ERCC1 expression and activity of PELF regimen as first-line treatment of metastatic gastric cancer patients.

Abstract

e14603 Background: The role of the excision repair cross-complementing 1 (ERCC1) is well documented in a large number of tumor types with cisplatin-based chemotherapy. The aim of this study was to determine whether ERCC1 expression predict clinical outcome in patients affected by metastatic gastric cancer (MGC) treated with cisplatin (P), epirubicin (E), leucovorin (L), 5-fluorouracil (F) chemotherapy (PELF). Methods: The study population included 33 MGC patients (median age 62 years, 24 male) treated from 2001 to 2008 in our center. Patients were treated with cisplatin (40 mg/m2, day 1), epirubicin (30 mg/m2, day 1), 5-fluorouracil (400 mg/m2 bolus, followed by 600 mg/m2, 22 h continuous infusion, day 1 and 2) and leucovorin (100 mg/m2, 2-h infusion, day 1 and 2). Treatment was repeated every 14 days. The expression of ERCC1 of primary tumors was examined by immunohistochemistry and then analysed by semiquantitative H-score method. Results: The positive rate of ERCC1 was 42%. Median overall survival (OS) was significantly longer in patients with low ERCC1 expression than those with high ERCC1 expression (13 months vs. 9 months, log- rank p = 0.018), likewise 1-year survival rate (62% vs. 21%, Fisher's exact p = 0.033). Of note a stepwise logistic regression analysis comparing 1-year survivors and non-survivors showed that ERCC1 expression unfavourably impacted on OS (odds ratio 0.62; 95% CI = 0.010- 0.78; p = 0.03). Conclusions: Immunohistochemical studies for ERCC1 might be useful to predict the clinical outcome in MGC patients treated with PELF regimen. No significant financial relationships to disclose.