Predictive and Prognostic Value of Human Equilibrative Nucleoside Transporter 1 in Advanced Pancreatic Carcinoma

Abstract
Background: Pancreatic cancer is a very aggressive dis-ease. 5-year survival rates remain low at 10% to 30% even with adjuvant therapy, as most patients will succumb to the disease secondary to high rate of local and systemic recur-rences. Gemcitabine is one of the drugs of choice for the adjuvant treatment for patients with pancreatic cancer. The drug is transported into pancreatic cancer cells primarily by human equilibrative nucleoside transporter 1 (hENT1).
Aim of Study: To evaluate hNET-1 protein expression in patients with advanced pancreatic cancer treated with gemcit-abine-based chemotherapy as a predictive factor for the response of treatment as well as prognostic marker for overall survival and disease progression.
Patients and Methods: Prospective and retrospective study was conducted on 30 patients presented with advanced pan-creatic cancer; Immuno-histochemical staining of tumor tissue was performed for detecting hENT 1 expression. All the patients have been treated with gemcitabine based chemotherapy.
Results: Sixty percent of patients had high hENT 1 expres-sion and 40% had low hENT1 expression. Overall survival after median follow-up of 14 months showed that patients with high hENT1 expression had longer Overall survival than patients with low hENT1 expression and the difference was statistically significant (p=0.0025) respectively. Further, patients with high hENT1 expression showed longer disease free survival than patients with low hENT1 expression, and the difference was statistically significant (p=0.002).
Conclusion: A high level of hENT 1 expression is signif-icantly associated with a longer survival in patients who received gemcitabine mono therapy. Hence, the study suggests hENT 1 expression as potential assay for the prediction of response to gemcitabine based chemotherapy.