ABSTRACT
Gastric cancer is one of the most common malignant tumors in the world. Due to its high recurrence rate, gastric cancer is the second leading cause of cancer death. Up to now, surgical treatment is the only method of cure for patients with early disease, and with the development of endoscopy, neoadjuvant radiotherapy and chemotherapy, 5-year survival rate of patients with early gastric cancer could reach more than 95%. However, no specific symptoms were reported in the early stage of gastric cancer, most patients were diagnosed with middle and late stage when they were symptomatic, and no longer candidates for surgical treatment. In recent years, treatment for gastric cancer has evolved rapidly regarding neoadjuvant chemotherapy, molecular targeted therapy and immunotherapy as well as new chemotherapeutic regimens. The representative in the first-line chemotherapy includes platinum and fluorouracil, or a combination of these two agents. Meanwhile, targeted therapy is also widely used in this setting due to its specificity. Thus, it is necessary to summarize the therapeutic effects of current targeted therapy combined with chemotherapy in treating patients with advanced gastric cancer.
ABSTRACT
Objective To analyze the expression of excision repair cross-complementation group 1 (ERCC1),MutS protein homolog 2 (MSH2) and poly ADP-ribose polymerase 1 (PARP1) in non-small cell lung cancer (NSCLC) and their prognostic value for patients receiving platinum-based postoperative adjuvant chemotherapy.Methods Immunohistochemistry was applied to detect the expression of ERCC1,MSH2 and PARP1 in 111 cases of NSCLC paraffin embedded surgical specimens.Through OG-Rank survival analysis,the prognostic value of the ERCC1,MSH2,PARP1 and the related clinic pathological factors were evaluated.Cox regression analysis was used to determine whether ERCC1,MSH2 and PARP1 were independent prognostic factors or not.Results Among the 111 NSCLC patients,the positive expression rates of ERCC1,MSH2 and RARP1 were 33.3 ％(37/111),36.9 ％(41/111) and 55.9 ％(62/111),respectively.Besides,a total of 72 patients who received platinum-based chemotherapy had complete follow-up data.ERCC1 (P＜ 0.001) and PARP1 (P=0.033) were found to be correlated with the survival time while there was no correlation for MSH2 (P =0.298).Patients with both ERCC1 and PARP1 negative had significant longer survival time than those with ERCC1 (P=0.042) or PARP1 (P=0.027) positive alone.Similarly,the survival time of patients with both ERCC1 and PARP1 positive was shorter than those with ERCC1 (P=0.048) or PARP1 (P=0.010) positive alone.Conclusions The NSCLC patients with ERCC1 and (or) PARP1 negative may benefit from platinumbased postoperative adjuvant chemotherapy.The detection of ERCC1 and PARP1 can be used as an important method to assess the prognosis of patients with NSCLC.