New tricks for old biomarkers: thymidylate synthase expression as a predictor of pemetrexed activity in malignant mesothelioma

Abstract

Combination of platinum compounds/pemetrexed has become the standard first-line treatment of malignant pleural mesothelioma (MPM) [1], but predictors of responsiveness to pemetrexed and/or cisplatin/carboplatin are still lacking. Recently, Righi et al. [2] retrospectively investigated the correlation between expression of thymidylate synthase (TS) and excision repair cross-complementation group-1 (ERCC1) in MPM patients treated with platinum compounds/pemetrexed. TS messenger RNA (mRNA) and protein levels inversely correlated with pemetrexed sensitivity in non-small-cell lung cancer (NSCLC) cells, as well as with outcome in NSCLC patients treated with pemetrexed-based chemotherapy. Low ERCC1 protein levels were associated with improved outcomes for adjuvant platinum-based chemotherapies in NSCLC.