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Lack of effective biomarkers is one of the challenges in current chemotherapy to predict drug response and sensitivity.This study was to investigate the relationships between the expressions of class Ⅲ β-tubulin, microtubule-associated protein tau (MAPT), survivin and the sensitivity of primary gastric cancer to paclitaxel treatment.Reverse transcription-PCR and Western blot were used to evaluate the mRNA and protein expressions of class Ⅲ β-tubulin, MAPT and survivin in fifty-four gastric cancer tissues.Viable tumor cells from gastric carcinomas were tested for their sensitivity to paclitaxel using adenosine triphosphate-based tumor chemosensitivity assay (ATP-TCA) in vitro.Out of 54 samples, 30 samples were sensitive to paclitaxel, while the other 24 samples were resistant.The overall efficacy of paclitaxel was 55.56% (30/54).The mRNA expressions of Class Ⅲ β-tubulin and survivin were significantly correlated to the histological grade (P=0.029, 0.009, respectively).The sensitivity of gastric cancer patients to paclitaxel treatment was inversely correlated to the mRNA and protein expressions of class Ⅲ β-tubulin (P<0.0 t), MAPT (P<0.05), and survivin (P<0.05).A significant positive correlations were found between Class Ⅲ β-tubulin and MAPT expression at mRNA and protein levels (mRNA: P=0.037; protein: P=0.001).Our results indicate that the expression levels of Class Ⅲ β-tubulin, MAPT and survivin are good biomarkers for predicting the sensitivity of gastric cancer to paclitaxel treatment.