(ChemotherapyAdvisor) – High protein expression of the combination of vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR)1, and VEGFR2 was associated with lower risk of disease progression in patients with stage 1 squamous cell carcinoma (SCC) but not adenocarcinoma histology, a study published in the Journal of Clinical Oncology online February 21, 2012 concluded.

“This was a striking result, given that anti-VEGF therapy is considered a major anticancer treatment strategy,” the investigators wrote. “For early lung SCC, these results challenge the established paradigm that high VEGF expression is associated with poor prognosis. These data also suggest that the strategy of targeting the VEGF pathway in patients with stage I NSCLC with squamous histology requires a clearer understanding of the molecular mechanisms specifically involved in the biology of these tumors.”

The investigators used automatic immunostaining to evaluate VEGF, VEGFR1, and VEGFR2 tumor cell expression in 298 patients with early-stage NSCLC recruited as part of the multicenter European Early Lung Cancer Detection Group project and calculated a VEGF signaling pathway score.

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The prognostic value of VEGF pathway expression was found to differ significantly between SCC and adenocarcinoma, with a high score associated with a lower risk of disease progression in SCC vs. a trend toward poor prognosis for early adenocarcinoma. Results validated in two additional independent cohorts of patients with NSCLC confirmed these findings.