Gastrointestinal Cancers Symposium
SAN FRANCISCO — Patients with stage II to III
esophageal adenocarcinoma who had elevated levels of ERCC1 gene expression had
inferior 2-year PFS and OS.
All 90 patients in the phase 2 molecular correlative
study were assigned oxaliplatin plus infusion 5-FU and external beam radiation
Researchers sought to determine whether intratumoral
gene-expression levels in drug metabolism (DPD, GSTPi, TS and TP) and DNA
repair (ERCC1 and XPD) predicted clinical outcome. They then tested whether a
specific pattern of 12 polymorphisms in eight genes and DNA repair predicted
ERCC1 gene-expression cutoff was <1.7 x 10-3.
“When we looked at progression-free survival by
ERCC1 levels using the predefined cutoff of 1.7, there was a highest risk for
recurrence in the high ERCC1 group, with the hazard ratio nearly reaching
three,” said Pierre O. Bohanes, MD, an oncology fellow at the
University of Southern California Norris Comprehensive Cancer Center.
Bohanes presented the results Thursday at the 2011
Gastrointestinal Cancers Symposium.
“The median progression-free survival in the high
ERCC1 group was 14.8 months and was not reached in the low ERCC1 group,”
In univariate analysis, 2-year PFS was 17% for patients
with high ERCC1 gene expression vs. 67% for those with low gene expression
(HR=2.97; 95% CI, 1.37-6.45). Two-year OS was 72% for patients with low ERCC1
gene expression compared with 37% for high ERCC1 gene-expression levels
(HR=2.32; 95% CI, 1.01-5.31). Median OS was 22.4 months in the high ERCC1 group
and was not reached in the low gene-expression group.
Bohanes said ERCC1 gene-expression levels were not
associated with complete pathologic response.
None of the other gene-expression levels tested showed a
significant association with survival, and none of the tested polymorphisms
showed any association with survival. – by Jason Harris
For more information:
Disclosure: Dr. Bohanes reported no relevant financial