ERCC1 as a biomarker for bladder cancer patients likely to benefit from adjuvant chemotherapy

• Published in: BMC cancer 2012-05, Vol.12 (1), p.187-187, Article 187
• Main Authors: Sun, Jong-Mu, Sung, Ji-Youn, Park, Se Hoon, Kwon, Ghee Young, Jeong, Byong Chang, Seo, Seong Il, Jeon, Seong Soo, Lee, Hyun Moo, Jo, Jisuk, Choi, Han Yong, Lim, Ho Yeong
• Format: Article
• Language: English
• Subjects: Acquisitions & mergers; Adjuvant treatment; Adult; Aged; Analysis; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological markers; Biomarkers; Bladder; Bladder cancer; Cancer; Cancer patients; Cancer therapies; Chemotherapy; Chemotherapy, Adjuvant; Deoxyribonucleic acid; DNA; DNA-Binding Proteins - genetics; DNA-Binding Proteins - metabolism; Drug therapy; Endonucleases - genetics; Endonucleases - metabolism; Female; Gene Expression Regulation, Neoplastic; Health aspects; Humans; Immunohistochemistry; Male; Medical research; Medicine; Middle Aged; Neoplasm Grading; Neoplasm Staging; Physiological aspects; Prognosis; Retrospective Studies; Studies; Treatment Outcome; Tumors; Urinary Bladder Neoplasms - drug therapy; Urinary Bladder Neoplasms - genetics; Urinary Bladder Neoplasms - metabolism; Urinary Bladder Neoplasms - mortality
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/1471-2407-12-187

The role of adjuvant chemotherapy and the value of molecular biomarkers in bladder cancer have not been determined. We aimed to assess the predictive and prognostic values of excision repair cross-complementation 1 (ERCC1) in identifying appropriate patients who may potentially benefit from adjuvant chemotherapy for bladder cancer. A retrospective analysis was performed on 93 patients with completely resected transitional cell carcinoma of the bladder. ERCC1 expression was assessed by immunohistochemistry. ERCC1 expression was analyzed in 57 patients treated with adjuvant gemcitabine plus cisplatin chemotherapy and 36 who were not treated. Among 93 patients, ERCC1 expression was positive in 54 (58.1%) and negative in 39 (41.9%). ERCC1 positivity was significantly associated with longer survival (adjusted hazard ratio for death, 0.12, 95% confidence interval [CI] 0.014-0.99; P = 0.049) in the group without adjuvant chemotherapy while ERCC1 positivity was associated with shorter survival among patients who have received adjuvant chemotherapy (adjusted hazard ratio for death, 2.64; 95% CI 1.01-6.85; P = 0.047). Therefore, clinical benefit from adjuvant chemotherapy was associated with ERCC1 negativity as measured by overall survival (test for interaction, P = 0.034) and by disease-free survival (test for interaction, P = 0.20). Among patients with completely resected transitional cell carcinoma of the bladder, those with ERCC1-negative tumors seemed to benefit more from adjuvant gemcitabine plus cisplatin chemotherapy than those with ERCC1-positive tumors. Future prospective, randomized studies are warranted to confirm our findings.