ERCC1 as a Biological Marker Guiding Management in Malignant Pleural Mesothelioma


Background: To determine prognostic value of excision repair cross-complementation 1 (ERCC1) in patientswith malignant pleural mesothelioma (MPM). Materials and
Methods: The study included 60 patients withMPM who were diagnosed and treated in the Radiation Oncology Department of Kayseri Teaching Hospitaland Medical Oncology Department of Erciyes University, Medicine School between 2005 and 2013. By usingimmunohistochemical methods, ERCC1 expression in biopsy specimens was evaluated. We retrospectivelyassessed whether there is a correlation between ERCC1 and response to anti-neoplastic therapy or survival.
Results: There were 50 men and 10 women with median age of 62 years (range: 39-83). Histological type wasepithelial mesothelioma in the majority of the cases (85%), most commonly presenting in stage four. Of the cases,20 (33%) received radiotherapy, 60 (%100) received first-line chemotherapy and 15 (%25) received second-linechemotherapy. In the assessment after therapy, it was found that there was partial response in 12 cases (20%),stable disease in 19 cases (31.4%) and progression in 25 cases (41.7%). ERCC1 was positive in 43% of the cases.Mean OS was 11.7 months and mean DFS was 9.5 months in ERCC1-positive cases regardless of therapy, whilethey were 19.2 months and 17.1 months in ERCC1-negative cases, respectively. The difference was found to besignificant (p<0.05). In univariate analysis, stage, comorbidity, response to treatment and ERCC1 expressionwere found to be significantly associated with OS (p=0.083; p=0.043; p=0.041; p=0.050). In multivariate analysis,response to treatment remained to be significant for OS (p=0.005). In univariate and multivariate analyses,response to treatment and ERCC1 were found to be significantly associated with DFS (p=0.049; p=0.041).
Conclusions: ERCC1 was identified as poor prognostic factor in patients with MPM.