Correlation Analysis of Chemoresistant Gene Polymorphism and Survival in Patients with Advanced Non-small Cell Lung Cancer

• Main Authors: Yu-Kai Cheng, 鄭宇凱
• Other Authors: 楊志新
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/84106231846314775041

碩士 === 國立臺灣大學 === 臨床藥學研究所 === 97 === In Taiwan, lung cancer is one of the most common cancer and the leading cause of cancer-related death. Although chemotherapy is the standard treatment for advanced non-small cell lung cancer (NSCLC), its effect has reached a plateau. Analyzing prognostic factors and predictive factors for patients who are clinical long-survivors or better responders to systemic treatments may provide hints for future research. In this study, we included 84 advanced NSCLC patients from National Taiwan University Hospital and Taipei Veterans General Hospital. These patients survived at least 2 years after diagnosis of incurable metastatic disease. Medical treatments are reviewed from both of above hospitals. Polymorphisms of some chemotherapy resistant associated genes were detected by either RFLP or direct sequence. We used propensity score method to reduce the bias of first-line chemotherapy, and Cox’s proportional model to estimate the hazard ratio for all variables. The protective factors identified were ERCC1 8092 G/G (HR=0.024; p=0.0013) and XRCC1 399 A/A (HR=0.007; p=0.0133) genotype, and RRM1 2455 A/A with regimens containing gemcitabine as first-line therapy (HR=0.022; p=0.0056). The risk factors are incurable disease in first-time diagnosis (HR=17.948; p=0.0005) and heavy smokers with ERCC1 8092 T/T genotype (HR=102.398; p=0.0002). This study shows that SNPs of ERCC1 8092, XRCC1 399 and RRM1 2455 can influence survival of selected advanced NSCLC patients. Although the results may not be applicable to the whole advanced NSCLC population, further confirmation in large NSCLC population is needed.