Purpose: The purpose of this study was to characterize insulin receptor (IR) and insulin-like growth factor-1 receptor (IGF-1R) expression in patients with non-small cell lung cancer (NSCLC).

Methods: A total of 459 patients who underwent curative resection of NSCLC were studied (median follow-up duration, 4.01 years). Expression of the IR and IGF-1R protein in tumor specimens was assessed immunohistochemically using tissue microarrays.

Results: The cytoplasmic IR score was higher in patients with adenocarcinoma (ADC) than in those with squamous cell carcinoma (SCC) whereas cytoplasmic IGF-1R was higher in patients with SCC than those with ADC. Neither IR nor IGF-1R expression was associated with sex, smoking history, or clinical stage. Patients with positive IR or IGF-1R expression levels had poor recurrence-free (3.8 vs. 3.3 years; 3.8 vs. 2.0 years, respectively) but similar overall survival durations. Patients with high expression levels both IR and IGF-1R had shorter recurrence-free and overall survival compared to those with low levels of IR and/or IGF-1R expression. IGF-1R and IR expressions were negatively correlated with survival duration of patients with ADC and SCC, respectively. Finally, a multivariate analysis revealed the impact of IR, but not IGF-1R, as an independent prognostic predictor of survival: hazard ratio (HR) for OS, 1.005 (95% confidence interval [CI], 1.001 – 1.010], HR for RFS, 0.608 (95% CI, 1.001 – 1.009) when tested as a continuous variable.

Conclusions: Overexpression of IR, but not IGF-1R, appears to foretell a poor survival among patients with NSCLC, especially those with SCC. Thus, expression of IR has a negative prognostic value and future clinical trials with therapy interventions of IR regulation should be under the consideration for this patient population.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1122. doi:10.1158/1538-7445.AM2011-1122