根据 RRM1 表达情况预测非小细胞肺癌患者一线化疗的反应。

Response to first-line chemotherapy in patients with non-small cell lung cancer according to RRM1 expression.

机构信息

Department of Thoracic Surgery, Second Hospital of Shandong University, Jinan, China.

Department of Thoracic Surgery, Affiliated Hospital of Qingdao University Medical College, Qingdao, China.

出版信息

PLoS One. 2014 Mar 19;9(3):e92320. doi: 10.1371/journal.pone.0092320. eCollection 2014.

DOI:10.1371/journal.pone.0092320

PMID:24647522

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3960222/

Abstract

BACKGROUND

The response to cytotoxic chemotherapy varies greatly in patients with advanced non-small cell lung cancer (NSCLC), and molecular markers may be useful in determining a preferable therapeutic approach for individual patients. This retrospective study was performed to evaluate the predictive value of ribonucleotide reductase regulatory subunit M1 (RRM1) on the therapeutic efficacy of platinum-based chemotherapy in patients with NSCLC.

METHODS

Patients with advanced NSCLC who received platinum doublet chemotherapy (n = 229) were included in this retrospective study, and their clinical outcomes were analyzed according to RRM1 expression.

RESULTS

In patients receiving gemcitabine-based therapy, the disease control rate (DCR) and progression-free survival (PFS) of patients with RRM1-negative tumors were significantly higher than in patients with RRMI-positive tumors (P = 0.041 and P = 0.01, respectively), and multivariate analysis showed that RRM1 expression was an independent prognostic factor (P = 0.013). No similar differences were found in patients receiving docetaxel- or vinorelbine-based therapy. In RRM1-positive patients, the DCRs for docetaxel and vinorelbine were higher than for gemcitabine (P = 0.047 and P = 0.047, respectively), and docetaxel and vinorelbine showed a longer PFS than gemcitabine-based chemotherapy (P = 0.012 and P = 0.007). No similar differences were found among patients with RRM1-negative tumors.

CONCLUSIONS

Negative RRM1 expression in advanced NSCLC is associated with a higher response rate to gemcitabine-based chemotherapy. In patients with RRM1-positive tumors, docetaxel and vinorelbine showed a higher therapeutic efficacy than gemcitabine-based therapy. Additional prospective studies are needed to investigate the predictive meaning of RRM1 in the response to chemotherapy.

摘要

背景

晚期非小细胞肺癌（NSCLC）患者对细胞毒性化疗的反应差异很大，分子标志物可能有助于确定个体患者的更优治疗方法。本回顾性研究旨在评估核苷酸还原酶调节亚基 M1（RRM1）对 NSCLC 患者铂类化疗疗效的预测价值。

方法

本回顾性研究纳入了 229 例接受铂类双药化疗的晚期 NSCLC 患者，根据 RRM1 表达情况分析其临床结局。

结果

在接受吉西他滨为基础的治疗的患者中，RRM1 阴性肿瘤患者的疾病控制率（DCR）和无进展生存期（PFS）显著高于 RRM1 阳性肿瘤患者（P=0.041 和 P=0.01，分别），多因素分析显示 RRM1 表达是独立的预后因素（P=0.013）。在接受多西他赛或长春瑞滨为基础的治疗的患者中未发现类似差异。在 RRM1 阳性的患者中，多西他赛和长春瑞滨的 DCR 高于吉西他滨（P=0.047 和 P=0.047，分别），且多西他赛和长春瑞滨的 PFS 长于吉西他滨化疗（P=0.012 和 P=0.007）。在 RRM1 阴性的肿瘤患者中未发现类似差异。