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Small cell lung cancer is the most aggressive lung cancer subtype. The standardtreatment approach is based on cisplatin regimens. Although response rates totreatment are approximately 60-80%, the median survival is still very poor. Excisionrepair cross complementation group 1 (ERCC1) is an enzyme that removes cisplatin-inducedDNA adducts and has been related with prognosis and cisplatin response. Topotecanis the standard treatment as second-line therapy and it is an inhibitor of topoisomeraseI (TOP I). We selected 76 patients with small cell lung (SCLC) to analyze theERCC1 and TOP I mRNA expression. ERCC1 was studied both by quantitative PCR andimmunohistochemistry. A significant association was found between the inmunohistochemistryexpression of ERCC1 and the lack of platinum response (p=0.001). Moreover, lowlevels of TOP I RNA were shown to be linked to cisplatin response (p=0.002). Inthe survival analysis, a significant correlation between a better PFS with a lowTOP I RNA expression as well as a negative ERCC1 inmunostaining were found, inboth cases with a significant p-value (p=0.02 and 0.009, respectively). In summary,our results suggest the use of ERCC1 immunohistochemistry and TOP I mRNA analysisto predict cisplatin response and prognosis in SCLC patients.

ERCC1 and topoisomerase I expression in small cell lung cancer: Prognostic and predictive implications