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Bax Predicts Outcome in Gastric Cancer Patients Treated with 5-fluorouracil, Leucovorin, and Oxaliplatin Palliative Chemotherapy

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Abstract

Background

Platinum and 5-fluorouracil (5-FU)-based regimens have been used the most frequently in palliative chemotherapy for gastric cancer. The present study evaluated the prognostic significance of Bax, excision repair cross-complementation group 1 (ERCC1), and thymidylate synthase (TS) in advanced gastric cancer patients treated with 5-FU, leucovorin, and oxaliplatin (FOLFOX) palliative chemotherapy.

Methods

Seventy-two patients with metastatic or recurrent gastric cancer were treated with FOLFOX regimen. Pretreatment tumor biopsy specimens were analyzed for Bax, ERCC1, and TS expression by immunohistochemistry.

Results

High expression of Bax, ERCC1, and TS was observed in 31 (43%), 33 (46%), and 35 (49%) patients, respectively. The median overall survival (OS) of patients was 12 months. Low expression of Bax was associated with poor OS (median, 9 months vs. 18 months; 2-year, 10% vs. 48%; p = 0.0005) in univariate analysis, while expression of ERCC1 and TS was not correlated with patient outcome. In multivariate analysis, low expression of Bax was a significant independent predictor of poor OS (p = 0.028). Low expression of Bax was significantly associated with poor survival of patients with metastatic or recurrent gastric cancer treated with FOLFOX chemotherapy.

Conclusions

Immunohistochemical staining for Bax with pretreatment biopsy specimen may be useful in selecting FOLFOX regimen as a treatment option for advanced gastric cancer patients.

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Acknowledgments

None of the authors have a financial interest in the subject matter or materials discussed in this manuscript. The authors are grateful to Ms. Geum Sook Jeong for her administrative assistance in preparing and submitting this manuscript.

Conflict of interest statement

None declared.

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Authors and Affiliations

  1. Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, 443-721, Republic of Korea

    Seong Hyun Jeong, Mi Sun Ahn, Yoon Ho Hwang, Hyun Woo Lee, Seok Yun Kang, Joon Seong Park & Jin-Hyuk Choi

  2. Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea

    Jae Ho Han & Jang Hee Kim

  3. Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea

    Kwang Jae Lee

  4. Section of Clinical Epidemiology and Biostatistics in Clinical Trial Center, Ajou University School of Medicine, Suwon, Republic of Korea

    Seung Soo Sheen

  5. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea

    Ho-Yeong Lim

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  1. Seong Hyun Jeong
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  2. Jae Ho Han
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Correspondence to Jin-Hyuk Choi.

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Grant: Grant from Ajou University Medical Center, Suwon, Korea.

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Jeong, S.H., Han, J.H., Kim, J.H. et al. Bax Predicts Outcome in Gastric Cancer Patients Treated with 5-fluorouracil, Leucovorin, and Oxaliplatin Palliative Chemotherapy. Dig Dis Sci 56, 131–138 (2011). https://doi.org/10.1007/s10620-010-1280-8

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  • DOI: https://doi.org/10.1007/s10620-010-1280-8

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