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. 2012 Jun;5(3):155-9.
doi: 10.1596/tlo.12151. Epub 2012 Jun 1.

Bax expression is predictive of favorable clinical outcome in chemonaive advanced gastric cancer patients treated with capecitabine, oxaliplatin, and irinotecan regimen

Filippo Pietrantonio  1 , Pamela Biondani, Filippo de Braud, Alessandro Pellegrinelli, Giampaolo Bianchini, Federica Perrone, Barbara Formisano, Maria Di Bartolomeo
Affiliations

Bax expression is predictive of favorable clinical outcome in chemonaive advanced gastric cancer patients treated with capecitabine, oxaliplatin, and irinotecan regimen

Filippo Pietrantonio et al. Transl Oncol. 2012 Jun.

Abstract

Objective: Bax protein is a key mediator of apoptosis, and it might be related to chemosensitivity. The purpose of this study was to evaluate the prognostic role of Bax in patients with advanced gastric cancer treated with triplet chemotherapy COI regimen (capecitabine, oxaliplatin, and irinotecan).

Methods: Pretreatment tissue blocks were available for 23 consecutive patients, selected for good performance status (ECOG ≤ 1) and consenting for treatment with first-line COI at a single institution. Bax levels were classified as positive or negative by immunohistochemistry (bax N20; Santa Cruz Biotechnology) and related to outcome in terms of response rate, progression-free survival, and overall survival.

Results: Bax-negative and -positive samples were 26% and 74%, respectively. Bax expression was associated with significantly higher response rate (87% vs 33%), progression-free survival (8.7 vs 4.9 months, P = .016), and overall survival (23.8 vs 12.7 months, P = .025). In multivariate analysis including Bax and performance status, low Bax independently predicted worse outcome, along with suboptimal performance status.

Conclusions: In advanced gastric cancer, Bax expression was related to clinical benefit with COI regimen. Whether Bax is a prognostic or mixed prognostic/predictive factor warrants prospective confirmation. It is to be defined if Bax predicts sensitivity to platinum analogs or to whatever chemotherapy regimen.

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Conflict of interest statement

All authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Representative immunohistochemical detection of BAX in two gastric adenocarcinoma samples. (A) Bax cytoplasmic immunostaining in well-differentiated tubular gastric adenocarcinoma and in germinal center (positive control). Magnification, x10. (B) Bax cytoplasmic immunostaining in moderately differentiated metastatic tubular gastric adenocarcinoma. Magnification, x20.
Figure 2
Figure 2
PFS according to Bax status.
Figure 3
Figure 3
OS according to Bax status.
See this image and copyright information in PMC

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