Expression of BRCA1, a factor closely associated with relapse-free survival, in patients who underwent neoadjuvant chemotherapy with docetaxel, cisplatin, and fluorouracil for squamous cell carcinoma of the esophagus

A Preliminary Study of NER and MMR Pathways Involved in Chemotherapy Response in Bladder Transitional Cell Carcinoma: Impact on progression-free survival

One of the main genotoxic drugs used in bladder cancer chemotherapy is cisplatin. While it is applied in most types of cancers, resistance to cisplatin is wildly common. In order to overcome drug resistance, it is necessary to determine a predictive marker. This study was conducted to provide basic data for selecting and designing a gene profile for further cohort and RCT studies in the future to improve response to treatment in bladder cancer. The expression levels of ERCC1, MLH1, MSH2, and CTR1 mRNA were determined in the tumor tissue using real-time q-PCR. Progression-free survival (PFS) was analyzed in term of the level of genes expression. The results revealed that the level of ERCC1 mRNA expression was higher in the recurrence (R) group compared to the no recurrence (NR) group. Moreover, the PFS time was increased in the patients with an ERCC1 expression level of below 1.57. The level of MLH1 and MSH2 mRNA expression was lower in the R group compared to the NR group; therefore, PFS time was increased in the patients with MLH1 and MSH2 gene expression levels above the cutoff point. While the level of CTR1 mRNA expression was higher in the R group versus the NR group, the PFS time was longer in the patients with CTR1 expression levels of below 1.265 compared to the patients with high levels of CTR1 expression. It can be concluded that the level of ERCC1, MLH1, MSH2, and CTR1 mRNA expression may be associated with PFS time as possible therapeutic targets for decreasing cisplatin resistance.

Clinical Role of Excision Repair Cross-Complementing 1 Gene Expression in Resected Esophageal Squamous Cell Carcinoma: A Meta-Analysis

AIMS

To explore the relationship between excision repair cross-complementing 1 (ERCC1) gene expression and clinical pathological parameters and prognosis of esophageal squamous cell carcinoma (ESCC) patients who received the surgical therapy.

METHODS

To identify relevant articles, a systematic literature retrieval was conducted in several databases, including the Embase, Web of Science, Cochrane Library, PubMed, VIP, Wanfang, and CNKI. The association of ERCC1 gene expression with clinicopathological characteristics and survival was assessed by the pooled relative risk (RR) and hazard ratio (HR) with the corresponding 95% confidence interval (CI), respectively. Sensitivity analysis was conducted to assess the stability of pooled results. Begg's funnel plot and Egger's test were applied to detect potential publication bias.

RESULTS

A total of nine studies involving 746 patients were included in our meta-analysis, and all patients were from Asian countries, including China, Korea, and Japan. The results indicated that ERCC1 gene expression was significantly associated with lymph node metastasis (RR = 1.30, 95% CI 1.11-1.53; P = 0.002), higher TNM stage (RR = 1.23, 95% CI 1.06-1.43; P = 0.006), worse overall survival (HR = 2.40, 95% CI 1.32-4.37; P < 0.001), and disease-free survival (HR = 1.67, 95% CI 1.15-2.41; P = 0.007). Sensitivity analysis manifested that the pooled results were stable and no significant publication bias was observed.

CONCLUSIONS

ERCC1 gene expression is significantly related to tumor stage and prognosis in resected ESCC patients from Asian countries. More prospective studies with larger samples are needed to testify our findings.

Predictive Value of Excision Repair Cross-Complementation Group 1 in the Response to Platinum-Based Chemotherapy in Esophageal Cancer: A Meta-Analysis

INTRODUCTION

Platinum is widely used in the treatment of esophageal cancer. In clinical practice, it is significant to distinguish patients who respond to platinum from those who do not. Excision repair cross-complementation group 1 (ERCC1) is thought to be the key in the resistance to platinum. However, whether it is related to the platinum-based chemotherapy response on real esophageal cancer patients is controversial. We conducted this meta-analysis to explore the association between ERCC1 polymorphisms, its expression levels and platinum-based chemotherapy response, and identify the most sensitive genotypes.

METHODS

The study was carried out according to the Cochrane handbook for systemic reviews of intervention. The study protocol has been registered on PROSPERO.

RESULTS

Three studies were included in the analysis of C8092A polymorphisms, 5 in the C118T, and another 6 in ERCC1 expression levels. In C118T polymorphisms, compared to wild genotype, patients with mutant genotypes had a significantly higher response rate. As for C8092A polymorphisms, the mutant genotypes also presented a better response than the wild genotype. The pooled analysis indicated a significantly higher response rate in patients with a low expression of ERCC1.

CONCLUSIONS

ERCC1 is a valuable biomarker for platinum-based chemotherapy in esophageal cancer. Patients with ERCC1 mutations or low-level ERCC1 expression are more sensitive to platinum-based chemotherapy.

Application of dynamic magnetic resonance imaging information technology in adjuvant chemotherapy for breast cancer

In order to study the application of dynamic magnetic resonance imaging information technology in breast cancer adjuvant chemotherapy, female patients diagnosed with breast cancer in The People's Hospital of Shanxi Province are selected as research objects. Dynamic enhanced magnetic resonance imaging scans are performed to compare pathological changes by hematoxylin and eosin staining. The dynamic NMR morphological changes are used to evaluate the efficacy of neoadjuvant chemotherapy. Semi-quantitative analysis is used to compare the TIC types of lesions, and the changes in quantitative analysis parameters are used to evaluate the efficacy. The results show that in the dynamic magnetic resonance imaging technique, the effective group (RECIST standard is CR and PR) has statistically significant changes in the quantitative analysis parameters K^trans and K_ep before and after neoadjuvant chemotherapy. K^trans and K_ep are used in neoadjuvant chemotherapy for breast cancer. The assessment is consistent with the morphological RECIST criteria assessment and can be used for qualitative diagnosis of breast tumors.

ERCC1-C19007T基因多态性与中晚期食管癌铂类药物化疗敏感性的Meta分析

目的

定量分析中晚期食管癌患者切除修复交叉互补基因1(excision repair cross comple-menting 1, ERCC1)C-19007T基因多态性与铂类药物化疗敏感性的关系.

方法

计算机检索PubMed、EMBASE、Cochrane Library, 中文科技期刊数据库、中国生物医学文献数据库、中国期刊全文数据库和万方数据库, 收集有关中晚期食管癌患者ERCC1-C19007T基因多态性与基于铂类药物方案化疗敏感性的相关研究, 以临床化疗有效率(完全缓解＋部分缓解)作为化疗敏感评价指标, 采用Reviewm5.2及Stata12.1软件进行统计学分析, 计算合并比值比(odd ratio, OR)及95%可信区间(confidence interval, CI).

结果

本研究共纳入8篇文献. Meta分析结果显示, 各基因型之间(CT vs CC: OR = 3.31, 95%CI: 1.94-5.64); (CT vs TT: OR = 5.48, 95%CI: 3.21-9.35); (CT vs CC+TT: OR = 4.06, 95%CI: 2.66-6.18); 差异有统计学意义, 表明ERCC1-C19007T基因多态性与中晚期食管癌对铂类化疗药物敏感性的差异有统计学意义.

结论

ERCC1-C19007T基因多态性可能与食管癌铂类药物化疗耐药相关.

Conversion surgery after combination chemotherapy of docetaxel, cisplatin and S-1 (DCS) for far-advanced gastric cancer

PURPOSE

A triplet regimen of docetaxel, cisplatin, and S-1(DCS) is highly effective against metastatic gastric cancer. We performed this study to clarify the safety and efficacy of surgical resection in patients with initially unresectable gastric cancer, after down-staging or disease control was achieved by DCS chemotherapy.

METHODS

The subjects of this retrospective study were 31 consecutive patients with initially unresectable gastric cancer, who underwent surgical resection between October, 2006 and December, 2012, after down-staging or disease control was achieved by DCS chemotherapy. We evaluated the clinicopathological factors and clinical outcomes and assessed radiographic response based on the RECIST criteria, not by central review.

RESULT

Before DCS chemotherapy, 18 patients had extra-regional lymph node metastasis, 5 had liver metastasis, 8 had macroscopic peritoneal metastasis, and 8 had pancreatic head invasion. Twenty-three (74.2%) of the 31 patients underwent R0 resection. Postoperative morbidity and mortality rates were 16.1 and 0%. During chemotherapy, grade 3/4 toxicities included neutropenia (54.8%), leukopenia (32.3%), and anemia (16.1%). Median progression-free survival and median overall survival (OS) were 42.1 and 56.1 months, respectively. These results were similar for all patients, except those with locally advanced disease alone. In the multivariate analysis for OS, ypN remained an independent negative prognostic factor (p = 0.018).

CONCLUSION

Surgical resection after DCS chemotherapy for initially unresectable gastric cancer was safe and provided a reasonable R0 resection rate and good mid-term survival.

Treatment of lung adenocarcinoma by molecular-targeted therapy and immunotherapy

Lung adenocarcinoma (LADC) is a cancer treatable using targeted therapies against driver gene aberrations. EGFR mutations and ALK fusions are frequent gene aberrations in LADC, and personalized therapies against those aberrations have become a standard therapy. These targeted therapies have shown significant positive efficacy and tolerable toxicity compared to conventional chemotherapy, so it is necessary to identify additional druggable genetic aberrations. Other than EGFR mutations and ALK fusions, mutations in KRAS, HER2, and BRAF, and driver fusions involving RET and ROS1, have also been identified in LADC. Interestingly, the frequency of driver gene aberrations differs according to ethnicity, sex, and smoking, which leads to differences in treatment efficacy. To date, several molecular-targeted drugs against driver genes have been developed, and several clinical trials have been conducted to evaluate the efficacy. However, targeted therapies against driver-gene-negative cases have not yet been well developed. Efforts to identify a new druggable target for such cases are currently underway. Furthermore, immune checkpoint blockade therapy might be effective for driver-negative cases, especially those with accumulated mutations.