ERCC1 expression affects outcome in metastatic pancreatic carcinoma treated with FOLFIRINOX: A single institution analysis
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Antonia Strippoli1, Sabrina Rossi1, Maurizio Martini2, Michele Basso1, Ettore D’Argento1, Giovanni Schinzari1, Rosalba Barile1, Alessandra Cassano1, Carlo Barone1
1Department of Medical Oncology, Catholic University of Sacred Heart, 00168 Rome, Italy
2Department of Pathology, Catholic University of Sacred Heart, 00168 Rome, Italy
Sabrina Rossi, e-mail: [email protected]
Keywords: metastatic pancreatic cancer, oxaliplatin sensitivity, ERCC1, survival, response to treatment
Received: March 02, 2016 Accepted: April 10, 2016 Published: April 27, 2016
Introduction: No clinically useful predictive factor has been yet identified for treatment of metastatic pancreatic cancer (mPC). It is noteworthy that FOLFIRINOX, despite its high toxicity, is effective only in some patients. We retrospectively analyzed expression of excision repair cross-complementing group-1 (ERCC1) - involved in the repair of platinum induced damage - in patients affected by mPC treated with FOLFIRINOX in order to evaluate its predictive role.
Results: FOLFIRINOX resulted more effective in patients with normal ERCC1 levels than in those with ERCC1 hyper-expression. Median progression free survival (PFS) was 11 vs. 4 months (HR 0.26; 95% CI 0.14-0.50; p<.0001), median overall survival (OS) 16 vs. 8 months (HR 0.23; 95% CI 0.12-0.46; p<.0001) and disease control rate (DCR) 93% vs. 50% (p=0.00006). The advantage was confirmed at univariate and multivariate analysis.
Patients and Methods: 71 patients with histologically proven mPC and treated with FOLFIRINOX as first-line therapy were considered eligible. mRNA ERCC1 expression was determined using RT-PCR analysis.
Discussion: ERCC1 might be an effective predictor of response to FOLFIRINOX in mPC. Patients overexpressing ERCC1 should be excluded by this often toxic therapy and referred to an alternative treatment.
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