Science and Research

ERCC1 assessment in upfront treatment with and without cisplatin-based chemotherapy in stage IIIB/IV non-squamous non-small cell lung cancer

Prior studies have demonstrated an association between excision repair cross-complementation group 1 (ERCC1) expression level and outcomes in patients with advanced non-small cell lung cancer (NSCLC) treated with platinum-based chemotherapy. The aim of this study was to assess the impact of ERCC1 on survival for patients with stage IIIB/IV non-squamous NSCLC (NS-NSCLC) enrolled in the INNOVATIONS trial, thus receiving as treatment either erlotinib/bevacizumab (EB) or cisplatin/gemcitabine/bevacizumab (PGB). We retrospectively analyzed tumor tissue of 72 patients using immunohistochemistry to assess the expression of ERCC1. The distribution between treatment arms was equal (36 patients each). Two different H scores were calculated and correlated with survival. In ERCC1-positive patients, no significant difference in terms of progression-free survival (PFS) between treatment arms has been detected. ERCC1-negative patients benefited from PGB compared to EB arm (H score: HR = 0.377, 95% CI [0.167-0.849], p = 0.0151; modified H score: HR = 0.484, 95% CI [0.234-1.004], p = 0.0468). With respect to the scoring system, in the EB-arm, a significant superior PFS turned out in ERCC1-positive patients when employing the H-score (HR = 0.430, 95% CI [0.188-0.981], p = 0.0397; median 4.9 vs. 3.9 months), but not with the modified H-score. Our findings support the hypothesis that NS-NSCLC displaying a low ERCC1 expression might benefit from cisplatin-based chemotherapy. High expression indicated better PFS in the EB arm supporting the prognostic impact. However, as impact of ERCC1-assessment even might depend on scoring systems differences, the need in standardization of assessment methodology is emphasized.

  • Villalobos, M.
  • Czapiewski, P.
  • Reinmuth, N.
  • Fischer, J. R.
  • Andreas, S.
  • Kortsik, C.
  • Serke, M.
  • Wolf, M.
  • Neuser, P.
  • Reuss, A.
  • Schnabel, P. A.
  • Thomas, M.

Keywords

  • Ercc1
  • H score
  • Non-small cell lung cancer
  • Prognostic biomarkers
Publication details
DOI: 10.1007/s12032-018-1169-5
Journal: Medical oncology (Northwood, London, England)
Pages: 106 
Number: 7
Work Type: Original
Location: TLRC
Disease Area: LC
Partner / Member: UKHD
Access-Number: 29905882
See publication on PubMed

DZL Engagements

chevron-down