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妇科肿瘤学组关于Ⅲ期上皮性卵巢癌腹腔内与静脉注射顺铂和紫杉醇的Ⅲ期试验中,ERCC1基因多态性、疾病进展和生存之间的关系。

Relationship between ERCC1 polymorphisms, disease progression, and survival in the Gynecologic Oncology Group Phase III Trial of intraperitoneal versus intravenous cisplatin and paclitaxel for stage III epithelial ovarian cancer.

作者信息

Krivak Thomas C, Darcy Kathleen M, Tian Chunqiao, Armstrong Deborah, Baysal Bora E, Gallion Holly, Ambrosone Christine B, DeLoia Julie A

机构信息

University of Pittsburgh Magee-Women's Hospital; Precision Therapeutics/PTI, Pittsburgh, PA 15213, USA.

出版信息

J Clin Oncol. 2008 Jul 20;26(21):3598-606. doi: 10.1200/JCO.2008.16.1323.

Abstract

PURPOSE

We hypothesized that common polymorphisms in excision repair cross-complementation group 1 (ERCC1), involved in nucleotide excision repair of platinum-induced damage, would be associated with progression-free survival (PFS) and overall survival (OS) in women with optimally resected, stage III epithelial ovarian cancer (EOC) treated with cisplatin and paclitaxel (C+P).

PATIENTS AND METHODS

Single nucleotide polymorphism analysis was carried out by direct pyrosequencing at two sites (codon 118 and C8092A) in ERCC1 in leukocyte DNA from women who participated in the Gynecologic Oncology Group (GOG) phase III protocol-172 and were randomly assigned to intraperitoneal or intravenous C+P.

RESULTS

ERCC1 genotyping was performed in 233 of the 429 women who participated in GOG-172. The genotype distribution at codon 118 was 17% with C/C, 43% with C/T, and 40% with T/T, and the genotype distribution at C8092A was 56% with C/C, 37% with C/A, and 7% with A/A. Adjusted Cox regression analysis revealed that the codon 118 polymorphism in ERCC1 was not significantly associated with disease progression or death. Women with the C8092A C/A or A/A genotypes compared with the C/C genotype had an increased risk of disease progression (hazard ratio [HR] = 1.44; 95% CI, 1.06 to 1.94; P = .018) and death (HR = 1.50; 95% CI, 1.07 to 2.09; P = .018). Median PFS and OS were 6 and 17 months shorter for women with the C8092A C/A or A/A genotypes versus the C/C genotype, respectively.

CONCLUSION

Although the ERCC1 codon 118 polymorphism does not seem to be associated with clinical outcome, the C8092A polymorphism was an independent predictor of PFS and OS in women with optimally resected EOC.

摘要

目的

我们假设,参与铂诱导损伤核苷酸切除修复的切除修复交叉互补组1(ERCC1)中的常见多态性,与接受顺铂和紫杉醇(C + P)治疗的、手术切除效果最佳的III期上皮性卵巢癌(EOC)女性的无进展生存期(PFS)和总生存期(OS)相关。

患者与方法

通过直接焦磷酸测序法,对参与妇科肿瘤学组(GOG)III期方案-172、并被随机分配接受腹腔或静脉注射C + P的女性白细胞DNA中ERCC1基因的两个位点(第118密码子和C8092A)进行单核苷酸多态性分析。

结果

在参与GOG-172的429名女性中,对233名进行了ERCC1基因分型。第118密码子处的基因型分布为:C/C型占17%,C/T型占43%,T/T型占40%;C8092A处的基因型分布为:C/C型占56%,C/A型占37%,A/A型占7%。校正后的Cox回归分析显示,ERCC1基因第118密码子多态性与疾病进展或死亡无显著相关性。与C/C基因型相比,C8092A位点为C/A或A/A基因型的女性疾病进展风险增加(风险比[HR]=1.44;95%可信区间[CI],1.06至1.94;P = 0.018),死亡风险增加(HR = 1.50;95%CI,1.07至2.09;P = 0.018)。C8092A位点为C/A或A/A基因型的女性,其PFS和OS的中位数分别比C/C基因型女性短6个月和17个月。

结论

虽然ERCC1基因第118密码子多态性似乎与临床结局无关,但C8092A多态性是手术切除效果最佳的EOC女性PFS和OS的独立预测因素。

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