(ChemotherapyAdvisor) – A molecular diagnostic assay reliably identified patients with nonsquamous non–small-cell lung cancer (NSCLC) at high risk for mortality after survival resection, results of a study reported online first January 27 in The Lancet has found.

The quantitative-PCR-based 14-gene expression assay “was the strongest predictor of five-year mortality compared with standard criteria such as sex, age, smoking status, tumor size, and even disease stage, and outperformed National Comprehensive Cancer Network guidelines used to identify high-risk patients with stage I disease,” said Michael J. Mann, MD, and David M. Jablons, MD, of the University of California, San Francisco, and colleagues.

“This assay provides prognostic differentiation of patients with early stage disease and might be helpful in the identification of the most appropriate application of treatment guidelines to improve clinical outcomes,” they added.

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The assay was independently validated in a cohort of 433 patients with stage I nonsquamous NSCLC in California and a cohort of 1,006 patients with stage I-III nonsquamous NSCLC in China. The assay improved prognostic accuracy beyond NCCN criteria for stage I high-risk tumors (P<0.0001) and differentiated patients at low-, intermediate-, and high-risk within all disease stages, the study found.