Predicting chemotherapy response to paclitaxel-based therapy in advanced non-small-cell lung cancer with P-glycoprotein expression.
BACKGROUND
It was reported that multidrug resistance gene 1 (MDR1) encoding human P-glycoprotein (Pgp) may play an important role in multidrug resistance of lung cancer. Therefore, before initiating chemotherapy, it is important to accurately determine the presence of Pgp in lung cancer, to achieve a satisfactory chemotherapy response.


OBJECTIVE
The aim of this study was to compare immunohistochemical analyses of Pgp expression and response to paclitaxel in non-small-cell lung cancer (NSCLC).


METHODS
Before chemotherapy with paclitaxel, 50 patients with stage IIIb or IV NSCLC were enrolled in this study. Immunohistochemical analyses were performed on multiple nonconsecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the 3rd month after completion of treatment by clinical and radiological methods.


RESULTS
All of the 28 (100%) cases with good response had negative Pgp expression and 15 of the 22 (68%) cases with poor response had positive Pgp expression (p < 0.05). No significant differences were found for other prognostic factors (age, sex, body weight loss, performance status, tumor cell type, and tumor stage) between good response and poor response groups.


CONCLUSIONS
Although Pgp expression in NSCLC does not fully predict chemotherapy response to paclitaxel-based therapy, detection of Pgp expression will aid in planning paclitaxel-based therapy for patients with advanced NSCLC. Further studies with a larger number of patients and a longer time of follow-up are necessary to confirm our findings.
Yeh
J J
JJ
Department of Thoracic Medicine, Ping Tung Christian Hospital, and Mei Ho Institute of Technology, Ping Tung, Taiwan.
Hsu
W H
WH
Wang
J J
JJ
Ho
S T
ST
Kao
A
A
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000627:therapeutic use*; D011237:Predictive Value of Tests
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000972:Antineoplastic Agents, Phytogenic; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D017239:Paclitaxel