title: ERCC1 Expression in Metastatic Triple Negative Breast Cancer Patients Treated with Platinum-Based Chemotherapy
abstract: Background: Possible targeted therapies for metastatic triple negative breast cancer (TNBC) include cytotoxic
  chemotherapy that causes interstrand breaks (platinum-based drugs). The excision repair cross-complementation 1
  (ERCC1) enzyme plays an essential role in the nucleotide excision repair pathway, removing platinum-induced DNA
  adducts and contributing to cisplatin resistance. Detecting ERCC1 overexpression is important in considering treatment
  options for metastatic TNBC, including individualized approaches to therapy, and may facilitate improved responses or
  reduction of unnecessary toxicity. We hypothesized that assigning cisplatin based on pretreatment ERCC1 expression
  would improve response and survival. This study was conducted to assess the impact of ERCC1 expression on PFS,
  OS and response rates in metastatic triple negative breast cancer patients treated with platinum-based chemotherapy.
  Methods: From June 2012 to November 2013, 52 metastatic triple negative breast cancer patients were enrolled.
  ERCC1 protein expression was detected from pretreatment biopsies by Immunohistochemistry. All patients received
  cisplatin plus paclitaxel. The primary end point was the impact of ERCC1 expression on PFS and OS. Results: 34
  patients (65.4%) showed positive ERCC1 expression while 18 (34.6%) proved negative. Positive ERCC1 expression
  was associated with short PFS (median, 5 months vs. 7 months; P = 0.043), short OS (median, 9 months vs. 11 months;
  P = 0.033) and poor response to cisplatin based chemotherapy (P = 0.046). Conclusions: This prospective study further
  validated ERCC1 as a reliable biomarker for customized chemotherapy in metastatic triple negative breast cancer
  patients. High expression of ERCC1 was thereby fond to be significantly associated with poor outcome in patients
  treated with platinum based chemotherapy.
authors.affiliation: Medical Oncology Unit, Oncology Center, Faculty of medicine, Mansoura University.Email:malibasha1@yahoo.com
authors.forename: Mohamed Ali
authors.initials: MA
authors.lastname: EL Baiomy
authors.forename: Wagdi F
authors.initials: WF
authors.lastname: El Kashef
keywords: ERCC1; triple negative; metastatic; breast