Evaluation On Clinical Effect Of Chemotherapy For Patients With Advanced HER-2 Negative Gastric Cancer By The Guidance Of TUBB3、ERCC1/XRCC1 Molecular Detection

Objective:The objective of our research is to analyze the effects of β-tubulin III(TUBB3)and resection repair cross-complementary gene 1(ERCC1)/ X-ray repair crosscomplementary gene 1(XRCC1)detection on the individualized chemotherapy and prognosis of HER-2 negative advanced gastric cancer.Methods:Clinical data of 89 patients with HER-2 negative advanced gastric cancer.RTPCR and immunohistochemical methods were used to detect the expression of TUBB3,ERCC1 / XRCC1 genes and proteins in tumor tissues of patients,and finally they were included in the TUBB3 low expression group and ERCC1 / XRCC1 low expression group.Patients in the TUBB3 low expression group received taxane combined with fluorouracil chemotherapy;patients in the ERCC1 / XRCC1 low expression group received platinum combined with fluorouracil chemotherapy.The patients were followed up until the patient’s death or follow-up deadline.The observation indicators were total response rate(CR + PR),Time to disease progression(TTP)and total survival time(OS).Results:The low expression rate of TUBB3 、ERCC1 、XRCC1 was 60.47%(52/86)、41.86%(36/86)and 41.86%(36/86)relatively in the enrolled patients.The overall ORR of patients in the therapy group was 60.42%(29/48),of which 2 patients had a complete response to CR(4.17%),and 27 patients had a partial response to PR(56.25%).Chemotherapy response rate in patients with TUBB3 low expression group was 58.3%,and median TTP and median OS were 8.0 and 15.0 months,respectively.The response rate of chemotherapy in patients with low expression of ERCC1 / XRCC1 was 62.5%,and the median TTP and median OS were 7.2 and 12.0 months,respectively.Conclusions:Patients with low expression of TUBB3 in patients with HER-2 negative advanced gastric cancer can benefit from chemotherapy with taxane combined with fluorouracil,while those with low expression of ERCC1 / XRCC1 can benefit from chemotherapy with platinum combined with fluorouracil.Chemotherapy based on molecular detection for HER-2 negative advanced gastric cancer may improve the efficacy of first-line treatment of advanced gastric cancer.