Abstract
BackgroundClass III β-tubulin (TUBB3) is a prognostic marker in various tumors, but the role of TUBB3 in advanced gastric cancer is not clearly defined. We analyzed the significance of TUBB3 expression, along with that of excision repair cross-complementation group 1 (ERCC1) in recurrent and metastatic gastric cancer patients receiving taxane-based first-line palliative chemotherapy.MethodsWe reviewed the cases of 146 patients with advanced gastric adenocarcinoma who received taxane-based first-line palliative chemotherapy between 2004 and 2010 at Chonnam National University Hwasun Hospital (Gwangju, Korea). Immunohistochemical staining for TUBB3 and ERCC1 was performed using paraffin wax-embedded tumor tissues. We evaluated the patients’ response to chemotherapy, progression-free survival (PFS), and overall survival (OS).ResultsIn total, 146 patients with advanced gastric cancer received docetaxel and cisplatin (n = 15) or paclitaxel and cisplatin (n = 131). The median PFS was significantly shorter for patients with high-level TUBB3 expression than for patients with low-level TUBB3 expression (3.63 vs. 6.67 months, P = 0.001). OS was not associated with TUBB3 expression (13.1 vs. 13.1 months, P = 0.769). By multivariate analysis, only TUBB3 was related to a shorter PFS (HR 2.74, 95% CI 1.91-3.91, P = 0.001). Patients with high-level ERCC1 expression showed a lower response rate than patients with low-level ERCC1 expression (24 vs. 63.2%, P = 0.001); however, ERCC1 had no clinical effect on PFS or OS.ConclusionsTUBB3 was a strong predictive marker in recurrent and metastatic gastric cancer patients receiving taxane-based first-line palliative chemotherapy. No clinical impact of ERCC1 was evident in this setting.
Highlights
Class III β-tubulin (TUBB3) is a prognostic marker in various tumors, but the role of TUBB3 in advanced gastric cancer is not clearly defined
The objective of this study was to determine the role of TUBB3 and excision repair cross-complementation group 1 (ERCC1) as predictive or prognostic markers in taxane + cisplatin chemotherapy
Patients We reviewed the cases of 146 patients with unresectable recurrent or metastatic gastric adenocarcinoma who were treated with taxane-based first-line palliative chemotherapy between January 2004 and December 2010 at Chonnam National University Hwasun Hospital (Gwangju, Korea), and whose paraffin wax-embedded tumor tissue at diagnosis and medical records were available (Figure 1)
Summary
Class III β-tubulin (TUBB3) is a prognostic marker in various tumors, but the role of TUBB3 in advanced gastric cancer is not clearly defined. Its global incidence is declining, gastric cancer remains highly prevalent in many Asian countries [1,2]. Conventional treatments such as surgery, radiotherapy, and chemotherapy play a role primarily in patients with early-stage disease. They have only modest efficacy in treating patients with recurrent or metastatic gastric cancer [3]. Markers can be prognostic and/or predictive [7]
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