期刊
LUNG CANCER
卷 72, 期 1, 页码 84-91出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.lungcan.2010.07.008
关键词
First-line; Methylation; CHFR; EGFR; Non-small cell lung cancer
资金
- Spanish Ministry of Health through the Red de Centros de Epidemiologia y Salud Palica (RCESP)
- Red Tematica de Investigacion Cooperativa de Centros de Cancer [CO-010]
- La Fundacion Badalona Contra el Cancer
The potential differential effect of first-line treatment and molecular mechanisms on survival to second-line chemotherapy or EGFR tyrosine kinase inhibitors (TKIs) in non-small-cell lung cancer (NSCLC) has not been fully investigated. In particular, CHFR is frequently methylated in NSCLC and may influence outcome. We analyzed the outcome of second-line chemotherapy or EGFR TKIs in 179 of 366 patients who had been treated in an ERCC1 mRNA-based customized cisplatin trial and correlated the results with CHFR methylation status. CHFR methylation in circulating DNA was examined by methylation-specific assay. A panel of seven human EGFR wild-type NSCLC cell lines was characterized for their sensitivity to sequential treatment with cisplatin and erlotinib, and the results were correlated with CHFR. Patients who had received first-line docetaxel/cisplatin attained an overall survival of 19.2 months when treated with second-line EGFR TKIs, in comparison with 10.7 months when treated with second-line chemotherapy (P=0.0002). However, for patients who had received first-line docetaxel/gemcitabine, overall survival was 14.8 months with EGFR TKIs and 10.8 months with chemotherapy (P=0.29). For patients with unmethylated CHFR overall survival to EGFRTKIs was 21.4 months, and 11.2 months for those with treated with chemotherapy (P=0.0001). In the only lung tumor cell line not expressing CHFR, pretreatment with cisplatin was antagonistic to erlotinib, while it was synergistic in the other six lines. Second-line EGFR TKIs improved survival in patients receiving first-line cisplatin-based treatment. Unmethylated CHFR predicts increased survival to EGFR TKIs. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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