developed metas tasis at the time of diagnosis. Approximately 50% of NSCLC patients receive chemotherapy as part of their Gemcitabine treatment. Agents that alter tubulin dynamics, such as paclitaxel and vinore bine, are commonly used in NSCLC treatment, either individually or combined with platinum drugs such as carboplatin or cis platin. Paclitaxel/vinorebine based chemotherapy has been shown to increase overall survival time for advanced or inoperable NSCLC. For the patients with early stage disease, surgery followed by a paclitaxel/vinorebine based chemotherapy is the most effective treatment available. Several clinical studies have reported that NSCLC patients with high class III tubulin expression were more resistant to paclitaxel/vinorebine based chemotherapy regi men than patients with low levels of expression.
Anti tubulin agents such as paclitaxel and vinorebine inhibit microtubule dynamics, leading to the growth arrest of tumor Maraviroc Selzentry cells and subsequently cell death. The efficacy of anti tubulin treat ment can be limited by the development of resistance to these agents by cancer cells. The mechanisms controlling resistance to tubulin binding agents are complex, involving increased expres sion of multidrug resistance proteins such as the P gp, changes in tubulin structure, and alterations in the levels of key proteins that control cell survival. Another reported source of resistance to these drugs is elevated expression of class III tubulin in the cancer tissue. The studies evaluating class III tubulin expression variation associated with paclitaxel based or vinorebine based chemotherapy have yielded inconsistent results.
For several studies, high expression of class III tubulin was corre lated with an adverse response rate for patients with NSCLC treated with paclitaxel based or vinorebine based chemotherapy. For other studies, the correlation between tubulin pi3k gene expression and clinical response was more ambiguous. Therefore, class III tubulin might be a promising prognostic marker for NSCLC treated with paclitaxel based or vinorebine based chemotherapy. However, there has not been a systematic assessment of the literature regarding the association of resistance to paclitaxel/vinorebine based chemotherapy with high class III tubulin expression. Also, most of the individual studies had a small number of patients.
Furthermore, most of the stud ies that investigated the association between paclitaxel based or vinorebine based chemotherapy and class III tubulin expression involved either one or the other drug, but not both. Therefore, it is still unknown whether there is a significant difference between paclitaxel jak stat based canon law and vinorebine based chemotherapy in treatment of patients with NSCLC. We performed a meta analysis to provide a systematic assess ment of whether class III tubulin expression is associated with objective response and median survival time in patients with NSCLC based on treatment with paclitaxel/vinorebine based chemother apy, and compared difference of objective response between paclitaxel based and vinorebine based chemotherapy in treatment for NSCLC. We did systematic computerized searches of several databases, including MEDLINE, EMBASE, CNKI, using the keywords Class III tubulin/tubulin, Cancer and Chemotherapy.