Prediction of the effect of capecitabine in gastric cancer by immunohistochemical staining of thymidine phosphorylase and dihydropyrimidine dehydrogenase

Anticancer Drugs. 2008 Sep;19(8):819-24. doi: 10.1097/CAD.0b013e3283094b5d.


The objective of this study was to investigate the relationship between the expression of thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) and the response to capecitabine in patients with advanced/recurrent gastric cancer. TP and DPD expression in paraffin-embedded specimens of primary lesions, obtained from 25 patients before capecitabine chemotherapy, were evaluated by immunohistochemical staining with anti-TP and anti-DPD monoclonal antibodies. The patients (19 male and six female) had a median age of 65 years (range 37-74). All had a good performance status [Eastern Cooperative Oncology Group (ECOG) 0 or 1]. Overall response rate to capecitabine therapy was 32%. TP was positive in 19 tumors (76%) and DPD was positive in 13 tumors (52%). The response rate (RR) was significantly higher (Fisher's exact test, P=0.028) in patients with TP-positive and DPD-negative tumors (RR=60%, 6/10) than in the remaining patients (RR=13%, 2/15). TP and DPD expression profiles are useful for predicting a response to capecitabine.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Capecitabine
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Dihydrouracil Dehydrogenase (NADP) / metabolism*
  • Female
  • Fluorouracil / analogs & derivatives*
  • Fluorouracil / therapeutic use
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Paraffin Embedding
  • Predictive Value of Tests
  • Stomach Neoplasms / drug therapy*
  • Stomach Neoplasms / enzymology
  • Stomach Neoplasms / pathology
  • Stromal Cells / enzymology
  • Stromal Cells / pathology
  • Thymidine Phosphorylase / metabolism*


  • Antibodies, Monoclonal
  • Antimetabolites, Antineoplastic
  • Deoxycytidine
  • Capecitabine
  • Dihydrouracil Dehydrogenase (NADP)
  • Thymidine Phosphorylase
  • Fluorouracil