Expression of phosphorylated Akt in patients with small cell carcinoma of the lung indicates good prognosis

Patients with pulmonary small cell carcinoma are well known to have a poor prognosis. However, predictors of prognosis and treatment outcome have not been reported for this type of cancer. We examined whether excision repair cross-complementation group 1 (ERCC1), phosphorylated Akt (p-Akt), phosphorylated mammalian target of rapamycin (p-mTOR), and the uridine diphosphate glucuronosyl transferase1A1 (UGT1A1) genetic polymorphism were useful indicators of prognosis in cases of small cell carcinoma of the lung. We investigated 45 patients with advanced small cell lung cancer who received chemotherapy with irinotecan combined with cisplatin or carboplatin. Staining results showed that 12 of 45 cases (27%) were positive for p-Akt, while 18 (40%) were positive for p-mTOR and 16 (36%) were positive for ERCC1. As for UGT1A1, more than one polymorphism was found in 30 cases (67%). There was a significant relationship observed between the expressions of p-Akt and p-mTOR (P = 0.0006). Univariate analysis indicated a significantly better survival rate for patients positive for p-Akt or p-mTOR, while multivariate analysis using a Cox test showed p-Akt to be the strongest prognostic factor. Our results indicate that p-Akt is a reliable prognostic factor in patients with small cell carcinoma of the lung.