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Review
. 2014 Jul;31(3):249-59.
doi: 10.4103/0970-2113.135767.

Usage patterns of biomarkers in non-small-cell lung cancer patients in India: Findings from a systematic review and survey

Chirag Desai  1 , Anurag Mehta  2 , Divya Mishra  3
Affiliations
Review

Usage patterns of biomarkers in non-small-cell lung cancer patients in India: Findings from a systematic review and survey

Chirag Desai et al. Lung India. 2014 Jul.

Abstract

Introduction: Personalized medicine has facilitated improved management of non-small cell lung cancer (NSCLC) patients by identifying predictive and prognostic biomarkers for enhanced efficiency of detection and efficacy of treatment. This systematic review and survey assessed the patterns of biomarker usage, molecular testing techniques to diagnose patients with NSCLC in India and testing techniques recommended by cancer societies.

Materials and methods: Studies were retrieved from Embase, PubMed, and Cochrane databases for the last 12 years, using relevant search strategies as per the Cochrane methodology for systematic reviews. Outcomes of interest were biomarkers for NSCLC, patterns of biomarker testing, diagnostic methods, guidelines and cost of biomarker testing.

Results: In all, 499 studies were identified for screening and 17 primary publications were included in the review. Epidermal growth factor receptor (EGFR) expression and epithelial markers (particularly cytokeratins (CK)) were the most commonly reported biomarkers (7/17) and immunohistochemical (IHC) staining was the most common technique for detection of biomarkers. The frequency of EGFR mutations was higher among women than men. Significantly elevated levels of CK-18 were observed in patients with squamous cell carcinoma and of CK-19 in patients with adenocarcinoma, squamous cell carcinoma, and NSCLC (P < 0.001). Prognostic or predictive role of cytokines and angiogenic markers as well as DNA expression were evaluated. The survey also showed that IHC was the most common technique for detection of biomarkers.

Conclusions: This systematic review and survey provides valuable information on biomarker usage in the Indian population, and highlights the need for initiatives required for future biomarker testing in India.

Keywords: Biomarkers; India; non small cell lung cancer; prognosis; tumor markers.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Trial flow as per PRISMA statement
Figure 2
Figure 2
General perception for the usage of biomarkers in India
Figure 3
Figure 3
Testing techniques for detection of biomarkers. FISH: fluorescence in situ hybdridization; IHC: Immunohistochemical; PCR: Polymerase chain reaction
Figure 4
Figure 4
Payment options for testing biomarkers in India. A: Patient out-of-pocket; B: Reimbursed by public health care system; C: It comes out of prescribing oncologist budget; D: Mostly used for research and paid by organization performing the research; E: Supported by pharmaceutical manufacturer; F: Reimbursed by patient' private insurance; G: The lab performing the test pays for it.
See this image and copyright information in PMC

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References

    1. Majumdar A, Puri T. Evolution of systemic therapy in advanced non-small-cell lung cancer. Journal, Indian Academy of Clinical Medicine. 2012;13:138–41.
    1. Pathak AK, Bhutani M, Mohan A, Guleria R, Bal S, Kochupillai V. Non small cell lung cancer (NSCLC): Current status and future prospects. Indian J Chest Dis Allied Sci. 2004;46:191–203. - PubMed
    1. Behera D. Lung cancer in India. Med Update. 2012;22:401–7.
    1. Boyer MJ. Drug therapy for lung cancer. Aust Prescr. 2003;26:103–5.
    1. Shaw AT, Yeap BY, Mino-Kenudson M, Digumarthy SR, Costa DB, Heist RS, et al. Clinical features and outcome of patients with non-small-cell lung cancer who harbor EML4-ALK. J Clin Oncol. 2009;27:4247–53. - PMC - PubMed