title: Bax predicts outcome in gastric cancer patients treated with 5-fluorouracil, leucovorin, and oxaliplatin palliative chemotherapy.
abstract: BACKGROUND
  Platinum and 5-fluorouracil (5-FU)-based regimens have been used the most frequently in palliative chemotherapy for gastric cancer. The present study evaluated the prognostic significance of Bax, excision repair cross-complementation group 1 (ERCC1), and thymidylate synthase (TS) in advanced gastric cancer patients treated with 5-FU, leucovorin, and oxaliplatin (FOLFOX) palliative chemotherapy.
  
  
  METHODS
  Seventy-two patients with metastatic or recurrent gastric cancer were treated with FOLFOX regimen. Pretreatment tumor biopsy specimens were analyzed for Bax, ERCC1, and TS expression by immunohistochemistry.
  
  
  RESULTS
  High expression of Bax, ERCC1, and TS was observed in 31 (43%), 33 (46%), and 35 (49%) patients, respectively. The median overall survival (OS) of patients was 12 months. Low expression of Bax was associated with poor OS (median, 9 months vs. 18 months; 2-year, 10% vs. 48%; p=0.0005) in univariate analysis, while expression of ERCC1 and TS was not correlated with patient outcome. In multivariate analysis, low expression of Bax was a significant independent predictor of poor OS (p=0.028). Low expression of Bax was significantly associated with poor survival of patients with metastatic or recurrent gastric cancer treated with FOLFOX chemotherapy.
  
  
  CONCLUSIONS
  Immunohistochemical staining for Bax with pretreatment biopsy specimen may be useful in selecting FOLFOX regimen as a treatment option for advanced gastric cancer patients.
authors.affiliation: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, 443-721, Republic of Korea.
authors.forename: Seong Hyun
authors.initials: SH
authors.lastname: Jeong
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Jang Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Mi Sun
authors.initials: MS
authors.lastname: Ahn
authors.forename: Yoon Ho
authors.initials: YH
authors.lastname: Hwang
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Lee
authors.forename: Seok Yun
authors.initials: SY
authors.lastname: Kang
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: Jin-Hyuk
authors.initials: JH
authors.lastname: Choi
authors.forename: Kwang Jae
authors.initials: KJ
authors.lastname: Lee
authors.forename: Seung Soo
authors.initials: SS
authors.lastname: Sheen
authors.forename: Ho-Yeong
authors.initials: HY
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy; D004268:DNA-Binding Proteins / Q000378:metabolism; D004720:Endonucleases / Q000378:metabolism; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D013940:Thymidylate Synthase / Q000378:metabolism; D016896:Treatment Outcome; D051028:bcl-2-Associated X Protein / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D009944:Organoplatinum Compounds; D051028:bcl-2-Associated X Protein; D013940:Thymidylate Synthase; C071447:ERCC1 protein, human; D004720:Endonucleases; D002955:Leucovorin; D005472:Fluorouracil