Abstract

The influences of glutathione s-transferase P1, M1, and T1 variants on the efficacy of platinum-based chemotherapy in non-small cell lung cancer (NSCLC) patients were inconsistent in previous studies. Our meta-analysis enrolled 31 publications including 5712 patients and provided more convincing and reliable conclusions. Results showed that GSTP1 IIe105Val IIe/Val and Val/Val Asian patients were more likely to have better response rates compared to IIe/IIe patients (odds ratio (OR) = 1.592, 95% confidence intervals (CIs), 1.087–2.332, P = 0.017). The Asian patients bearing the favorable GSTM1 null genotype were more likely to have better response rates to platinum-based chemotherapy compared to those patients with the unfavorable GSTM1 present genotype (OR = 1.493 (1.192–1.870), P < 0.001). Caucasian lung cancer patients bearing GSTT1 null genotype might be more closely associated with shorter survival time and higher risks of death than the GSTT1 present patients (hazard ratio (HR) = 1.423, CI = 1.084–1.869, P = 0.011). Our meta-analysis suggested that the GSTP1 IIe105Val, GSTM1 and GSTT1 null variants might be predictive factors for the efficacy of platinum-based chemotherapy to NSCLC patients. The use of GSTP1 IIe105Val, GSTM1 and GSTT1 null polymorphisms as predictive factors of efficacy of personalized platinum-based chemotherapy to NSCLC patients requires further verification with multi-center, multi-ethnic and large-sample-size pharmacogenetic studies.

Highlights

  • Lung cancer is the most common cancer worldwide and the most common causes of cancer death are cancers of the lung and bronchus in both man and woman[1, 2]

  • 29 studies were involved in GSTP1 Ile105Val; 16 studies were involved in GSTM1; and 11 studies were involved in GSTT1

  • The information of objective response rate (ORR), overall survival (OS) and hazard ratios (HRs), median survival time (MST), the median time to progression (TTP) and the median progression-free survival (PFS) in each study are shown in Tables 2 and 3

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Summary

Introduction

Lung cancer is the most common cancer worldwide and the most common causes of cancer death are cancers of the lung and bronchus in both man and woman[1, 2]. There were two meta-analyses which reported the inconsistent results for evaluating the associations between GSTP1 and GSTM1 polymorphisms and response to platinum-based chemotherapy in lung cancer[17, 40]. These two meta-analyses have not enrolled update studies and just analyzed a few studies, and may have biased conclusions. After combining all available data and derived more precise and comprehensive assessment, we have updated this system review and meta-analysis to find out the reliable associations of GSTP1 (Ile105Val), GSTM1 (null/present) and GSTT1 (null/present) variants with the efficacy and clinical outcomes of NSCLC patients treated with platinum-based chemotherapy

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