PURPOSE: The predictive value of excision repair cross-complementation group 1 (ERCC1) for prognosis and sensitivity to platinum-based chemotherapy in patients with non-small cell lung cancer (NSCLC) remains controversial. This meta-analysis was performed to provide an assessment of whether expression variations of ERCC1 are associated with objective response and median survival in patients with advanced NSCLC treated with platinum-based chemotherapy.
METHODS: We searched MEDLINE, EMBASE and China National Knowledge Infrastructure (CNKI) for all eligible studies and conducted a meta-analysis of 12 studies (n = 836 patients) that evaluated the correlation between ERCC1 levels (detected by immunohistochemistry or real-time reverse transcriptase PCR) and objective response or median survival in patients receiving platinum-based chemotherapy for advanced NSCLC. Pooled odds ratios (OR) for the objective response were calculated using the Mantel-Haenszel method. Pooled median ratios for median survival were calculated using the weighted sum of the log-ratio of median ratios from each individual study.
RESULTS: Among 836 tumors, ERCC1 expression was high/positive in 416 (49.8%) and low/negative in 420 (50.2%). Response to platinum-based chemotherapy was significantly higher in patients with ERCC1 low/negative expression (OR = 0.48; 95% confidence Interval, 0.35 to 0.64; P < 0.00001). Median survival time was significantly prolonged when ERCC1 low/negative expression was compared with ERCC1 high/positive expression (Median Ratio: 0.77; 95% confidence Interval, 0.47 to 1.07; P < 0.00001).
CONCLUSION: This is the first meta-analysis to study the association between ERCC1 expression and platinum-based treatments for advanced non-small cell lung cancer. Low/negative expression of ERCC1 was associated with higher objective response and median survival in advanced NSCLC patients treated with platinum-based chemotherapy.
CLINICAL IMPLICATIONS: ERCC1 may be a suitable marker of prognosis and sensitivity to platinum-based chemotherapy in patients with advanced NSCLC.
DISCLOSURE: Jie Zhang, No Financial Disclosure Information; No Product/Research Disclosure Information