440P - Association of glucocorticoid receptor expression with the treatment outcome of pemetrexed-based chemotherapy in NSCLC patients

Date 20 December 2015
Event ESMO Asia 2015 Congress
Session Poster presentation 2
Topics Cytotoxic agents
Thoracic malignancies
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Biological therapy
Presenter xinmin Zhao
Citation Annals of Oncology (2015) 26 (suppl_9): 125-147. 10.1093/annonc/mdv532
Authors X. Zhao1, J. Wang1, J. Zhao2, Z.G. Luo1, H.J. Wang1, H. Yu1, J.H. Chang1, X.H. Wu1
  • 1Medical Oncology, Shanghai Cancer Center Fudan University, 200032 - Shanghai/CN
  • 2Medical Oncology, Shanghai Pulmonary Hospital, Tongji University, Shanghai/CN



Pemetrexed is the preferred chemotherapy in the management of non-squamous non-small cell lung cancer (non-sq-NSCLC), yet in lack of biomarkers for predicting efficacy. Dexamethasone which is one of premedication of pemetrexated, may downregulate p53 through the glucocorticoid receptor (GR). The purpose of our study was to explore the effect of GR in peripheral blood mononuclear cell (PBMC) on pemetrexed efficacy.


One hundred and twenty-two patients with stage IV non-sq-NSCLC who received first-line pemetrexed-containing chemotherapy were retrospectively reviewed. The expression of GR in PBMC were measured before treatment with pemetrexed using flow cytometry, and Real-Time PCR was used to detect the level of GRα and GRß.


The response rate for all patients was 38.5%, with a median PFS of 5.9 months and OS of 14.3 months. In univariate analyses, patients with low level of GRα/GRß ratio in PBMC had higher RR, better PFS, and better OS than those with high level of GRα/GRß ratio (RR: 48.2% vs. 30.3%, p = 0.043; mPFS: 6.9 months vs. 4.0 months, p = 0.000; mOS: 18.7 months vs. 12.2 months, p = 0.005). The baseline GRα/GRß ratio was an independent factor for RR (odds ratio [OR] = 0.451, 95%CI: 0.208-0.978, p = 0.044), PFS (HR = 1.584, 95%CI: 1.094-2.295, p = 0.015), and OS (HR = 1.761, 95%CI: 1.195-2.595, p = 0.004).

Demographic and clinical characteristics of patients

Characteristics No. of patients
Aage (years) < 60 60
≥60 62
Gender Male 57
Female 65
Smoker non-smoker 78
current or ever 44
T stage 1 or 2 63
3 or 4 59
N stage negative 35
positive 87
M stage M1a 41
M1b 81
GRα/GRß ratio < 450 56
≥450 66
regimen PEM + DDP 86
PEM + CBP 36


Baseline GRα/GRß ratio in PBMC may play a role in predicting the efficacy of first-line pemetrexed-containing chemotherapy in stage IV non-sqNSCLC patients.

Clinical trial identification



All authors have declared no conflicts of interest.