Gao et al. BMC Cancer 2011, 11:177 http://www.biomedcentral.com/1471-2407/11/177 R E S E A R C H A R T I C L E Open Access Thymidine Phosphorylase/b-tubulin III expressions predict the response in Chinese advanced gastric cancer patients receiving first-line capecitabine plus paclitaxel Jing Gao†, Ming Lu†, Jing-wei Yu, Yan-yan Li and Lin Shen* Abstract Background: To assess the role of Thymidine Phosphorylase and b-tubulin III in clinical outcome of Chinese advanced gastric cancer patients receiving first-line capecitabine plus paclitaxel. Methods: The clinical data and tumor biopsies prior treatment from 33 advanced gastric cancer patients receiving capecitabine plus paclitaxel (cohort 1, experimental group) and 18 patients receiving capecitabine plus cisplatin (cohort 2, control group) in Beijing Cancer Hospital from July 2003 to December 2008 were retrospectively collected and analyzed for Thymidine Phosphorylase and b-tubulin III expressions by immunohistochemistry. The relationships between expressions of biomarkers and response or survival were determined by statistical analysis. Results: The median age of 51 patients was 57 years (range, 27-75) with male 34 and female 17, and the response rate, median progression-free survival and overall survival were 43.1%, 120d and 265d. Among cohort 1, the response rate, median progression-free survival and overall survival in b-tubulin III positive (n = 22) and negative patients (n = 11) were 36.4%/72.7% (positive vs negative, P = 0.049), 86d/237d (P = 0.046) and 201d/388d (P = 0.029), respectively; the response rate (87.5% vs 14.3%, P = 0.01) and median progression-free survival (251d vs 84d, P = 0.003) in Thymidine Phosphorylase positive & b-tubulin III negative patients (n = 8) were also significantly higher than those in Thymidine Phosphorylase negative & b-tubulin III positive patients (n = 7). There was no correlation between b-tubulin III expression and response or survival among cohort 2 (n = 18). Conclusions: In Chinese advanced gastric cancer, Thymidine Phosphorylase positive & b-tubulin III negative might predict response and prognosis to capecitabine plus paclitaxel chemotherapy. Further prospective evaluation in large samples should be performed to confirm these preliminary findings. Background Gastric cancer remains one of the most common causes of cancer death worldwide [1], especially in China [2]. Although the improvement of diagnostic methods enables some patients to receive radical cure at early disease, about 40% patients still miss the opportunity of radical cure at the time of diagnosis, furthermore, about 50% patients occur relapse and metastasis after opera- tion. For these patients, chemotherapy is still the main * Correspondence: lin100@medmail.com.cn † Contributed equally Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of GI Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China method general accepted in the world. Several agents are now available for the systemic chemotherapy of patients with gastric cancer, including fluoropyrimidines, platinum, taxanes and so on. But fluoropyrimidines are fundamental in gastric cancer. For advanced gastric can- cer patients (AGC), combination chemotherapy with two or three drugs is most common with superiority compared to best supportive care in first-line or second- line therapy [3-6]. Capecitabine is an orally-administered chemothera- peutic agent which was designed to generate 5-Fluor- ouracil (5-FU) preferentially in tumors. It is a prodrug which is converted to 5-FU in the tumors through a © 2011 Gao et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.