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Objective  Personalized chemotherapy based on predictive biomarkers can maximize efficacy. However, tumor tissue obtained at the time of initial diagnosis will not reflect genetic alterations observed at the time of disease progression. We have examined whether plasma mRNA levels can be a surrogate for tumor levels in predicting chemosensitivity.    Methods  In 150 gastric cancer patients, mRNA levels of BRCA1 and TS were assessed in plasma and paired tumor tissue. The Mann-Whitney U-test was used to compare mRNA expression levels between tumor samples exhibiting  in vitro  sensitivity or resistance to docetaxel and pemetrexed. All statistical tests were two-sided.    Results  There were significant correlations between plasma and tumor mRNA levels of BRCA1 (rho = 0.696, P < 0.001) and TS (rho = 0.620, P < 0.001). BRCA1 levels in plasma (docetaxel-sensitive: 1.25; docetaxel-resistant: 0.50,  P  < 0.001) and tumor (docetaxel-sensitive: 8.81; docetaxel-resistant: 4.88,  P  < 0.001) were positively associated with docetaxel sensitivity. TS levels in plasma (pemetrexed-sensitive: 0.90; pemetrexed-resistant: 1.82,  P  < 0.001) and tumor (pemetrexed-sensitive: 6.56; pemetrexed-resistant: 16.69,  P  < 0.001) were negatively associated with pemetrexed sensitivity.    Conclusions  Plasma mRNA expression levels mirror those in the tumor and may have a promising role as potential predictive biomarkers for chemotherapy.    Electronic supplementary material  The online version of this article (doi:10.1186/s12967-014-0355-2) contains supplementary material, which is available to authorized users.

Plasma mRNA expression levels of BRCA1 and TS as potential predictive biomarkers for chemotherapy in gastric cancer