title: Association between TYMS expression and efficacy of pemetrexed-based chemotherapy in advanced non-small cell lung cancer: a meta-analysis.
abstract: BACKGROUND
  The predictive value of thymidylate synthase (TYMS) to sensitivity to pemetrexed-based chemotherapy in advanced non-small cell lung cancer (NSCLC) patients is controversial. We conducted a meta-analysis of all relevant published data to assess the association of TYMS expression with the clinical outcomes of pemetrexed-based regimen in advanced NSCLC.
  
  
  METHODS
  We conducted an electronic search using using PubMed, Embase, OVID and Cochrane Library databases and manual search. Pooled odds ratio (OR) for the response rate and hazard ratio (HR) for the overall survival and progression free survival were calculated using the software Revman 5.0.
  
  
  RESULTS
  There were 11 studies (n=798) met our criteria for evaluation. Response rate to pemetrexed-based regimen was significantly higher in patients with low/negative TYMS (OR=2.96, 95%CI [1.81, 4.86] P<0.0001). Patients with low/negative TYMS who were treated with pemetrexed-based regimen had longer progression free survival (HR 0.50, 95%CI [0.41, 0.61] P <0.00001) and overall survival (HR 0.41, 95%CI [0.22, 0.78] P=0.007) than those with high/positive TYMS.
  
  
  CONCLUSIONS
  Low/negative TYMS expression was significantly associated with higher response rate, longer median survival and longer progression free survival for advanced NSCLC patients receiving pemtrexed-based chemotherapy. Hence, TYMS may be a potential predictor of sensitivity to pemtrexed-based chemotherapy in advanced NSCLC. Large scale prospective clinical trials are still warranted.
authors.affiliation: Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Chengdu, Sichuan, PR China.
authors.forename: Ting
authors.initials: T
authors.lastname: Wang
authors.forename: Chang
authors.initials: C
authors.lastname: Chuan Pan
authors.forename: Jing
authors.initials: J
authors.lastname: Rui Yu
authors.forename: Yu
authors.initials: Y
authors.lastname: Long
authors.forename: Xiao
authors.initials: X
authors.lastname: Hong Cai
authors.forename: Xu
authors.initials: X
authors.lastname: De Yin
authors.forename: Li
authors.initials: L
authors.lastname: Qiong Hao
authors.forename: Li
authors.initials: L
authors.lastname: Li Luo
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D016206:Databases, Bibliographic; D018572:Disease-Free Survival; D015870:Gene Expression; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality; D009367:Neoplasm Staging; D016017:Odds Ratio; D000068437:Pemetrexed; D013940:Thymidylate Synthase / Q000235:genetics*; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D013940:Thymidylate Synthase
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