Prognostic and predictive significance of thymidylate synthase protein expression in non-small cell lung cancer: A systematic review and meta-analysis

Qingyun Liu, Zubin Yu, Ying Xiang, Na Wu, Long Wu, Bin Xu, Liang Wang, Ping Yang, Yafei Li, Li Bai

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

BACKGROUND: It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC).

OBJECTIVE: To evaluate prognostic and predictive significance of tumor TS protein level in NSCLC.

METHODS: Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test.

RESULTS: Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias.

CONCLUSION: Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLC patients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.

Original languageEnglish (US)
Pages (from-to)65-78
Number of pages14
JournalCancer Biomarkers
Volume15
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Thymidylate Synthase
Non-Small Cell Lung Carcinoma
Meta-Analysis
Proteins
Disease-Free Survival
Survival
Publication Bias
Pemetrexed
Pharmaceutical Preparations
Survival Analysis
PubMed
Fluorouracil
Databases

Keywords

  • Non-small cell lung cancer
  • predictive factor
  • prognosis
  • thymidylate synthase

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Genetics
  • Medicine(all)

Cite this

Prognostic and predictive significance of thymidylate synthase protein expression in non-small cell lung cancer : A systematic review and meta-analysis. / Liu, Qingyun; Yu, Zubin; Xiang, Ying; Wu, Na; Wu, Long; Xu, Bin; Wang, Liang; Yang, Ping; Li, Yafei; Bai, Li.

In: Cancer Biomarkers, Vol. 15, No. 1, 2015, p. 65-78.

Research output: Contribution to journalReview article

Liu, Qingyun ; Yu, Zubin ; Xiang, Ying ; Wu, Na ; Wu, Long ; Xu, Bin ; Wang, Liang ; Yang, Ping ; Li, Yafei ; Bai, Li. / Prognostic and predictive significance of thymidylate synthase protein expression in non-small cell lung cancer : A systematic review and meta-analysis. In: Cancer Biomarkers. 2015 ; Vol. 15, No. 1. pp. 65-78.
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abstract = "BACKGROUND: It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC).OBJECTIVE: To evaluate prognostic and predictive significance of tumor TS protein level in NSCLC.METHODS: Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test.RESULTS: Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias.CONCLUSION: Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLC patients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.",
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T1 - Prognostic and predictive significance of thymidylate synthase protein expression in non-small cell lung cancer

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AU - Liu, Qingyun

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AU - Wu, Na

AU - Wu, Long

AU - Xu, Bin

AU - Wang, Liang

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AU - Li, Yafei

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N2 - BACKGROUND: It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC).OBJECTIVE: To evaluate prognostic and predictive significance of tumor TS protein level in NSCLC.METHODS: Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test.RESULTS: Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias.CONCLUSION: Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLC patients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.

AB - BACKGROUND: It remains controversial whether thymidylate synthase (TS) protein expression is associated with survival for patients with non-small cell lung cancer (NSCLC).OBJECTIVE: To evaluate prognostic and predictive significance of tumor TS protein level in NSCLC.METHODS: Electronic searches were performed for relevant studies in PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were pooled for meta-analysis. Subgroup and sensitivity analyses were performed. Publication bias was evaluated by funnel plot and Begg's test.RESULTS: Twenty-four studies, including 2280 patients, were eligible. This analysis showed that patients with low TS expression had statistically significantly longer OS and PFS than those with high TS (HR=0.51 and HR=0.49, respectively). Based on TS-targeted drug use status, TS expression was significantly associated with OS in pemetrexed (HR=0.42) and 5-Fluorouracil subgroups (HR=0.34), but not in no TS-targeted drug subgroup. There were similar results for PFS analyses. Sensitivity analysis indicated that the results were robust. Begg's test did not reveal any publication bias.CONCLUSION: Low TS protein expression is a favorable predictive factor for better OS/PFS in NSCLC patients treated with TS-targeted drugs. Prognostic value of TS protein expression needs further validation.

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