Immunohistochemical expression of BCRP and ERCC1 in biopsy specimen predicts survival in advanced non-small-cell lung cancer treated with cisplatin-based chemotherapy

Purpose: The aim of this Study was to determine the prognostic value of expression of ATP binding cassette (ABC) transporter proteins and DNA repair gene Proteins by immunohistochemically staining tumor biopsy specimens from patients with advanced non-small-cell lung cancer (NSCLC) being treated with platinum-based chemotherapy. Experimental design: Expression of ABC transporter proteins, including BCRP (breast cancer resistance protein) and MRP2 (multidrug resistance proteins 2), and the DNA-repair related proteins, ERCC1 (excision repair Cross-complementation group 1) and BRCA1 (breast cancer type 1 susceptibility protein) was assessed immunohistochemically in 156 tumor samples from untreated stage IV NSCLC patients. All of the patients had received platinum-based chemotherapy. Response to chemotherapy, progression-free Survival (PFS), and overall survival were compared in relation to expression of each of the proteins and to clinicopathological factors. Results: High ERCC1 expression was associated with short survival (237 clays vs. 453 days, log-rank P=0.03), but not with response to chemotherapy or PFS. And high BCRP expression was associated with short survival (214 days vs. 412 days, log-rank P=0.02) but not with response to chemotherapy OF PFS. Multivariate analysis confirmed that negativity for the expression of BCRP tends to be an independent variable related to overall survival (P=0.06). Conclusions: This study examined ERCC1 and BCRP expression in biopsy specimens as candidates for predictors of the survival of patients with advanced NSCLC treated with platinum-based chemotherapy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.