ERCC1 Predicts Responses to Chemotherapy in Early Lung Cancer

ERCC1 Predicts Responses to Chemotherapy in Early Lung Cancer

According to an article recently published in the New England Journal of Medicine, the protein referred to as the excision repair cross-complementation group 1 (ERCC1) can identify patients who will achieve a benefit from Platinol® (cisplatin)-based chemotherapy for the treatment of early lung cancer.

Lung cancer is the most common cause of cancer-related deaths. Non–small cell lung cancer (NSCLC) refers to the type of cell within the lung where cancer originated. It accounts for approximately 75-80% of all lung cancers.

Early NSCLC refers to cancer that has not spread outside the lung to distant sites in the body. Patients with early NSCLC often undergo the surgical removal of their cancer, referred to as resection. Following surgery survival for patients with early NSCLC may be improved with additional chemotherapy (adjuvant chemotherapy). Adjuvant chemotherapy is used to kill cancer cells that remain in the body following surgery.

Although an overall survival benefit has been demonstrated for patients with early NSCLC who are treated with adjuvant chemotherapy, a large portion of patients treated with chemotherapy do not achieve a survival benefit. Researchers are evaluating ways to identify which patients with early NSCLC will or will not achieve benefit from adjuvant chemotherapy.

Researchers affiliated with the International Adjuvant Lung Cancer Trial (IALCT) trial recently conducted a study to evaluate the potential association between the expression of the ERCC1 protein and benefits from adjuvant chemotherapy among patients with early NSCLC. This study included 761 lung cancers from patients who underwent surgical resection of their cancer followed by either adjuvant chemotherapy containing Platinol or no further chemotherapy. Cancer tissues were tested for ERCC1 expression.

  • Adjuvant chemotherapy improved survival among patients with no ERCC1 expression by 35%; however, adjuvant chemotherapy did not improve survival for patients with ERCC1 expression.
  • Among the group of patients who did not receive adjuvant chemotherapy, patients with ERCC1 expression had significantly better survival than patients whose cancer did not expression ERCC1.

The researchers concluded that among patients with early NSCLC, adjuvant chemotherapy containing Platinol improves survival for those whose cancers do not express ERCC1, but not among patients whose cancer does express ERCC1. Patients with early NSCLC who have undergone surgery may whish to speak with their physician regarding their individual risks and benefits of adjuvant chemotherapy.

Reference: Olaussen K, Dunant A, Fouret P, et al. DNA Repair by ERCC1 in Non-Small Cell Lung Cancer and Cisplatin-Based Adjuvant Chemotherapy. New England
Journal of Medicine . 2006;355:983-991.

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