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Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis

PURPOSE: Although several studies have suggested an association between thymidylate synthase (TS) expression and outcomes of gastric cancer (GC) patients treated with fluoropyrimidine-based chemotherapy (FUC), the predictive value of TS for response and survival in this setting is unclear. This meta...

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Autores principales: Gao, Yunhe, Cui, Jianxin, Xi, Hongqing, Cai, Aizhen, Shen, Weisong, Li, Jiyang, Zhang, Kecheng, Wei, Bo, Chen, Lin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790522/
https://www.ncbi.nlm.nih.gov/pubmed/27022289
http://dx.doi.org/10.2147/OTT.S98540
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author Gao, Yunhe
Cui, Jianxin
Xi, Hongqing
Cai, Aizhen
Shen, Weisong
Li, Jiyang
Zhang, Kecheng
Wei, Bo
Chen, Lin
author_facet Gao, Yunhe
Cui, Jianxin
Xi, Hongqing
Cai, Aizhen
Shen, Weisong
Li, Jiyang
Zhang, Kecheng
Wei, Bo
Chen, Lin
author_sort Gao, Yunhe
collection PubMed
description PURPOSE: Although several studies have suggested an association between thymidylate synthase (TS) expression and outcomes of gastric cancer (GC) patients treated with fluoropyrimidine-based chemotherapy (FUC), the predictive value of TS for response and survival in this setting is unclear. This meta-analysis aimed to estimate prognostic and predictive significance of TS more precisely. METHODS: We searched PubMed, Embase, Cochrane Library, and Web of Science databases for literature published up to June 2015. Primary outcomes included hazard ratios (HRs) for overall survival (OS), and event-free survival (EFS) and odds ratio (OR) for chemotherapy response. Fixed- or random-effects models were used to calculate pooled HR and OR according to heterogeneity. RESULTS: A total of 2,442 GC patients in 25 studies met our inclusion criteria. Response rates for FUC were significantly lower in patients with high TS expression than in those with low expression (OR: 0.43, 95% confidence interval [CI]: 0.22–0.84, P=0.013). High TS expression was significantly correlated with unfavorable OS (HR: 1.62, 95% CI: 1.28–2.05, P<0.001) and EFS (HR: 1.54, 95% CI: 1.22–1.93, P<0.001) in advanced disease. However, TS expression was not significantly related to OS (HR: 1.06, 95% CI: 0.74–1.50, P=0.760) or EFS (HR: 1.16, 95% CI: 0.84–1.61, P=0.374) in the adjuvant setting. CONCLUSION: Higher TS expression might predict drug resistance and adverse prognosis in patients with advanced GC treated with FUC.
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spelling pubmed-47905222016-03-28 Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis Gao, Yunhe Cui, Jianxin Xi, Hongqing Cai, Aizhen Shen, Weisong Li, Jiyang Zhang, Kecheng Wei, Bo Chen, Lin Onco Targets Ther Original Research PURPOSE: Although several studies have suggested an association between thymidylate synthase (TS) expression and outcomes of gastric cancer (GC) patients treated with fluoropyrimidine-based chemotherapy (FUC), the predictive value of TS for response and survival in this setting is unclear. This meta-analysis aimed to estimate prognostic and predictive significance of TS more precisely. METHODS: We searched PubMed, Embase, Cochrane Library, and Web of Science databases for literature published up to June 2015. Primary outcomes included hazard ratios (HRs) for overall survival (OS), and event-free survival (EFS) and odds ratio (OR) for chemotherapy response. Fixed- or random-effects models were used to calculate pooled HR and OR according to heterogeneity. RESULTS: A total of 2,442 GC patients in 25 studies met our inclusion criteria. Response rates for FUC were significantly lower in patients with high TS expression than in those with low expression (OR: 0.43, 95% confidence interval [CI]: 0.22–0.84, P=0.013). High TS expression was significantly correlated with unfavorable OS (HR: 1.62, 95% CI: 1.28–2.05, P<0.001) and EFS (HR: 1.54, 95% CI: 1.22–1.93, P<0.001) in advanced disease. However, TS expression was not significantly related to OS (HR: 1.06, 95% CI: 0.74–1.50, P=0.760) or EFS (HR: 1.16, 95% CI: 0.84–1.61, P=0.374) in the adjuvant setting. CONCLUSION: Higher TS expression might predict drug resistance and adverse prognosis in patients with advanced GC treated with FUC. Dove Medical Press 2016-03-09 /pmc/articles/PMC4790522/ /pubmed/27022289 http://dx.doi.org/10.2147/OTT.S98540 Text en © 2016 Gao et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Gao, Yunhe
Cui, Jianxin
Xi, Hongqing
Cai, Aizhen
Shen, Weisong
Li, Jiyang
Zhang, Kecheng
Wei, Bo
Chen, Lin
Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
title Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
title_full Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
title_fullStr Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
title_full_unstemmed Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
title_short Association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
title_sort association of thymidylate synthase expression and clinical outcomes of gastric cancer patients treated with fluoropyrimidine-based chemotherapy: a meta-analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790522/
https://www.ncbi.nlm.nih.gov/pubmed/27022289
http://dx.doi.org/10.2147/OTT.S98540
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