The prognostic and predictive value of excision repair cross-complementation group 1 (ERCC1) protein in 1288 patients with head and neck squamous cell carcinoma treated with platinum-based therapy: a meta-analysis.

Abstract

Excision repair cross-complementation group 1 (ERCC1) protein has been extensively investigated as a prognostic and predictive factor for platinum-based treatment in head and neck squamous cell carcinoma (HNSCC) but with inconsistent results. We performed the present meta-analysis to better elucidate this issue in advanced HNSCC. A literature search was conducted using the PubMed and Web of Science databases. The inclusion criteria were head and neck cancer patients with platinum-based treatment and evaluation of the correlation between ERCC1 expression and clinical outcomes [objective response rate (ORR), progression-free survival (PFS), and overall survival (OS), both unadjusted and adjusted estimates]. In high vs. low pooled analyses, high ERCC1 expression was associated with unfavorable OS [hazard ratio (HR)=1.95, 95% confidence interval (CI) 1.18-3.21, p=0.009], PFS (HR=2.39, 95% CI 1.74-3.28, p=0.000) and ORR (odds ratio=0.48, 95% CI 0.23-0.98, p=0.044). In the subgroup analysis of adjusted OS estimates, ERCC1 was a predictor of shorter survival in Asians (HR=3.13, 95% CI 2.09-4.70, p=0.000) and Caucasians (HR=2.02, 95% CI 1.32-3.07, p=0.001) but of longer survival in South Americans (HR=0.17, 95% CI 0.07-0.40, p=0.000). Immunohistochemistry proved to be of predictive value irrespective of used antibody (p=0.009). In the stratified analysis according to the tumor site, ERCC1 expression was associated with OS in nasopharyngeal cancer (HR=2.72, 95% CI 1.79-4.13, p=0.000). ERCC1 has a potential to become predictive and prognostic factor enabling treatment tailoring in HNSCC patients.