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

Authors
Jeong, SH; Han, JH; Kim, JH; Ahn, MS; Hwang, YH; Lee, HW; Kang, SY; Park, JS; Choi, JH; Lee, KJ; Sheen, SS; Lim, HY
Citation
Digestive diseases and sciences, 56(1):131-138, 2011
Journal Title
Digestive diseases and sciences
ISSN
0163-21161573-2568
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.
MeSH terms
AdultAgedAntineoplastic Combined Chemotherapy Protocols/administration & dosage/*therapeutic useBiopsyDNA-Binding Proteins/metabolismEndonucleases/metabolismFemaleFluorouracil/administration & dosageHumansLeucovorin/administration & dosageMaleMiddle AgedOrganoplatinum Compounds/administration & dosagePredictive Value of TestsPrognosisRetrospective StudiesStomach/metabolism/pathologyStomach Neoplasms/diagnosis/*drug therapy/*metabolismThymidylate Synthase/metabolismTreatment OutcomeTumor Markers, Biological/metabolismbcl-2-Associated X Protein/*metabolism
DOI
10.1007/s10620-010-1280-8
PMID
20503071
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Hematology-Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
AJOU Authors
정, 성현한, 재호김, 장희안, 미선이, 현우강, 석윤박, 준성최, 진혁이, 광재신, 승수
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