identify genes and proteins that facilitate metastasis. Study Population: 78 patients with NSCLC (n=39 squamous cell (SQ), and n=39 adenocarcinoma (AC) tumors) metastatic to the brain to compare with published microarray studies of non-metastatic NSCLC patients with these tumor types as well as with one another to help explain the differential trend toward metastasis in some patients with NSCLC and not others, as well as the differential trend to brain metastasis in the AC subtype. Anticipated Risks and Benefits: Less than minimal risk to the patients to sample tissue already removed from the brain as part of medically-necessary surgery and to sample blood. No direct benefit to the patient is expected. Outcome Estimate and Potential Meaning for the Field: That this very detailed investigation of the genes and proteins expressed differentially between the non-metastatic and metastatic NSCLCs, as well as between SQ and AC subtypes will identify new or previously-unsuspected targets for new therapies to either prevent the development of brain metastasis or to treat brain metastases more effectively.