Wan Yi-Yuan, Hui Hong-Xia, Wang Xiao-Wei, Sun Su-An, Wu Jian
Department of Medical Oncology, the First Hospital of Huai'an City Affiliated Nanjing Medical College, Jiangsu Province, Huai'an, China.
Zhonghua Nei Ke Za Zhi. 2011 Jun;50(6):469-73. doi: 10.3760/cma.j.issn.0578-142.2011.06.006.
To investigate the predictive value of breast cancer susceptibility gene 1 (BRCA1) and class IIIβ-tubulin protein expression in tumor tissue for the efficacy of taxol and cisplatin combined chemotherapy (TP) in stage IIIB/IV non-small cell lung cancer (NSCLC) patients.
A total of 92 stage IIIB/IV NSCLC patients were recruited with 87 patients evaluated. Bronchoscopy or lung puncture tumor biopsy samples were obtained with BRCA1 and class IIIβ-tubulin protein expression examined immunohistochemically before chemotherapy. The patients were randomly assigned to be received 4 to 6 cycles of TP chemotherapy regiments and followed up until death or lost. Response rate (RR), overall survival (OS) and time to tumor progression (TTP) were assessed.
Among the 87 evaluated patients, the positive expression rates of BRCA1 and class IIIβ-tubulin were 57.5% (50/87) and 48.3% (42/87) respectively. There was no significant difference in clinical characteristics among patients with different positive expression rate. According to different expression of BRCA1 and class IIIβ-tubulin, the patients were divided into four groups: group A (low expression of both BRCA1 and class IIIβ-tubulin), group B (high expression of both BRCA1 and class IIIβ-tubulin), group C (high expression of only BRCA1) and group D (high expression of only class IIIβ-tubulin). The RR was higher in group A than other three groups (60.7%, 34.8%, 9/19 and 6/17 respectively). The OS and TTP were longer in group A than other three groups [OS: (539.4 ± 17.6) days, (267.2 ± 20.5) days, (325.6 ± 24.1) days and (283.7 ± 26.2) days respectively; TTP: (256.9 ± 28.4) days, (143.8 ± 17.6) days, (179.3 ± 19.8) days and (152.6 ± 23.5) days respectively]. There were no significant differences among the other three groups.
The expression level of BRCA1 and class IIIβ-tubulin in tumor tissue is probably a predictor for the efficacy of TP chemotherapy in NSCLC patients. TP chemotherapy is more suitable for the NSCLC patients with lower expression of both BRCA1 and class IIIβ-tubulin. Our study may provide a new sight for tailored chemotherapy in NSCLC patients.
探讨肿瘤组织中乳腺癌易感基因1（BRCA1）和Ⅲβ类微管蛋白的表达对ⅢB/Ⅳ期非小细胞肺癌（NSCLC）患者紫杉醇联合顺铂化疗（TP）疗效的预测价值。
共纳入92例ⅢB/Ⅳ期NSCLC患者，其中87例患者接受评估。化疗前通过支气管镜或肺穿刺获取肿瘤活检样本，采用免疫组织化学方法检测BRCA1和Ⅲβ类微管蛋白的表达。患者被随机分配接受4至6周期的TP化疗方案，并随访至死亡或失访。评估缓解率（RR）、总生存期（OS）和肿瘤进展时间（TTP）。
在87例接受评估的患者中，BRCA1和Ⅲβ类微管蛋白的阳性表达率分别为57.5%（50/87）和48.3%（42/87）。不同阳性表达率患者的临床特征无显著差异。根据BRCA1和Ⅲβ类微管蛋白的不同表达，将患者分为四组：A组（BRCA1和Ⅲβ类微管蛋白均低表达）、B组（BRCA1和Ⅲβ类微管蛋白均高表达）、C组（仅BRCA1高表达）和D组（仅Ⅲβ类微管蛋白高表达）。A组的RR高于其他三组（分别为60.7%、34.8%、9/19和6/17）。A组的OS和TTP长于其他三组[OS：分别为（539.4±17.6）天、（267.2±20.5）天、（325.6±24.1）天和（283.7±26.2）天；TTP：分别为（256.9±28.4）天、（143.8±17.6）天、（179.3±19.8）天和（152.6±23.5）天]。其他三组之间无显著差异。
肿瘤组织中BRCA1和Ⅲβ类微管蛋白的表达水平可能是NSCLC患者TP化疗疗效的预测指标。TP化疗更适合BRCA1和Ⅲβ类微管蛋白均低表达的NSCLC患者。本研究可能为NSCLC患者的个体化化疗提供新的视角。
