Yuan Peng, Miao Xiao-ping, Zhang Xue-mei, Wang Zhong-hua, Tan Wen, Sun Yan, Xu Bing-he, Lin Dong-xin
Department of Medical Oncology, Cancer Hospital & Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2005 Apr 13;85(14):972-5.
Nucleotide excision repair has been shown to have great impact on the sensitivity of tumors to platinum-based chemotherapy. This study was to examine the association between genetic polymorphisms in XPC and XPD, two important components in nucleotide excision repair system, and clinical response to platinum-based chemotherapy in advanced non-small cell lung cancer.
Patients (n = 151) treated with platinum-based chemotherapy were genotyped for the AT dinucleotide insertion or deletion in intron 9 of XPC or Lys751Gln polymorphism in XPD. Clinical response to chemotherapy was obtained after 2 to 3 cycles. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression model and adjusted for sex, age, clinical stage, and regime of chemotherapy.
The overall response rate to the chemotherapy (CR + PR) was 35.1%, with 1 CR, 52 PR, 75 SD, and 23 PD. It was found that patients with the XPC LL genotype had significantly higher response rate than patients with the XPC SS genotype (adjusted OR = 3.19, 95% CI = 1.11 - 9.17; P = 0.031). However, no association was found between the XPD Lys751Gln polymorphism and response to the chemotherapy. In addition, these two polymorphisms seemed to have synergic effect, with the OR being 2.90 (95% CI = 1.07 - 7.86) for patients carrying the XPC LL and XPD Lys/Lys genotypes compared with those carrying the XPC SS or SL and XPD Lys/Lys genotypes.
These results suggest that genetic polymorphisms in nucleotide excision repair might be associated with clinical response to platinum-based chemotherapy.
已证实核苷酸切除修复对肿瘤对铂类化疗的敏感性有重大影响。本研究旨在探讨核苷酸切除修复系统的两个重要组成部分XPC和XPD的基因多态性与晚期非小细胞肺癌对铂类化疗的临床反应之间的关联。
对151例接受铂类化疗的患者进行基因分型,检测XPC第9内含子中AT二核苷酸插入或缺失情况以及XPD的Lys751Gln多态性。化疗2至3个周期后获得化疗的临床反应。使用无条件逻辑回归模型计算调整后的优势比(OR)和95%置信区间(CI),并对性别、年龄、临床分期和化疗方案进行调整。
化疗的总体缓解率(CR+PR)为35.1%,其中1例CR,52例PR,75例SD,23例PD。发现XPC LL基因型患者的缓解率显著高于XPC SS基因型患者(调整后的OR=3.19, 95% CI=1.11 - 9.17;P=0.031)。然而,未发现XPD Lys751Gln多态性与化疗反应之间存在关联。此外,这两种多态性似乎具有协同作用,携带XPC LL和XPD Lys/Lys基因型的患者与携带XPC SS或SL和XPD Lys/Lys基因型的患者相比,OR为2.90(95% CI=1.07 - 7.86)。
这些结果表明,核苷酸切除修复中的基因多态性可能与铂类化疗的临床反应有关。