The tailored chemotherapy based on RRM1 immunohistochemical expression in patients with advanced non-small cell lung cancer

BACKGROUND: Ribonucleotide reductase subunit M1 (RRM1) has emerged as a promising biomarker to predict the efficacy of gemcitabine. The purpose of the study was to evaluate whether the tailored chemotherapy based on RRM1 immunohistochemical (IHC) expression had any benefit for patients with advanced non-small cell lung cancer (NSCLC). METHODS: A single-institution study was conducted in patients with advanced NSCLC. In personalized therapy group, patients received chemotherapy based on RRM-1 IHC expression levels. Low RRM1 group received gemcitabine or gemcitabine/cisplatin, high RRM1 group received docetaxel or docetaxel/cisplatin. In standard therapy group, non-customized chemotherapy was delivered. In this trial, Patients aged >= 70 years received single agent chemotherapy, whereas patients below 70 had platinum-based chemotherapy. RESULTS: There were statistically significant improvements between the personalized therapy group versus the standard therapy group in disease control rate (82.9% vs 55.3%, P = 0.004), and PFS (median: 5.5 months vs 3.0 months, P = 0.005). Besides, the OS had a tendency to become more prolonged (median: 16.0 months vs 12.4 months, P = 0.286). The subgroup analysis suggested the survival benefit in the elderly patients was more obvious. CONCLUSION: RRM1 IHC expression tailored selection of first-line therapy could improve therapeutic outcomes in patients with advanced NSCLC.