gms | German Medical Science

Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie

24.-26.10.2013, Basel, Schweiz

ERCC1 as a predictor of response to induction therapy for stage III non-small cell lung cancer

Meeting Abstract

  • A. Marra - Thoraxchirurgie, Niels-Stensen-Kliniken, Ostercappeln
  • D. Kemming - European Laboratory Association, Ibbenbüren
  • U. Bosse - Institut für Pathologie, Osnabrück
  • T. Krüer - Institut für Pathologie, Osnabrück
  • M. Netchaeva - Hämatologie/Onkologie, Klinikum Osnabrück, Osnabrück
  • W. Wagner - Strahlentherapie, Paracelsus Klinik, Osnabrück
  • O. Koch - Hämatologie/Onkologie, Klinikum Osnabrück, Osnabrück
  • U. Vogt - European Laboratory Association, Ibbenbüren
  • L. Hillejan - Thoraxchirurgie, Niels-Stensen-Kliniken, Ostercappeln

Deutsche Gesellschaft für Thoraxchirurgie. Österreichische Gesellschaft für Thoraxchirurgie. Schweizerische Gesellschaft für Thoraxchirurgie. Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaft für Thoraxchirurgie. Basel, Schweiz, 24.-26.10.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocS1.7

doi: 10.3205/13dgt014, urn:nbn:de:0183-13dgt0141

Published: October 14, 2013

© 2013 Marra et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Neoadjuvant platinum-based chemotherapy in stage III non-small cell lung cancer (NSCLC) offers the chance to eradicate occult metastases and decrease the tumor volume, thus improving curative surgical resection rates. A remission after induction therapy is correlated with prolonged survival. However, only 40–50% of patients respond to therapy since there is still no validated predictor for the benefit of platinum based chemotherapy. As DNA repair mechanisms are related with resistance of lung cancer cells to platinum-based chemotherapy, aim of the study was to compare ERCC1 level in lymph node metastases with the degree of pathologic tumor regression after induction treatment and surgery.

Methods: From July 2004 to June 2009, 46 NSCLC patients with clinically staged IIIA (N=32) or IIIB (N=14) NSCLC underwent at least two cycles of platinum-based induction chemotherapy and combined radio-chemotherapy. After restaging radical surgery was performed. ERCC1 was determined from pretreatment samples of metastatic nodes taken on mediastinoscopy. Real time RT-PCR assays were performed to determine ERCC1 mRNA expression. Tumor regression has been classified on surgical specimen using an score system ranging from grade I (pCR) to grade VI (non-responder). The samples were categorized into three groups according to their ERCC1 expression values and in two groups according to their chemotherapy response (either pCR or non-pCR).

Results: A significant correlation between the ERCC1 expression level and the chance to achieve a pCR during a platinum-based chemotherapy could be demonstrated in our samples (P<0.05). Furthermore, the median overall survival in the pCR group was 44 vs. 29 month in the non-pCR group (HR 0.33 [95%-CI: 0.02–1.15]; P=0.06). However, no direct correlation between ERCC1 expression and local or distant metastasis formation could be found.

Conclusion: Assessment of ERCC1 mRNA expression in pretreatment tumor tissue is feasible in the clinical setting and predicts response to platinum-based induction therapy. Additional studies are warranted to optimize methodologies for ERCC1 analysis in small tumor samples and to redefine induction protocols on an individual basis, thus enhancing response rates and perhaps outcome.