1. ¹Department of Oncology, Drum Tower Hospital, Clinical Cancer Institute of Nanjing University, Medical School of Nanjing University, Nanjing 210008, China
2. ²Medical Oncology Service, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Badalona 08916, Spain
3. ³Department of Preventive Medicine and Public Health, Autonomous University of Madrid, Madrid 28029, Spain
4. ⁴Department of Epidemiology and Biostatistics and Data Analysis Center, School of Public Health, Nanjing Medical University, Nanjing 210019, China
5. ⁵Department of Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China
6. ⁶Department of Oncology, Changzhou Cancer Hospital, Suzhou University, Changzhou 213001, China

Correspondence: Dr B Liu, E-mails: baoruiliu@nju.edu.cn and weijia01627@hotmail.com

Received 3 January 2008; Revised 20 February 2008; Accepted 26 February 2008; Published online 25 March 2008.

Abstract

Molecular markers involved in DNA repair can help to predict survival in gastric cancer patients treated with 5-FU plus platinum chemotherapy. Excision repair cross-complementing 1 (ERCC1) and thymidylate synthase (TS) mRNA expression levels were assessed in advanced gastric cancer tumour samples using real-time quantitative PCR in 76 patients treated with a modified FOLFOX (biweekly oxaliplatin plus 5-FU and folinic acid) regimen. Median survival time in patients with low ERCC1 levels was significantly longer than in those with high levels (15.8 vs 6.2 months; P<0.0001). Patients with high TS levels had longer survival than those with low levels (12.2 vs 10.1 months; P=0.01). Forty-eight patients with low ERCC1 and high TS levels had a median survival of 16.1 months (P<0.0001). The hazard ratio for patients with high ERCC1 expression was 9.4 (P<0.0001). In patients with high mRNA levels of ERCC1, alternative chemotherapy regimens should be considered.