title: The platinum-based treatments for advanced non-small cell lung cancer, is low/negative ERCC1 expression better than high/positive ERCC1 expression? A meta-analysis.
abstract: BACKGROUND
  The predictive value of ERCC1 for prognosis and sensitivity to platinum-based chemotherapy in patients with non-small cell lung cancer (NSCLC) remains controversial. This meta-analysis was performed to provide an assessment of whether expression variations of ERCC1 are associated with objective response and median survival in patients with advanced NSCLC treated with platinum-based chemotherapy.
  
  
  METHODS
  We searched MEDLINE, EMBASE and CNKI for all eligible studies and conducted a meta-analysis of 12 studies (n=836 patients) that evaluated the correlation between ERCC1 levels (detected by immunohistochemistry or real-time reverse transcriptase PCR) and objective response or median survival in patients receiving platinum-based chemotherapy for advanced NSCLC. Pooled odds ratios (OR) for the objective response were calculated using the Mantel-Haenszel method. Pooled median ratios for median survival were calculated using the weighted sum of the log-ratio of median ratios from each individual study.
  
  
  RESULTS
  Among 836 tumors, ERCC1 expression was high/positive in 416 (49.8%) and low/negative in 420 (50.2%). Response to platinum-based chemotherapy was significantly higher in patients with ERCC1 low/negative expression (OR=0.48; 95% CI, 0.35-0.64; P<0.00001). Median survival time was significantly prolonged when ERCC1 low/negative expression was compared with ERCC1 high/positive expression (MR: 0.77; 95% CI, 0.47-1.07; P<0.00001).
  
  
  CONCLUSIONS
  Low/negative expression of ERCC1 was associated with higher objective response and median survival in advanced NSCLC patients treated with platinum-based chemotherapy. ERCC1 may be a suitable marker of prognosis and sensitivity to platinum-based chemotherapy in patients with advanced NSCLC.
authors.affiliation: Department of Cardiothoracic Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 600 Yishan Road, Shanghai 200233, People's Republic of China.
authors.forename: Sufeng
authors.initials: S
authors.lastname: Chen
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Luo
authors.forename: Haiquan
authors.initials: H
authors.lastname: Chen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000201:enzymology*; D004268:DNA-Binding Proteins / Q000096:biosynthesis* / Q000172:deficiency; D004720:Endonucleases / Q000096:biosynthesis* / Q000172:deficiency; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000201:enzymology*; D009944:Organoplatinum Compounds / Q000008:administration & dosage*; D015996:Survival Rate
chemical_list: D004268:DNA-Binding Proteins; D009944:Organoplatinum Compounds; C071447:ERCC1 protein, human; D004720:Endonucleases