Abstract
Background: The immunohistochemical (IHC) detection of the "excision repair cross-complementation group 1” (ERCC1) protein in resected NSCLC is prognostically relevant. Pts with ERCC1-neg. tumors appear to benefit from adjuvant cisplatin-based chemotherapy (Ctx), whereas pts with ERCC1-pos. tumors do not.
Aim: We compared survival of pts with non-operated NSCLC III/IV according to ERCC1.
Methods: We analyzed 398 pts (m=248, f=150) newly diagnosed with NSCLC stage III/IV between 10/2009 and 12/2010. Prospectively, ERCC1 expression determined by IHC was measured and indicated as H-score. Pts where no IHC and/or no H-score could be performed were excluded.
Results: 271/398 cases (68%) were suitable for IHC. 175/271 (65%) of tumors were ERCC1 pos., 96/271 (35%) ERCC1 neg. 177/271 (65%) received platin. Survival times in days were (mean ± SEM): platin+/ERCC1- 404 ± 25 (n=67); platin+/ERCC1+ 346 ± 23 (n=110); platin-/ERCC1- 144 ± 23 (n=29); platin-/ERCC1+ 268 ± 33 (n=65). In Cox hazard regression analysis, the factors platinum (p<0.001) and ERCC1 (p=0.01) were not independent (p=0.001, interaction term).
Conclusions: Pts with palliative platin-based Ctx for advanced NSCLC had significantly longer OS when the tumor showed no significant ERCC1 expression. In pts who did not have platin-based Ctx, the absence of ERCC1 expression was prognostically unfavorable. This study confirms observations from adjuvant therapy also for palliative Ctx.
- © 2012 ERS