From Thoracic Oncology Program, H. Lee Moffitt Cancer Center & Reserach Institute, 12902 Magnolia Drive, Tampa, FL
Author's disclosure of potential conflicts of interest is found at the end of this article.
Address reprint requests to Gerold Bepler, MD, PhD, 12902 Magnolia Drive, Tampa, FL; e-mail: gerold.bepler{at}moffitt.org
Overview: Protein and/or mRNA levels of several genes are beginning to emerge as predictive markers of chemotherapeutic efficacy in non-small cell lung cancer (NSCLC). ERCC1, the 5'-endonuclease of the nucleotide excision repair complex, is a molecular determinant for efficacy of platinum-based regimens. RRM1, the regulatory subunit of ribonucleotide reductase, is the molecular target of gemcitabine, and its expression levels are the key determinant of the efficacy of gemcitabine-based regimens. TS, the gatekeeper enzyme of thymidine production, has seemingly emerged as a determinant of efficacy for not only 5-FU but also for pemetrexed. Finally, data suggest that BRCA1, the gene important for DNA damage response, appears to increase efficacy of antimicrotubulin agents such as taxanes while simultaneously mediating resistance to DNA-damaging agents such as platinum.
