473P Personalized treatment of advanced non-small cell lung cancer based on excision repair cross-complementation group 1 (ERCC-1) expression

Abstract

Background: Although current treatment option for advanced non-small-cell lung cancer (NSCLC) relies on cisplatin-based chemotherapy, individualized approaches to therapy may improve response or reduce unnecessary toxicity. Excision repair crosscomplementing 1 (ERCC1) has been associated with cisplatin resistance. Methods: One hundred and twenty chemotherapy naïve stages IIIB and IV NSCLC patients were enrolled. Patients were randomly assigned in a 1:1 ratio to either the control or genotypic arm before ERCC1 assessment. Patients in the control arm received cisplatin plus gemcitabine. In the genotypic arm, patients with low ERCC1 levels received cisplatin plus gemcitabine, and those with high levels received gemcitabine plus paclitaxel. Results: In the experimental arm 26 patients (43.3%) showed positive ERCC1 expression. Gemcitabine/cisplatin and gemcitabine/taxanes in the experimental arm show RR (52.9%) and (34.6%), respectively without any significant impact (p-value= 0.15). Gemcitabine/taxanes in the experimental arm versus the gemcitabine/cisplatin in the control arm show RR (34.6%) versus (41.7%), respectively without any significant impact (p-value= 0. 5). Gemcitabine/cisplatin in the experimental arm versus the control arm show RR (52.9%) versus (41.7%), respectively but still not statistically significant (p-value =0.4). Gemcitabine/cisplatin in the experimental arm versus the control arm show RR (52.9%) versus (41.7%), respectively but still not statistically significant (p-value =0.4). The treatment regimes in the experimental arm did not show any significant impact on PFS or OS (p-value= 0.14 and 0.13 respectively). Also the treatment regimes in the experimental arm according to ERCC-1 expression did not show any significant impact on PFS or OS with (p-value= 0.7 and 0.44 respectively). Conclusions: This prospective study further validates ERCC1 as a biomarker in advanced NSCLC patients and showed that ERCC1 protein expression was not significantly correlated with RR, PFS or OS in the personalized arm. ERCC1 protein levels should be assessed with additional biomarkers to determine an optimal method for personalize therapy in advanced NSCLC patients.