Abstract
BackgroundA number of studies have examined the relationship between the expression of the class III β-tubulin (TUBB3) and the treatment responses to the taxane/vinorebine-based chemotherapy in patients with non-small cell lung cancer (NSCLC). However, the results of these studies were inconsistent and inconclusive. Therefore, we conducted an up-to-date meta-analysis to evaluate the prognostic role of TUBB3 in the taxane/vinorebine-based chemotherapy.MethodsA literature search for relevant studies was conducted in PubMed, Embase, and CNKI. The inclusion criteria were the taxane/vinorebine-based chemotherapy in patients with NSCLC and the evaluation of the clinical outcomes in relation to the expression of TUBB3. The clinical outcomes analyzed in this study included the overall response rate (ORR), overall survival (OS), and event-free survival (EFS). Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were calculated to assess the risk associated with the TUBB3 expression in the taxane/vinorebine-based chemotherapy.ResultsA total of 28 studies with 2401 NSCLC patients were qualified for this meta-analysis. We found that the positive or high level of TUBB3 expression was associated with a poorer ORR (OR = 0.24, 95% CI = 0.16–0.36, p<0.001), an unfavorable OS (HR = 1.52, 95% CI = 1.27–1.82, p<0.001), and a worse EFS (HR = 1.47, 95% CI = 1.24–1.74, p<0.001) compared to the negative or low level of TUBB3 expression. The statistically significant associations between TUBB3 and chemotherapy responses were also observed in the stratified subgroup analysis, which included the analysis by ethnic subgroup (Asian and Caucasian), chemotherapy regimen (taxane-based and vinorebine-based), TUBB3 detection method (IHC and PCR), and treatment strategy (surgery plus adjuvant chemotherapy and palliative chemotherapy).ConclusionsThe expression level of TUBB3 may be a useful biomarker to predict the clinical outcomes of the taxane/vinorebine-based chemotherapy in patients with NSCLC.
Highlights
Lung cancer is the most common type of cancer and a leading cause of cancer-related death for both men and women worldwide [1]
Inclusion and exclusion criteria Eligible studies were identified according to the following criteria: (1) human-based investigations; (2) pathologically confirmed non-small cell lung cancer; (3) articles published in English or Chinese; (4) taxane/vinorebine-based chemotherapy treatment; (5) investigation of the association between the expression of class III b-tubulin and the clinical outcomes of chemotherapy, including the objective response rate (ORR), overall survival (OS), and event-free survival (EFS) (including progression-free survival (PFS), disease-free survival (DFS), and recurrence-free survival (RFS)); (6) the full-text of the published articles were available
The results of our analysis showed that the negative or low b-III tubulin (TUBB3) expression was associated with a longer OS than the positive or high TUBB3 expression in non-small cell lung cancer (NSCLC) patients receiving the taxane-based, or vinorebine-based, or both taxane- and vinorebine-based regimens
Summary
Lung cancer is the most common type of cancer and a leading cause of cancer-related death for both men and women worldwide [1]. The non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. Two-thirds of NSCLC cases are diagnosed at advanced stages because the patients are typically asymptomatic at early stages [2]. Due to the recent advancements in the surgical techniques and chemoradiation therapy, the one-year relative survival rate for lung cancer has increased from 35.7% to 44.5% [3]. The prognosis of lung cancer, especially for the advanced stage of NSCLC, is still poor. The high morbidity and mortality rates of lung cancer has continued to be a major public health concern worldwide [4]. A number of studies have examined the relationship between the expression of the class III b-tubulin (TUBB3) and the treatment responses to the taxane/vinorebine-based chemotherapy in patients with non-small cell lung cancer (NSCLC). We conducted an up-to-date meta-analysis to evaluate the prognostic role of TUBB3 in the taxane/vinorebine-based chemotherapy
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