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Sakon K, Sasaki M, Tanaka K, Mizunaga T, Yano K, Kawamura Y, Okada A, Ikeda T, Tanabe S, Takamori A, Yamada N, Morioka K, Koshiji T. Intratumoral gene expression of dihydrofolate reductase and folylpoly-c-glutamate synthetase affects the sensitivity to 5-fluorouracil in non-small cell lung cancer. Discov Oncol 2021; 12:19. [PMID: 35201464 PMCID: PMC8777502 DOI: 10.1007/s12672-021-00413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/16/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Various factors related to the sensitivity of non-small cell lung carcinoma (NSCLC) to 5-fluorouracil (5-FU) have been reported, and some of them have been clinically applied. In this single-institutional prospective analysis, the mRNA expression level of five folic acid-associated enzymes was evaluated in surgical specimens of NSCLC. We investigated the correlation between the antitumor effect of 5-FU in NSCLC using an anticancer drug sensitivity test and the gene expression levels of five enzymes. MATERIALS AND METHODS Forty patients who underwent surgery for NSCLC were enrolled, and the antitumor effect was measured using an in vitro anticancer drug sensitivity test (histoculture drug response assay) using freshly resected specimens. In the same sample, the mRNA expression levels of five enzymes involved in the sensitivity to 5-FU were measured in the tumor using real-time PCR. The expression levels and the result of the sensitivity test were compared. RESULTS No correlation was found between dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), or DPD/OPRT expression and the antitumor effects of 5-FU. On the other hand, a correlation was found between thymidylate synthase (TS), folylpoly-c-glutamate synthetase (FPGS), and dihydrofolate reductase (DHFR) expression and 5-FU sensitivity. CONCLUSION Expression of FPGS and DHFR may be useful for predicting the efficacy of 5-FU-based chemotherapy for NSCLC.
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Affiliation(s)
- Kayo Sakon
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Masato Sasaki
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Kaede Tanaka
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Tae Mizunaga
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Keita Yano
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Yuuko Kawamura
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Akitoshi Okada
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Takeshi Ikeda
- Department of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjyuku-ku, Tokyo, 162-8655 Japan
| | - Sawaka Tanabe
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Atsushi Takamori
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Narihisa Yamada
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Kouichi Morioka
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Takaaki Koshiji
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
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A phase II trial of carboplatin plus S-1 for elderly patients with advanced non-small-cell lung cancer with wild-type epidermal growth factor receptor: The Okayama Lung Cancer Study Group Trial 1202. Lung Cancer 2017; 112:188-194. [DOI: 10.1016/j.lungcan.2017.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 07/30/2017] [Accepted: 08/09/2017] [Indexed: 02/01/2023]
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Lu B, Zhang H, Zhang T, Cai Y, Hu Y, Zheng H, Li B. Topoisomerase I expression is associated with prognosis in postoperative non-small cell lung cancer patients. Thorac Cancer 2016; 7:486-94. [PMID: 27385993 PMCID: PMC4930970 DOI: 10.1111/1759-7714.12359] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/05/2016] [Indexed: 11/30/2022] Open
Abstract
Background Biomarkers may help to improve non‐small cell lung cancer (NSCLC) prognosis. However, the prognostic effect of topoisomerase I (Topo I) on NSCLC is unknown. We evaluated the clinicopathologic and prognostic significance of tumor Topo I and thymidylate synthase (TS) protein expression in postoperative NSCLC patients. Methods One hundred and fifteen patients with postoperative NSCLC were enrolled. Topo I and TS protein were detected in removed tumors by immunohistochemistry. The correlations between Topo I/TS protein expression and clinicopathologic characters and outcomes of patients were analyzed. Results Increased expression of Topo I was found in 57 (49.6%) tumors. The largest diameter of the tumor was significantly different between patients with high and low Topo I expression (P = 0.035). TS staining showed that 35 (30.4%) carcinomas were TS positive. The level of TS expression was correlated with tumor differentiation (P = 0.037). Patients with low Topo I expression had significantly longer overall survival (OS) than those with high expression (P = 0.004). The correlation between Topo I expression and OS was demonstrated among patients with squamous cell carcinoma (P = 0.030) and patients in pathological tumor node metastasis stage I (P = 0.027). Topo I expression was positively correlated with TS expression in tumor tissue (R = 0.251, P = 0.007). Conclusions Low Topo I expression is an independent favorable prognostic factor for longer OS in postoperative NSCLC patients, especially in squamous cell carcinoma. There is a correlation between the expression of TS and Topo I in removed tumor tissue.
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Affiliation(s)
- Baohua Lu
- Division of Medical Oncology Beijing Chest Hospital, Capital Medical University Beijing China
| | - Hongmei Zhang
- Division of Medical Oncology Beijing Chest Hospital, Capital Medical University Beijing China
| | - Tongmei Zhang
- Division of Medical Oncology Beijing Chest Hospital, Capital Medical University Beijing China
| | - Yiran Cai
- Division of Pathology Beijing Chest Hospital, Capital Medical University Beijing China
| | - Ying Hu
- Division of Medical Oncology Beijing Chest Hospital, Capital Medical University Beijing China
| | - Hua Zheng
- Division of Medical Oncology Beijing Chest Hospital, Capital Medical University Beijing China
| | - Baolan Li
- Division of Medical Oncology Beijing Chest Hospital, Capital Medical University Beijing China
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Ma Y, Lin Y, Zou B, Liu W, Zhang Y, Zhao L, Huang Y, Yang Y, Fang W, Zhao Y, Sheng J, Qin T, Hu Z, Zhang L, Zhao H. Pharmacokinetic and Pharmacodynamic Analyses of 5-Fluorouracil in East-Asian Patients with Nasopharyngeal Carcinoma. Clin Pharmacokinet 2016; 55:1205-1216. [DOI: 10.1007/s40262-016-0395-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sun S, Shi W, Wu Z, Zhang G, Yang BO, Jiao S. Prognostic significance of the mRNA expression of ERCC1, RRM1, TUBB3 and TYMS genes in patients with non-small cell lung cancer. Exp Ther Med 2015; 10:937-941. [PMID: 26622418 DOI: 10.3892/etm.2015.2636] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 04/29/2015] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to investigate the prognostic value of excision repair cross-complementing 1 (ERCC1), ribonucleotide reductase subunit M1 (RRM1), class III β-tubulin (TUBB3) and thymidylate synthase (TYMS) in patients with non-small cell lung cancer (NSCLC) receiving platinum-based adjuvant chemotherapy. The mRNA expression of these genes was assessed in 72 tumor tissue samples obtained following surgery, using multiplex branched-DNA technology. Subsequent to surgery, all 72 patients with NSCLC were treated with platinum-based chemotherapy. The expression of these five genes was analyzed and the correlation with clinical characteristics and patient survival was investigated. Among the 72 samples, the incidence rate of mRNA expression of ERCC1 was 38.9% (28/72), RRM1 was 55.6% (40/72), TUBB3 was 47.2% (34/72) and TYMS was 62.5% (45/72). The incidence rate of ERCC1 expression in adenocarcinoma (34.2%) was significantly lower than that in non-adenocarcinoma (44.1%; P<0.05). Furthermore, the incidence rates of TYMS and TUBB3 expression in the high-median differentiation tissue samples were significantly lower than those in the low differentiation tissue samples (P<0.05). When the correlation of gene expression and patient survival was analyzed, high expression of ERCC1, RRM1, TUBB3 or TYMS was found to be associated with poor prognosis (P<0.001, P=0.001, P=0.001 and P=0.001, respectively). ERCC1, RRM1, TUBB3 and TYMS are key factors involved in survival following surgical treatment in patients with NSCLC. The mRNA expression of these genes may have prognostic value for patients with NSCLC treated with platinum-based chemotherapy.
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Affiliation(s)
- Shengjie Sun
- Department of Oncology, The General Hospital of People's Liberation Army, Beijing 100853, P.R. China
| | - Weiwei Shi
- Department of Oncology, The General Hospital of People's Liberation Army, Beijing 100853, P.R. China
| | - Zhiyong Wu
- Department of Oncology, The General Hospital of People's Liberation Army, Beijing 100853, P.R. China
| | - Guoqing Zhang
- Department of Oncology, The General Hospital of People's Liberation Army, Beijing 100853, P.R. China
| | - B O Yang
- Department of Oncology, The General Hospital of People's Liberation Army, Beijing 100853, P.R. China
| | - Shunchang Jiao
- Department of Oncology, The General Hospital of People's Liberation Army, Beijing 100853, P.R. China
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Effect of thymidylate synthase gene polymorphism on the response to chemotherapy and clinical outcome of non-small cell lung cancer patients. Tumour Biol 2015; 36:7151-7. [DOI: 10.1007/s13277-015-3447-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/08/2015] [Indexed: 12/11/2022] Open
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Eguchi K, Oyama T, Tajima A, Abiko T, Sawafuji M, Horio H, Hashizume T, Matsutani N, Kato R, Nakayama M, Kawamura M, Kobayashi K. Intratumoral gene expression of 5-fluorouracil pharmacokinetics-related enzymes in stage I and II non-small cell lung cancer patients treated with uracil-tegafur after surgery: a prospective multi-institutional study in Japan. Lung Cancer 2014; 87:53-8. [PMID: 25468199 DOI: 10.1016/j.lungcan.2014.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 09/22/2014] [Accepted: 10/23/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This investigation was conducted to assess the use of the intratumoral mRNA expression levels of nucleic acid-metabolizing enzymes as biomarkers of adjuvant chemotherapy for non-small cell lung cancer (NSCLC) using uracil-tegafur in a multi-institutional prospective study. MATERIALS AND METHODS 236 patients with a completely resected NSCLC (adenocarcinoma and squamous cell carcinoma) of pathological stage IA (maximum tumor diameter of 2 cm or greater), IB, and II tumors were given a dose of 250 mg of uracil-tegafur per square meter of body surface area per day orally for two years after surgery. Intratumoral mRNA levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), and thymidine phosphorylase (TP) genes relative to an internal standard, β-actin, were determined using laser-capture microdissection and fluorescence-based real time PCR detection systems. RESULTS AND CONCLUSION Among 5-FU target enzymes, TS was the only one that showed a significant difference in the level of gene expression between the high and low gene expression groups, for both disease-free survival (DFS) and overall survival (OS), when patients were divided according to median values; 5-year DFS rates in high/low TS gene expression were 60.4% and 72.6%, respectively (p=0.050), 5-year OS rates were 78.1% and 88.6%, respectively (p=0.011). Cox's proportional hazard model indicated that the pathological stage and TS gene expression level were independent values for predicting DFS. The TS gene expression level was shown to be an independent predictive factor for DFS in stage I and II NSCLC patients who were treated with uracil-tegafur following surgery.
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Affiliation(s)
- Keisuke Eguchi
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan; Department of General Thoracic Surgery, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan
| | - Takahiko Oyama
- Department of Pulmonology, National Hospital Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan
| | - Atsushi Tajima
- Department of General Thoracic Surgery, Saiseikai Utsunomiya Hospital, Tochigi, 911-1 Takebayashi, Utsunomiya, Tochigi 321-0974, Japan
| | - Tomohiro Abiko
- Department of General Thoracic Surgery, Kawasaki Municipal Ida Hospital, 1272 Ida, Nakahara-ku, Kawasaki, Kanagawa 211-0035, Japan
| | - Makoto Sawafuji
- Department of General Thoracic Surgery, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-ku, Kawasaki, Kanagawa 210-0013, Japan
| | - Hirotoshi Horio
- Department of General Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Toshinori Hashizume
- Department of General Thoracic Surgery, National Hospital Organization, Ibaraki-higashi Hospital, Ibaraki, Japan
| | - Noriyuki Matsutani
- Department of Surgery, School of Medicine Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
| | - Ryoichi Kato
- Department of Pulmonology, National Hospital Organization, Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan
| | - Mitsuo Nakayama
- Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Masafumi Kawamura
- Department of Surgery, School of Medicine Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
| | - Koichi Kobayashi
- Division of General Thoracic Surgery, School of Medicine Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Zhao HY, Ma GW, Zou BY, Li M, Lin SX, Zhao LP, Guo Y, Huang Y, Tian Y, Xie D, Zhang L. Prognostic significance of thymidylate synthase in postoperative non-small cell lung cancer patients. Onco Targets Ther 2014; 7:1301-10. [PMID: 25114572 PMCID: PMC4109640 DOI: 10.2147/ott.s65067] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The aim of the present study was to investigate the clinicopathologic/prognostic significance of thymidylate synthase (TS), orotate phosphoribosyltransferase (OPRT), and thymidine phosphorylase (TP) proteins in postoperative non-small cell lung cancer (NSCLC) patients. Microarray slides from a set of 178 NSCLC patients were used for the detection of TS, OPRT, and TP expression by immunohistochemistry. The correlation between clinicopathologic factors and protein expression of three proteins was analyzed. Ninety seven carcinomas (57.4%) were TS-positive, 90 carcinomas (53.9%) were OPRT-positive, and 102 carcinomas (69.4%) were TP-positive. Compared with the TS-positive patients, the overall survival (OS) was significantly lower in the TS-negative patients (hazard ratio [HR] =1.766, 95% confidence interval [CI] =1.212–2.573, P=0.003). Significant differences between TS-positive and TS-negative patients was also observed in the following stratified analyses: 1) adenocarcinoma subgroup (HR =2.079, 95% CI =1.235–3.500, P=0.006); 2) less than 60-year-old subgroup (HR =1.890, 95% CI =1.061–3.366, P=0.031); 3) stage II/III subgroup (HR =1.594, 95% CI =1.036–2.453, P=0.034); and 4) surgery plus adjuvant therapy subgroup (HR =1.976, 95% CI =1.226–3.185, P=0.005). However, the OS was not significantly correlated with OPRT or TP protein expression. This study demonstrates that the TS level in tumor tissues may be a useful marker to predict the postoperative OS in NSCLC patients.
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Affiliation(s)
- Hong-Yun Zhao
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Guo-Wei Ma
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ben-Yan Zou
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Mei Li
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Su-Xia Lin
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Li-Ping Zhao
- Department of Medical Oncology, Zhongshan Hospital of Sun Yat-Sen University, Zhongshan People's City Hospital, Zhongshan, People's Republic of China
| | - Ying Guo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Yan Huang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Ying Tian
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Dan Xie
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
| | - Li Zhang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China
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Abstract
Adjuvant chemotherapy using a cisplatin-based regimen is currently recommended for patients with stage II and III non-small cell lung cancer (NSCLC) after complete tumor resection and may be considered for patients with stage IB NSCLC. Although adjuvant chemotherapy after complete resection of localized NSCLC is associated with an absolute survival advantage of approximately 5% at 5 years, there is still a relatively high risk of relapse even for early-stage NSCLC. Efforts are ongoing to identify new treatments in the adjuvant setting and to select patients for individualized treatment based on biomarkers.
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Mascaux C, Ekman S, Dooms C, Shepherd FA. Individualized therapy in the adjuvant setting for non-small cell lung cancer (NSCLC). ACTA ACUST UNITED AC 2012. [DOI: 10.1007/s13665-012-0035-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kotoula V, Krikelis D, Karavasilis V, Koletsa T, Eleftheraki AG, Televantou D, Christodoulou C, Dimoudis S, Korantzis I, Pectasides D, Syrigos KN, Kosmidis PA, Fountzilas G. Expression of DNA repair and replication genes in non-small cell lung cancer (NSCLC): a role for thymidylate synthetase (TYMS). BMC Cancer 2012; 12:342. [PMID: 22866924 PMCID: PMC3503623 DOI: 10.1186/1471-2407-12-342] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 07/18/2012] [Indexed: 11/10/2022] Open
Abstract
Background BRCA1 (B), ERCC1 (E), RRM1 (R) and TYMS (T) mRNA expression has been extensively studied with respect to NSCLC patient outcome upon various chemotherapy agents. However, these markers have not been introduced into clinical practice yet. One of the reasons seems to be lack of a standard approach for the classification of the reported high/low mRNA expression. The aim of this study was to determine the prognostic/predictive impact of B, E, R, T in routinely-treated NSCLC patients by taking into account the expression of these genes in the normal lung parenchyma. Methods B, E, R, T mRNA expression was examined in 276 NSCLC samples (real-time PCR). The normal range of B, E, R, T transcript levels was first determined in matched tumor – normal pairs and then applied to the entire tumor series. Four main chemotherapy categories were examined: taxanes-without-platinum (Tax); platinum-without-taxanes (Plat); taxanes/platinum doublets (Tax/Plat); and, all-other combinations. Results In comparison to remotely located normal lung parenchyma, B, E, R, T mRNA expression was generally increased in matched tumors, as well as in the entire tumor series. Therefore, tumors were classified as expressing normal or aberrant B, E, R, T mRNA. In general, no marker was associated with overall and progression free survival (OS, PFS). Upon multivariate analysis, aberrant intratumoral TYMS predicted for shorter PFS than normal TYMS in 1st line chemo-naïve treated patients (p = 0.012). In the same setting, specific interactions were observed for aberrant TYMS with Plat and Tax/Plat (p = 0.003 and p = 0.006, respectively). Corresponding patients had longer PFS in comparison to those treated with Tax (Plat: HR = 0.234, 95% CI:0.108-0.506, Wald’s p < 0.0001; Tax/Plat: HR = 0.242, 95% CI:0.131-0.447, Wald’s p < 0.0001). Similar results were obtained for PFS in 1st line chemo-naïve and (neo)adjuvant pre-treated patients. Adenocarcinoma, early disease stage, and treatment with Tax/Plat doublets independently predicted for prolonged OS in patients who received only one line of treatment (adjuvant or 1st line). Conclusion Classifying intratumoral B, E, R, T mRNA expression in comparison to normal lung may facilitate standardization of these parameters for prospective studies. With this approach, NSCLC patients with aberrant intratumoral TYMS expression will probably fare better with platinum-based treatments.
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Affiliation(s)
- Vassiliki Kotoula
- Department of Pathology, Aristotle University of Thessaloniki School of Medicine, Greece.
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Nakajima T, Yasufuku K, Suzuki M, Hiroshima K, Nakatani Y, Fujisawa T, Yoshino I. Thymidylate Synthase, Dihydropyrimidine Dehydrogenase, Thymidine Phosphorylase, Orotate Phosphoribosyltransferase mRNA Expression in Lung Cancer Metastatic Lymph Node Samples Obtained by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration – A Pilot Study. Clin Lung Cancer 2011; 12:293-7. [DOI: 10.1016/j.cllc.2011.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Revised: 12/12/2010] [Accepted: 01/10/2011] [Indexed: 10/17/2022]
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Abstract
Lung cancer is the leading cause of cancer-related mortality in the United States with 222,520 new cases and 157,300 deaths anticipated in 2010. The primary objective of any cancer treatment is to improve patient outcomes including overall survival and quality of life while minimizing treatment toxicity. As our knowledge of the molecular mechanisms involved in the pathogenesis of lung cancer evolves, improved methods of therapeutic selection may help clinicians better realize these goals. Such selection may be accomplished by examining biomarkers within patients' tumors that may provide prognostic information such as risk of recurrence in early stage disease or predict benefit from specific therapies regardless of disease stage. Three such biomarkers have emerged--excision repair cross-complementation group 1, the regulatory subunit of the ribonucleotide reductase enzyme, and thymidylate synthase--and are actively being evaluated in patients with non-small cell lung cancer. This review will focus on the role of these biomarkers as predictive and/or prognostic markers in the selection of chemotherapy regimens in non-small cell lung cancer patients.
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