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We conducted a meta-analysis to determine if  MTHFR  polymorphisms are effective biomarkers for non-small cell lung cancer (NSCLC) patient survival and pemetrexed (PEM) treatment toxicity. Because of data heterogeneity, fixed or random effects models were chosen, and pooled HRs and 95% confidence intervals (CIs) were calculated. No correlation between  MTHFR  677 C &gt; T polymorphism and progression-free survival (PFS) or overall survival (OS) was detected in NSCLC patients; however, patients with the T allele benefited more than those with the wild-type allele. Two papers reported hematologic toxicity of single-agent PEM treatment in patients with the  MTHFR  677 C &gt; T polymorphism. However, data on  MTHFR  polymorphisms and toxicity could not be combined, even though publication bias and sensitivity analysis results were stable and reliable. We conclude that the  MTHFR  677 C &gt; T polymorphism could not predict PEM efficacy in NSCLC patients; however, the T allele may increase the risk of haematological toxicity. A large-scale clinical trial is recommended.

journal of chemotherapy

Systematic review and meta-analysis of the predictive power of  MTHFR  polymorphisms for pemetrexed drug efficacy and toxicity in non-small cell lung cancer patients