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The prognostic value of excision repair cross-complementation group 1 (ERCC1) in patients with small cell lung cancer (SCLC) receiving platinum-based chemotherapy: evidence from meta-analysis.

Yang Y, Luo X, Yang N, Feng R, Xian L - PLoS ONE (2014)

Bottom Line: Our analysis indicated that positive/high ERCC1 expression was associated with unfavorable OS (HR = 1.18, 95%CI = 1.02-1.37) and PFS (HR = 1.46, 95%CI = 1.14-1.88).Subgroup analysis according to disease stage suggested the significant relationship was found in limited stage (LS-SCLC), but not in extensive stage (ES-SCLC).However, no significant association was found between ERCC1 expression and ORR.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.

ABSTRACT
Recently, the correlation between the efficacy of platinum-based chemotherapy and ERCC1 expression in patients with SCLC has attracted wide-spread attention, and a lot of investigations have been conducted, whereas conflicting results were presented. Therefore, we performed the present meta-analysis of eligible studies to derive a more precise evaluation of the association between ERCC1 expression and the clinical outcome in SCLC patients receiving platinum-based chemotherapy. A literature search for relevant studies was conducted in the electronic databases of PubMed, EMBASE and Web of Science. The inclusive criteria were SCLC patients treated by platinum-based chemotherapy, and evaluated the relationship between ERCC1 expression and the clinical outcomes [including overall response rate (ORR), overall survival (OS) or progression-free survival (PFS)]. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) was calculated to assess the risk. A total of nine studies including 1129 patients were included in final analysis. Our analysis indicated that positive/high ERCC1 expression was associated with unfavorable OS (HR = 1.18, 95%CI = 1.02-1.37) and PFS (HR = 1.46, 95%CI = 1.14-1.88). Subgroup analysis according to disease stage suggested the significant relationship was found in limited stage (LS-SCLC), but not in extensive stage (ES-SCLC). However, no significant association was found between ERCC1 expression and ORR. Our analysis suggested ERCC1 expression may be a prognostic factor in SCLC patients receiving platinum-based chemotherapy, especially for LS-SCLC.

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Forest plot for the association between ERCC1 level and overall survival (OS) in LS-SCLC patients receiving platinum-based chemotherapy.
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pone-0111651-g004: Forest plot for the association between ERCC1 level and overall survival (OS) in LS-SCLC patients receiving platinum-based chemotherapy.

Mentions: A total of eight studies [10], [21]–[24], [32], [33], [35] composed of 1053 patients reported the data on overall survival (OS). Overall, the pooled analysis showed that positive/high ERCC1 expression was significantly associated with shorter OS for SCLC patients receiving platinum-based chemotherapy (HR = 1.18, 95% CI = 1.02–1.37, I2 = 19.8%, P = 0.27 for heterogeneity; Table 2, Figure 3). Of the eight studies reporting the data on OS, three studies [10], [22], [32] were conducted in Asian patients, four studies [21], [24], [33], [35] were conducted in Caucasians and one study [23] was conducted in mixed ethnicity. In the stratified analysis according to ethnicity, our analysis indicated that ERCC1 expression was related to OS in Caucasian population (HR = 1.25, 95% CI = 1.01–1.53, I2 = 0.0%, P = 0.41 for heterogeneity; Table 2), but not in Asian population (HR = 1.25, 95% CI = 0.96–1.63, I2 = 47.4%, P = 0.13 for heterogeneity; Table 2). Five studies [10], [21], [24], [32], [35] focused on limited stage, Four studies [10], [23], [32], [35] focused on extensive stage. Subgroup analysis based on disease stage suggested that the patients with positive/high ERCC1 expression would have shorter OS for limited stage (positive/high vs. negative/low: HR = 1.54, 95% CI = 1.21–1.96, I2 = 38.2%, P = 0.17 for heterogeneity; Table 2, Figure 4), but not for extensive stage (positive/high vs. negative/low: HR = 0.96, 95% CI = 0.74–1.24, I2 = 0.0%, P = 0.74 for heterogeneity; Table 2). We then focused on ERCC1 detection method, only two studies [21], [24] using RT-PCR showed a significant association between the expression of ERCC1 and the OS in patients with SCLC (HR = 1.37, 95% CI = 1.06–1.78, I2 = 0.0%, P = 0.74 for heterogeneity; Table 2).


The prognostic value of excision repair cross-complementation group 1 (ERCC1) in patients with small cell lung cancer (SCLC) receiving platinum-based chemotherapy: evidence from meta-analysis.

Yang Y, Luo X, Yang N, Feng R, Xian L - PLoS ONE (2014)

Forest plot for the association between ERCC1 level and overall survival (OS) in LS-SCLC patients receiving platinum-based chemotherapy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4222940&req=5

pone-0111651-g004: Forest plot for the association between ERCC1 level and overall survival (OS) in LS-SCLC patients receiving platinum-based chemotherapy.
Mentions: A total of eight studies [10], [21]–[24], [32], [33], [35] composed of 1053 patients reported the data on overall survival (OS). Overall, the pooled analysis showed that positive/high ERCC1 expression was significantly associated with shorter OS for SCLC patients receiving platinum-based chemotherapy (HR = 1.18, 95% CI = 1.02–1.37, I2 = 19.8%, P = 0.27 for heterogeneity; Table 2, Figure 3). Of the eight studies reporting the data on OS, three studies [10], [22], [32] were conducted in Asian patients, four studies [21], [24], [33], [35] were conducted in Caucasians and one study [23] was conducted in mixed ethnicity. In the stratified analysis according to ethnicity, our analysis indicated that ERCC1 expression was related to OS in Caucasian population (HR = 1.25, 95% CI = 1.01–1.53, I2 = 0.0%, P = 0.41 for heterogeneity; Table 2), but not in Asian population (HR = 1.25, 95% CI = 0.96–1.63, I2 = 47.4%, P = 0.13 for heterogeneity; Table 2). Five studies [10], [21], [24], [32], [35] focused on limited stage, Four studies [10], [23], [32], [35] focused on extensive stage. Subgroup analysis based on disease stage suggested that the patients with positive/high ERCC1 expression would have shorter OS for limited stage (positive/high vs. negative/low: HR = 1.54, 95% CI = 1.21–1.96, I2 = 38.2%, P = 0.17 for heterogeneity; Table 2, Figure 4), but not for extensive stage (positive/high vs. negative/low: HR = 0.96, 95% CI = 0.74–1.24, I2 = 0.0%, P = 0.74 for heterogeneity; Table 2). We then focused on ERCC1 detection method, only two studies [21], [24] using RT-PCR showed a significant association between the expression of ERCC1 and the OS in patients with SCLC (HR = 1.37, 95% CI = 1.06–1.78, I2 = 0.0%, P = 0.74 for heterogeneity; Table 2).

Bottom Line: Our analysis indicated that positive/high ERCC1 expression was associated with unfavorable OS (HR = 1.18, 95%CI = 1.02-1.37) and PFS (HR = 1.46, 95%CI = 1.14-1.88).Subgroup analysis according to disease stage suggested the significant relationship was found in limited stage (LS-SCLC), but not in extensive stage (ES-SCLC).However, no significant association was found between ERCC1 expression and ORR.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.

ABSTRACT
Recently, the correlation between the efficacy of platinum-based chemotherapy and ERCC1 expression in patients with SCLC has attracted wide-spread attention, and a lot of investigations have been conducted, whereas conflicting results were presented. Therefore, we performed the present meta-analysis of eligible studies to derive a more precise evaluation of the association between ERCC1 expression and the clinical outcome in SCLC patients receiving platinum-based chemotherapy. A literature search for relevant studies was conducted in the electronic databases of PubMed, EMBASE and Web of Science. The inclusive criteria were SCLC patients treated by platinum-based chemotherapy, and evaluated the relationship between ERCC1 expression and the clinical outcomes [including overall response rate (ORR), overall survival (OS) or progression-free survival (PFS)]. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) was calculated to assess the risk. A total of nine studies including 1129 patients were included in final analysis. Our analysis indicated that positive/high ERCC1 expression was associated with unfavorable OS (HR = 1.18, 95%CI = 1.02-1.37) and PFS (HR = 1.46, 95%CI = 1.14-1.88). Subgroup analysis according to disease stage suggested the significant relationship was found in limited stage (LS-SCLC), but not in extensive stage (ES-SCLC). However, no significant association was found between ERCC1 expression and ORR. Our analysis suggested ERCC1 expression may be a prognostic factor in SCLC patients receiving platinum-based chemotherapy, especially for LS-SCLC.

Show MeSH
Related in: MedlinePlus