Chao Chen, Haiqing Hua, ChenglongHan, Yuan Cheng, Yin Cheng, Xueying Ren

Department of Medical Oncology of PLA Cancer Center,81 Hospital of PLA

Objective:The prognostic role of thymidylatesynthase (TS) in non-small cell lung cancer (NSCLC) patients treated with oralfluoropyrimidines remains controversial. To clarify the association of TS withsurvival in NSCLC patients treated with oral fluoropyrimidines, we performed ameta-analysis of the literature with meta-analysis. Method: Trials wereselected for further analysis if they provided an independent assessment of TSin NSCLC patients treated with oral fluoropyrimidines and reported the survivaldata in the context of TS status. Sensitivity analyses were conducted using thepatient's disease stage, testing methods, and ethnicity. Result: A totalof 5 trials, which comprised 475 patients, were included in the meta-analysis.The combined hazardratio (HR) of 0.39 [95% CI, 0.24-0.62; test forheterogeneity P=0.181] suggests that low TS expression was associatedwith a longer survival. Sensitivity analyses were conducted to evaluate whethermodifying the inclusion criteria of this meta-analysis involved limiting themeta-analysis to studies that included more than 50 patients, testing method,drug type, and disease stage affected the outcome or eliminated heterogeneity. Conclusion:Low TS expression is associated with better prognosis for NSCLC patientstreated with oralfluoropyrimidines.

Key Words: thymidylate synthase  prognosis non-small cell lung