Department of Integrated Traditional Chinese and Western Medicine, Huashan Hospital, Fudan University, 12 Middle Wulumuqi Road, Shanghai, PR China.
Lung Cancer. 2012 Mar;75(3):374-80. doi: 10.1016/j.lungcan.2011.08.003. Epub 2011 Sep 1.
The predictive value of RRM1 to therapeutic efficacy of gemicitabine-containing chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC) remains disputable. This meta-analysis is performed to systematically evaluate whether RRM1 expression is associated with the clinical outcome of gemcitabine-containing regimen in advanced NSCLC.
An electronic search was conducted using the databases Pubmed, Medline, EMBASE, Cochrane library and CNKI, from inception to May, 2011. A systemic review of the studies on the association between RRM1 expression in advanced NSCLC and clinical outcome of gemcitabine-containing regimen was performed. Pooled odds ratios (OR) for the response rate, weighted median survival and time to progression were calculated using the software Revman 5.0.
The search strategy identified 18 eligible studies (n=1243). Response rate to gemcitabine-containing regimen was significantly higher in patients with low/negative RRM1 (OR=0.31, 95% CI 0.21-0.45, P<0.00001). NSCLC patients with low/negative RRM1 who were treated with gemicitabine-containing regimen survived 3.94 months longer (95% CI 2.15-5.73, P<0.0001) and had longer time to progression for 2.64 months (95% CI 0.39-4.89, P=0.02) than those with high/positive RRM1.
Low/negative RRM1 expression in advanced NSCLC was associated with higher response rate to gemcitabine-containing regimen and better prognosis. Large phase III randomized trials are required to identify whether RRM1 detection is clinically valuable for predicting the prognosis and sensitivity to gemcitabine-containing regimen in advanced NSCLC.
RRM1 对含吉西他滨化疗方案治疗晚期非小细胞肺癌（NSCLC）的疗效的预测价值仍存在争议。本 meta 分析旨在系统评估 RRM1 表达是否与含吉西他滨方案治疗晚期 NSCLC 的临床疗效相关。
采用电子检索数据库 Pubmed、Medline、EMBASE、Cochrane 图书馆和中国知网（CNKI），检索时间从建库至 2011 年 5 月。对 RRM1 表达与含吉西他滨方案治疗晚期 NSCLC 临床疗效相关的研究进行系统评价。采用 Revman 5.0 软件计算反应率、加权中位生存时间和无进展时间的合并比值比（OR）。
搜索策略共确定 18 项符合条件的研究（n=1243）。低/阴性 RRM1 组患者对含吉西他滨方案的反应率显著更高（OR=0.31，95%CI 0.21-0.45，P<0.00001）。低/阴性 RRM1 的 NSCLC 患者接受含吉西他滨方案治疗的生存时间延长 3.94 个月（95%CI 2.15-5.73，P<0.0001），无进展时间延长 2.64 个月（95%CI 0.39-4.89，P=0.02）。
晚期 NSCLC 中低/阴性 RRM1 表达与含吉西他滨方案的高反应率和更好的预后相关。需要开展大型 III 期随机临床试验，以确定 RRM1 检测是否对预测晚期 NSCLC 对含吉西他滨方案的预后和敏感性具有临床价值。
