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Sadien ID, Davies RJ, Wheeler JMD. The genomics of sporadic and hereditary colorectal cancer. Ann R Coll Surg Engl 2024; 106:313-320. [PMID: 38555871 PMCID: PMC10981993 DOI: 10.1308/rcsann.2024.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2024] [Indexed: 04/02/2024] Open
Abstract
Colorectal cancer (CRC) is a leading cause of cancer deaths worldwide. Over the past three decades, extensive efforts have sought to elucidate the genomic landscape of CRC. These studies reveal that CRC is highly heterogeneous at the molecular level, with different subtypes characterised by distinct somatic mutational profiles, epigenetic aberrations and transcriptomic signatures. This review summarises our current understanding of the genomic and epigenomic alterations implicated in CRC development and progression. Particular focus is given to how characterisation of CRC genomes is leading to more personalised approaches to diagnosis and treatment.
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Affiliation(s)
| | | | - JMD Wheeler
- Cambridge University Hospitals NHS Foundation Trust, UK
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2
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Kasprzak A. Prognostic Biomarkers of Cell Proliferation in Colorectal Cancer (CRC): From Immunohistochemistry to Molecular Biology Techniques. Cancers (Basel) 2023; 15:4570. [PMID: 37760539 PMCID: PMC10526446 DOI: 10.3390/cancers15184570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/04/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common and severe malignancies worldwide. Recent advances in diagnostic methods allow for more accurate identification and detection of several molecular biomarkers associated with this cancer. Nonetheless, non-invasive and effective prognostic and predictive testing in CRC patients remains challenging. Classical prognostic genetic markers comprise mutations in several genes (e.g., APC, KRAS/BRAF, TGF-β, and TP53). Furthermore, CIN and MSI serve as chromosomal markers, while epigenetic markers include CIMP and many other candidates such as SERP, p14, p16, LINE-1, and RASSF1A. The number of proliferation-related long non-coding RNAs (e.g., SNHG1, SNHG6, MALAT-1, CRNDE) and microRNAs (e.g., miR-20a, miR-21, miR-143, miR-145, miR-181a/b) that could serve as potential CRC markers has also steadily increased in recent years. Among the immunohistochemical (IHC) proliferative markers, the prognostic value regarding the patients' overall survival (OS) or disease-free survival (DFS) has been confirmed for thymidylate synthase (TS), cyclin B1, cyclin D1, proliferating cell nuclear antigen (PCNA), and Ki-67. In most cases, the overexpression of these markers in tissues was related to worse OS and DFS. However, slowly proliferating cells should also be considered in CRC therapy (especially radiotherapy) as they could represent a reservoir from which cells are recruited to replenish the rapidly proliferating population in response to cell-damaging factors. Considering the above, the aim of this article is to review the most common proliferative markers assessed using various methods including IHC and selected molecular biology techniques (e.g., qRT-PCR, in situ hybridization, RNA/DNA sequencing, next-generation sequencing) as prognostic and predictive markers in CRC.
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Affiliation(s)
- Aldona Kasprzak
- Department of Histology and Embryology, University of Medical Sciences, Swiecicki Street 6, 60-781 Poznan, Poland
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3
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Jayasinghe M, Prathiraja O, Caldera D, Jena R, Coffie-Pierre JA, Silva MS, Siddiqui OS. Colon Cancer Screening Methods: 2023 Update. Cureus 2023; 15:e37509. [PMID: 37193451 PMCID: PMC10182334 DOI: 10.7759/cureus.37509] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/18/2023] Open
Abstract
Colorectal cancer (CRC) is a significant cause of morbidity and mortality worldwide. National screening guidelines have been implemented to identify and remove precancerous polyps before they become cancer. Routine CRC screening is advised for people with average risk starting at age 45 because it is a common and preventable malignancy. Various screening modalities are currently in use, ranging from stool-based tests (fecal occult blood test (FOBT), fecal immunochemical test (FIT), and FIT-DNA test), radiologic tests (computed tomographic colonography (CTC), double contrast barium enema), and visual endoscopic examinations (flexible sigmoidoscopy (FS), colonoscopy, and colon capsule endoscopy (CCE)) with their varying sensitivity and specificity. Biomarkers also play a vital role in assessing the recurrence of CRC. This review offers a summary of the current screening options, including biomarkers available to detect CRC, highlighting the benefits and challenges encompassing each screening modality.
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Affiliation(s)
| | | | | | - Rahul Jena
- Neurology/Internal Medicine, Bharati Vidyapeeth Medical College/Bharati Hospital, Pune, IND
| | | | | | - Ozair S Siddiqui
- Medicine, GMERS Medical College and Hospital, Dharpur-Patan, Patan, IND
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4
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Su A, Pedraza R, Kennecke H. Developments in Checkpoint Inhibitor Therapy for the Management of Deficient Mismatch Repair (dMMR) Rectal Cancer. Curr Oncol 2023; 30:3672-3683. [PMID: 37185392 PMCID: PMC10136520 DOI: 10.3390/curroncol30040279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Deficient mismatch repair (dMMR)/microsatellite instability-high (MSIH) colorectal cancer is resistant to conventional chemotherapy but responds to immune checkpoint inhibition (ICI). We review the standard of care in locally advanced dMMR rectal cancer with a focus on ICI. We also present a case report to highlight the treatment complexities and unique challenges of this novel treatment approach. ICI can lead to immune related adverse events (irAEs), resulting in early treatment discontinuation as well as new challenges to surveillance and surgical management. Overall, neoadjuvant ICI can lead to robust treatment responses, but its impact on durable response and organ preservation requires further study.
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5
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Tang L, Yu S, Zhang Q, Cai Y, Li W, Yao S, Cheng H. Identification of hub genes related to CD4 + memory T cell infiltration with gene co-expression network predicts prognosis and immunotherapy effect in colon adenocarcinoma. Front Genet 2022; 13:915282. [PMID: 36105107 PMCID: PMC9465611 DOI: 10.3389/fgene.2022.915282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022] Open
Abstract
Background: CD4+ memory T cells (CD4+ MTCs), as an important part of the microenvironment affecting tumorigenesis and progression, have rarely been systematically analyzed. Our purpose was to comprehensively analyze the effect of CD4+ MTC infiltration on the prognosis of colon adenocarcinoma (COAD). Methods: Based on RNA-Seq data, weighted gene co-expression network analysis (WGCNA) was used to screen the CD4+ MTC infiltration genes most associated with colon cancer and then identify hub genes and construct a prognostic model using the least absolute shrinkage and selection operator algorithm (LASSO). Finally, survival analysis, immune efficacy analysis, and drug sensitivity analysis were performed to evaluate the role of the prognostic model in COAD. Results: We identified 929 differentially expressed genes (DEGs) associated with CD4+ MTCs and constructed a prognosis model based on five hub genes (F2RL2, TGFB2, DTNA, S1PR5, and MPP2) to predict overall survival (OS) in COAD. Kaplan-Meier analysis showed poor prognosis in the high-risk group, and the analysis of the hub gene showed that overexpression of TGFB2, DTNA, S1PR5, or MPP2 was associated with poor prognosis. Clinical prediction nomograms combining CD4+ MTC-related DEGs and clinical features were constructed to accurately predict OS and had high clinical application value. Immune efficacy and drug sensitivity analysis provide new insights for individualized treatment. Conclusion: We constructed a prognostic risk model to predict OS in COAD and analyzed the effects of risk score on immunotherapy efficacy or drug sensitivity. These studies have important clinical significance for individualized targeted therapy and prognosis.
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Affiliation(s)
- Lingxue Tang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
| | - Sheng Yu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
| | - Qianqian Zhang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
| | - Yinlian Cai
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
| | - Wen Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
| | - Senbang Yao
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
| | - Huaidong Cheng
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Oncology, Anhui Medical University, Hefei, China
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6
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Glaire MA, Ryan NAJ, Ijsselsteijn ME, Kedzierska K, Obolenski S, Ali R, Crosbie EJ, Bosse T, de Miranda NFCC, Church DN. Discordant prognosis of mismatch repair deficiency in colorectal and endometrial cancer reflects variation in antitumour immune response and immune escape. J Pathol 2022; 257:340-351. [PMID: 35262923 PMCID: PMC9322587 DOI: 10.1002/path.5894] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/01/2022] [Accepted: 03/07/2022] [Indexed: 12/04/2022]
Abstract
Defective DNA mismatch repair (dMMR) causes elevated tumour mutational burden (TMB) and microsatellite instability (MSI) in multiple cancer types. dMMR/MSI colorectal cancers (CRCs) have enhanced T-cell infiltrate and favourable outcome; however, this association has not been reliably detected in other tumour types, including endometrial cancer (EC). We sought to confirm this and explore the underpinning mechanisms. We first meta-analysed CRC and EC trials that have examined the prognostic value of dMMR/MSI and confirmed that dMMR/MSI predicts better prognosis in CRC, but not EC, with statistically significant variation between cancers (hazard ratio [HR] = 0.63, 95% confidence interval [CI] = 0.54-0.73 versus HR = 1.15, 95% CI = 0.72-1.58; PINT = 0.02). Next, we studied intratumoural immune infiltrate in CRCs and ECs of defined MMR status and found that while dMMR was associated with increased density of tumour-infiltrating CD3+ and CD8+ T-cells in both cancer types, the increases were substantially greater in CRC and significant only in this group (PINT = 4.3e-04 and 7.3e-03, respectively). Analysis of CRC and EC from the independent Cancer Genome Atlas (TCGA) series revealed similar variation and significant interactions in proportions of tumour-infiltrating lymphocytes, CD8+ , CD4+ , NK cells and immune checkpoint expression, confirming a more vigorous immune response to dMMR/MSI in CRC than EC. Agnostic analysis identified the IFNγ pathway activity as strongly upregulated by dMMR/MSI in CRC, but downregulated in EC by frequent JAK1 mutations, the impact of which on IFNγ response was confirmed by functional analyses. Collectively, our results confirm the discordant prognosis of dMMR/MSI in CRC and EC and suggest that this relates to differences in intratumoural immune infiltrate and tumour genome. Our study underscores the need for tissue-specific analysis of cancer biomarkers and may help inform immunotherapy use. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Mark A Glaire
- Cancer Genomics and Immunology Group, Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Neil AJ Ryan
- Division of Cancer Sciences, Faculty of Biology, Medicine and HealthUniversity of Manchester, St Mary's HospitalManchesterUK
- Division of Evolution and Genomic Medicine, Faculty of Biology, Medicine and HealthUniversity of Manchester, St. Mary's HospitalManchesterUK
- The Academic Women's Health Unit, Translational Health SciencesBristol Medical School, University of BristolBristolUK
| | | | - Katarzyna Kedzierska
- Cancer Genomics and Immunology Group, Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Sofia Obolenski
- Cancer Genomics and Immunology Group, Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Reem Ali
- Cancer Genomics and Immunology Group, Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Emma J Crosbie
- Division of Cancer Sciences, Faculty of Biology, Medicine and HealthUniversity of Manchester, St Mary's HospitalManchesterUK
- Department of Obstetrics and GynaecologySt Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUK
| | - Tjalling Bosse
- Department of PathologyLeiden University Medical CenterLeidenThe Netherlands
| | - Noel FCC de Miranda
- Department of PathologyLeiden University Medical CenterLeidenThe Netherlands
| | - David N Church
- Cancer Genomics and Immunology Group, Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
- Oxford Cancer Centre, Churchill Hospital, Oxford University Hospitals Foundation NHS TrustOxfordUK
- Oxford NIHR Comprehensive Biomedical Research Centre, Oxford University Hospitals NHS Foundation TrustOxfordUK
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7
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Li K, Li J, Ye M, Jin X. The role of Siah2 in tumorigenesis and cancer therapy. Gene 2022; 809:146028. [PMID: 34687788 DOI: 10.1016/j.gene.2021.146028] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 12/12/2022]
Abstract
Seven in absentia homolog 2 (Siah2), an RING E3 ubiquitin ligases, has been characterized to play the vital role in tumorigenesis and cancer progression. Numerous studies have determined that Siah2 promotes tumorigenesis in a variety of human malignancies such as prostate, lung, gastric, and liver cancers. However, several studies revealed that Siah2 exhibited tumor suppressor function by promoting the proteasome-mediated degradation of several oncoproteins, suggesting that Siah2 could exert its biological function according to different stages of tumor development. Moreover, Siah2 is subject to complex regulation, especially the phosphorylation of Siah2 by a variety of protein kinases to regulate its stability and activity. In this review, we describe the structure and regulation of Siah2 in human cancer. Moreover, we highlight the critical role of Siah2 in tumorigenesis. Furthermore, we note that the potential clinical applications of targeting Siah2 in cancer therapy.
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Affiliation(s)
- Kailang Li
- The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315020, China; Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathphysiology, Medical School of Ningbo University, Ningbo 315211, China
| | - Jinyun Li
- The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315020, China; Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathphysiology, Medical School of Ningbo University, Ningbo 315211, China
| | - Meng Ye
- The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315020, China; Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathphysiology, Medical School of Ningbo University, Ningbo 315211, China.
| | - Xiaofeng Jin
- The Affiliated Hospital of Medical School, Ningbo University, Ningbo 315020, China; Department of Biochemistry and Molecular Biology, Zhejiang Key Laboratory of Pathphysiology, Medical School of Ningbo University, Ningbo 315211, China.
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8
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Labadie JD, Savas S, Harrison TA, Banbury B, Huang Y, Buchanan DD, Campbell PT, Gallinger SJ, Giles GG, Gunter MJ, Hoffmeister M, Hsu L, Jenkins MA, Lin Y, Ogino S, Phipps AI, Slattery ML, Steinfelder RS, Sun W, Van Guelpen B, Hua X, Figuieredo JC, Pai RK, Nassir R, Qi L, Chan AT, Peters U, Newcomb PA. Genome-wide association study identifies tumor anatomical site-specific risk variants for colorectal cancer survival. Sci Rep 2022; 12:127. [PMID: 34996992 PMCID: PMC8741984 DOI: 10.1038/s41598-021-03945-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/06/2021] [Indexed: 12/16/2022] Open
Abstract
Identification of new genetic markers may improve the prediction of colorectal cancer prognosis. Our objective was to examine genome-wide associations of germline genetic variants with disease-specific survival in an analysis of 16,964 cases of colorectal cancer. We analyzed genotype and colorectal cancer-specific survival data from a consortium of 15 studies. Approximately 7.5 million SNPs were examined under the log-additive model using Cox proportional hazards models, adjusting for clinical factors and principal components. Additionally, we ran secondary analyses stratifying by tumor site and disease stage. We used a genome-wide p-value threshold of 5 × 10-8 to assess statistical significance. No variants were statistically significantly associated with disease-specific survival in the full case analysis or in the stage-stratified analyses. Three SNPs were statistically significantly associated with disease-specific survival for cases with tumors located in the distal colon (rs698022, HR = 1.48, CI 1.30-1.69, p = 8.47 × 10-9) and the proximal colon (rs189655236, HR = 2.14, 95% CI 1.65-2.77, p = 9.19 × 10-9 and rs144717887, HR = 2.01, 95% CI 1.57-2.58, p = 3.14 × 10-8), whereas no associations were detected for rectal tumors. Findings from this large genome-wide association study highlight the potential for anatomical-site-stratified genome-wide studies to identify germline genetic risk variants associated with colorectal cancer-specific survival. Larger sample sizes and further replication efforts are needed to more fully interpret these findings.
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Affiliation(s)
- Julia D Labadie
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Sevtap Savas
- Discipline of Genetics, Faculty of Medicine, Memorial University, St. John's, NL, Canada
- Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, NL, Canada
| | - Tabitha A Harrison
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Barb Banbury
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yuhan Huang
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Daniel D Buchanan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, VIC, Australia
- Genetic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Peter T Campbell
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Steven J Gallinger
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Medicine, School of Clinical Sciences at Monash Health, Monash University, VIC, Australia
| | - Marc J Gunter
- Nutrition and Metabolism Section, International Agency for Research On Cancer, World Health Organization, Lyon, France
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Yi Lin
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Shuji Ogino
- Program in Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Cancer Immunology Program, Dana-Farber Harvard Cancer Center, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Amanda I Phipps
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Martha L Slattery
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Robert S Steinfelder
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Wei Sun
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Bethany Van Guelpen
- Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Umeå, Sweden
| | - Xinwei Hua
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Jane C Figuieredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rish K Pai
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rami Nassir
- Department of Pathology, School of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
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9
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Ali A, Akhtar J, Ahmad U, Basheer AS, Jaiswal N, Jahan A. Armamentarium in drug delivery for colorectal cancer. Crit Rev Ther Drug Carrier Syst 2022; 40:1-48. [DOI: 10.1615/critrevtherdrugcarriersyst.2022039241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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10
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Keller A, Spits C. The Impact of Acquired Genetic Abnormalities on the Clinical Translation of Human Pluripotent Stem Cells. Cells 2021; 10:cells10113246. [PMID: 34831467 PMCID: PMC8625075 DOI: 10.3390/cells10113246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/07/2021] [Accepted: 11/17/2021] [Indexed: 12/23/2022] Open
Abstract
Human pluripotent stem cells (hPSC) are known to acquire chromosomal abnormalities, which range from point mutations to large copy number changes, including full chromosome aneuploidy. These aberrations have a wide-ranging influence on the state of cells, in both the undifferentiated and differentiated state. Currently, very little is known on how these abnormalities will impact the clinical translation of hPSC, and particularly their potential to prime cells for oncogenic transformation. A further complication is that many of these abnormalities exist in a mosaic state in culture, which complicates their detection with conventional karyotyping methods. In this review we discuss current knowledge on how these aberrations influence the cell state and how this may impact the future of research and the cells’ clinical potential.
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11
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Mousavi N. Characterization of in vitro 3D cultures. APMIS 2021; 129 Suppl 142:1-30. [PMID: 34399444 DOI: 10.1111/apm.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Over the past decade, 3D culture models of human and animal cells have found their way into tissue differentiation, drug development, personalized medicine and tumour behaviour studies. Embryoid bodies (EBs) are in vitro 3D cultures established from murine pluripotential stem cells, whereas tumoroids are patient-derived in vitro 3D cultures. This thesis aims to describe a new implication of an embryoid body model and to characterize the patient-specific microenvironment of the parental tumour in relation to tumoroid growth rate. In this thesis, we described a high-throughput monitoring method, where EBs are used as a dynamic angiogenesis model. In this model, digital image analysis (DIA) is implemented on immunohistochemistry (IHC) stained sections of the cultures over time. Furthermore, we have investigated the correlation between the genetic profile and inflammatory microenvironment of parental tumours on the in vitro growth rate of tumoroids. The EBs were cultured in spinner flasks. The samples were collected at days 4, 6, 9, 14, 18 and 21, dehydrated and embedded in paraffin. The histological sections were IHC stained for the endothelial marker CD31 and digitally scanned. The virtual whole-image slides were digitally analysed by Visiopharm® software. Histological evaluation showed vascular-like structures over time. The quantitative DIA was plausible to monitor significant increase in the total area of the EBs and an increase in endothelial differentiation. The tumoroids were established from 32 colorectal adenocarcinomas. The in vitro growth rate of the tumoroids was followed by automated microscopy over an 11-day period. The parental tumours were analysed by next-generation sequencing for KRAS, TP53, PIK3CA, SMAD4, MAP2K1, BRAF, FGFR3 and FBXW7 status. The tumoroids established from KRAS-mutated parental tumours showed a significantly higher growth rate compared to their wild-type counterparts. The density of CD3+ T lymphocytes and CD68+ macrophages was calculated in the centre of the tumours and at the invasive margin of the tumours. The high density of CD3+ cells and the low density of CD68+ cells showed a significant correlation with a higher growth rate of the tumoroids. In conclusion, a novel approach for histological monitoring of endothelial differentiation is presented in the stem cell-derived EBs. Furthermore, the KRAS status and density of CD3+ T cells and macrophages in the parental tumour influence the growth rate of the tumoroids. Our results indicate that these parameters should be included when tumoroids are to be implemented in personalized medicine.
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Affiliation(s)
- Nabi Mousavi
- Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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12
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Kumar R, Harilal S, Carradori S, Mathew B. A Comprehensive Overview of Colon Cancer- A Grim Reaper of the 21st Century. Curr Med Chem 2021; 28:2657-2696. [PMID: 33106132 DOI: 10.2174/0929867327666201026143757] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/18/2020] [Accepted: 09/18/2020] [Indexed: 12/09/2022]
Abstract
A few decades ago, the incidence of colorectal cancer (CRC) was low and is now the fourth in the list of deadly cancers producing nearly a million deaths annually. A population that is aging along with risk factors such as smoking, obesity, sedentary lifestyle with little or no physical activity, and non-healthy food habits of developed countries can increase the risk of colorectal cancer. The balance in gut microbiota and the metabolites produced during bacterial fermentation within the host plays a significant role in regulating intestinal diseases as well as colorectal cancer development. Recent progress in the understanding of illness resulted in multiple treatment options such as surgery, radiation, and chemotherapy, including targeted therapy and multitherapies. The treatment plan for CRC depends on the location, stage and grade of cancer as well as genomic biomarker tests. Despite all the advancements made in the genetic and molecular aspects of the disease, the knowledge seems inadequate as the drug action as well as the wide variation in drug response did not appear strongly correlated with the individual molecular and genetic characteristics, which suggests the requirement of comprehensive molecular understanding of this complex heterogeneous disease. Furthermore, multitherapies or a broad spectrum approach, which is an amalgamation of the various promising as well as effective therapeutic strategies that can tackle heterogeneity and act on several targets of the disease, need to be validated in clinical studies. The latest treatment options have significantly increased the survival of up to three years in the case of advanced disease. The fact that colorectal cancer is developed from a polypoid precursor, as well as the symptoms of the disease that occur at an advanced stage, underlines how screening programs can help early detection and decrease mortality as well as morbidity from CRC.
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Affiliation(s)
- Rajesh Kumar
- Department of Pharmacy, Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Seetha Harilal
- Department of Pharmacy, Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Simone Carradori
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, via dei Vestini 31, 66100 Chieti, Italy
| | - Bijo Mathew
- Department of Pharmaceutical Chemistry, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi-682 041, India
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13
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Profiling Colorectal Cancer in the Landscape Personalized Testing-Advantages of Liquid Biopsy. Int J Mol Sci 2021; 22:ijms22094327. [PMID: 33919272 PMCID: PMC8122648 DOI: 10.3390/ijms22094327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 12/11/2022] Open
Abstract
Drug-specific therapeutic approaches for colorectal cancer (CRC) have contributed to significant improvements in patient health. Nevertheless, there is still a great need to improve the personalization of treatments based on genetic and epigenetic tumor profiles to maximize the quality and efficacy while limiting cytotoxicity. Currently, CEA and CA 19-9 are the only validated blood biomarkers in clinical practice. For this reason, laboratories are trying to identify new specific prognostics and, more importantly, predictive biomarkers for CRC patient profiling. Thus, the unique landscape of personalized biomarker data should have a clinical impact on CRC treatment strategies and molecular genetic screening tests should become the standard method for diagnosing CRC. This review concentrates on recent molecular testing in CRC and discusses the potential modifications in CRC assay methodology with the upcoming clinical application of novel genomic approaches. While mechanisms for analyzing circulating tumor DNA have been proven too inaccurate, detecting and analyzing circulating tumor cells and protein analysis of exosomes represent more promising options. Blood liquid biopsy offers good prospects for the future if the results align with pathologists’ tissue analyses. Overall, early detection, accurate diagnosis and treatment monitoring for CRC with specific markers and targeted molecular testing may benefit many patients.
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14
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Zhang X, Sjöblom T. Targeting Loss of Heterozygosity: A Novel Paradigm for Cancer Therapy. Pharmaceuticals (Basel) 2021; 14:ph14010057. [PMID: 33450833 PMCID: PMC7828287 DOI: 10.3390/ph14010057] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 12/13/2022] Open
Abstract
Loss of heterozygosity (LOH) is a common genetic event in the development of cancer. In certain tumor types, LOH can affect more than 20% of the genome, entailing loss of allelic variation in thousands of genes. This reduction of heterozygosity creates genetic differences between tumor and normal cells, providing opportunities for development of novel cancer therapies. Here, we review and summarize (1) mutations associated with LOH on chromosomes which have been shown to be promising biomarkers of cancer risk or the prediction of clinical outcomes in certain types of tumors; (2) loci undergoing LOH that can be targeted for development of novel anticancer drugs as well as (3) LOH in tumors provides up-and-coming possibilities to understand the underlying mechanisms of cancer evolution and to discover novel cancer vulnerabilities which are worth a further investigation in the near future.
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15
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Halliwell J, Barbaric I, Andrews PW. Acquired genetic changes in human pluripotent stem cells: origins and consequences. Nat Rev Mol Cell Biol 2020; 21:715-728. [DOI: 10.1038/s41580-020-00292-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2020] [Indexed: 12/14/2022]
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16
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Ogunwobi OO, Mahmood F, Akingboye A. Biomarkers in Colorectal Cancer: Current Research and Future Prospects. Int J Mol Sci 2020; 21:E5311. [PMID: 32726923 PMCID: PMC7432436 DOI: 10.3390/ijms21155311] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/12/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is a leading cause of death worldwide, despite progress made in detection and management through surgery, chemotherapy, radiotherapy, and immunotherapy. Novel therapeutic agents have improved survival in both the adjuvant and advanced disease settings, albeit with an increased risk of toxicity and cost. However, metastatic disease continues to have a poor long-term prognosis and significant challenges remain due to late stage diagnosis and treatment failure. Biomarkers are a key tool in early detection, prognostication, survival, and predicting treatment response. The past three decades have seen advances in genomics and molecular pathology of cancer biomarkers, allowing for greater individualization of therapy with a positive impact on survival outcomes. Clinically useful predictive biomarkers aid clinical decision making, such as the presence of KRAS gene mutations predicting benefit from epidermal growth factor receptor (EGFR) inhibiting antibodies. However, few biomarkers have been translated into clinical practice highlighting the need for further investigation. We review a range of protein, DNA and RNA-based biomarkers under investigation for diagnostic, predictive, and prognostic properties for CRC. In particular, long non-coding RNAs (lncRNA), have been investigated as biomarkers in a range of cancers including colorectal cancer. Specifically, we evaluate the potential role of lncRNA plasmacytoma variant translocation 1 (PVT1), an oncogene, as a diagnostic, prognostic, and therapeutic biomarker in colorectal cancer.
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Affiliation(s)
- Olorunseun O. Ogunwobi
- Department of Biological Sciences, Hunter College of The City University of New York, New York, NY 10065, USA
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY 10021, USA
| | - Fahad Mahmood
- The Dudley Group Hospitals, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, Dudley, West Midlands DY1 2HQ, UK;
| | - Akinfemi Akingboye
- The Dudley Group Hospitals, Russells Hall Hospital, The Dudley Group NHS Foundation Trust, Dudley, West Midlands DY1 2HQ, UK;
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17
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Koulis C, Yap R, Engel R, Jardé T, Wilkins S, Solon G, Shapiro JD, Abud H, McMurrick P. Personalized Medicine-Current and Emerging Predictive and Prognostic Biomarkers in Colorectal Cancer. Cancers (Basel) 2020; 12:cancers12040812. [PMID: 32231042 PMCID: PMC7225926 DOI: 10.3390/cancers12040812] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/24/2020] [Accepted: 03/24/2020] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer diagnosed worldwide and is heterogeneous both morphologically and molecularly. In an era of personalized medicine, the greatest challenge is to predict individual response to therapy and distinguish patients likely to be cured with surgical resection of tumors and systemic therapy from those resistant or non-responsive to treatment. Patients would avoid futile treatments, including clinical trial regimes and ultimately this would prevent under- and over-treatment and reduce unnecessary adverse side effects. In this review, the potential of specific biomarkers will be explored to address two key questions—1) Can the prognosis of patients that will fare well or poorly be determined beyond currently recognized prognostic indicators? and 2) Can an individual patient’s response to therapy be predicted and those who will most likely benefit from treatment/s be identified? Identifying and validating key prognostic and predictive biomarkers and an understanding of the underlying mechanisms of drug resistance and toxicity in CRC are important steps in order to personalize treatment. This review addresses recent data on biological prognostic and predictive biomarkers in CRC. In addition, patient cohorts most likely to benefit from currently available systemic treatments and/or targeted therapies are discussed in this review.
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Affiliation(s)
- Christine Koulis
- Cabrini Monash University Department of Surgery, Cabrini Health, Malvern 3144, VIC, Australia; (R.Y.); (R.E.); (S.W.); (G.S.); (P.M.)
- Correspondence: ; Tel.: +61-03-9508-3547
| | - Raymond Yap
- Cabrini Monash University Department of Surgery, Cabrini Health, Malvern 3144, VIC, Australia; (R.Y.); (R.E.); (S.W.); (G.S.); (P.M.)
| | - Rebekah Engel
- Cabrini Monash University Department of Surgery, Cabrini Health, Malvern 3144, VIC, Australia; (R.Y.); (R.E.); (S.W.); (G.S.); (P.M.)
- Department of Anatomy and Developmental Biology, Monash University, Clayton 3800, VIC, Australia; (T.J.); (H.A.)
- Monash Biomedicine Discovery Institute, Stem Cells and Development Program, Monash University, Clayton 3800, VIC, Australia
| | - Thierry Jardé
- Department of Anatomy and Developmental Biology, Monash University, Clayton 3800, VIC, Australia; (T.J.); (H.A.)
- Monash Biomedicine Discovery Institute, Stem Cells and Development Program, Monash University, Clayton 3800, VIC, Australia
- Centre for Cancer Research, Hudson Institute of Medical Research, Clayton 3168, VIC, Australia
| | - Simon Wilkins
- Cabrini Monash University Department of Surgery, Cabrini Health, Malvern 3144, VIC, Australia; (R.Y.); (R.E.); (S.W.); (G.S.); (P.M.)
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne 3000, VIC, Australia
| | - Gemma Solon
- Cabrini Monash University Department of Surgery, Cabrini Health, Malvern 3144, VIC, Australia; (R.Y.); (R.E.); (S.W.); (G.S.); (P.M.)
| | - Jeremy D. Shapiro
- Cabrini Haematology and Oncology Centre, Cabrini Health, Malvern 3144, VIC, Australia;
| | - Helen Abud
- Department of Anatomy and Developmental Biology, Monash University, Clayton 3800, VIC, Australia; (T.J.); (H.A.)
- Monash Biomedicine Discovery Institute, Stem Cells and Development Program, Monash University, Clayton 3800, VIC, Australia
| | - Paul McMurrick
- Cabrini Monash University Department of Surgery, Cabrini Health, Malvern 3144, VIC, Australia; (R.Y.); (R.E.); (S.W.); (G.S.); (P.M.)
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18
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Guillén-Ponce C, Lastra E, Lorenzo-Lorenzo I, Martín Gómez T, Morales Chamorro R, Sánchez-Heras AB, Serrano R, Soriano Rodríguez MC, Soto JL, Robles L. SEOM clinical guideline on hereditary colorectal cancer (2019). Clin Transl Oncol 2020; 22:201-212. [PMID: 31981079 DOI: 10.1007/s12094-019-02272-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 12/16/2019] [Indexed: 12/21/2022]
Abstract
In the last 2 decades, clinical genetics on hereditary colorectal syndromes has shifted from just a molecular characterization of the different syndromes to the estimation of the individual risk of cancer and appropriate risk reduction strategies. In the last years, new specific therapies for some subgroups of patients have emerged as very effective alternatives. At the same time, germline multigene panel testing by next-generation sequencing (NGS) technology has become the new gold standard for molecular genetics.
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Affiliation(s)
- C Guillén-Ponce
- Medical Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Carretera de Colmenar Viejo, Km 9,100, 28034, Madrid, Spain.
| | - E Lastra
- Medical Oncology Department, Hospital Universitario de Burgos, Burgos, Spain
| | - I Lorenzo-Lorenzo
- Medical Oncology Department, Complejo Hospitalario Universitario de Vigo (CHUVI), Pontevedra, Spain
| | - T Martín Gómez
- Medical Oncology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - R Morales Chamorro
- Medical Oncology Department, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad Real, Spain
| | - A B Sánchez-Heras
- Medical Oncology Department, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - R Serrano
- Medical Oncology Department, Hospital Universitario Reina Sofía, IMIBIC, CIBERONC, Córdoba, Spain
| | | | - J L Soto
- Molecular Genetics Laboratory, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - L Robles
- Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain.
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19
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Wong CK, Lambert AW, Ozturk S, Papageorgis P, Lopez D, Shen N, Sen Z, Abdolmaleky HM, Győrffy B, Feng H, Thiagalingam S. Targeting RICTOR Sensitizes SMAD4-Negative Colon Cancer to Irinotecan. Mol Cancer Res 2020; 18:414-423. [PMID: 31932471 DOI: 10.1158/1541-7786.mcr-19-0525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/04/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022]
Abstract
Deciphering molecular targets to enhance sensitivity to chemotherapy is becoming a priority for effectively treating cancers. Loss of function mutations of SMAD4 in colon cancer are associated with metastatic progression and resistance to 5-fluorouracil (5-FU), the most extensively used drug of almost all chemotherapy combinations used in the treatment of metastatic colon cancer. Here, we report that SMAD4 deficiency also confers resistance to irinotecan, another common chemotherapeutic frequently used alone or in combination with 5-FU against colon cancer. Mechanistically, we find that SMAD4 interacts with and inhibits RICTOR, a component of the mTORC2 complex, resulting in suppression of downstream effector phosphorylation of AKT at Serine 473. In silico meta-analysis of publicly available gene expression datasets derived from tumors indicates that lower levels of SMAD4 or higher levels of RICTOR/AKT, irrespective of the SMAD4 status, correlate with poor survival, suggesting them as strong prognostic biomarkers and targets for therapeutic intervention. Moreover, we find that overexpression of SMAD4 or depletion of RICTOR suppresses AKT signaling and increases sensitivity to irinotecan in SMAD4-deficient colon cancer cells. Consistent with these observations, pharmacologic inhibition of AKT sensitizes SMAD4-negative colon cancer cells to irinotecan in vitro and in vivo. Overall, our study suggests that hyperactivation of the mTORC2 pathway is a therapeutic vulnerability that could be exploited to sensitize SMAD4-negative colon cancer to irinotecan. IMPLICATIONS: Hyperactivation of the mTORC2 pathway in SMAD4-negative colon cancer provides a mechanistic rationale for targeted inhibition of mTORC2 or AKT as a distinctive combinatorial therapeutic opportunity with chemotherapy for colon cancer.
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Affiliation(s)
- Chen Khuan Wong
- Graduate Program in Genetics and Genomics, Boston University School of Medicine, Boston, Massachusetts.,Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Arthur W Lambert
- Graduate Program in Molecular and Translational Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Sait Ozturk
- Graduate Program in Molecular and Translational Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Panagiotis Papageorgis
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Delia Lopez
- Graduate Program in Molecular and Translational Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Ning Shen
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Zaina Sen
- Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Hamid M Abdolmaleky
- Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Balázs Győrffy
- MTA TTK Lendület Cancer Biomarker Research Group, Institute of Enzymology, Budapest, Hungary.,Semmelweis University 2nd Department of Pediatrics, Budapest, Hungary
| | - Hui Feng
- Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts
| | - Sam Thiagalingam
- Graduate Program in Genetics and Genomics, Boston University School of Medicine, Boston, Massachusetts. .,Biomedical Genetics Section, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.,Graduate Program in Molecular and Translational Medicine, Boston University School of Medicine, Boston, Massachusetts.,Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, Massachusetts.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts
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20
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Sinicrope FA. Evaluating the Combination of Microsatellite Instability and Mutation in BRAF as Prognostic Factors for Patients With Colorectal Cancer. Clin Gastroenterol Hepatol 2019; 17:391-394. [PMID: 29966708 DOI: 10.1016/j.cgh.2018.06.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 06/26/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Frank A Sinicrope
- Division of Gastroenterology and Hepatology, Division of Oncology, Mayo Clinic and Mayo Comprehensive Cancer Center, Rochester, Minnesota
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21
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Vacante M, Borzì AM, Basile F, Biondi A. Biomarkers in colorectal cancer: Current clinical utility and future perspectives. World J Clin Cases 2018; 6:869-881. [PMID: 30568941 PMCID: PMC6288499 DOI: 10.12998/wjcc.v6.i15.869] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 02/05/2023] Open
Abstract
Colorectal cancer (CRC) is a major cause of cancer death worldwide. CRC has poor prognosis and there is a crucial need for new diagnostic and prognostic biomarkers to avoid CRC-related deaths. CRC can be considered a sporadic disease in most cases (75%-80%), but it has been suggested that crosstalk between gene mutations (i.e., mutations of BRAF, KRAS, and p53 as well as microsatellite instability) and epigenetic alterations (i.e., DNA methylation of CpG island promoter regions) could play a pivotal role in cancer development. A number of studies have focused on molecular testing to guide targeted and conventional treatments for patients with CRC, sometimes with contrasting results. Some of the most useful innovations in the management of CRC include the possibility to detect the absence of KRAS, BRAF, NRAS and PIK3CA gene mutations with the subsequent choice to administer targeted adjuvant therapy with anti-epidermal growth factor receptor antibodies. Moreover, CRC patients can benefit from tests for microsatellite instability and for the detection of loss of heterozygosity of chromosome 18q that can be helpful in guiding therapeutic decisions as regards the administration of 5-FU. The aim of this review was to summarize the most recent evidence on the possible use of genetic or epigenetic biomarkers for diagnosis, prognosis and response to therapy in CRC patients.
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Affiliation(s)
- Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Antonio Maria Borzì
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Francesco Basile
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
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22
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Affiliation(s)
- Frank A Sinicrope
- From the Divisions of Oncology and of Gastroenterology and Hepatology, Mayo Clinic and Mayo Comprehensive Cancer Center, Rochester, MN
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23
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Villéger R, Lopès A, Veziant J, Gagnière J, Barnich N, Billard E, Boucher D, Bonnet M. Microbial markers in colorectal cancer detection and/or prognosis. World J Gastroenterol 2018; 24:2327-2347. [PMID: 29904241 PMCID: PMC6000297 DOI: 10.3748/wjg.v24.i22.2327] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/03/2018] [Accepted: 05/18/2018] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is the second leading cause of cancer worldwide. CRC is still associated with a poor prognosis among patients with advanced disease. On the contrary, due to its slow progression from detectable precancerous lesions, the prognosis for patients with early stages of CRC is encouraging. While most robust methods are invasive and costly, actual patient-friendly screening methods for CRC suffer of lack of sensitivity and specificity. Therefore, the development of sensitive, non-invasive and cost-effective methods for CRC detection and prognosis are necessary for increasing the chances of a cure. Beyond its beneficial functions for the host, increasing evidence suggests that the intestinal microbiota is a key factor associated with carcinogenesis. Many clinical studies have reported a disruption in the gut microbiota balance and an alteration in the faecal metabolome of CRC patients, suggesting the potential use of a microbial-based test as a non-invasive diagnostic and/or prognostic tool for CRC screening. This review aims to discuss the microbial signatures associated with CRC known to date, including dysbiosis and faecal metabolome alterations, and the potential use of microbial variation markers for non-invasive early diagnosis and/or prognostic assessment of CRC and advanced adenomas. We will finally discuss the possible use of these markers as predicators for treatment response and their limitations.
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Affiliation(s)
- Romain Villéger
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
| | - Amélie Lopès
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Research Biologics, Sanofi R&D, Vitry-Sur-Seine 94400, France
| | - Julie Veziant
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Chirurgie digestive, Centre Hospitalier Universitaire, Clermont-Ferrand 63000, France
| | - Johan Gagnière
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Chirurgie digestive, Centre Hospitalier Universitaire, Clermont-Ferrand 63000, France
| | - Nicolas Barnich
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Université Clermont Auvergne, Institut Universitaire de Technologie de Clermont-Ferrand, Clermont-Ferrand 63000, France
| | - Elisabeth Billard
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Université Clermont Auvergne, Institut Universitaire de Technologie de Clermont-Ferrand, Clermont-Ferrand 63000, France
| | - Delphine Boucher
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Université Clermont Auvergne, Institut Universitaire de Technologie de Clermont-Ferrand, Clermont-Ferrand 63000, France
| | - Mathilde Bonnet
- Université Clermont Auvergne, Inserm U1071, USC-INRA 2018, M2iSH, CRNH Auvergne, Clermont-Ferrand 63000, France
- Université Clermont Auvergne, Institut Universitaire de Technologie de Clermont-Ferrand, Clermont-Ferrand 63000, France
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24
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van Dijk E, Biesma HD, Cordes M, Smeets D, Neerincx M, Das S, Eijk PP, Murphy V, Barat A, Bacon O, Prehn JHM, Betge J, Gaiser T, Fender B, Meijer GA, McNamara DA, Klinger R, Koopman M, Ebert MPA, Kay EW, Hennessey BT, Verheul HMW, Gallagher WM, O'Connor DP, Punt CJA, Loupakis F, Lambrechts D, Byrne AT, van Grieken NCT, Ylstra B. Loss of Chromosome 18q11.2-q12.1 Is Predictive for Survival in Patients With Metastatic Colorectal Cancer Treated With Bevacizumab. J Clin Oncol 2018; 36:2052-2060. [PMID: 29792754 DOI: 10.1200/jco.2017.77.1782] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Patients with metastatic colorectal cancer (mCRC) have limited benefit from the addition of bevacizumab to standard chemotherapy. However, a subset probably benefits substantially, highlighting an unmet clinical need for a biomarker of response to bevacizumab. Previously, we demonstrated that losses of chromosomes 5q34, 17q12, and 18q11.2-q12.1 had a significant correlation with progression-free survival (PFS) in patients with mCRC treated with bevacizumab in the CAIRO2 clinical trial but not in patients who did not receive bevacizumab in the CAIRO trial. This study was designed to validate these findings. Materials and Methods Primary mCRC samples were analyzed from two cohorts of patients who received bevacizumab as first-line treatment; 96 samples from the European multicenter study Angiopredict (APD) and 81 samples from the Italian multicenter study, MOMA. A third cohort of 90 samples from patients with mCRC who did not receive bevacizumab was analyzed. Copy number aberrations of tumor biopsy specimens were measured by shallow whole-genome sequencing and were correlated with PFS, overall survival (OS), and response. Results Loss of chromosome 18q11.2-q12.1 was associated with prolonged PFS most significantly in both the cohorts that received bevacizumab (APD: hazard ratio, 0.54; P = .01; PFS difference, 65 days; MOMA: hazard ratio, 0.55; P = .019; PFS difference, 49 days). A similar association was found for OS and overall response rate in these two cohorts, which became significant when combined with the CAIRO2 cohort. Median PFS in the cohort of patients with mCRC who did not receive bevacizumab and in the CAIRO cohort was similar to that of the APD, MOMA, and CAIRO2 patients without an 18q11.2-q12.1 loss. Conclusion We conclude that the loss of chromosome 18q11.2-q12.1 is consistently predictive for prolonged PFS in patients receiving bevacizumab. The predictive value of this loss is substantiated by a significant gain in OS and overall response rate.
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Affiliation(s)
- Erik van Dijk
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Hedde D Biesma
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Martijn Cordes
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Dominiek Smeets
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Maarten Neerincx
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Sudipto Das
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Paul P Eijk
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Verena Murphy
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Anna Barat
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Orna Bacon
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Jochen H M Prehn
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Johannes Betge
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Timo Gaiser
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Bozena Fender
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Gerrit A Meijer
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Deborah A McNamara
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Rut Klinger
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Miriam Koopman
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Matthias P A Ebert
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Elaine W Kay
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Bryan T Hennessey
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Henk M W Verheul
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - William M Gallagher
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Darran P O'Connor
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Cornelis J A Punt
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Fotios Loupakis
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Diether Lambrechts
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Annette T Byrne
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Nicole C T van Grieken
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
| | - Bauke Ylstra
- Erik van Dijk, Hedde D. Biesma, Martijn Cordes, Maarten Neerincx, Paul P. Eijk, Henk M.W. Verheul, Nicole C.T. van Grieken, and Bauke Ylstra, Vrije Universiteit Medical Center; Gerrit A. Meijer, Netherlands Cancer Institute; Cornelis J.A. Punt, Academic Medical Center, Amsterdam; Miriam Koopman, University Medical Center Utrecht, Utrecht, the Netherlands; Dominiek Smeets and Diether Lambrechts, KU Leuven, Leuven, Belgium; Sudipto Das, Orna Bacon, Jochen H.M. Prehn, Bryan T. Hennessey, Darran P. O'Connor, and Annette T. Byrne, Royal College of Surgeons in Ireland; Verena Murphy, Cancer Trials Ireland; Anna Barat, Deborah A. McNamara, and Elaine W. Kay, Beaumont Hospital; Bozena Fender and William M. Gallagher, OncoMark Ltd; Rut Klinger and William M. Gallagher, University College Dublin, Dublin, United Kingdom; Johannes Betge, Timo Gaiser, and Matthias P.A. Ebert, University Hospital Mannheim, Mannheim, Germany; and Fotios Loupakis, Veneto Institute of Oncology IOV-IRCCS Padua, Italy
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25
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Peluso G, Incollingo P, Calogero A, Tammaro V, Rupealta N, Chiacchio G, Sandoval Sotelo ML, Minieri G, Pisani A, Riccio E, Sabbatini M, Bracale UM, Dodaro CA, Carlomagno N. Current Tissue Molecular Markers in Colorectal Cancer: A Literature Review. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2605628. [PMID: 29214162 PMCID: PMC5682052 DOI: 10.1155/2017/2605628] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/18/2017] [Accepted: 10/03/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most spread neoplasia types all around the world, especially in western areas. It evolves from precancerous lesions and adenomatous polyps, through successive genetic and epigenetic mutations. Numerous risk factors intervene in its development and they are either environmental or genetic. AIM OF THE REVIEW Alongside common screening techniques, such as fecal screening tests, endoscopic evaluation, and CT-colonography, we have identified the most important and useful biomarkers and we have analyzed their role in the diagnosis, prevention, and prognosis of CRC. CONCLUSION Biomarkers can become an important tool in the diagnostic and therapeutic process for CRC. But further studies are needed to identify a noninvasive, cost-effective, and highly sensible and specific screening test for their detection and to standardize their use in clinical practice.
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Affiliation(s)
- Gaia Peluso
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Paola Incollingo
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Vincenzo Tammaro
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Niccolò Rupealta
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Gaetano Chiacchio
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Maria Laura Sandoval Sotelo
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Gianluca Minieri
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Antonio Pisani
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Eleonora Riccio
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Massimo Sabbatini
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Concetta Anna Dodaro
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced Biomedical Science, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
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26
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Katkoori VR, Manne U, Chaturvedi LS, Basson MD, Haan P, Coffey D, Bumpers HL. Functional consequence of the p53 codon 72 polymorphism in colorectal cancer. Oncotarget 2017; 8:76574-76586. [PMID: 29100333 PMCID: PMC5652727 DOI: 10.18632/oncotarget.20580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/16/2017] [Indexed: 01/22/2023] Open
Abstract
Background The codon 72 polymorphism in p53 has been implicated in colorectal cancer (CRC) risk, prognosis and CRC health disparities. We examined the functional consequence of this polymorphism in CRC. Experimental Design Plasmids (pCMV6) that express different phenotypes of p53 [p53 wild type (wt) at codon 72 (R72wt), R72wt with mutation at codon 273 cysteine (R72273Cys), p53 mutation at codon 72 (P72wt) and P72wt with mutation at codon 273 (P72273Cys)] were constructed. The CRC cell line Caco2, which does not express p53 for in vitro studies, was used as host. CRC xenografts were established in severe combined immunodeficient (SCID) mice using established cell lines. CRC surgical specimens, corresponding normal colon, and tumor xenografts were sequenced for codon 72 polymorphism of p53. Proteins signaling mechanisms were evaluated to assess the functional consequence of P72 phenotype of p53. Results This study demonstrated a significantly increased survival of cells expressing P72wt, mutant phenotype, versus R72wt phenotype. WB analyses revealed that P72wt induced activation of p38 and RAF/MEK/ extracellular signal-regulated kinase (ERK) MAP kinases. Activation of CREB was found to be higher in tumors that exhibit P72 phenotype. Metastatic lesions of CRC expressed more phospho-CREB than non-metastatic lesions. The expression of P72wt promoted CRC metastasis. Conclusions P72 contributes to the aggressiveness of CRC. Because P72 is over-expressed in CRC, specifically in African-American patients, this suggests a role for P72 in cancer health disparities. This work was supported by NIH/NCI Workforce Diversity Grant R21-CA171251 & U54CA118948.
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Affiliation(s)
- Venkat R Katkoori
- Department of Surgery, Michigan State University, College of Human Medicine, Lansing, MI, USA
| | - Upender Manne
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lakshmi S Chaturvedi
- Department of Surgery, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Marc D Basson
- Department of Surgery, University of North Dakota, School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Pam Haan
- Department of Surgery, Michigan State University, College of Human Medicine, Lansing, MI, USA
| | | | - Harvey L Bumpers
- Department of Surgery, Michigan State University, College of Human Medicine, Lansing, MI, USA
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27
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Saleh K, Khalife-Saleh N, Kourie HR, Chahine G. How and when adjuvant treatment should be intensified in stage III colorectal cancers? Future Oncol 2017; 13:1999-2006. [PMID: 28829195 DOI: 10.2217/fon-2017-0197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The adjuvant chemotherapy (FOLFOX) represents the standard of care in stage III colon cancer with some exceptions in old patients. Adjuvant treatment must also be discussed in high-risk stage II colon cancer. However, 40-50% of patients develop disease recurrence after curative R0 surgical resection. The liver was the most common site of recurrence followed by peritoneum. Although adjuvant chemotherapy improved disease-free survival and overall survival, 5-year overall survival remains less than 55% in stage III colon cancer. Different strategies could be adopted to escalate the standard adjuvant chemotherapy in these patients going from aggressive intravenous chemotherapy, hepatic arterial infusion chemotherapy, hyperthermic intraperitoneal chemotherapy to adding targeted therapies or immunotherapies. We reported in this review the published and ongoing trials evaluating these treatment modalities in colon cancer.
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Affiliation(s)
- Khalil Saleh
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nadine Khalife-Saleh
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | | | - Georges Chahine
- Oncology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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28
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Abstract
Colorectal cancer (CRC) is a leading cause of cancer deaths worldwide. CRC develops as a consequence of genomic instability, characterized by various genetic and epigenetic alterations. Its molecular heterogeneity explains the large variability in patient prognosis and treatment response, emphasizing the need for development of accurate prognostic and predictive biomarkers. This article delineates the different pathways of colorectal carcinogenesis and its molecular subtype classification. With this review, we aim to provide a comprehensive overview of the current and future biomarkers guiding clinical decision-making and CRC treatment.
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Affiliation(s)
- Pieter-Jan Cuyle
- Department of Gastroenterology/Digestive Oncology, Imelda General Hospital, Bonheiden, Belgium
- Department of Gastroenterology/Digestive Oncology, University Hospitals Gasthuisberg Leuven, Leuven, Belgium
| | - Hans Prenen
- Department of Gastroenterology/Digestive Oncology, University Hospitals Gasthuisberg Leuven, Leuven, Belgium
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29
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Sefrioui D, Vermeulin T, Blanchard F, Chapusot C, Beaussire L, Armengol-Debeir L, Sesboué R, Gangloff A, Hebbar M, Copin MC, Houivet E, Schwarz L, Clatot F, Tuech JJ, Bénichou J, Martin L, Bouvier AM, Sabourin JC, Sarafan-Vasseur N, Frébourg T, Lepage C, Michel P, Di Fiore F. Copy number variations inDCC/18q andERBB2/17q are associated with disease-free survival in microsatellite stable colon cancer. Int J Cancer 2017; 140:1653-1661. [DOI: 10.1002/ijc.30584] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 11/10/2016] [Accepted: 11/23/2016] [Indexed: 01/05/2023]
Affiliation(s)
- David Sefrioui
- Digestive Oncology Unit, Department of Hepato-Gastroenterology; Rouen University Hospital; Rouen France
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
| | - Thomas Vermeulin
- Department of Biostatistics; Rouen University Hospital; Rouen France
| | - France Blanchard
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
- Department of Pathology; Rouen University Hospital; Rouen France
| | - Caroline Chapusot
- Department of Pathology; Dijon University Hospital, University of Burgundy; Dijon France
| | - Ludivine Beaussire
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
| | - Laura Armengol-Debeir
- Digestive Oncology Unit, Department of Hepato-Gastroenterology; Rouen University Hospital; Rouen France
| | - Richard Sesboué
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
| | - Alice Gangloff
- Digestive Oncology Unit, Department of Hepato-Gastroenterology; Rouen University Hospital; Rouen France
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
| | - Mohamed Hebbar
- Department of Medical Oncology; Lille University Hospital; Lille France
| | | | - Estelle Houivet
- Department of Biostatistics; Rouen University Hospital; Rouen France
| | - Lilian Schwarz
- Department of Surgery; Rouen University Hospital; Rouen France
| | - Florian Clatot
- Department of Medical Oncology; Centre Henri Becquerel; Rouen France
| | | | - Jacques Bénichou
- Department of Biostatistics; Rouen University Hospital; Rouen France
| | - Laurent Martin
- Department of Pathology; Dijon University Hospital, University of Burgundy; Dijon France
| | - Anne-Marie Bouvier
- Digestive Cancer Registry of Burgundy, INSERM U866, University Hospital Dijon, University of Burgundy; Dijon France
| | - Jean-Christophe Sabourin
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
- Department of Pathology; Rouen University Hospital; Rouen France
| | - Nasrin Sarafan-Vasseur
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
| | - Thierry Frébourg
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
| | - Côme Lepage
- Digestive Cancer Registry of Burgundy, INSERM U866, University Hospital Dijon, University of Burgundy; Dijon France
| | - Pierre Michel
- Digestive Oncology Unit, Department of Hepato-Gastroenterology; Rouen University Hospital; Rouen France
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
| | - Frédéric Di Fiore
- Digestive Oncology Unit, Department of Hepato-Gastroenterology; Rouen University Hospital; Rouen France
- Inserm U1079, University of Rouen, Institute for Biomedical Research and Innovation; Rouen France
- EquIpe de Recherche en ONcogie (IRON), Rouen University Hospital; Rouen France
- Department of Medical Oncology; Centre Henri Becquerel; Rouen France
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30
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Colorectal Carcinoma: A General Overview and Future Perspectives in Colorectal Cancer. Int J Mol Sci 2017; 18:ijms18010197. [PMID: 28106826 PMCID: PMC5297828 DOI: 10.3390/ijms18010197] [Citation(s) in RCA: 767] [Impact Index Per Article: 109.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/06/2017] [Accepted: 01/11/2017] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer-related death. Most cases of CRC are detected in Western countries, with its incidence increasing year by year. The probability of suffering from colorectal cancer is about 4%–5% and the risk for developing CRC is associated with personal features or habits such as age, chronic disease history and lifestyle. In this context, the gut microbiota has a relevant role, and dysbiosis situations can induce colonic carcinogenesis through a chronic inflammation mechanism. Some of the bacteria responsible for this multiphase process include Fusobacterium spp, Bacteroides fragilis and enteropathogenic Escherichia coli. CRC is caused by mutations that target oncogenes, tumour suppressor genes and genes related to DNA repair mechanisms. Depending on the origin of the mutation, colorectal carcinomas can be classified as sporadic (70%); inherited (5%) and familial (25%). The pathogenic mechanisms leading to this situation can be included in three types, namely chromosomal instability (CIN), microsatellite instability (MSI) and CpG island methylator phenotype (CIMP). Within these types of CRC, common mutations, chromosomal changes and translocations have been reported to affect important pathways (WNT, MAPK/PI3K, TGF-β, TP53), and mutations; in particular, genes such as c-MYC, KRAS, BRAF, PIK3CA, PTEN, SMAD2 and SMAD4 can be used as predictive markers for patient outcome. In addition to gene mutations, alterations in ncRNAs, such as lncRNA or miRNA, can also contribute to different steps of the carcinogenesis process and have a predictive value when used as biomarkers. In consequence, different panels of genes and mRNA are being developed to improve prognosis and treatment selection. The choice of first-line treatment in CRC follows a multimodal approach based on tumour-related characteristics and usually comprises surgical resection followed by chemotherapy combined with monoclonal antibodies or proteins against vascular endothelial growth factor (VEGF) and epidermal growth receptor (EGFR). Besides traditional chemotherapy, alternative therapies (such as agarose tumour macrobeads, anti-inflammatory drugs, probiotics, and gold-based drugs) are currently being studied to increase treatment effectiveness and reduce side effects.
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31
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Alotaibi AM, Lee JL, Kim J, Lim SB, Yu CS, Kim TW, Kim JH, Kim JC. Prognostic and Oncologic Significance of Perineural Invasion in Sporadic Colorectal Cancer. Ann Surg Oncol 2017; 24:1626-1634. [PMID: 28070726 DOI: 10.1245/s10434-016-5748-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The presence of perineural invasion (PNI) in colorectal cancer (CRC) indicates a more aggressive phenotype, resulting in a poor prognosis. The aims of this study were to evaluate the oncologic outcome of PNI+ tumors and to investigate whether PNI status affects patient survival. METHODS The study retrospectively enrolled 3807 patients from a single institution who underwent surgery for colorectal adenocarcinoma between January 2006 and December 2010. The patients were classified into two groups based on PNI status: PNI+ and PNI-. RESULTS The PNI+ group included 565 patients (14.8 %) and had significantly more involved circumferential resection margins (p = 0.001) and a more advanced TNM stage (p = 0.001) than the PNI- group. Compared with the PNI- group, the PNI+ group had worse 5-year overall survival (65 vs. 88 %; p = 0.001) and 5-year disease-free survival (63 vs. 85 %; p = 0.001). Among PNI+ patients with stage IIA disease, those who received adjuvant therapy had significantly greater 5-year overall survival than those who did not (89.3 vs. 50.8 %; p = 0.001). In multivariate analyses, PNI+ was an independent negative prognostic factor for 5-year overall survival (hazard ratio [HR] 1.518, 95 % confidence interval [CI] 1.175-1.961; p = 0.001) and 5-year disease-free survival (HR 1.495, 95 % CI 1.237-1.806; p = 0.001). CONCLUSIONS PNI positivity is an independent predictor of aggressive behavior and unfavorable prognosis in CRC. Further evaluation is needed to confirm the impact of PNI status on survival in stage IIA CRC.
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Affiliation(s)
| | - Jong Lyul Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jihun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seok-Byung Lim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Sik Yu
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Tae Won Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Hoon Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Cheon Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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32
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Das V, Kalita J, Pal M. Predictive and prognostic biomarkers in colorectal cancer: A systematic review of recent advances and challenges. Biomed Pharmacother 2016; 87:8-19. [PMID: 28040600 DOI: 10.1016/j.biopha.2016.12.064] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 12/15/2016] [Accepted: 12/15/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the leading cause of cancer deaths worldwide. Since CRC is largely asymptomatic until alarm features develop to advanced stages, the implementation of the screening programme is very much essential to reduce cancer incidence and mortality rates. CRC occurs predominantly from accumulation of genetic and epigenetic changes in colon epithelial cells, which later gets transformed into adenocarcinomas. SCOPE OF REVIEW The current challenges of screening paradigm and diagnostic ranges are from semi-invasive methods like colonoscopy to non-invasive stool-based test, have resulted in over-diagnosis and over-treatment of CRC. Hence, new screening initiatives and deep studies are required for early diagnosis of CRC. In this regard, we not only summarise current predictive and prognostic biomarkers with their potential for diagnostic and therapeutic applications, but also describe current limitations, future perspectives and challenges associated with the progression of CRC. MAJOR CONCLUSIONS Currently many potential biomarkers have already been successfully translated into clinical practice eg. Fecal haemoglobin, Carcinoembryonic antigen (CEA) and CA19.9, although these are not highly promising diagnostic target for personalized medicine. So there is a critical need for reliable, minimally invasive, highly sensitive and specific genetic markers of an individualised and optimised patient treatment at the earliest disease stage possible. GENERAL SIGNIFICANCE Identification of a new biomarker, or a set of biomarkers to the development of a valid, and clinical sensible assay that can be served as an alternative tool for early diagnosis of CRC and open up promising new targets in therapeutic intervention strategies.
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Affiliation(s)
- Vishal Das
- Biotechnology Division, CSIR-North East Institute of Science and Technology, Jorhat, Assam 785006, India
| | - Jatin Kalita
- Biotechnology Division, CSIR-North East Institute of Science and Technology, Jorhat, Assam 785006, India
| | - Mintu Pal
- Biotechnology Division, CSIR-North East Institute of Science and Technology, Jorhat, Assam 785006, India.
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33
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Forrest CM, McNair K, Vincenten MCJ, Darlington LG, Stone TW. Selective depletion of tumour suppressors Deleted in Colorectal Cancer (DCC) and neogenin by environmental and endogenous serine proteases: linking diet and cancer. BMC Cancer 2016; 16:772. [PMID: 27716118 PMCID: PMC5054602 DOI: 10.1186/s12885-016-2795-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 09/21/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The related tumour suppressor proteins Deleted in Colorectal Cancer (DCC) and neogenin are absent or weakly expressed in many cancers, whereas their insertion into cells suppresses oncogenic behaviour. Serine proteases influence the initiation and progression of cancers although the mechanisms are unknown. METHODS The effects of environmental (bacterial subtilisin) and endogenous mammalian (chymotrypsin) serine proteases were examined on protein expression in fresh, normal tissue and human neuroblastoma and mammary adenocarcinoma lines. Cell proliferation and migration assays (chemoattraction and wound closure) were used to examine cell function. Cells lacking DCC were transfected with an ectopic dcc plasmid. RESULTS Subtilisin and chymotrypsin selectively depleted DCC and neogenin from cells at nanomolar concentrations without affecting related proteins. Cells showed reduced adherence and increased migration, but after washing they re-attached within 24 h, with recovery of protein expression. These effects are induced by chymotryptic activity as they are prevented by chymostatin and the soybean Bowman-Birk inhibitor typical of many plant protease inhibitors. CONCLUSIONS Bacillus subtilis, which secretes subtilisin is widely present in soil, the environment and the intestinal contents, while subtilisin itself is used in meat processing, animal feed probiotics and many household cleaning agents. With chymotrypsin present in chyme, blood and tissues, these proteases may contribute to cancer development by depleting DCC and neogenin. Blocking their activity by Bowman-Birk inhibitors may explain the protective effects of a plant diet. Our findings identify a potential non-genetic contribution to cancer cell behaviour which may explain both the association of processed meats and other factors with cancer incidence and the protection afforded by plant-rich diets, with significant implications for cancer prevention.
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Affiliation(s)
- Caroline M Forrest
- College of Medical, Veterinary and Life Sciences, West Medical Building, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Kara McNair
- College of Medical, Veterinary and Life Sciences, West Medical Building, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Maria C J Vincenten
- College of Medical, Veterinary and Life Sciences, West Medical Building, University of Glasgow, Glasgow, G12 8QQ, UK
| | | | - Trevor W Stone
- College of Medical, Veterinary and Life Sciences, West Medical Building, University of Glasgow, Glasgow, G12 8QQ, UK.
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Abstract
: More than 1.6 million new cases of cancer will be diagnosed in the U.S. in 2016, resulting in more than 500,000 deaths. Although chemotherapy has been the mainstay of treatment in advanced cancers, immunotherapy development, particularly with PD-1 inhibitors, has changed the face of treatment for a number of tumor types. One example is the subset of tumors characterized by mismatch repair deficiency and microsatellite instability that are highly sensitive to PD-1 blockade. Hereditary forms of cancer have been noted for more than a century, but the molecular changes underlying mismatch repair-deficient tumors and subsequent microsatellite unstable tumors was not known until the early 1990s. In this review article, we discuss the history and pathophysiology of mismatch repair, the process of testing for mismatch repair deficiency and microsatellite instability, and the role of immunotherapy in this subset of cancers. IMPLICATIONS FOR PRACTICE Mismatch repair deficiency has contributed to our understanding of carcinogenesis for the past 2 decades and now identifies a subgroup of traditionally chemotherapy-insensitive solid tumors as sensitive to PD-1 blockade. This article seeks to educate oncologists regarding the nature of mismatch repair deficiency, its impact in multiple tumor types, and its implications for predicting the responsiveness of solid tumors to immune checkpoint blockade.
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Lee V, Murphy A, Le DT, Diaz LA. Mismatch Repair Deficiency and Response to Immune Checkpoint Blockade. Oncologist 2016; 21:1200-1211. [PMID: 27412392 DOI: 10.1634/theoncologist.2016-0046] [Citation(s) in RCA: 186] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 05/04/2016] [Indexed: 02/06/2023] Open
Abstract
: More than 1.6 million new cases of cancer will be diagnosed in the U.S. in 2016, resulting in more than 500,000 deaths. Although chemotherapy has been the mainstay of treatment in advanced cancers, immunotherapy development, particularly with PD-1 inhibitors, has changed the face of treatment for a number of tumor types. One example is the subset of tumors characterized by mismatch repair deficiency and microsatellite instability that are highly sensitive to PD-1 blockade. Hereditary forms of cancer have been noted for more than a century, but the molecular changes underlying mismatch repair-deficient tumors and subsequent microsatellite unstable tumors was not known until the early 1990s. In this review article, we discuss the history and pathophysiology of mismatch repair, the process of testing for mismatch repair deficiency and microsatellite instability, and the role of immunotherapy in this subset of cancers. IMPLICATIONS FOR PRACTICE Mismatch repair deficiency has contributed to our understanding of carcinogenesis for the past 2 decades and now identifies a subgroup of traditionally chemotherapy-insensitive solid tumors as sensitive to PD-1 blockade. This article seeks to educate oncologists regarding the nature of mismatch repair deficiency, its impact in multiple tumor types, and its implications for predicting the responsiveness of solid tumors to immune checkpoint blockade.
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Affiliation(s)
- Valerie Lee
- Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland, USA
| | - Adrian Murphy
- Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland, USA
| | - Dung T Le
- Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland, USA
| | - Luis A Diaz
- The Swim Across America Laboratory, Baltimore, Maryland, USA the Ludwig Center for Cancer Genetics and Therapeutics, Johns Hopkins Kimmel Cancer Center, Baltimore, Maryland, USA
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Lech G, Słotwiński R, Słodkowski M, Krasnodębski IW. Colorectal cancer tumour markers and biomarkers: Recent therapeutic advances. World J Gastroenterol 2016; 22:1745-1755. [PMID: 26855534 PMCID: PMC4724606 DOI: 10.3748/wjg.v22.i5.1745] [Citation(s) in RCA: 258] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 10/05/2015] [Accepted: 12/21/2015] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) is the second most commonly diagnosed cancer among females and third among males worldwide. It also contributes significantly to cancer-related deaths, despite the continuous progress in diagnostic and therapeutic methods. Biomarkers currently play an important role in the detection and treatment of patients with colorectal cancer. Risk stratification for screening might be augmented by finding new biomarkers which alone or as a complement of existing tests might recognize either the predisposition or early stage of the disease. Biomarkers have also the potential to change diagnostic and treatment algorithms by selecting the proper chemotherapeutic drugs across a broad spectrum of patients. There are attempts to personalise chemotherapy based on presence or absence of specific biomarkers. In this review, we update review published last year and describe our understanding of tumour markers and biomarkers role in CRC screening, diagnosis, treatment and follow-up. Goal of future research is to identify those biomarkers that could allow a non-invasive and cost-effective diagnosis, as well as to recognise the best prognostic panel and define the predictive biomarkers for available treatments.
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Turner N, Wong HL, Templeton A, Tripathy S, Whiti Rogers T, Croxford M, Jones I, Sinnathamby M, Desai J, Tie J, Bae S, Christie M, Gibbs P, Tran B. Analysis of local chronic inflammatory cell infiltrate combined with systemic inflammation improves prognostication in stage II colon cancer independent of standard clinicopathologic criteria. Int J Cancer 2015; 138:671-8. [PMID: 26270488 DOI: 10.1002/ijc.29805] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/21/2015] [Accepted: 07/02/2015] [Indexed: 12/18/2022]
Abstract
In Stage II colon cancer, multiple independent studies have shown that a dense intratumoural immune infiltrate (local inflammation) is associated with improved outcomes, while systemic inflammation, measured by various markers, has been associated with poorer outcomes. However, previous studies have not considered the interaction between local and systemic inflammation, nor have they assessed the type of inflammatory response compared with standard clinicopathologic criteria. In order to evaluate the potential clinical utility of inflammatory markers in Stage II colon cancer, we examined local and systemic inflammation in a consecutive series of patients with resected Stage II colon cancer between 2000 and 2010 who were identified from a prospective clinical database. Increased intratumoural chronic inflammatory cell (CIC) density, as assessed by pathologist review of hematoxylin and eosin stained slides, was used to represent local inflammation. Neutrophil-to-lymphocyte ratio (NLR) >5, as calculated from pre-operative full blood counts, was used to represent systemic inflammation. In 396 eligible patients identified, there was a non-significant inverse relationship between local and systemic inflammation. Increased CIC density was significantly associated with improved overall (HR 0.45, p = 0.001) and recurrence-free survival (HR 0.37, p = 0.003). High NLR was significantly associated with poorer overall survival (HR 2.56, p < 0.001). The combination of these markers further stratified prognosis independent of standard high-risk criteria, with a dominant systemic inflammatory response (low CIC/high NLR) associated with the worst outcome (5-year overall survival 55.8%). With further validation this simple, inexpensive combined inflammatory biomarker might assist in patient selection for adjuvant chemotherapy in Stage II colon cancer.
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Affiliation(s)
- Natalie Turner
- Walter & Eliza Hall Institute of Medical Research, Melbourne, Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Australia
| | - Hui-Li Wong
- Walter & Eliza Hall Institute of Medical Research, Melbourne, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Australia
| | - Arnoud Templeton
- Department of Medical Oncology, Kantonsspital, St Gallen, Switzerland
| | - Sagarika Tripathy
- Centre for Translational Pathology, University of Melbourne, Parkville, Australia
| | - Te Whiti Rogers
- Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia
| | - Matthew Croxford
- Department of Colorectal Surgery, Western Health, Footscray, Australia
| | - Ian Jones
- Department of Colorectal Surgery, Royal Melbourne Hospital, Parkville, Australia
| | | | - Jayesh Desai
- Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Australia
| | - Jeanne Tie
- Walter & Eliza Hall Institute of Medical Research, Melbourne, Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Australia.,Department of Medical Oncology, Western Health, Footscray, Australia
| | - Susie Bae
- BioGrid Australia, Melbourne, Australia
| | - Michael Christie
- Centre for Translational Pathology, University of Melbourne, Parkville, Australia.,Department of Anatomical Pathology, Royal Melbourne Hospital, Parkville, Australia
| | - Peter Gibbs
- Walter & Eliza Hall Institute of Medical Research, Melbourne, Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Australia.,Department of Medical Oncology, Western Health, Footscray, Australia.,BioGrid Australia, Melbourne, Australia
| | - Ben Tran
- Walter & Eliza Hall Institute of Medical Research, Melbourne, Australia.,Department of Medical Oncology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medical Biology, University of Melbourne, Parkville, Australia.,Department of Medical Oncology, Western Health, Footscray, Australia
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Cai H, Zhang G, Wang Z, Luo Z, Zhou X. Relationship between the use of statins and patient survival in colorectal cancer: a systematic review and meta-analysis. PLoS One 2015; 10:e0126944. [PMID: 26030771 PMCID: PMC4451009 DOI: 10.1371/journal.pone.0126944] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/09/2015] [Indexed: 12/30/2022] Open
Abstract
Background Studies have indicated that statins influence the risks and mortality rates of several types of solid tumors. However, the association between statin use and survival in patients with colorectal cancer (CRC) remains unclear. Methods We searched the PubMed and Embase databases for relevant studies published up to September 2014 that assessed statin use and CRC prognosis. The primary outcomes were overall survival (OS) and cancer-specific survival (CSS). The secondary outcomes were disease-free survival (DFS) and recurrence-free survival (RFS). Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted and pooled with Mantel–Haenszel random-effect modeling. All statistical tests were two-sided. Results Four studies on post-diagnosis statin therapy and five studies on pre-diagnosis statin use were included in our meta-analysis of 70,608 patients. Compared with the non-users, the patients with post-diagnosis statin use gained survival benefits for OS (HR 0.76; 95% CI: 0.68 to 0.85, P<0.001) and CSS (HR 0.70; 95% CI: 0.60 to 0.81, P<0.001). In addition, we observed that pre-diagnosis statin use prolonged the survival of patients with CRC for OS (HR 0.70; 95% CI: 0.54 to 0.91, P=0.007) and CSS (HR 0.80; 95% CI: 0.74 to 0.86, P<0.001). However, we did not observe a survival benefit for DFS (HR 1.13; 95% CI: 0.78 to 1.62, P=0.514) or RFS (HR 0.98; 95% CI: 0.36 to 2.70, P=0.975) in the CRC patients with post-diagnosis statin use. Conclusions Statin use before or after cancer diagnosis is related to reductions in overall and cancer-specific mortality in colorectal cancer survivors.
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Affiliation(s)
- Heping Cai
- Department of Pharmacy, Anhui Provincial Children's Hospital, Hefei, Anhui Province, China
| | - Gongwu Zhang
- Department of Pharmacy, Anhui Provincial Children's Hospital, Hefei, Anhui Province, China
| | - Zhuo Wang
- Department of Pharmacy, Changhai Hospital, Second Military Medical University, Shanghai, China
- * E-mail: (ZW); (ZL); (XZ)
| | - Zhihong Luo
- Department of Pharmacy, Anhui Provincial Children's Hospital, Hefei, Anhui Province, China
- * E-mail: (ZW); (ZL); (XZ)
| | - Xiaochun Zhou
- Department of General Surgery, Lianyungang Oriental Hospital, Lianyun District, Lianyungang City, Jiangsu Province, China
- * E-mail: (ZW); (ZL); (XZ)
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Colorectal Cancer Biomarkers: Where Are We Now? BIOMED RESEARCH INTERNATIONAL 2015; 2015:149014. [PMID: 26106599 PMCID: PMC4461726 DOI: 10.1155/2015/149014] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 02/19/2015] [Indexed: 12/18/2022]
Abstract
Colorectal cancer is one of the major causes of cancer-related death in the Western world. Patient survival is highly dependent on the tumor stage at the time of diagnosis. Reduced sensitivity to chemotherapy is still a major obstacle in effective treatment of advanced disease. Due to the fact that colorectal cancer is mostly asymptomatic until it progresses to advanced stages, the implementation of screening programs aimed at early detection is essential to reduce incidence and mortality rates. Current screening and diagnostic methods range from semi-invasive procedures such as colonoscopy to noninvasive stool-based tests. The combination of the absence of symptoms, the semi-invasive nature of currently used methods, and the suboptimal accuracy of fecal blood tests results in colorectal cancer diagnosis at advanced stages in a significant number of individuals. Alterations in gene expression leading to colorectal carcinogenesis are reflected in dysregulated levels of nucleic acids and proteins, which can be used for the development of novel, minimally invasive molecular biomarkers. The purpose of this review is to discuss the commercially available colorectal cancer molecular diagnostic methods as well as to highlight some of the new candidate predictive and prognostic molecular markers for tumor, stool, and blood samples.
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Herzig DO, Tsikitis VL. Molecular markers for colon diagnosis, prognosis and targeted therapy. J Surg Oncol 2014; 111:96-102. [PMID: 25297801 DOI: 10.1002/jso.23806] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 09/09/2014] [Indexed: 12/11/2022]
Abstract
Colorectal adenocarcinoma (CRC), the second leading cancer-related death in the United States, remains a global public health issue. Sporadic CRC is considered the result of sequential mucosal changes from normal colonic mucosa to adenocarcinoma. Efforts in understanding the molecular pathways leading to CRC tumorigenesis may lead to identifying novel, individually tailored therapeutic targets for patients. In this review, we focus on well-published prognostic and predictive markers in CRC and examine their role in clinical practice.
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Affiliation(s)
- Daniel O Herzig
- Department of Surgery, Oregon Health & Science University, Portland, Oregon
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Ingebrigtsen VA, Boye K, Nesland JM, Nesbakken A, Flatmark K, Fodstad Ø. B7-H3 expression in colorectal cancer: associations with clinicopathological parameters and patient outcome. BMC Cancer 2014; 14:602. [PMID: 25139714 PMCID: PMC4148536 DOI: 10.1186/1471-2407-14-602] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 07/30/2014] [Indexed: 12/13/2022] Open
Abstract
Background We have previously reported overexpression of the immunoregulatory protein B7-H3 in colorectal cancer and that nuclear expression predicted poor outcome in colon cancer patients. The present study was performed to examine the prognostic role of B7-H3 in an independent colorectal cancer cohort. Methods Using tissue microarrays from 731 colorectal cancer patients, tumour B7-H3 expression was assessed by immunohistochemistry. Associations with clinicopathological parameters and patient outcome were investigated. Results Nuclear expression of B7-H3 in cancer cells was present in 27% of the samples in the total study cohort, while cytoplasmic/membrane and stromal expression was seen in 86% and 77% of the samples, respectively. Nuclear B7-H3 had no prognostic relevance in the complete outcome cohort, neither in colon cancer patients. However, nuclear B7-H3 was significantly associated with reduced recurrence-free survival in TNM stage I colorectal cancer patients. Conclusions Overexpression of B7-H3 in colorectal cancer was confirmed, but in contrast to previous results, nuclear B7-H3 was not a strong prognostic biomarker in this cohort. The discrepancy might be related to the use of single-core tissue microarrays for detection of the heterogeneously expressed B7-H3, and the role of B7-H3 in colorectal cancer still needs further examination. Electronic supplementary material The online version of this article (doi:10.1186/1471-2407-14-602) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Vibeke A Ingebrigtsen
- Department of Tumor Biology, Norwegian Radium Hospital, Oslo University Hospital, PO Box 4950, Nydalen, N-0424 Oslo, Norway.
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Environmental Exposures, Tumor Heterogeneity, and Colorectal Cancer Outcomes. CURRENT COLORECTAL CANCER REPORTS 2014. [DOI: 10.1007/s11888-014-0221-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Choi YJ, Kim MS, An CH, Yoo NJ, Lee SH. Regional bias of intratumoral genetic heterogeneity of nucleotide repeats in colon cancers with microsatellite instability. Pathol Oncol Res 2014; 20:965-71. [PMID: 24748498 DOI: 10.1007/s12253-014-9781-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
Abstract
Intratumoral heterogeneity (ITH) may produce regional biases in genotype and phenotype evaluation in a single tumor and may impede proper cancer diagnosis. To evaluate the extent of ITH in colorectal cancer (CRC) with microsatellite instability (MSI), we obtained 4-7 biopsies from 39 CRCs followed by MSI analysis either using the Bethesda MSI evaluation system or Promega system with 5 mononucleotide markers. We found decreased prevalence of MSI (+) by the Promega system compared to the Bethesda system. The overall discordance between the two systems was 54 %. In contrast to the previous studies that had shown discordance only in low MSI (MSI-L), our results showed the discordance not only in MSI-L, but also in high MSI (MSI-H) cases. Among the MSI (+) CRCs, ITH of MSI status was identified in 41.7 % of CRC by the Bethesda system and 22.2 % by the Promega system. In terms of MSI markers, the ITH originated from dinucleotide markers in most cases (69 %), but it originated from mononucleotide markers (31 %) as well. Pooling of DNA from a regional biopsy with MSI (+) with additional biopsies from stable MSI (MSS) showed that this approach was beneficial to increase the sensitivity of MSI detection. Our results indicate that ITH of MSI phenotype by the Bethesda system is more overestimated than previously identified. However, because there was considerable ITH of MSI subtypes and markers even by the Promega system, our data suggest that analysis of MSI status in multiple regional biopsies is needed for a better evaluation of MSI status in CRC.
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Affiliation(s)
- Youn Jin Choi
- Department of Pathology, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Socho-gu, Seoul, 137-701, Korea
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Staal S, Daily K, Allegra C. Controversies in Adjuvant Chemotherapy. COLORECTAL CANCER 2014. [DOI: 10.1002/9781118337929.ch10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Prognostic biomarkers in colorectal cancer: where do we stand? Virchows Arch 2014; 464:379-91. [PMID: 24487787 DOI: 10.1007/s00428-013-1532-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 12/03/2013] [Accepted: 12/23/2013] [Indexed: 12/13/2022]
Abstract
Colorectal cancer remains a major cause of cancer-related death worldwide. One way to reduce its staggering mortality rate and socio-economic burden is to predict outcome based on the aggressiveness of the tumor biology in order to treat patients accordingly to their risk profile. As such, it comes as no surprise that prognostic biomarker discovery is a hot topic in colorectal cancer research. The last two decades have literally produced tons of new data and an avalanche of potential clinically applicable biomarkers. This review explores and summarizes data concerning the prognostic strength and clinical utility of current and future tissue biomarkers in the diagnosis and treatment of colorectal cancer.
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47
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Colon and rectal cancer. Mol Oncol 2013. [DOI: 10.1017/cbo9781139046947.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Fucosylated TGF-β receptors transduces a signal for epithelial-mesenchymal transition in colorectal cancer cells. Br J Cancer 2013; 110:156-63. [PMID: 24253505 PMCID: PMC3887298 DOI: 10.1038/bjc.2013.699] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/11/2013] [Accepted: 10/08/2013] [Indexed: 02/06/2023] Open
Abstract
Background: Transforming growth factor-β (TGF-β) is a major inducer of epithelial–mesenchymal transition (EMT) in different cell types. TGF-β-mediated EMT is thought to contribute to tumour cell spread and metastasis. Sialyl Lewis antigens synthesised by fucosyltransferase (FUT) 3 and FUT6 are highly expressed in patients with metastatic colorectal cancer (CRC) and are utilised as tumour markers for cancer detection and evaluation of treatment efficacy. However, the role of FUT3 and FUT6 in augmenting the malignant potential of CRC induced by TGF-β is unclear. Methods: Colorectal cancer cell lines were transfected with siRNAs for FUT3/6 and were examined by cell proliferation, invasion and migration assays. The expression and phosphorylation status of TGF-β downstream molecules were analysed by western blot. Fucosylation of TGF-β receptor (TβR) was examined by lectin blot analysis. Results: Inhibition of FUT3/6 expression by siRNAs suppressed the fucosylation of type I TβR and phosphorylation of the downstream molecules, thereby inhibiting the invasion and migration of CRC cells by EMT. Conclusion: Fucosyltransferase 3/6 has an essential role in cancer cell adhesion to endothelial cells by upregulation of sialyl Lewis antigens and also by enhancement of cancer cell migration through TGF-β-mediated EMT.
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Kin C, Kidess E, Poultsides GA, Visser BC, Jeffrey SS. Colorectal cancer diagnostics: biomarkers, cell-free DNA, circulating tumor cells and defining heterogeneous populations by single-cell analysis. Expert Rev Mol Diagn 2013; 13:581-99. [PMID: 23895128 DOI: 10.1586/14737159.2013.811896] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Reliable biomarkers are needed to guide treatment of colorectal cancer, as well as for surveillance to detect recurrence and monitor therapeutic response. In this review, the authors discuss the use of various biomarkers in addition to serum carcinoembryonic antigen, the current surveillance method for metastatic recurrence after resection. The clinical relevance of mutations including microsatellite instability, KRAS, BRAF and SMAD4 is addressed. The role of circulating tumor cells and cell-free DNA with regards to their implementation into clinical use is discussed, as well as how single-cell analysis may fit into a monitoring program. The detection and characterization of circulating tumor cells and cell-free DNA in colorectal cancer patients will not only improve the understanding of the development of metastasis, but may also supplant the use of other biomarkers.
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Affiliation(s)
- Cindy Kin
- Department of Surgery, Stanford University School of Medicine, CA, USA.
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Mouradov D, Domingo E, Gibbs P, Jorissen RN, Li S, Soo PY, Lipton L, Desai J, Danielsen HE, Oukrif D, Novelli M, Yau C, Holmes CC, Jones IT, McLaughlin S, Molloy P, Hawkins NJ, Ward R, Midgely R, Kerr D, Tomlinson IPM, Sieber OM. Survival in stage II/III colorectal cancer is independently predicted by chromosomal and microsatellite instability, but not by specific driver mutations. Am J Gastroenterol 2013; 108:1785-93. [PMID: 24042191 DOI: 10.1038/ajg.2013.292] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 08/05/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Microsatellite instability (MSI) is an established marker of good prognosis in colorectal cancer (CRC). Chromosomal instability (CIN) is strongly negatively associated with MSI and has been shown to be a marker of poor prognosis in a small number of studies. However, a substantial group of "double-negative" (MSI-/CIN-) CRCs exists. The prognosis of these patients is unclear. Furthermore, MSI and CIN are each associated with specific molecular changes, such as mutations in KRAS and BRAF, that have been associated with prognosis. It is not known which of MSI, CIN, and the specific gene mutations are primary predictors of survival. METHODS We evaluated the prognostic value (disease-free survival, DFS) of CIN, MSI, mutations in KRAS, NRAS, BRAF, PIK3CA, FBXW7, and TP53, and chromosome 18q loss-of-heterozygosity (LOH) in 822 patients from the VICTOR trial of stage II/III CRC. We followed up promising associations in an Australian community-based cohort (N=375). RESULTS In the VICTOR patients, no specific mutation was associated with DFS, but individually MSI and CIN showed significant associations after adjusting for stage, age, gender, tumor location, and therapy. A combined analysis of the VICTOR and community-based cohorts showed that MSI and CIN were independent predictors of DFS (for MSI, hazard ratio (HR)=0.58, 95% confidence interval (CI) 0.36-0.93, and P=0.021; for CIN, HR=1.54, 95% CI 1.14-2.08, and P=0.005), and joint CIN/MSI testing significantly improved the prognostic prediction of MSI alone (P=0.028). Higher levels of CIN were monotonically associated with progressively poorer DFS, and a semi-quantitative measure of CIN was a better predictor of outcome than a simple CIN+/- variable. All measures of CIN predicted DFS better than the recently described Watanabe LOH ratio. CONCLUSIONS MSI and CIN are independent predictors of DFS for stage II/III CRC. Prognostic molecular tests for CRC relapse should currently use MSI and a quantitative measure of CIN rather than specific gene mutations.
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Affiliation(s)
- Dmitri Mouradov
- 1] Ludwig Colon Cancer Initiative Laboratory, Ludwig Institute for Cancer Research, Parkville, Victoria, Australia [2] Faculty of Medicine, Dentistry and Health Sciences, Department of Medical Biology, University of Melbourne, Royal Melbourne Hospital, Parkville, Victoria, Australia
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