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Cayún JP, Cerpa LC, Colombo A, Cáceres DD, Leal JL, Reyes F, Gutiérrez-Cáceres C, Calfunao S, Varela NM, Quiñones LA. Genetic Polymorphisms and Tumoral Mutational Profiles over Survival in Advanced Colorectal Cancer Patients: An Exploratory Study. Curr Oncol 2024; 31:274-295. [PMID: 38248103 PMCID: PMC10814806 DOI: 10.3390/curroncol31010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Colorectal cancer is a common disease, both in Chile and worldwide. The most widely used chemotherapy schemes are based on 5-fluorouracil (5FU) as the foundational drug (FOLFOX, CapeOX). Genetic polymorphisms have emerged as potential predictive biomarkers of response to chemotherapy, but conclusive evidence is lacking. This study aimed to investigate the role of genetic variants associated with 5FU-based chemotherapy on therapeutic response, considering their interaction with oncogene mutations (KRAS, NRAS, PI3KCA, AKT1, BRAF). In a retrospective cohort of 63 patients diagnosed with metastatic colorectal cancer, a multivariate analysis revealed that liver metastases, DPYD, ABCB1, and MTHFR polymorphisms are independent indicators of poor prognosis, irrespective of oncogene mutations. BRAF wild-type status and high-risk drug-metabolism polymorphisms correlated with a poor prognosis in this Chilean cohort. Additionally, findings from the genomics of drug sensitivity (GDSC) project demonstrated that cell lines with wild-type BRAF have higher IC50 values for 5-FU compared to BRAF-mutated cell lines. In conclusion, the genetic polymorphisms DPYDrs1801265, ABCB1rs1045642, and MTHFRrs180113 may serve as useful biomarkers for predicting a poor prognosis in patients undergoing 5-fluorouracil chemotherapy, regardless of oncogene mutations.
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Affiliation(s)
- Juan Pablo Cayún
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile; (J.P.C.); (L.C.C.); (C.G.-C.); (S.C.)
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago 8350499, Chile
| | - Leslie Carol Cerpa
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile; (J.P.C.); (L.C.C.); (C.G.-C.); (S.C.)
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago 8350499, Chile
| | - Alicia Colombo
- Anatomy Pathology Service, Hospital Clínico de la Universidad de Chile, Santiago 8350499, Chile;
- Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile
| | - Dante Daniel Cáceres
- Institute of Population Health, School of Public Health, Faculty of Medicine, University of Chile, Santiago 8350499, Chile;
| | - José Luis Leal
- Cancer Research Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago 8350499, Chile; (J.L.L.); (F.R.)
| | - Felipe Reyes
- Cancer Research Department, Instituto Oncológico Fundación Arturo López Pérez, Santiago 8350499, Chile; (J.L.L.); (F.R.)
| | - Carolina Gutiérrez-Cáceres
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile; (J.P.C.); (L.C.C.); (C.G.-C.); (S.C.)
- Department of Pharmaceutical Sciences and Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago 8350499, Chile
| | - Susan Calfunao
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile; (J.P.C.); (L.C.C.); (C.G.-C.); (S.C.)
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago 8350499, Chile
- Laboratory Pathological Anatomy, Hospital Luis Calvo Mackenna, Santiago 8350499, Chile
| | - Nelson Miguel Varela
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile; (J.P.C.); (L.C.C.); (C.G.-C.); (S.C.)
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago 8350499, Chile
| | - Luis Abel Quiñones
- Laboratory of Chemical Carcinogenesis and Pharmacogenetics, Department of Basic-Clinical Oncology (DOBC), Faculty of Medicine, University of Chile, Santiago 8350499, Chile; (J.P.C.); (L.C.C.); (C.G.-C.); (S.C.)
- Latin American Network for Implementation and Validation of Clinical Pharmacogenomics Guidelines (RELIVAF-CYTED), Santiago 8350499, Chile
- Department of Pharmaceutical Sciences and Technology, Faculty of Chemical and Pharmaceutical Sciences, University of Chile, Santiago 8350499, Chile
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Guijarro-Eguinoa J, Arjona-Hernandez S, Stewart S, Pernia O, Arias P, Losantos-García I, Rubio T, Burdiel M, Rodriguez-Antolin C, Cruz-Castellanos P, Higuera O, Borobia AM, Rodriguez-Novoa S, de Castro-Carpeño J, Ibanez de Caceres I, Rosas-Alonso R. Prognostic Impact of Dihydropyrimidine Dehydrogenase Germline Variants in Unresectable Non-Small Cell Lung Cancer Patients Treated with Platin-Based Chemotherapy. Int J Mol Sci 2023; 24:9843. [PMID: 37372990 DOI: 10.3390/ijms24129843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Platin-based chemotherapy is the standard treatment for patients with non-small cell lung cancer (NSCLC). However, resistance to this therapy is a major obstacle in successful treatment. In this study, we aimed to investigate the impact of several pharmacogenetic variants in patients with unresectable NSCLC treated with platin-based chemotherapy. Our results showed that DPYD variant carriers had significantly shorter progression-free survival and overall survival compared to DPYD wild-type patients, whereas DPD deficiency was not associated with a higher incidence of high-grade toxicity. For the first time, our study provides evidence that DPYD gene variants are associated with resistance to platin-based chemotherapy in NSCLC patients. Although further studies are needed to confirm these findings and explore the underlying mechanisms of this association, our results suggest that genetic testing of DPYD variants may be useful for identifying patients at a higher risk of platin-based chemotherapy resistance and might be helpful in guiding future personalized treatment strategies in NSCLC patients.
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Affiliation(s)
| | - Sara Arjona-Hernandez
- Laboratory Medicine Department, Puerta Del Mar University Hospital, 11009 Cadiz, Spain
| | - Stefan Stewart
- Clinical Pharmacology Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Olga Pernia
- Cancer Epigenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
| | - Pedro Arias
- Pharmacogenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Itsaso Losantos-García
- Biostatistics Department, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
| | - Tania Rubio
- Cancer Epigenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
| | - Miranda Burdiel
- Cancer Epigenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
| | - Carlos Rodriguez-Antolin
- Cancer Epigenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
| | - Patricia Cruz-Castellanos
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
- Oncology Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Oliver Higuera
- Oncology Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Alberto M Borobia
- Clinical Pharmacology Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Sonia Rodriguez-Novoa
- Genetics of Metabolic Diseases Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Javier de Castro-Carpeño
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
- Oncology Department, La Paz University Hospital, 28046 Madrid, Spain
| | - Inmaculada Ibanez de Caceres
- Cancer Epigenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
| | - Rocio Rosas-Alonso
- Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, 28029 Madrid, Spain
- Pharmacogenetics Laboratory, Genetics Department, La Paz University Hospital, 28046 Madrid, Spain
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A Systematic Review of Clinical Validated and Potential miRNA Markers Related to the Efficacy of Fluoropyrimidine Drugs. DISEASE MARKERS 2022; 2022:1360954. [PMID: 36051356 PMCID: PMC9427288 DOI: 10.1155/2022/1360954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/15/2022] [Accepted: 07/29/2022] [Indexed: 12/24/2022]
Abstract
Colorectal cancer (CRC) is becoming increasingly prevalent worldwide. Fluoropyrimidine drugs are the primary chemotherapy regimens in routine clinical practice of CRC. However, the survival rate of patients on fluoropyrimidine-based chemotherapy varies significantly among individuals. Biomarkers of fluoropyrimidine drugs'' efficacy are needed to implement personalized medicine. This review summarized fluoropyrimidine drug-related microRNA (miRNA) by affecting metabolic enzymes or showing the relevance of drug efficacy. We first outlined 42 miRNAs that may affect the metabolism of fluoropyrimidine drugs. Subsequently, we filtered another 41 miRNAs related to the efficacy of fluoropyrimidine drugs based on clinical trials. Bioinformatics analysis showed that most well-established miRNA biomarkers were significantly enriched in the cancer pathways instead of the fluoropyrimidine drug metabolism pathways. The result also suggests that the miRNAs screened from metastasis patients have a more critical role in cancer development than those from non-metastasis patients. There are five miRNAs shared between these two lists. The miR-21, miR-215, and miR-218 can suppress fluoropyrimidine drugs'' catabolism. The miR-326 and miR-328 can reduce the efflux of fluoropyrimidine drugs. These five miRNAs could jointly act by increasing intracellular levels of fluoropyrimidine drugs'' cytotoxic metabolites, leading to better chemotherapy responses. In conclusion, we demonstrated that the dynamic changes in the transcriptional regulation via miRNAs might play significant roles in the efficacy and toxicity of the fluoropyrimidine drug. The reported miRNA biomarkers would help evaluate the efficacy of fluoropyrimidine drug-based chemotherapy and improve the prognosis of colorectal cancer patients.
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Lee HH, Chen CH, Huang YH, Chiang CH, Huang MY. Biomarkers of Favorable vs. Unfavorable Responses in Locally Advanced Rectal Cancer Patients Receiving Neoadjuvant Concurrent Chemoradiotherapy. Cells 2022; 11:cells11101611. [PMID: 35626648 PMCID: PMC9139800 DOI: 10.3390/cells11101611] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 02/04/2023] Open
Abstract
Colorectal cancer is the second leading cause of cancer death globally. The gold standard for locally advanced rectal cancer (LARC) nowadays is preoperative concurrent chemoradiation (CCRT). Approximately three quarters of LARC patients do not achieve pathological complete response and hence suffer from relapse, metastases and inevitable death. The exploration of trustworthy and timely biomarkers for CCRT response is urgently called for. This review focused upon a broad spectrum of biomarkers, including circulating tumor cells, DNA, RNA, oncogenes, tumor suppressor genes, epigenetics, impaired DNA mismatch repair, patient-derived xenografts, in vitro tumor organoids, immunity and microbiomes. Utilizing proper biomarkers can assist in categorizing appropriate patients by the most efficient treatment modality with the best outcome and accompanied by minimal side effects. The purpose of this review is to inspect and analyze accessible data in order to fully realize the promise of precision oncology for rectal cancer patients.
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Affiliation(s)
- Hsin-Hua Lee
- Ph.D. Program in Environmental and Occupational Medicine, National Health Research Institutes, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (C.-H.C.); (C.-H.C.)
- Department of Radiation Oncology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chien-Hung Chen
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (C.-H.C.); (C.-H.C.)
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Radiation Oncology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
| | - Yu-Hsiang Huang
- Post-Graduate Year Training, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Cheng-Han Chiang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (C.-H.C.); (C.-H.C.)
| | - Ming-Yii Huang
- Ph.D. Program in Environmental and Occupational Medicine, National Health Research Institutes, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan; (C.-H.C.); (C.-H.C.)
- Department of Radiation Oncology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 7158)
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Predictive Value of FOLFOX-Based Regimen, Long Interval, Hemoglobin Levels and Clinical Negative Nodal Status, and Postchemoradiotherapy CEA Levels for Pathological Complete Response in Patients with Locally Advanced Rectal Cancer after Neoadjuvant Chemoradiotherapy. JOURNAL OF ONCOLOGY 2020; 2020:9437684. [PMID: 32411245 PMCID: PMC7204332 DOI: 10.1155/2020/9437684] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/12/2019] [Accepted: 11/05/2019] [Indexed: 02/01/2023]
Abstract
We aimed to identify predictors of a pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) following a multimodality therapy. We retrospectively reviewed 236 patients with LARC treated with neoadjuvant chemoradiotherapy (CRT) followed by radical resection from January 2011 to December 2017. Patients were administered CRT, which comprised radiotherapy and chemotherapy with an oxaliplatin plus 5-fluorouracil- or fluoropyrimidine-based regimen. Clinical factors were correlated with treatment response. The multivariate logistic regression revealed that a negative nodal stage (odds ratio (OR) = 3.2, P=0.0135), a high hemoglobin level (>10 g/dL) during neoadjuvant CRT (OR = 3.067, P=0.0125), an oxaliplatin-containing neoadjuvant CRT (OR = 5.385, P=0.0044), a long interval (>8 weeks) between radiotherapy and surgery (OR = 1.135, P=0.0469), and a post-CRT CEA ≤2 ng/mL (OR = 2.891, P=0.0233) were the independent predictors of increased pCR rates. The prediction nomogram was developed according to the above independent variables. The concordance index was 0.74, and the calibration curve showed good agreement. In summary, negative nodal stages, high hemoglobin levels during treatment, oxaliplatin-containing neoadjuvant therapy, a long radiotherapy-surgery interval (>8 weeks), and post-CRT CEA levels ≤2 ng/mL were favorable predictors of a pCR. This prediction nomogram might be crucial for patients with LARC undergoing a multimodality therapy.
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Liu W, Zhang J, Yao X, Jiang C, Ni P, Cheng L, Liu J, Ni S, Chen Q, Li Q, Zhou K, Wang G, Zhou F. Bevacizumab-enhanced antitumor effect of 5-fluorouracil via upregulation of thymidine phosphorylase through vascular endothelial growth factor A/vascular endothelial growth factor receptor 2-specificity protein 1 pathway. Cancer Sci 2018; 109:3294-3304. [PMID: 30151975 PMCID: PMC6172063 DOI: 10.1111/cas.13779] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/24/2018] [Accepted: 07/29/2018] [Indexed: 11/29/2022] Open
Abstract
Bevacizumab (Bv) can be used synergistically with fluoropyrimidine-based chemotherapy to treat colorectal cancer. Whether and how it affects the delivery of fluoropyrimidine drugs is unknown. The present study aimed to explore the effect of Bv on the delivery of 5-fluorouracil (5-FU) to tumors and the underlying mechanism from metabolic perspective. Bv enhanced the anti-tumor effects of 5-FU in LoVo colon cancer xenograft mice and increased the 5-FU concentration in tumors without affecting hepatic 5-FU metabolism. Interestingly, Bv remarkably upregulated thymidine phosphorylase (TP) in tumors, which mediated the metabolic activation of 5-FU. Although TP is reported to promote angiogenesis and resistance, the combination of Bv and 5-FU resulted in anti-angiogenesis and vessel normalization in tumors, indicating that the elevated TP mainly contributed to the enhanced response to 5-FU. Bv also induced TP upregulation in LoVo cancer cells. Treatment with vascular endothelial growth factor receptor 2 (VEGFR2) antagonist apatinib and VEGFR2 silencing further confirmed TP upregulation. Bv and apatinib both enhanced the cytotoxicity of 5-FU in LoVo cells, but there was no synergism with adriamycin and paclitaxel. We further demonstrated that the effect of Bv was dependent on VEGFR2 blockade and specificity protein 1 activation via MDM2 inhibition. In summary, Bv enhanced the accumulation of 5-FU in tumors and the cytotoxicity of 5-FU via TP upregulation. We provide data to better understand how Bv synergizes with 5-FU from metabolic perspective, and it may give clues to the superiority of Bv in combination with fluoropyrimidine drugs compared to other chemotherapeutic drugs in colon cancer.
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Affiliation(s)
- Wenyue Liu
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Jingwei Zhang
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Xuequan Yao
- Department of Digestive Tumor SurgeryAffiliated Hospital of Nanjing University of Chinese MedicineNanjingChina
| | - Chao Jiang
- Department of Digestive Tumor SurgeryAffiliated Hospital of Nanjing University of Chinese MedicineNanjingChina
| | - Ping Ni
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Lingge Cheng
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Jiali Liu
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Suiying Ni
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Qianying Chen
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Qingran Li
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Kai Zhou
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Guangji Wang
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
| | - Fang Zhou
- State Key Laboratory of Natural MedicinesKey Laboratory of Drug Metabolism and PharmacokineticsChina Pharmaceutical UniversityNanjingChina
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Gajjar KK, Vora HH, Kobawala TP, Trivedi TI, Ghosh NR. Deciphering the potential value of 5-fluorouracil metabolic enzymes in predicting prognosis and treatment response of colorectal cancer patients. Int J Biol Markers 2018; 33:180-188. [DOI: 10.1177/1724600817748539] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Introduction: 5-flourouracil (5-FU) is one of the standard chemotherapeutic drugs used today in the treatment of colorectal cancer patients. Disruption of 5-FU metabolic pathway may contribute to altered effectiveness towards 5-FU-based therapy. Hence, the study of 5-FU metabolizing enzymes might have the potential efficacy to predict survival and response to treatment in colorectal cancer patients. Materials and methods: Immunohistochemical localization of 5-FU metabolic enzymes (TS, MTHFR, DPYD, and TP) was evaluated in 143 untreated patients with colorectal cancer; their prognostic and predictive values were also evaluated. Results: Immuno-positivity for TS, MTHFR, DPYD, and TP was observed in 77%, 75%, 88%, and 96% of colorectal cancer patients, respectively. Univariate survival analysis in total patients showed that low DPYD expression significantly predicted adverse overall survival ( P=0.042). Moreover, subgroup of colon cancer patients with low TS expression was associated with unfavorable prognosis. TP expression also emerged as a prognosticator in the subgroup of early and advanced stage patients. Additionally, when effect of co-expression of 5-FU metabolic enzymes was evaluated in total patients, low coexpression of all four proteins was predictive of poor overall survival than for individuals expressing high coexpression of these proteins ( P=0.045). In contrast, none of the 5-FU metabolic enzymes—either singly or on coexpression—emerged as a useful biomarker of potential therapeutic value when evaluated in the subgroup of patients treated with 5-FU alone or 5-FU plus oxaliplatin. Conclusion: The above findings suggest that coexpression of 5-FU metabolic enzymes possess significant prognostic value and could be useful biomarkers in colorectal cancer patients.
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Affiliation(s)
- Kinjal K. Gajjar
- Tumor Biology Lab 2, Cancer Biology Department, The Gujarat Cancer & Research Institute, NCH Compound, Asarwa, Ahmedabad, Gujarat- India
| | - Hemangini H. Vora
- Immuno-haematology Lab 1, Cancer Biology Department, The Gujarat Cancer & Research Institute, NCH Compound, Asarwa, Ahmedabad, Gujarat- India
| | - Toral P. Kobawala
- Tumor Biology Lab 2, Cancer Biology Department, The Gujarat Cancer & Research Institute, NCH Compound, Asarwa, Ahmedabad, Gujarat- India
| | - Trupti I. Trivedi
- Clinical Carcinogenesis Lab 3, Cancer Biology Department, The Gujarat Cancer & Research Institute, NCH Compound, Asarwa, Ahmedabad, Gujarat- India
| | - Nandita R. Ghosh
- Tumor Biology Lab 2, Cancer Biology Department, The Gujarat Cancer & Research Institute, NCH Compound, Asarwa, Ahmedabad, Gujarat- India
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8
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Li Y, Wei R, Song S. Diagnostic and Prognostic Value of Serum Thymidine Kinase 1 in Cancer Patients. Indian J Hematol Blood Transfus 2018; 34:168-170. [DOI: 10.1007/s12288-017-0812-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 04/03/2017] [Indexed: 10/19/2022] Open
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Mehrmohamadi M, Jeong SH, Locasale JW. Molecular features that predict the response to antimetabolite chemotherapies. Cancer Metab 2017; 5:8. [PMID: 29026541 PMCID: PMC5627437 DOI: 10.1186/s40170-017-0170-3] [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: 05/29/2017] [Accepted: 09/18/2017] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Antimetabolite chemotherapeutic agents that target cellular metabolism are widely used in the clinic and are thought to exert their anti-cancer effects mainly through non-specific cytotoxic effects. However, patients vary dramatically with respect to treatment outcome, and the sources of heterogeneity remain largely unknown. METHODS Here, we introduce a computational method for identifying gene expression signatures of response to chemotherapies and apply it to human tumors and cancer cell lines. Furthermore, we characterize a set of 17 antimetabolite agents in various contexts to investigate determinants of sensitivity to these agents. RESULTS We identify distinct favorable and unfavorable metabolic expression signatures for 5-FU and Gemcitabine. Importantly, we find that metabolic pathways targeted by each of these antimetabolites are specifically enriched in its expression signatures. We provide evidence against the common notion about non-specific cytotoxic functions of antimetabolite drugs. CONCLUSIONS This study demonstrates through unbiased analyses that the activities of metabolic pathways likely contribute to therapeutic response.
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Affiliation(s)
- Mahya Mehrmohamadi
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710 USA.,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27710 USA.,Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710 USA.,Department of Molecular Biology and Genetics, Field of Genetics, Genomics and Development, Cornell University, Ithaca, NY 14853 USA
| | - Seong Ho Jeong
- Department of Molecular Biology and Genetics, Field of Genetics, Genomics and Development, Cornell University, Ithaca, NY 14853 USA
| | - Jason W Locasale
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710 USA.,Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC 27710 USA.,Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC 27710 USA
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10
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Oh BY, Huh JW, Lee WY, Park YA, Cho YB, Yun SH, Kim HC, Chun HK. Are We Predicting Disease Progress of the Rectal Cancer Patients without Surgery after Neoadjuvant Chemoradiotherapy? Cancer Res Treat 2017; 50:634-645. [PMID: 28675024 PMCID: PMC6056953 DOI: 10.4143/crt.2017.069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/21/2017] [Indexed: 01/18/2023] Open
Abstract
Purpose There are patients who do not undergo surgery, regardless of tumor response for neoadjuvant chemoradiotherapy (nCRT) in rectal cancer. However, there have been few reports focused on how oncologic outcomes are worse in these patients. We sought to investigate oncologic outcomes for these non-operated patients with rectal cancer after nCRT. Materials and Methods A total of 1,063 records of patients with rectal cancer who were treated with nCRT from January 2002 to December 2013 were retrospectively reviewed. We categorized patients into the non-operated group (n=77), transanal local excision (TLE) group (n=54), ortotal mesorectal excision (TME) group (n=932) and compared each group using propensity score matching. Results In the non-operated group, the most common reason for no surgery was patient refusal (n=64). Eleven patients were considered to have achieve clinical complete response (cCR), which was an independent prognostic factor of progression-free survival (p=0.045). In patients with disease progression in the non-operated group, the overall survival did not improved according to salvage treatments (p=0.451). The non-operated group showed worse survivals compared to the TLE or TME group before and after matching (p < 0.001). This finding was also noted in the analysis of survival only in patients with cCR. Conclusion In this study, non-operated patients did not secure oncologic safety regardless of cCR after nCRT. Our results suggest that a non-operative management must be carefully considered even if cCR is achieved.
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Affiliation(s)
- Bo Young Oh
- Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jung Wook Huh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Ah Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Beom Cho
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seong Hyeon Yun
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Cheol Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho-Kyung Chun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Correlation between tumor engraftment in patient-derived xenograft models and clinical outcomes in colorectal cancer patients. Oncotarget 2016; 6:16059-68. [PMID: 25965827 PMCID: PMC4599256 DOI: 10.18632/oncotarget.3863] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/02/2015] [Indexed: 02/07/2023] Open
Abstract
Despite numerous studies involving patient-derived xenograft (PDX) models, few studies have investigated the relationship between the ability of the tumor to engraft (tumorigenicity) and the clinical features of colorectal cancer (CRC). The aim of this study was to determine whether tumorigenicity correlates with clinical outcomes of CRC patients. We included 241 CRC patients who underwent radical surgery from 2010 to 2013. PDX models were established by implanting tumor fragments obtained from these patients into the subcutaneous layer of immunodeficient mice. Xenografts were successfully established from 62.2%. Successful engraftment was associated with advanced stage (p < 0.001) and moderate/poor differentiation (p = 0.029). Three-year disease-free survival (DFS) rates were lower for patients with tumorigenicity (p = 0.011). In stage III patients, tumorigenicity was an independent predictor of poor DFS (p = 0.034). In addition, mutation of TP53 was most frequently detected in stage III patients with tumorigenicity. Two models of stage IV disease without KRAS mutations showed high sensitivity to EGFR-targeted agents, while none of the models with KRAS mutations showed high sensitivity. In conclusion, PDX models may provide an effective preclinical tool for predicting cancer progression and could be used to further genomic and pharmacologic research on personalized treatments.
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Oh BY, Park YA, Huh JW, Cho YB, Yun SH, Lee WY, Park HC, Choi DH, Park YS, Kim HC. Metformin enhances the response to radiotherapy in diabetic patients with rectal cancer. J Cancer Res Clin Oncol 2016; 142:1377-85. [PMID: 27011019 DOI: 10.1007/s00432-016-2148-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/12/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE Metformin may have anticancer effects and could improve response to radiotherapy in several malignancies. We aimed to investigate the effect of metformin on response to radiotherapy in rectal cancer. METHODS A total of 543 rectal cancer patients who were treated with neoadjuvant chemoradiotherapy followed by radical surgery from January 2007 to December 2011 were reviewed. Patients were divided into three groups: diabetics taking metformin (n = 42), diabetics not taking metformin (n = 29), and non-diabetics (n = 472). Tumor response and survival were compared between groups. RESULTS The rates of N downstaging and tumor regression grades (TRG) 3-4 were significantly higher in diabetics taking metformin (p = 0.006 and p = 0.029, respectively). There were no significant differences between groups in terms of T downstaging and pathologic complete response. On multivariate analysis, metformin use was associated with increased rates of N downstaging and TRG 3-4 (p = 0.003 and p = 0.019, respectively). Recurrence-free survival, disease-free survival, and overall survival rates were not significantly different between groups. CONCLUSIONS Metformin is associated with higher tumor response rates to radiotherapy in rectal cancer, especially in patients with diabetes.
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Affiliation(s)
- Bo Young Oh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Yoon Ah Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Jung Wook Huh
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Yong Beom Cho
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Seong Hyeon Yun
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea
| | - Hee Chul Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo Ho Choi
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Suk Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Cheol Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea.
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Animal models of colorectal cancer with liver metastasis. Cancer Lett 2016; 387:114-120. [PMID: 26850374 DOI: 10.1016/j.canlet.2016.01.048] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/26/2016] [Accepted: 01/26/2016] [Indexed: 01/01/2023]
Abstract
Liver metastasis is a leading cause of death in patients with colorectal cancer. Investigating the mechanisms of liver metastasis and control of disease progression are important strategies for improving survival of these patients. Liver metastasis is a multi-step process and relevant models representing these steps are necessary to understand the mechanism of liver metastasis and establish appropriate treatments. Recently, the development of animal models for use in metastasis research has greatly increased; however, there is still a lack of models that sufficiently represent human cancer. Thus, in order to select an optimal model for of a given study, it is necessary to fully understand the characteristics of each animal model. In this review, we describe the mouse models currently used for colorectal cancer with liver metastasis, their characteristics, and their pros and cons. This may help us specify the mechanism of liver metastasis and provide evidence relevant to clinical applications.
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