Search

Sex differences in incidence, prognosis, and treatment response have been described for many cancers. In malignant pleural mesothelioma (MPM), a lethal disease associated with asbestos exposure, men outnumber women 4 to 1, but women consistently live longer than men following surgery-based therapy. This study investigated whether tumor expression of genes associated with estrogen signaling could potentially explain observed survival differences. Two microarray datasets of MPM tumors were analyzed to discover estrogen-related genes associated with survival. A validation cohort of MPM tumors was selected to balance the numbers of men and women and control for competing prognostic influences. The RAS like estrogen regulated growth inhibitor (RERG) gene was identified as the most differentially-expressed estrogen-related gene in these tumors and predicted prognosis in discovery datasets. In the sex-matched validation cohort, low RERG expression was significantly associated with increased risk of death among women. No association between RERG expression and survival was found among men, and no relationship between estrogen receptor protein or gene expression and survival was found for either sex. Additional investigations are needed to elucidate the molecular mechanisms underlying this association and its sex specificity. Published version

Complete surgical resection is the main therapy for early-stage non-small cell lung cancer. Survival rates remain, at best, 80% for stage IA, necessitating the development of effective systemic therapy. Several large randomized control trials and meta-analyses provide evidence for the use of adjuvant chemotherapy for stage I to III, and are the basis for the standards of care. Cisplatin-based adjuvant chemotherapy regimens have shown 4% to 15% survival advantage at 5 years. Given this modest survival benefit, research is focused on the identification of prognostic and predictive markers to aid in the selection of appropriate adjuvant chemotherapy regimens.