Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTSTUESDAY MORNINGMAY 12, 20097:00 a.m. GENERAL THORACIC FORUM SESSIONRoom 302–306, Hynes Convention Center(5 minutes presentation, 7 minutes discussion)Moderators: Yolonda L. Colson, David S. SchrumpF10. MAGE-A3 Expression Is an Independent Determinant ofWorse Survival in Stage IA Non-Small Cell Lung CancerJeffrey L. Port, 1 Sacha Gnjatic, 2 Otavia Caballero, 2 Ramon Chua, 2Achim A. Jungbluth, 2 Gerd Ritter, 2 Cathy A. Ferrara, 1 Paul C. Lee, 1Lloyd J. Old, 2 Nasser K. Altorki 1*1. Weill Cornell Medical College/NY Presbyterian Hospital, New York, NY,USA; 2. Ludwig Institute for Cancer Research, New York, NY, USAInvited Discussant: Dao M. NguyenOBJECTIVE: MAGE-A3 is a tumor specific antigen that belongs to the cancer –testis (CT) gene family. MAGE-A3 is expressed in 40–50% of non-small cell lungcancer (NSCLC) and its expression is negatively correlated with survival. Membersof the CT antigen family are considered ideal targets for tumor immunotherapyand a randomized trial is currently underway to evaluate the efficacy of MAGE-A3vaccination in the adjuvant setting for stage IB-IIIA NSCLC (MAGRIT). However,no information is available about the expression of MAGE-A3 in early stage disease.In this study we examined the expression of MAGE-A3 in patients withresected IA disease using tumor tissues from an institutional tissue bank linked toa prospectively established clinical database.METHODS: Fresh tumor tissue was obtained at surgery from stage IA patientswho underwent curative resection (1996–2008) without preoperative therapy. TotalRNA was extracted for semiquanitiative RT-PCR. Univariate analysis was performedusing the Wilcoxon rank sum and the chi-square test, as appropriate. The effect ofexpression on overall survival (OS) was evaluated using the Kaplan-Meier methodand differences between groups compared by the log-rank test. The independentimpact of MAGE-A3 expression on survival was calculated using a multivariableCox regression model. Informed consent for tissue banking was obtained and thecurrent study was approved by the IRB and patient consent was waived.RESULTS: 195 stage IA patients (117 female) with a median age of 69, a mediantumor size of 2.0 cm, and a median follow-up of 3.8 years were analyzed. PositiveMAGE-A3 expression was seen in 56% of patients and was significantly correlated* AATS Member136