Prospective Clinical Study of Postoperative Individualized Adjuvant Chemotherapy for Patients with Non-Small-Cell Lung Cancer Based on mRNA Expression of the Molecular Markers RRM1, TUBB3, and ERCC1

Author:

Li Jingyao1,Qiu Yang1,Yi Junxiu2,Liu Xi1,Zhang Shixin1,Tan Deli1,Jing Tao3,Liao Yi1,Tang Meng1,Liu Jie1,Wang Haidong1ORCID

Affiliation:

1. Department of Thoracic Surgery, Southwest Hospital, Army Medical University, Chongqing 400038, China

2. Department of Ultrasonic Diagnosis, Southwest Hospital, Army Medical University, Chongqing 400038, China

3. Department of Vasculocardiology, Southwest Hospital, Army Medical University, Chongqing 400038, China

Abstract

Objective. To investigate the clinical significance of the mRNA expression of RRM1, TUBB3, and ERCC1 in non-small-cell lung cancer (NSCLC) tissues for the selection of adjuvant/postoperative chemotherapy regimens. Methods. Patients diagnosed with stage Ib-IIIa NSCLC were enrolled and randomly divided into a control group (undetected group) and an experimental group (detected group) after radical operation. The control group randomly received chemotherapy with gemcitabine plus cisplatin or paclitaxel plus cisplatin. The mRNA expression of RRM1, TUBB3, and ERCC1 was detected in the experimental group before chemotherapy, and based on the detected expression, the chemotherapy regimen of cisplatin plus gemcitabine or cisplatin plus paclitaxel was chosen. The disease-free survival (DFS) of the control group and experimental group was compared. Results. Pathological type, stage, gene expression detection, and treatment method were not significantly correlated with DFS ( P > 0.05 ). In the subgroups treated with gemcitabine, the median DFS was 17 months in the detected group and 10.5 months in the undetected group (hazard ratio = 0.2147, 95% confidence interval: 0.07909–0.5827, P = 0.0025 ). Multivariate regression analysis was performed to analyse whether gene expression detection was independently correlated with DFS in the subgroups treated with gemcitabine ( P = 0.025 ). In the detected group, the prognosis of patients with low expression of RRM1 was better than that of patients with high expression of RRM1 after paclitaxel treatment ( P = 0.0039 ). Conclusions. The selection of chemotherapy regimen based on mRNA expression of the RRM1, TUBB3, and ERCC1 genes may improve selection of candidate patients to receive clinical chemotherapy. However, large-scale prospective clinical studies are needed for in-depth investigation.

Funder

Army Medical University

Publisher

Hindawi Limited

Subject

Oncology

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