Joint detection of ERCC1, TUBB3, and TYMS guidance selection of docetaxel, 5-fluorouracil and cisplatin (DDP) individual chemotherapy in advanced gastric cancer patients.

Yushuang Luo,Miaozhou Wang,Milu Wu,Sen Cui,Junhui Zhao,Ge Ri-Li,Zhanquan Li,Yuying Li,Zhibo Liu,Cunfang Shen,Rong Chen

doi:10.1186/s40001-014-0050-z

Yushuang Luo, Miaozhou Wang + Show 9 more

Open Access

https://doi.org/10.1186/s40001-014-0050-z

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Abstract

BackgroundTo investigate the guidance selection of docetaxel (D), cisplatin (DDP) (C), and 5-fluorouracil (5-FU) (F) as individual chemotherapy agents via joint detection of ERCC1, TUBB3, and TYMS genes in patients with advanced gastric cancer (AGC).MethodClinical data of 120 patients with AGC who enrolled in our hospital between May 2009 and May 2012 were analyzed. These patients were randomly assigned to experimental and control groups. The mRNA expression of ERCC1, TUBB3, and TYMS was measured by DNA chip technology in the experimental group. Different chemotherapies were administered according to the mRNA expression levels of the three genes, while DCF chemotherapy was directly applied to the control group. Correlation between the three genes’ mRNA levels, efficiency rate, the median time to progression (MTP), median survival time (MST) and adverse reactions was evaluated.ResultsAs a result, there was a significant correlation between ERCC1 and TUBB3 mRNA expression (P = 0.005), but no obvious correlation between TUBB3 and TYMS or ERCC1 and TYMS. There was also no significant difference in the efficiency rate of chemotherapy (50% versus 55%; P = 0.357) and the MTP (10 months versus 7 months; P = 0.091) between the two groups. However, there was obvious significance in MST (13.7 months versus 11.6 months; P = 0.004). Additionally, the experimental group provided us with a more effective way for controlling adverse reactions to chemotherapy.ConclusionCombination regimen of D, C, and F in AGC patients according to their ERCC1, TUBB3, and TYMS mRNA expression level may reduce adverse reactions and improve MST.

Highlights

To investigate the guidance selection of docetaxel (D), cisplatin (DDP) (C), and 5-fluorouracil (5-FU) (F) as individual chemotherapy agents via joint detection of ERCC1, TUBB3, and TYMS genes in patients with advanced gastric cancer (AGC)
As a result, there was a significant correlation between ERCC1 and TUBB3 mRNA expression (P = 0.005), but no obvious correlation between TUBB3 and TYMS or ERCC1 and TYMS
Combination regimen of D, C, and F in AGC patients according to their ERCC1, TUBB3, and TYMS mRNA expression level may reduce adverse reactions and improve median survival time (MST)

Summary

Introduction

To investigate the guidance selection of docetaxel (D), cisplatin (DDP) (C), and 5-fluorouracil (5-FU) (F) as individual chemotherapy agents via joint detection of ERCC1, TUBB3, and TYMS genes in patients with advanced gastric cancer (AGC). Gastric cancer, which ranks as the cancer with the second highest mortality rate, is the fourth most common malignant tumor overall [1]. The incidence and mortality of gastric cancer is high in China, especially in Qinghai province. The genetic differences relating to drug sensitivity and resistance in patients have been found by detecting genetic alterations in patients using pharmacogenomics [12]. Selection of appropriate chemotherapeutic drugs will be benefited leading to efficacy improvement, reducing side effects, and avoiding ineffective treatment. Chemotherapeutic tolerance and drug resistance are the main causes of chemotherapy failure in gastric cancer [13]

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