524PD - ERCC1, defective mismatch repair status as predictive biomarker of survival for stage III colon cancer patients receiving oxaliplatin based adjuvant...

Date 29 September 2012
Event ESMO Congress 2012
Session Gatrointestinal tumors, colorectal
Topics Biomarkers
Colon Cancer
Presenter Pan Li
Authors P. Li, G. Chen
  • Colorectal Surgery, Cancer Center, Sun Yat-sen Universtiy, 510060 - guangzhou/CN

 

Abstract

Background

Several trials showed excision repair cross-complementation group 1 (ERCC1) expression status is a candidate marker for predicting efficacy of oxaliplatin (OX) treatment for metastatic colorectal cancer (CRC). Association between the expression of mismatch repair genes (MMR) and favorable postoperative survival in stage II CRC receiving 5-FU chemotherapy has been identified. whether the expression of ERCC1 protein and MMR status are associated with survival of stage IIIB colon cancer receiving OX-based chemotherapy is unclear.

Patients and methods

We enrolled 255 patients with stage III colon cancer after radical surgery. There were 95 patients receiving full-course Mayo clinic chemotherapy and 160 patients received mFOLFOX6 or XELOX chemotherapy. Immunohistochemistry analysis of the expression of MMR and ERCC1 was performed in tumor tissue. A predictive model for 5-year disease-free survival (DFS) and overall survival (OS) was constructed by using Kaplan-Meier analysis, logistic and Cox regression.

Results

The patients with positive ERCC1 tumors had lower 5-year DFS (54%) than those with negative ERCC1 tumors (72%) in combined therapy group (HR: 1.98 95%CI: 1.19-3.31 p = 0.009).The OS was also lower in combined therapy group with positive ERCC1 tumors (60%) than those patients with negative ERCC1 tumors (78% HR: 2.44 95%CI: 1.37-4.34 p = 0.02). In multivariate analysis, ERCC1 expression remained an independent significant predictive factor for DFS and OS (DFS HR: 2.33 95%CI: 1.37-3.93 p < 0.001, OS HR: 2.87 95%CI: 1.59-5.16 p < 0.001). The protein expression of ERCC1 showed no statistical significance of DFS or OS in fluorouracil group (DFS HR: 1.16 95%CI: 0.63-2.14 p = 0.62, OS HR: 1.16 95%CI: 0.63-2.14 p = 0.63). The MMR status had no statistical significance of DFS or OS between combined therapy group and single-drug group.

Conclusion

ERCC1 status was shown to be a highly predictive selection criterion in relation to the treatment decision regarding the addition of OX to 5-FU for stage IIIB colon cancer. MMR status had no predictive value in this setting.

Disclosure

All authors have declared no conflicts of interest.