69. Stomach cancer β-tubul in III expression in relation to sensitivity of with taxane chemotherapy

Objective: Gastric cancer is a common gastrointestinal malignancy, which threaten human health seriously. In all malignant tumors, the incidence rate rank fourth, the mortality rate rank second. For these patients with relapse or metastasis diseases, chemotherapy is the main method general accepted in the world. However, the overall efficacy of the chemotherapy for advanced gastric cancer is still not satisfactory. Taxanes, including paclitaxel and docetaxel, are active antitumor agent for gastric cancer. But we find that patients with gastric cancer show great individual difference in the treatment of taxane. A number of studies had shown that the expression of β-tubulinIII was related to taxan chemotherapy sensitivity. The purpose of this study was to learn the betatubulinIII expression in gastric cancer tissues, investigate the relationship between β-tubulinIII expression and taxane chemosensitivity, and investigate if β-tubulinIII was a predictor of taxane chemosensitivity in patients with gastric cancer, in order to achieve individualized treatment. Methods: This study was a prospective study. Patients diagnosed with advanced gastric cancer in May 2010 to November 2011 in Tianjin Medical University Cancer Hospital digestive oncology department. The detection of β-tubulinIIImRNA. Patients who detected β-tubulinIIIentered into the trial group, while who didn’t detect β-tubulinIII entered into the control group. Trial group in accordance with the expression of β-tubulinIII was divided into the low expression group and the high expression group. The low expression group and the control group used taxane-based chemotherapy, while the high expression group used taxane-free chemotherapy.
Results: The trial group included 40 cases, 31 cases with low betatubulinIII expression, the low expression rate was 77.5%, nine cases with high beta-tubulinIII expression, the high expression rate was 22.5%. There was no correlation between beta-tubulinIII and clinical characteristics, such as age, gender, primary tumor location, pathological type. The low β-tubulinIII expression group used taxane-based chemotherapy, chemotherapy cycles ranged from 2 to 8, with a median of 5 cycles, RR45.2%, DCR77.4%, median PFS 7.3 months and 1 year progression-free survival 20%, median survival 11.6 months and 1 year survival rate 47%. The control group include 31 cases, also treated with taxane-based chemontherapy, chemotherapy cycles ranged from 2 to 8, with a median of 4 cycles, RR22.6%, DCR67.7%, median PFS 5.7 months and 1 year progression-free survival 17%, median survival 11.2 months and 1 year survival rate 24%. RR, DCR, PFS, OS of the two group did not reach statistical difference, P=0.106, 0.570, 0.305, 0.402, respectively. The total of patients treated with taxane-based chemotherapy was 62 cases. Multivatriate analysis found that age, sex, tumor location, pathological type and the expression of beta-tubulinIII were not independent prognostic factors (P=0.483, 0.805, 0.232, 0.737, 0.756, respectively).
Conclusions: There was no correlation between beta-tubulinIII expression and clinical characteristics, such as age, gender, primary tumor location, pathological type. The β-tubulinIII expression level in gastric cancer tissue may be a good predictor of taxane sensitivity.