Prognostic and predictive significance of thymidylate synthase protein expression in non-small cell lung cancer: a systematic review and meta-analysis.

Abstract

BACKGROUND:

It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC).

OBJECTIVE:

To evaluate prognostic and predictive significance of tumor TS protein level in NSCLC.

METHODS:

Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test.

RESULTS:

Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias.

CONCLUSION:

Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLC patients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.

• Authors: Qingyun Liu, Zubin Yu, Ying Xiang, Na Wu, Long Wu, Bin Xu, Liang Wang, Ping Yang, Yafei Li, Li Bai
• Journal: Cancer biomarkers : section A of Disease markers (Cancer Biomark) Vol. 15 Issue 1 Pg. 65-78 ( 2015) ISSN: 1875-8592 [Electronic] Netherlands
• PMID: 25524944 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)

Chemical References

• Thymidylate Synthase

Topics

• Carcinoma, Non-Small-Cell Lung (enzymology, pathology)
• Disease-Free Survival
• Humans
• Lung Neoplasms (enzymology, pathology)
• Prognosis
• Survival Analysis
• Thymidylate Synthase (metabolism)