XRCC1 Arg399GIn and clinical outcome of platinum-based treatment for ad- vanced non-small cell lung cancer： a meta-analysis in 17 studies

Objective： XRCC1 polymorphism is a research hotpot in individual treatment for non-small cell lung cancer （NSCLC）. To obtain the association between XRCC1 polymorphism and clinical outcome of platinum-based treatment for NSCLC, a meta-analysis was conducted. Methods： Databases including PubMed, Embase, Cochrane, and Chinese National Knowledge Infrastructure （CNKI） were searched for publications that met the inclusion criteria. A fixed effect model was used to estimate pooled odds ratio （OR） and hazard ratio （HR） with 95% confidence interval （CI） for the association between XRCCI Arg399Gln and response or survival of platinum-based treatment for advanced NSCLC. A chi-squared-based Q-test was used to test the heterogeneity hypothesis. Egger＇s test was used to check publication bias. Results： Seventeen published case-control studies that focus on the association between XRCCI Arg399Gln and response or survival of platinum-based treatment for advanced NSCLC in 2 256 subjects were included in this meta-analysis, of whom 522 were AA genotypes （23.2% frequency）, 916 AG genotypes （40.6% frequency）, and 818 GG genotypes （36.2% frequency）. The overall response rate （ORR） was 45.2% （110/243） for AA genotype patients, 29.9% for AG genotype （73/244）, and 30.7% for GG genotype （124/403）. The heterogeneity test did not show any heterogeneity and the Egger＇s test did not reveal an obvious publication bias among the included studies. The meta-analysis indicated that AA genotype patients presented higher response rates toward platinum drug treatment compared with G model （GG＋GA） patients （GG vs. AA model： OR=0.489, 95% CI 0.266-0.900, P=0.021; AG vs. AA model： OR=0.608, 95% CI 0.392 0.941, P=0.026; GA＋AA vs. GG model： OR=1.259, 95% CI 0.931 1.701, P=0.135; GG＋GA vs. AA model： OR=0.455, 95% CI 0.313 0.663, P=-0.0001）. However, no evidence validates XRCC1 associates with the survival following platinum drug therapy. Conclusions： Our meta-analysis suggested that XRCC1 Arg399Gln is related with the sensitivity of NSCLC patients to platinum-based treatment. AA genotype patients present more desirable curative effectiveness compared with other patients.