Abstract
Increasing scientific evidence suggests that ribonucleotide reductase M1 (RRM1) may be a powerful predictor of survival in patients with pancreatic cancer treated with adjuvant gemcitabine-based chemotherapy after operative resection, but many existing studies have yielded inconclusive results. This meta-analysis aimed to assess the prognostic role of RRM1 in predicting survival in patients with pancreatic cancer treated with gemcitabine. An extensive literature search for relevant studies was conducted on PubMed, Embase, Web of Science, Cochrane Library, and CBM databases from their inception through May 1st, 2013. This meta-analysis was performed using the STATA 12.0 software and crude hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated. Eight clinical studies were included in this meta-analysis with a total of 665 pancreatic cancer patients treated with adjuvant gemcitabine-based chemotherapy, including 373 patients in the high RRM1 expression group and 292 patients in the low RRM1 expression group. Our meta-analysis revealed that high RRM1 expression was associated with improved overall survival (OS) of pancreatic cancer patients (HR=1.56, 95%CI=0.95-2.17, P<0.001). High RRM1 expression also was linked to longer disease-free survival (DFS) than low RRM1 expression (HR=1.37, 95%CI=0.25-2.48, P=0.016). In conclusion, our meta-analysis suggests that high RRM1 expression may be associated with improved OS and DFS of pancreatic cancer patients treated with adjuvant gemcitabine-based chemotherapy. Detection of RRM1 expression may be a promising biomarker for gemcitabine response and prognosis in pancreatic cancer patients.
Highlights
Pancreatic cancer is a highly aggressive cancer and the fourth leading cause of cancer death (Wang et al, 2009)
This meta-analysis aimed to assess the prognostic role of ribonucleotide reductase M1 (RRM1) in predicting survival in patients with pancreatic cancer treated with gemcitabine
Our meta-analysis revealed that high RRM1 expression was associated with improved overall survival (OS) of pancreatic cancer patients (HR=1.56, 95%confidence intervals (CIs)=0.95-2.17, P
Summary
Pancreatic cancer is a highly aggressive cancer and the fourth leading cause of cancer death (Wang et al, 2009). Surgery alone is not a sufficient treatment for pancreatic cancer, and adjuvant chemoradiation following curative resection have an impact on long-term survival (Traverso, 2006; Hsu et al, 2010). Gemcitabine is a pyrimidine nucleoside analogue used for the treatment of a wide range of solid tumors, including pancreatic cancer (Wonganan et al, 2012). Previous studies have demonstrated that adjuvant chemoradiation with gemcitabine has a beneficial effect on prognosis in patients with pancreatic cancer after curative resection (Oettle et al, 2007; Van Laethem et al, 2010). It has been widely accepted that gemcitabine-based regimen is the first-line chemotherapy for patients with unresectable or resected pancreatic cancer (Kanai et al, 2011; Kim et al, 2011b)
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