Systemic chemotherapies have proven to be effective for treating esophageal squamous cell carcinoma (ESCC). In advanced ESCC, predicting the response to primary chemotherapy is critical. In this study, we investigated the relationship between
NFE2L2 gene status and chemotherapy response in ESCC patients. A sequence analysis of 61 primary ESCCs revealed that 13 (21.3%) had mutations in
NFE2L2. Among the 50 ESCC patients who received primary chemotherapy, objective response rate of patients with
NFE2L2 mutation (2/8, 25.0%) was significantly lower than that of patients with
NFE2L2 wild type (30/42, 71.4%) (p = 0.02, Fisher’s exact test). Furthermore, among 43 patients who received triplet chemotherapy with docetaxel, cisplatin, and 5-FU,
NFE2L2 mutant patients (n = 5) had a significantly lower overall survival rate than
NFE2L2 wildtype patients (n = 38, p = 0.03, Log-rank test).
NFE2L2 mutations were also found in 4 of 11 (36.4%) ESCC cell lines. The rate of growth inhibition by anticancer drugs in
NFE2L2 mutant cells was significantly lower than in wildtype cells
(p < 0.01, Mann–Whitney U test). Our findings suggest that
NFE2L2 status can predict chemotherapy response in patients with ESCC.
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