Qingyun Liu1, Zubin Yu2, Ying Xiang1, Na Wu1, Long Wu1, Bin Xu1, Liang Wang3, Ping Yang4, Yafei Li1, Li Bai5. 1. Department of Epidemiology, College of Preventive Medicine, Third Military Medical University, Chongqing, China. 2. Department of Thoracic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China. 3. Department of Pathology, MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA. 4. Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MI, USA. 5. Department of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Abstract
BACKGROUND: It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC). OBJECTIVE: To evaluate prognostic and predictive significance of tumor TS protein level in NSCLC. METHODS: Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test. RESULTS: Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias. CONCLUSION: Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLC patients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.
BACKGROUND: It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC). OBJECTIVE: To evaluate prognostic and predictive significance of tumorTS protein level in NSCLC. METHODS: Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test. RESULTS: Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias. CONCLUSION: Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLCpatients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.