title: ERCC1 expression affects outcome in metastatic pancreatic carcinoma treated with FOLFIRINOX: A single institution analysis.
abstract: BACKGROUND
  No clinically useful predictive factor has been yet identified for treatment of metastatic pancreatic cancer (mPC). It is noteworthy that FOLFIRINOX, despite its high toxicity, is effective only in some patients. We retrospectively analyzed expression of excision repair cross-complementing group-1 (ERCC1) - involved in the repair of platinum induced damage - in patients affected by mPC treated with FOLFIRINOX in order to evaluate its predictive role.
  
  
  RESULTS
  FOLFIRINOX resulted more effective in patients with normal ERCC1 levels than in those with ERCC1 hyper-expression. Median progression free survival (PFS) was 11 vs. 4 months (HR 0.26; 95% CI 0.14-0.50; p<.0001), median overall survival (OS) 16 vs. 8 months (HR 0.23; 95% CI 0.12-0.46; p<.0001) and disease control rate (DCR) 93% vs. 50% (p=0.00006). The advantage was confirmed at univariate and multivariate analysis.
  
  
  METHODS
  71 patients with histologically proven mPC and treated with FOLFIRINOX as first-line therapy were considered eligible. mRNA ERCC1 expression was determined using RT-PCR analysis.
  
  
  CONCLUSIONS
  ERCC1 might be an effective predictor of response to FOLFIRINOX in mPC. Patients overexpressing ERCC1 should be excluded by this often toxic therapy and referred to an alternative treatment.
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Antonia
authors.initials: A
authors.lastname: Strippoli
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Rossi
authors.affiliation: Department of Pathology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Martini
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Basso
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: D'Argento
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schinzari
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Rosalba
authors.initials: R
authors.lastname: Barile
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cassano
authors.affiliation: Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Barone
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004268:DNA-Binding Proteins / Q000096:biosynthesis*; D018572:Disease-Free Survival; D004720:Endonucleases / Q000096:biosynthesis*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D000077146:Irinotecan; D053208:Kaplan-Meier Estimate; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D000077150:Oxaliplatin; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; C071447:ERCC1 protein, human; D004720:Endonucleases; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: ERCC1; metastatic pancreatic cancer; oxaliplatin sensitivity; response to treatment; survival