TS and ERCC-1 mRNA expressions and clinical outcome in patients with metastatic colon cancer in CONFIRM-1 and -2 clinical trials

Pharmacogenomics J. 2012 Oct;12(5):404-11. doi: 10.1038/tpj.2011.29. Epub 2011 Jul 26.

Abstract

To validate established cutoff levels of thymidylate synthase (TS) and excision repair cross-complementing (ERCC-1) intratumoral mRNA expressions in tumor samples from metastatic colorectal cancer (mCRC) patients treated with PTK787/ZK222584 (PTK/ZK). From 122 samples of patients with mCRC enrolled in CONFIRM-1 (Colorectal Oral Novel Therapy for the Inhibition of Angiogenesis and Retarding of Metastases) or CONFIRM-2, mRNA was isolated of microdissected formalin-fixed paraffin-embedded samples and quantitated using TaqMan-based technology. Existing TS and ERCC-1 cutoff levels were tested for their prognostic value in first-line and second-line therapy. TS expression was associated with overall survival (OS) in first-line, but not second-line therapy. ERCC-1 was associated with OS in patients treated with first-line and second-line FOLFOX4. In first-line FOLFOX4, combination of high TS and/or high ERCC-1 was associated with shorter OS. A correlation was observed between ERCC-1 expression and benefit from PTK/ZK+FOLFOX4 treatment. TS and ERCC-1 expression is associated with clinical outcome in mCRC. Baseline TS and ERCC-1 levels may allow the selection of patients who benefit from FOLFOX4 chemotherapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / pathology
  • DNA-Binding Proteins* / genetics
  • DNA-Binding Proteins* / metabolism
  • Endonucleases* / genetics
  • Endonucleases* / metabolism
  • Female
  • Fluorouracil / administration & dosage
  • Gene Expression Regulation, Neoplastic / drug effects
  • Gene Expression Regulation, Neoplastic / genetics
  • Humans
  • Leucovorin / administration & dosage
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Organoplatinum Compounds / administration & dosage
  • Prognosis
  • RNA, Messenger / metabolism
  • Survival Analysis
  • Thymidylate Synthase* / genetics
  • Thymidylate Synthase* / metabolism
  • Treatment Outcome

Substances

  • DNA-Binding Proteins
  • Organoplatinum Compounds
  • RNA, Messenger
  • Thymidylate Synthase
  • ERCC1 protein, human
  • Endonucleases
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol