The Use of Biomarkers-A Chemo Sensitivity Report For Cholangiocarcinom

Hi,Eli,
thanks to show interest on this bio markers subject.
IHC (Immunohistochemistry) method used “positive” and “negative ” and microarrayillumia method used “under expressed”,”no change” and “over expressed” to describe the result.
The above study of the two platium drugs used the IHC methods and therefore they use the term positive or negative to describe their findings.The study did not use the microarrayillumia method.
So based on the IHC method,you are right that cisplatin is better for me because of the NEGATIVE RESULT.
On the other hand from the microarray analysis ,my overexpression ratio for ERCC1 gene is only3.11(ie: the ratio is the difference in expression for this ERCC1 gene between my tumor and the control tissues.) I think my ratio is on the low side of the scale but I need to ask my oncologist for his opinion due to lower nephrotoxicity of oxaliplatin.
For a person has no medical training , and can show such interest and understanding about the subject matter of CC. I have to tip my hat to you.
Your wife is lucky to have you on her side.
God bless.

Hi, everyone,
For those who are interested in the bio markers subject,this is the continuation of my research based on my own results.

On the” Target Now” biomarkers report,my ERCC1 is negative by the IHC method but overexpressed by the microarrayillumina method.

This ERCC1 marker is used for testing the chemo sensitivity on cisplatin,carboplatin and oxaliplatin.(the platium group).
Usually when ERCC1 is overexpressed,the platin group is not recommended.
but my” Target Now “report said this group(the platium group) is associated with clinical benefit and is ok to use them because I think my ERCC1 by IHC method is NEGATIVE and supported by the following study that I dug up from my research.(see below).
God bless.

Different relation between ERCC1 overexpression and treatment outcomes of two platinum agents in advanced biliary tract adenocarcinoma patients.
Meeting:
2010 Gastrointestinal Cancers Symposium
Abstract No:
178
Author(s):
I. Hwang, J. Jang, G.National University, Jinju, South Korea; College of Medicine, Dong-A University, Busan, South Korea;

Abstract:

Background: Several clinical studies have shown that excision repair cross-complementation group 1 (ERCC1) overexpression is associated with resistance to platinum-based chemotherapy and poor prognosis in several tumors. However, these studies have never been tried on biliary tract cancer. The aim of this study was to evaluate the association between ERCC1 expression and treatment outcomes in advanced biliary tract adenocarcinoma (ABTA) patients treated with platinum-based chemotherapy. Methods: 106 patients with histologically confirmed adenocarcinoma of biliary tract were enrolled at 5 institutions between January 2002 and September 2008. Of 106 patients, 93 were assessed by immunohistochemistry from biopsy specimens. 65 patients were treated with cisplatin and the other 28 were treated with oxaliplatin. Results: ERCC1 expression was positive in 47 out of 93 specimens (51%). 20 (22%) of 93 patients showed response (including complete response and partial response). Among 20 patients who obtained response, eleven (55%) were positive for ERCC1 expression and nine (45%) were negative (p = 0.621). In subgroup analysis, ERCC1 expression of oxaliplatin treated adenocarcinomas was 13 of 28 specimens (46%). 6 (21%) of 28 patients achieved response. In patients treated with oxaliplatin, six (100%) were positive for ERCC1 and none (0%) were negative (p = 0.005) among the 6 patients who obtained response. With a median follow-up of 7.3 months (range, 0.8-47.5 months), median progression-free survival (PFS) and overall survival (OS) were 3.6 months and 7.3 months, respectively, and there were no significant differences of median PFS and median OS between ERCC1 negative and positive patients for the total study population (PFS, 4.2 versus 2.9 months, p = 0.116; OS, 7.0 versus 7.8 months, p = 0.143). In patients treated with cisplatin, the median OS was significantly longer in the ERCC1-negative group than in the ERCC1-positive group (9.1 vs 7.3 months, respectively; p = 0.017).
Conclusions: Patients with ERCC1-positive ABTA show a response benefit from oxaliplatin-containing chemotherapy. On the other hand, patients with ERCC1-negative ABTA show a survival benefit from cisplatin-containing chemotherapy.