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Sakon K, Sasaki M, Tanaka K, Mizunaga T, Yano K, Kawamura Y, Okada A, Ikeda T, Tanabe S, Takamori A, Yamada N, Morioka K, Koshiji T. Intratumoral gene expression of dihydrofolate reductase and folylpoly-c-glutamate synthetase affects the sensitivity to 5-fluorouracil in non-small cell lung cancer. Discov Oncol 2021; 12:19. [PMID: 35201464 PMCID: PMC8777502 DOI: 10.1007/s12672-021-00413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/16/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Various factors related to the sensitivity of non-small cell lung carcinoma (NSCLC) to 5-fluorouracil (5-FU) have been reported, and some of them have been clinically applied. In this single-institutional prospective analysis, the mRNA expression level of five folic acid-associated enzymes was evaluated in surgical specimens of NSCLC. We investigated the correlation between the antitumor effect of 5-FU in NSCLC using an anticancer drug sensitivity test and the gene expression levels of five enzymes. MATERIALS AND METHODS Forty patients who underwent surgery for NSCLC were enrolled, and the antitumor effect was measured using an in vitro anticancer drug sensitivity test (histoculture drug response assay) using freshly resected specimens. In the same sample, the mRNA expression levels of five enzymes involved in the sensitivity to 5-FU were measured in the tumor using real-time PCR. The expression levels and the result of the sensitivity test were compared. RESULTS No correlation was found between dihydropyrimidine dehydrogenase (DPD), orotate phosphoribosyltransferase (OPRT), or DPD/OPRT expression and the antitumor effects of 5-FU. On the other hand, a correlation was found between thymidylate synthase (TS), folylpoly-c-glutamate synthetase (FPGS), and dihydrofolate reductase (DHFR) expression and 5-FU sensitivity. CONCLUSION Expression of FPGS and DHFR may be useful for predicting the efficacy of 5-FU-based chemotherapy for NSCLC.
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Affiliation(s)
- Kayo Sakon
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Masato Sasaki
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Kaede Tanaka
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Tae Mizunaga
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Keita Yano
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Yuuko Kawamura
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Akitoshi Okada
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Takeshi Ikeda
- Department of Thoracic Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjyuku-ku, Tokyo, 162-8655 Japan
| | - Sawaka Tanabe
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Atsushi Takamori
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Narihisa Yamada
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Kouichi Morioka
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
| | - Takaaki Koshiji
- Department of Surgery (II), Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka Eiheijichou, Fukui, 910-1193 Japan
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Narimatsu T, Kambara T, Abe H, Uematsu T, Tokura Y, Suzuki I, Sakamoto K, Takei K, Nishihara D, Nakamura G, Kokubun H, Yuki H, Betsunoh H, Kamai T. 5-Fluorouracil-based adjuvant chemotherapy improves the clinical outcomes of patients with lymphovascular invasion of upper urinary tract cancer and low expression of dihydropyrimidine dehydrogenase. Oncol Lett 2019; 17:4429-4436. [PMID: 30944635 PMCID: PMC6444440 DOI: 10.3892/ol.2019.10086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/19/2019] [Indexed: 12/04/2022] Open
Abstract
Lymphovascular invasion (LVI) by urothelial carcinoma of the upper urinary tract (UC-UUT) is associated with an unfavorable prognosis. However, a high proportion of patients with UC-UUT are unable to receive the recommended doses of cisplatin-based adjuvant chemotherapy due to advanced age or renal dysfunction resulting from nephroureterectomy. Tegafur-uracil is an oral form of 5-fluorouracil whose efficacy is influenced by the activities of enzymes associated with its metabolism, such as dihydropyrimidine dehydrogenase (DPD), orotatephosphoribosyltransferase (OPRT) and thymidylate synthase (TS). The aim of the present study was to investigate the efficacy of adjuvant 5-fluorouracil chemotherapy for UC-UUT with LVI, and to assess the expression of enzymes associated with 5-fluorouracil metabolism as promising biomarkers of therapy efficacy. The present study retrospectively investigated 52 cases of UC-UUT. Following nephroureterectomy, tegafur-uracil was administered to 15 out of 30 patients with LVI who were not eligible for cisplatin-based adjuvant chemotherapy. Levels of DPD, OPRT and TS expression in tumor specimens were determined by reverse transcription-quantitative polymerase chain reaction, and their associations with the efficacy of adjuvant 5-fluorouracil chemotherapy were analyzed. The levels of DPD, OPRT and TS expression were not associated with pathological factors or outcome, although a higher expression of TS was associated with a poorer outcome. Adjuvant 5-fluorouracil chemotherapy significantly improved the outcome of patients with lower DPD expression. However, the levels of OPRT and TS expression did not influence therapeutic efficacy. Adjuvant 5-fluorouracil chemotherapy appears to be effective for lymphovascular-invasive UC-UUT in patients with lower DPD expression.
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Affiliation(s)
- Takahiro Narimatsu
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Tsunehito Kambara
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Hideyuki Abe
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Toshitaka Uematsu
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Yuumi Tokura
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Issei Suzuki
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Kazumasa Sakamoto
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Kouhei Takei
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Daisaku Nishihara
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Gaku Nakamura
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Hidetoshi Kokubun
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Hideo Yuki
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Hironori Betsunoh
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Takao Kamai
- Department of Urology, Dokkyo Medical University, Tochigi 321-0293, Japan
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