Li H M, Yuan P, Yu D K, Ma F, Tan W W, Feng T, Yang J, Huang Y, Lin D X, Xu B H, Tan W
Department of Etiology & Carcinogenesis, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2016 Jul;38(7):504-9. doi: 10.3760/cma.j.issn.0253-3766.2016.07.005.
To explore the associations between genetic variations of DNA repair gene RAD52 and response to platinum-based chemotherapy of small cell lung cancer (SCLC), and to analyze the influencing factors on survival.
Nine haplotype-tagging single nucleotide polymorphisms (htSNPs) of RAD52 were genotyped by Sequenom Mass ARRAY technology in 939 SCLC patients who received platinum-based chemotherapy, and had different response and survival time. The associations between genotypes and platinum-based chemotherapy response were analyzed by odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for sex, age, smoking, KPS, staging and chemotherapy regimens, by unconditional logistic regression model. The relative ratios (RRs) were estimated using Cox proportional hazards regression model.
Among the 939 cases, 483 (51.4%) cases received cis-platinum and etoposide treatment while others treated with carboplatin and etoposide. Six hundred and eighty two patients were chemotherapy responders in the study with a response rate of 72.6%. Patients were followed up to get their survival information. The median survival time (MST) of these patients was 25 months. We found that rs10774474 SNP which located in the 5'-flanking region of RAD52 was significantly associated with chemotherapy response. Compared with the TT genotype, patients with TA and AA genotype had a worse chemotherapy response and increased risk of no-response (P=0.004). Correlation analysis showed that patients with KPS >80 had a better chemotherapy response than those with KPS≤80 (P=0.001). The patients with extensive-stage had a worse chemotherapy response than those with limited-stage (P<0.001). Cox proportional hazards regression model analysis showed that nine htSNPs of RAD52 were not associated with the overall survival (OS) of SCLC patients who received platinum-based chemotherapy. Age≤56, KPS>80, limited-stage, chemotherapy response and radiation therapy can remarkably prolong OS (allP<0.05).
These results suggest that RAD52 genetic polymorphism rs10774474 plays an important role in the response to platinum-based chemotherapy, and may be a potential genetic biomarker for SCLC personalized treatment.
探讨DNA修复基因RAD52的基因变异与小细胞肺癌(SCLC)铂类化疗反应之间的关联,并分析生存的影响因素。
采用Sequenom Mass ARRAY技术对939例接受铂类化疗、有不同反应和生存时间的SCLC患者进行RAD52的9个单倍型标签单核苷酸多态性(htSNP)基因分型。通过无条件逻辑回归模型分析基因型与铂类化疗反应之间的关联,以比值比(OR)和95%置信区间(CI)表示,并对性别、年龄、吸烟、KPS、分期和化疗方案进行校正。使用Cox比例风险回归模型估计相对风险(RR)。
939例患者中,483例(51.4%)接受顺铂和依托泊苷治疗,其余患者接受卡铂和依托泊苷治疗。研究中有682例患者为化疗反应者,反应率为72.6%。对患者进行随访以获取其生存信息。这些患者的中位生存时间(MST)为25个月。我们发现位于RAD52 5'侧翼区域的rs10774474 SNP与化疗反应显著相关。与TT基因型相比,TA和AA基因型患者的化疗反应较差,无反应风险增加(P = 0.004)。相关性分析显示,KPS>80的患者化疗反应优于KPS≤80的患者(P = 0.001)。广泛期患者的化疗反应比局限期患者差(P<0.001)。Cox比例风险回归模型分析显示,RAD52的9个htSNP与接受铂类化疗的SCLC患者的总生存(OS)无关。年龄≤56岁、KPS>80、局限期、化疗反应和放射治疗可显著延长OS(均P<0.05)。
这些结果表明,RAD52基因多态性rs10774474在铂类化疗反应中起重要作用,可能是SCLC个体化治疗的潜在遗传生物标志物。