Lung Cancer in Women: The Differences in Epidemiology, Biology and Treatment Outcomes

Maria Patricia Rivera

Disclosures

Expert Rev Resp Med. 2009;3(6):627-634. 

In This Article

DNA Repair Capacity

DNA repair is an important defense mechanism that is critical to maintaining the integrity of the genome and repairing the damage from exposure to exogenous environmental toxins, as well as endogenous damage.[35] As mentioned earlier, DNA adducts are associated with a subsequent risk of lung cancer in both smokers and nonsmokers.[36,37] A complex family of proteins exists to remove and repair damaged DNA segments. Wei et al. evaluated the repair of tobacco carcinogen-induced DNA adducts and lung cancer risk, and found that younger patients, those with a family history of lung cancer and female patients had a lower DNA repair capacity and a higher lung cancer risk.[38] In a larger case–control study, the mean DNA repair capacity for 764 patients with lung cancer was 7.82% (± 2.82) compared with 8.79% (± 3.87) for 677 control subjects.[35] In this study, the DNA repair capacity was significantly lower in women (7.46%) compared with men (8.15%; p < 0.001) and younger patients exhibited a lower DNA repair capacity than their matched control subjects.[35] DNA adducts were reported to be significantly higher in nonsmoking Taiwanese women compared with nonsmoking men, suggesting a decreased DNA repair capacity in the former.[39] While a decreased DNA repair capacity places women at increased risk for lung cancer, it also may play a role in improved survival, for as it turns out, owing to decreased DNA repair capacity, women with lung cancer may have better response and improved survival after treatment with platinum-based chemotherapy due to decreased levels of the DNA repair enzyme excision repair cross-complementation group 1 (ERCC1).[40]

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