No suitable biological marker has been identified in patient with advanced uterine cervical cancer treated with platinum-based chemotherapy, although there is growing demand in clinical practice for individualized treatment planning. The aim of this study was to investigate whether excision repair cross-complementation group 1 (ERCC1) expression predicted tumor response and survival in uterine cervical cancer patients who had been treated with palliative platinum-containing chemotherapy.
Thirty two patients with recurrent or metastatic uterine cervical cancer, who were treated with platinum-based chemotherapy, were enrolled. Clinicopathological data were obtained through medical record reviews. ERCC1 expression was assessed by immunohistochemical staining from pretreatment cervical biopsy tissues.
Of the 32 tumors examined, 13(40.6%) were classified as ERCC1-positive expression and 19(59.4%) as ERCC1-negative expression. The clinical variables age, Eastern Cooperative Oncology Group performance status, histologic type, prior radiosensitizer, site of disease, and disease-free interval at treatment did not differ significantly between the ERCC1-positive and ERCC1-negative expression groups. However, patients with ERCC1-negative expression had a significantly higher tumor response (14/19, 73.7%) than those with ERCC1-positive expression (2/13,15.4%;P = 0.001). The patients with ERCC1-negative expression had significantly longer progression-free survival (median, 8.0 vs. 4.5 months, P = 0.017) and overall survival (median, 22.4 vs. 10.4 months, P = 0.032) than those with ERCC1-positive expression.
Multivariate analyses showed that ERCC1-positive expression (hazard ratio, 2.428; 95% confidence interval, 0.141–5.148; P = 0.021) was an independent risk factor predicting the progression-free survival of the patients.
These results suggest that the ERCC1 expression patterns in tumor specimens can be used to predict the clinical outcome, including the tumor response and survival in patients treated with cisplatin-based chemotherapy for recurrent or metastatic uterine cervical cancer.
Clinical trial identification
All authors have declared no conflicts of interest.