Bax predicts outcome in gastric cancer patients treated with 5-fluorouracil, leucovorin, and oxaliplatin palliative chemotherapy.

Abstract

BACKGROUND:

Platinum and 5-fluorouracil (5-FU)-based regimens have been used the most frequently in palliative chemotherapy for gastric cancer. The present study evaluated the prognostic significance of Bax, excision repair cross-complementation group 1 (ERCC1), and thymidylate synthase (TS) in advanced gastric cancer patients treated with 5-FU, leucovorin, and oxaliplatin (FOLFOX) palliative chemotherapy.

METHODS:

Seventy-two patients with metastatic or recurrent gastric cancer were treated with FOLFOX regimen. Pretreatment tumor biopsy specimens were analyzed for Bax, ERCC1, and TS expression by immunohistochemistry.

RESULTS:

High expression of Bax, ERCC1, and TS was observed in 31 (43%), 33 (46%), and 35 (49%) patients, respectively. The median overall survival (OS) of patients was 12 months. Low expression of Bax was associated with poor OS (median, 9 months vs. 18 months; 2-year, 10% vs. 48%; p=0.0005) in univariate analysis, while expression of ERCC1 and TS was not correlated with patient outcome. In multivariate analysis, low expression of Bax was a significant independent predictor of poor OS (p=0.028). Low expression of Bax was significantly associated with poor survival of patients with metastatic or recurrent gastric cancer treated with FOLFOX chemotherapy.

CONCLUSIONS:

Immunohistochemical staining for Bax with pretreatment biopsy specimen may be useful in selecting FOLFOX regimen as a treatment option for advanced gastric cancer patients.

• Authors: Seong Hyun Jeong, Jae Ho Han, Jang Hee Kim, Mi Sun Ahn, Yoon Ho Hwang, Hyun Woo Lee, Seok Yun Kang, Joon Seong Park, Jin-Hyuk Choi, Kwang Jae Lee, Seung Soo Sheen, Ho-Yeong Lim
• Journal: Digestive diseases and sciences (Dig Dis Sci) Vol. 56 Issue 1 Pg. 131-8 (Jan 2011) ISSN: 1573-2568 [Electronic] United States
• PMID: 20503071 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• DNA-Binding Proteins
• Organoplatinum Compounds
• bcl-2-Associated X Protein
• Thymidylate Synthase
• ERCC1 protein, human
• Endonucleases
• Leucovorin
• Fluorouracil

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Biomarkers, Tumor (metabolism)
• Biopsy
• DNA-Binding Proteins (metabolism)
• Endonucleases (metabolism)
• Female
• Fluorouracil (administration & dosage)
• Gastric Mucosa (metabolism)
• Humans
• Leucovorin (administration & dosage)
• Male
• Middle Aged
• Organoplatinum Compounds (administration & dosage)
• Predictive Value of Tests
• Prognosis
• Retrospective Studies
• Stomach (pathology)
• Stomach Neoplasms (diagnosis, drug therapy, metabolism)
• Thymidylate Synthase (metabolism)
• Treatment Outcome
• bcl-2-Associated X Protein (metabolism)