Department of Medical Oncology, Beijing Hospital, Beijing, China.
Cancer Biomark. 2013 Jan 1;13(6):433-40. doi: 10.3233/CBM-130381.
Ribonucleotide reductase subunit M1 (RRM1) has emerged as a promising biomarker to predict the efficacy of gemcitabine. The purpose of the study was to evaluate whether the tailored chemotherapy based on RRM1 immunohistochemical (IHC) expression had any benefit for patients with advanced non-small cell lung cancer (NSCLC).
A single-institution study was conducted in patients with advanced NSCLC. In personalized therapy group, patients received chemotherapy based on RRM-1 IHC expression levels. Low RRM1 group received gemcitabine or gemcitabine/cisplatin, high RRM1 group received docetaxel or docetaxel/ cisplatin. In standard therapy group, non-customized chemotherapy was delivered. In this trial, Patients aged ⩾ 70 years received single agent chemotherapy, whereas patients below 70 had platinum-based chemotherapy.
There were statistically significant improvements between the personalized therapy group versus the standard therapy group in disease control rate (82.9% vs 55.3%, P=0.004), and PFS (median: 5.5 months vs 3.0 months, P=0.005). Besides, the OS had a tendency to become more prolonged (median: 16.0 months vs 12.4 months, P=0.286). The subgroup analysis suggested the survival benefit in the elderly patients was more obvious.
RRM1 IHC expression tailored selection of first-line therapy could improve therapeutic outcomes in patients with advanced NSCLC.
核苷酸还原酶亚单位 M1（RRM1）已成为预测吉西他滨疗效的有前途的生物标志物。本研究旨在评估基于 RRM1 免疫组织化学（IHC）表达的个体化化疗是否对晚期非小细胞肺癌（NSCLC）患者有益。
在晚期 NSCLC 患者中进行了一项单机构研究。在个体化治疗组中，根据 RRM-1 IHC 表达水平为患者提供化疗。低 RRM1 组接受吉西他滨或吉西他滨/顺铂，高 RRM1 组接受多西他赛或多西他赛/顺铂。在标准治疗组中，给予非定制化疗。在这项试验中，年龄 ⩾ 70 岁的患者接受单药化疗，而年龄低于 70 岁的患者接受铂类化疗。
与标准治疗组相比，个体化治疗组在疾病控制率（82.9% vs 55.3%，P=0.004）和 PFS（中位数：5.5 个月 vs 3.0 个月，P=0.005）方面均有显著改善。此外，OS 有延长的趋势（中位数：16.0 个月 vs 12.4 个月，P=0.286）。亚组分析表明，老年患者的生存获益更为明显。
RRM1 IHC 表达的个体化选择一线治疗可改善晚期 NSCLC 患者的治疗结果。
