M. Tabata et al., MDR1 GENE-EXPRESSION AND TREATMENT OUTCOME IN SMALL-CELL LUNG-CANCER - MDR1 GENE-EXPRESSION AS AN INDEPENDENT PROGNOSTIC FACTOR, Acta medica Okayama, 47(4), 1993, pp. 243-248
We report a preliminary study to determine whether MDR1 gene expressio
n level in small cell lung cancer (SCLC) tumors is a useful predictor
of tumor response to chemotherapy and patient survival in association
with myc amplification in the tumor. We analyzed 18 patients with SCLC
receiving adriamycin and etoposide combination chemotherapy between A
ugust 1989 and November 1991; 16 males and 2 females, median age of 68
years, and 7 with limited disease and 11 with extensive disease. MDR1
mRNA expression level and myc family gene amplification were simultan
eously determined by polymerase chain reaction using transbronchial bi
opsy specimens which were obtained at diagnosis. Patients with tumors
expressing low MDR1 mRNA responded more favorably to chemotherapy than
those with tumors expressing high MDRI mRNA, however, the difference
in tumor response was statistically not significant (84.6 % versus 40
%). The overall survival was significantly shorter in the latter than
in the former (7.2 months versus 11.7 months; p=0.023). The survival o
f the 4 patients with tumor showing myc family gene amplification was
almost identical to that of patients with tumors showing no amplificat
ion of the gene (8.2 months versus 8.8 months;p=0.73). Multivariate Co
x's regression analysis supports the notion that MDR1 may be a useful
independent prognostic factor.