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Wang X, Zhu X, Zhang H, Fan X, Xue X, Chen Y, Ding C, Zhao J, Wu G. ERCC1_202 Is A Prognostic Biomarker in Advanced Stage Non-Small Cell Lung Cancer Patients Treated with Platinum-Based Chemotherapy. J Cancer 2017; 8:2846-2853. [PMID: 28928874 PMCID: PMC5604217 DOI: 10.7150/jca.19897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/25/2017] [Indexed: 12/12/2022] Open
Abstract
Purpose: To develop a qPCR method to examine the 202 isoform of excision repair cross-complementation group 1 (ERCC1_202) and to evaluate its clinical utility as a predictive biomarker for platinum-based chemotherapy in non-small cell lung cancer (NSCLC). Methods: The relative complementary DNA (cDNA) quantification for ERCC1_202 was conducted using a fluorescence-based, real-time detection method and β-actin was used as a reference gene. Results: A strong correlation was observed between ERCC1_202 mRNA and ERCC1 mRNA levels in NSCLC cells (P < 0.001). 28 patients completed this research. Our results implied that as ERCC1_202 levels increased, the risk of progression (HR = 4.296, P = 0.011) and death (HR = 6.503, P = 0.001) increased. At multivariate analysis, high expression of ERCC1_202 was shown to be an independent predictive factor for time to progression (P = 0.047), and progression-free survival (P = 0.014). However, the high expression of ERCC1_202 was not an independent predictive factor for response (P = 0.324). Conclusions: This study suggests that the efficacy of platinum-based chemotherapy can be improved when customized according to the expression of ERCC1_202.
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Affiliation(s)
- Xiyong Wang
- Medical school of Southeast University, Nanjing 210009, China.,Department of Respiratory Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - Xiaoli Zhu
- Medical school of Southeast University, Nanjing 210009, China.,Department of Respiratory Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - Hongming Zhang
- Medical school of Southeast University, Nanjing 210009, China.,Department of Respiratory Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China
| | - Xiaobo Fan
- Medical school of Southeast University, Nanjing 210009, China
| | - Xiulei Xue
- Medical school of Southeast University, Nanjing 210009, China
| | - Yan Chen
- Medical school of Southeast University, Nanjing 210009, China
| | - Chenbo Ding
- Medical school of Southeast University, Nanjing 210009, China
| | - Jianwen Zhao
- Medical school of Southeast University, Nanjing 210009, China
| | - Guoqiu Wu
- Medical school of Southeast University, Nanjing 210009, China.,Center of Clinical Laboratory Medicine, Zhongda Hospital, Southeast University, Nanjing, 210009, China
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Roca E, Berruti A, Sbiera S, Rapa I, Oneda E, Sperone P, Ronchi CL, Ferrari L, Grisanti S, Germano A, Zaggia B, Scagliotti GV, Fassnacht M, Volante M, Terzolo M, Papotti M. Topoisomerase 2α and thymidylate synthase expression in adrenocortical cancer. Endocr Relat Cancer 2017; 24:319-327. [PMID: 28432084 DOI: 10.1530/erc-17-0095] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 04/21/2017] [Indexed: 12/23/2022]
Abstract
Topoisomerase II alpha (TOP2A) and thymidylate synthase (TS) are known prognostic parameters in several tumors and also predictors of efficacy of anthracyclines, topoisomerase inhibitors and fluoropirimidines, respectively. Expression of TOP2A and TS mRNA was assessed in 98 patients with adrenocortical carcinoma (ACC) and protein expression was assessed by immunohistochemistry in a subset of 39 tumors. Ninety-two patients were radically resected for stage II-III disease and 38 of them received adjuvant mitotane. Twenty-six patients with metastatic disease received the EDP-M (etoposide, doxorubicin, Adriamycin, cisplatin plus mitotane). TOP2A and TS expression in ACC tissue was directly correlated with the clinical data. Both markers were not associated with either disease free survival (DFS) or overall survival (OS) in multivariate analyses and failed to be associated to mitotane efficacy. Disease response or stabilization to EDP-M treatment was observed in 12/17 (71%) and 1/9 (11%) patients with high and low TOP2A expressing tumors (P = 0.0039) and 9/13 (69%) and 4/13 (31%) patients with high and low TS expressing ACC, respectively (P = 0.049). High TOP2A expression was significantly associated with longer time to progression (TTP) after EDP-M. TOP2A and TS proteins assessed by immunohistochemistry significantly correlated with mRNA expression. Immunohistochemical TOP2A expression was associated with a non-significant better response and longer TTP after EDP-M. TOP2A and TS were neither prognostic nor predictive of mitotane efficacy in ACC patients. The predictive role of TOP2A expression of EDP-M activity suggests a significant contribution of Adriamycin and etoposide for the efficacy of the EDP scheme.
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Affiliation(s)
- Elisa Roca
- Department of Medical and Surgical SpecialtiesRadiological Sciences, and Public Health, University of Brescia, Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Alfredo Berruti
- Department of Medical and Surgical SpecialtiesRadiological Sciences, and Public Health, University of Brescia, Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Silviu Sbiera
- Division of Endocrinology and DiabetesDepartment of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Ida Rapa
- Department of OncologyUniversity of Turin, Pathology Unit, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Ester Oneda
- Department of Medical and Surgical SpecialtiesRadiological Sciences, and Public Health, University of Brescia, Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Paola Sperone
- Department of OncologyUniversity of Turin, Medical Oncology, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Cristina L Ronchi
- Division of Endocrinology and DiabetesDepartment of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Laura Ferrari
- Department of Medical and Surgical SpecialtiesRadiological Sciences, and Public Health, University of Brescia, Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Salvatore Grisanti
- Department of Medical and Surgical SpecialtiesRadiological Sciences, and Public Health, University of Brescia, Oncology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Antonina Germano
- Department of Clinical and Biological SciencesUniversity of Turin, Internal Medicine 1, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Barbara Zaggia
- Department of Clinical and Biological SciencesUniversity of Turin, Internal Medicine 1, San Luigi Gonzaga Hospital, Orbassano, Italy
| | | | - Martin Fassnacht
- Division of Endocrinology and DiabetesDepartment of Internal Medicine I, University Hospital, University of Wuerzburg, Wuerzburg, Germany
| | - Marco Volante
- Department of OncologyUniversity of Turin, Pathology Unit, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Massimo Terzolo
- Department of Clinical and Biological SciencesUniversity of Turin, Internal Medicine 1, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Mauro Papotti
- Department of OncologyUniversity of Turin, Pathology Unit, City of Health and Science Hospital, Turin, Italy
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Barsanti-Innes B, Hey SP, Kimmelman J. The Challenges of Validating in Precision Medicine: The Case of Excision Repair Cross-Complement Group 1 Diagnostic Testing. Oncologist 2016; 22:89-96. [PMID: 28126916 DOI: 10.1634/theoncologist.2016-0188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 07/21/2016] [Indexed: 12/12/2022] Open
Abstract
Personalized medicine relies upon the successful identification and translation of predictive biomarkers. Unfortunately, biomarker development has often fallen short of expectations. To better understand the obstacles to successful biomarker development, we systematically mapped research activities for a biomarker that has been in development for at least 12 years: excision repair cross-complement group 1 protein (ERCC1) as a biomarker for predicting clinical benefit with platinum-based chemotherapy in non-small cell lung cancer. We found that although research activities explored a wide range of approaches to ERCC1 testing, there was little replication or validation of techniques, and design and reporting of results were generally poor. Our analysis points to problems with coordinating and standardizing research in biomarker development. Clinically meaningful progress in personalized medicine will require concerted efforts to address these problems. In the interim, health care providers should be aware of the complexity involved in biomarker development, cautious about their near-term clinical value, and conscious of applying only validated diagnostics in the clinic. THE ONCOLOGIST 2017;22:89-96 IMPLICATIONS FOR PRACTICE: : Many hospitals, policy makers, and scientists have made ambitious claims about the promise of personalizing cancer care. When one uses a case example of excision repair cross-complement group 1 protein-a biomarker that has a strong biological rationale and that has been researched for 12 years-the current research environment seems poorly suited for efficient development of biomarker tests. The findings provide grounds for tempering expectations about personalized cancer care-at least in the near term-and shed light on the current gap between the promise and practice of personalized medicine.
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Affiliation(s)
| | - Spencer Phillips Hey
- Program on Regulation, Therapeutics, and Law, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Harvard Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
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