Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
J Thorac Oncol. 2012 Jun;7(6):973-81. doi: 10.1097/JTO.0b013e31824fe98c.
Elevated DNA-repair capacity has been related to chemoresistance of platinum doublet chemotherapy in non-small-cell lung cancer (NSCLC). We evaluated whether single nucleotide polymorphisms of DN- repair genes excision repair cross-complementing group 1 (ERCC1), ERCC2, x-ray repair cross-complementing group 1 (XRCC1), XRCC3, and RRM1 associate with treatment outcome in NSCLC patients receiving gemcitabine plus platinum as their first-line chemotherapy.
Genotyping for eight polymorphisms in five DNA-repair genes was performed with the GenomeLab nucleotide polymorphismstream Genotyping System in 62 advanced NSCLC patients in a training set and 45 patients in a validation set treated with gemcitabine/platinum.
In the training set, the wild-type genotype of XRCC1 Arg399Gln (G/G) was associated with decreased median overall survival (OS) (22 months, 95% confidence interval [CI], 10-34 months versus not reached, log-rank test, p = 0.005) than those carrying variant genotypes (G/A+A/A). In addition, there was a statistically significant longer median OS in patients carrying wild-type ERCC2 Asp312Asn genotype (G/G) (51 months, 95% CI, 19-82 months versus 10 months, log-rank test, p < 0.001) than those carrying heterozygous variant genotypes (G/A). In the multivariate Cox model, we found a significant effect of XRCC1 Arg399Gln (G/A+A/A versus G/G, hazard ratio [HR] 0.290; 95%CI, 0.12-0.705, p = 0.006) and ERCC2 Asp312Asn (G/A versus G/G, HR 14.04; 95% CI, 2.253-87.513, p = 0.005) polymorphisms on patients' OS. In the validation set, only XRCC1 399
Genetic polymorphism of XRCC1 Arg399Gln may be a candidate for contributing interindividual difference in the OS of gemcitabine/platinum-treated advanced NSCLC patients.
在非小细胞肺癌(NSCLC)中,DNA 修复能力的提高与铂类双联化疗的耐药性有关。我们评估了切除修复交叉互补基因 1(ERCC1)、ERCC2、X 射线修复交叉互补基因 1(XRCC1)、XRCC3 和 RRM1 的 DNA 修复基因单核苷酸多态性是否与接受吉西他滨加铂类药物作为一线化疗的 NSCLC 患者的治疗结果相关。
采用基因组实验室核苷酸多态性流基因分型系统,在 62 例接受吉西他滨/铂类药物治疗的晚期 NSCLC 患者的训练集和 45 例验证集中进行 5 个 DNA 修复基因中的 8 个多态性的基因分型。
在训练集中,XRCC1Arg399Gln(G/G)的野生型基因型与降低的中位总生存期(OS)(22 个月,95%置信区间[CI],10-34 个月与未达到,对数秩检验,p=0.005)相关,而携带变异基因型(G/A+A/A)的患者则较低。此外,携带野生型 ERCC2Asp312Asn 基因型(G/G)的患者中位 OS 显著延长(51 个月,95%CI,19-82 个月比 10 个月,对数秩检验,p<0.001)比携带杂合变异基因型(G/A)的患者。在多变量 Cox 模型中,我们发现 XRCC1Arg399Gln(G/A+A/A 比 G/G,风险比[HR]0.290;95%CI,0.12-0.705,p=0.006)和 ERCC2Asp312Asn(G/A 比 G/G,HR 14.04;95%CI,2.253-87.513,p=0.005)多态性对患者 OS 有显著影响。在验证集中,只有 XRCC1399
XRCC1Arg399Gln 的遗传多态性可能是导致吉西他滨/铂类药物治疗晚期 NSCLC 患者 OS 个体间差异的候选因素。