Originally published as JCO Early Release 10.1200/JCO.2008.18.8631 on August 10 2009

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Different Impact of Excision Repair Cross-Complementation Group 1 on Survival in Male and Female Patients With Inoperable Non–Small-Cell Lung Cancer Treated With Carboplatin and Gemcitabine

From the Departments of Oncology and Pathology (Division Gentofte), Herlev Hospital, Herlev; and the Brønshøj Kirkevej 49, Brønshøj, Denmark.

Corresponding author: Bente Holm, MD, PhD, Department of Oncology, Herlev Hospital, DK-2730 Herlev, Denmark; e-mail: bholm{at}dadlnet.dk.

Purpose The excision repair cross-complementation group 1 (ERCC1) status was assessed in patients receiving carboplatin and gemcitabine for inoperable non–small-cell lung cancer (NSCLC). We analyzed the association between the ERCC1 status and the overall survival after the chemotherapy.

Patients and Methods We retrospectively identified 163 patients with inoperable NSCLC and sufficient tumor tissue for ERCC1 analysis, who had received carboplatin and gemcitabine as first-line treatment. Immunohistochemistry was used to assess the expression of ERCC1.

Results One hundred sixty-three patients were included. Seventy (42%) were ERCC1 positive. Patients treated with carboplatin and gemcitabine and having ERCC1-negative tumors had a significantly increased survival when compared to patients with ERCC1-positive tumors (median survival, 12.0 months v 8.2 months; P = .02). This difference was mainly seen in men, where those with ERCC1-negative tumors had a significantly increased survival compared to men with ERCC1-positive tumors (median survival, 11.8 months v 7.9 months; P = .005). Conversely, women who were ERCC1 negative did not have a survival advantage over ERCC1-positive women.

Conclusion We confirmed previous reports that ERCC1 expression is predictive for outcome in patients treated with carboplatin and gemcitabine. Patients with ERCC1-negative tumors had an increased survival compared to patients with ERCC1-positive tumors and this difference was mainly attributable to a survival difference among men.

Supported in part by a grant from Sofie Clausens Fond.

Presented in part at the 1st European Lung Cancer Conference, Geneva, Switzerland, April 23-26, 2008.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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