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World J Gastroenterol. Jul 14, 2014; 20(26): 8482-8490
Published online Jul 14, 2014. doi: 10.3748/wjg.v20.i26.8482
hENT1 expression is predictive of gemcitabine outcome in pancreatic cancer: A systematic review
Stina Nordh, Daniel Ansari, Roland Andersson
Stina Nordh, Daniel Ansari, Roland Andersson, Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 85 Lund, Sweden
Author contributions: Nordh S performed the literature search; Nordh S and Ansari D were involved in data analysis and manuscript writing; Andersson R designed the study and revised the manuscript; all authors read and approved the final manuscript.
Correspondence to: Roland Andersson, MD, PhD, Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Paradisgatan 2, SE-221 85 Lund, Sweden. roland.andersson@med.lu.se
Telephone: +46-46-172359
Received: October 8, 2013
Revised: March 3, 2014
Accepted: March 12, 2014
Published online: July 14, 2014
Abstract

High human equilibrative nucleoside transporter 1 (hENT1)-expression has shown a survival benefit in pancreatic cancer patients treated with gemcitabine in several studies. The aim of this systematic review was to summarize the results and try to assess the predictive value of hENT1 for determining gemcitabine outcome in pancreatic cancer. Relevant articles were obtained from PubMed, Embase and Cochrane databases. Studies evaluating hENT1-expression in pancreatic tumor cells from patients treated with gemcitabine were selected. Outcome measures were overall survival, disease-free survival (DFS), toxicity and response rate. The database searches identified 10 studies that met the eligibility criteria, and a total of 855 patients were included. Nine of 10 studies showed a statistically significant longer overall survival in univariate analyses in patients with high hENT1-expression compared to those with low expression. In the 7 studies that reported DFS as an outcome measure, 6 had statistically longer DFS in the high hENT1 groups. Both toxicity and response rate were reported in only 2 articles and it was therefore hard to draw any major conclusions. This review provides evidence that hENT1 is a predictive marker for pancreatic cancer patients treated with gemcitabine. Some limitations of the review have to be taken into consideration, the majority of the included studies had a retrospective design, and there was no standardized scoring protocol for hENT1-expression.

Keywords: Pancreatic cancer, Gemcitabine, hENT1, Predictive, Survival

Core tip: Human equilibrative nucleoside transporter 1 is a predictive marker for pancreatic cancer patients treated with gemcitabine.