Prognostic and predictive significance of thymidylate synthase protein expression in non-small cell lung cancer: a systematic review and meta-analysis. Cancer Biomark 2015;15(1):65-78
Date
12/20/2014Pubmed ID
25524944DOI
10.3233/CBM-140432Scopus ID
2-s2.0-84916933541 (requires institutional sign-in at Scopus site) 17 CitationsAbstract
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.
Author List
Liu Q, Yu Z, Xiang Y, Wu N, Wu L, Xu B, Wang L, Yang P, Li Y, Bai LMESH terms used to index this publication - Major topics in bold
Carcinoma, Non-Small-Cell LungDisease-Free Survival
Humans
Lung Neoplasms
Prognosis
Survival Analysis
Thymidylate Synthase
