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- Title
Significance of glucocorticoid receptor expression in patients with non-small cell lung cancer treated with pemetrexed-based chemotherapy.
- Authors
Zhao, Xin-min; Zhao, Jing; Wu, Xiang-hua; Luo, Zhi-guo; Wang, Hui-jie; Yu, Hui; Chang, Jian-hua; Wang, Jia-lei
- Abstract
<bold>Background: </bold>Pemetrexed is the preferred chemotherapy agent in the management of non-squamous non-small cell lung cancer (non-sq-NSCLC), but lacks biomarkers predicting its efficacy. Dexamethasone, one of the premedications of pemetrexed, may downregulate p53 through the glucocorticoid receptor (GR). The purpose of our study was to explore the effect of GR in peripheral blood mononuclear cells (PBMC) and its role in predicting pemetrexed efficacy.<bold>Methods: </bold>In all, 122 patients with stage IV non-sq-NSCLC who received first-line pemetrexed-containing chemotherapy were retrospectively reviewed. The expression of GR in PBMC was measured before treatment with pemetrexed using real-time PCR was used to detect the levels of GRα and GRβ.<bold>Results: </bold>The response rate for all patients was 38.5%, with a median progression-free survival (PFS) of 5.9 months and overall survival (OS) of 14.3 months. In univariate analyses, patients with a low GRα/GRβ ratio in PBMC had higher RR, better PFS, and better OS than those with a high GRα/GRβ ratio (RR: 48.2 vs. 30.3%, p = 0.043; mPFS: 6.9 vs. 4.0 months, p < 0.001; mOS: 18.7 vs. 12.2 months, p = 0.005). The baseline GRα/GRβ ratio was an independent factor for RR (odds ratio [OR] = 0.451, 95% CI 0.208-0.978; p = 0.044), PFS (HR = 1.584, 95% CI 1.094-2.295; p = 0.015), and OS (HR = 1.761, 95% CI 1.195-2.595; p = 0.004).<bold>Conclusions: </bold>Baseline GRα/GRβ ratio in PBMC may play a role in predicting the efficacy of first-line pemetrexed-containing chemotherapy in stage IV non-sq NSCLC patients.
- Subjects
PEMETREXED; CANCER chemotherapy; CANCER treatment; NON-small-cell lung carcinoma; DEXAMETHASONE; GLUCOCORTICOID receptors; THERAPEUTICS; ANTINEOPLASTIC agents; CELL receptors; LUNG cancer; LUNG tumors; POLYMERASE chain reaction; PROGNOSIS; TUMOR classification; TREATMENT effectiveness; RETROSPECTIVE studies; MONONUCLEAR leukocytes
- Publication
Cancer Chemotherapy & Pharmacology, 2017, Vol 80, Issue 4, p851
- ISSN
0344-5704
- Publication type
journal article
- DOI
10.1007/s00280-017-3399-1