title: Relationship between p53 status and response to chemotherapy in patients with gastric cancer: a meta-analysis.
abstract: BACKGROUND
  Previous studies have yielded conflicting results regarding the relationship between p53 status and response to chemotherapy in patients with gastric cancer. We therefore performed a meta-analysis to expound the relationship between p53 status and response to chemotherapy.
  
  
  RESULTS
  Thirteen previously published eligible studies, including 564 cases, were identified and included in this meta-analysis. p53 positive status (high expression of p53 protein and/or a mutant p53 gene) was associated with improved response in gastric cancer patients who received chemotherapy (good response: risk ratio [RR] = 0.704; 95% confidence intervals [CI] = 0.550-0.903; P = 0.006). In further stratified analyses, association with a good response remained in the East Asian population (RR = 0.657; 95% CI = 0.488-0.884; P = 0.005), while in the European subgroup, patients with p53 positive status tended to have a good response to chemotherapy, although this did not reach statistical significance (RR = 0.828, 95% CI = 0.525-1.305; P = 0.417). As five studies used neoadjuvant chemotherapy (NCT) and one used neoadjuvant chemoradiotherapy (NCRT), we also analyzed these data, and found that p53 positive status was associated with a good response in gastric cancer patients who received chemotherapy-based neoadjuvant treatment (RR = 0.675, 95% CI = 0.463-0.985; P = 0.042).
  
  
  CONCLUSIONS
  This meta-analysis indicated that p53 status may be a useful predictive biomarker for response to chemotherapy in gastric cancer. Further prospective studies with larger sample sizes and better study designs are required to confirm our findings.
authors.affiliation: Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, People's Republic of China.
authors.forename: Hai-Yuan
authors.initials: HY
authors.lastname: Xu
authors.affiliation: Department of Central Laboratory, Zhenjiang Fourth People's Hospital Affiliated to Jiangsu University, Zhenjiang, People's Republic of China.
authors.forename: Wen-Lin
authors.initials: WL
authors.lastname: Xu
authors.affiliation: Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, People's Republic of China.
authors.forename: Li-Qiang
authors.initials: LQ
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Kunshan First People's Hospital Affiliated to Jiangsu University, Kunshan, People's Republic of China.
authors.forename: Min-Bin
authors.initials: MB
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, Zhenjiang First People's Hospital Affiliated to Jiangsu University, Zhenjiang, People's Republic of China.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Shen
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D044466:Asian People; D016903:Drug Monitoring; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D009154:Mutation; D020360:Neoadjuvant Therapy; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000235:genetics* / Q000378:metabolism; D044465:White People
chemical_list: D000970:Antineoplastic Agents; D016159:Tumor Suppressor Protein p53
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