Lung Cancer |

The Pemetrexed-Containing Treatments in the Non-small Cell Lung Cancer, Is -/Low Thymidylate Synthase Expression Better than +/High Thymidylate Synthase Expression? A Meta-analysis FREE TO VIEW

Lei Wang; Rui Wang, MD; Yunjian Pan, MS; Yihua Sun, MD; Jie Zhang, MD; Haiquan Chen, PhD
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Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China

Chest. 2014;145(3_MeetingAbstracts):349A. doi:10.1378/chest.1832401
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SESSION TYPE: Slide Presentations

PRESENTED ON: Saturday, March 22, 2014 at 02:15 PM - 03:45 PM

PURPOSE: The predictive value of thymidylate synthase (TS) for clinical sensitivity to pemetrexed-containing chemotherapy in patients with non-small cell lung cancer (NSCLC) remains controversial. This meta-analysis is performed to provide an assessment of whether expression variations of TS are associated with objective response in patients with NSCLC treated with pemetrexed-containing chemotherapy.

METHODS: An electronic search was conducted using the databases MEDLINE, EMBASE and CNKI, from inception to June 10th, 2013. A systemic review of the studies on the association between TS expression in NSCLC and objective response of pemetrexed-containing regimen was performed. Pooled odds ratios (OR) for the response rate were calculated using the software Revman 5.0.

RESULTS: There were a total of 526 patients in the eight studies that met our criteria for evaluation. +/high expression of TS was found in 269 patients (51.1%), and -/low expression for this gene was found in 257 (48.9%) patients. The objective response rate for pemetrexed-containing chemotherapy was significantly higher in patients with -/low expression TS expression (OR = 0.45; 95% CI, 0.29-0.70; P = 0.0004). Although patients with -/low expression of TS have a longer median survival time and relapse free survival than those with +/high expression of TS, the difference was not statistically significant.

CONCLUSIONS: -/low expression of TS was associated with higher objective response in NSCLC patients treated with pemetrexed-containing chemotherapy. TS may be a suitable marker of sensitivity to pemetrexed-based chemotherapy in patients with NSCLC.

CLINICAL IMPLICATIONS: Our meta-analysis demonstrated TS maybe a suitable marker of sensitivity to pemetrexed-containing chemotherapy in patients with NSCLC. Our findings may be useful for the further investigation of random clinical trial on patients receiving pemetrexed-based chemotherapy.

DISCLOSURE: The following authors have nothing to disclose: Lei Wang, Rui Wang, Yunjian Pan, Yihua Sun, Jie Zhang, Haiquan Chen

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