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Ferrando L, Cirmena G, Garuti A, Scabini S, Grillo F, Mastracci L, Isnaldi E, Marrone C, Gonella R, Murialdo R, Fiocca R, Romairone E, Ballestrero A, Zoppoli G. Development of a long non-coding RNA signature for prediction of response to neoadjuvant chemoradiotherapy in locally advanced rectal adenocarcinoma. PLoS One 2020; 15:e0226595. [PMID: 32023246 PMCID: PMC7001901 DOI: 10.1371/journal.pone.0226595] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/29/2019] [Indexed: 12/13/2022] Open
Abstract
Standard treatment for locally advanced rectal adenocarcinoma (LARC) includes a combination of chemotherapy with pyrimidine analogues, such as capecitabine, and radiation therapy, followed by surgery. Currently no clinically useful genomic predictors of benefit from neoadjuvant chemoradiotherapy (nCRT) exist for LARC. In this study we assessed the expression of 8,127 long noncoding RNAs (lncRNAs), poorly studied in LARC, to infer their ability in classifying patients’ pathological complete response (pCR). We collected and analyzed, using lncRNA-specific Agilent microarrays a consecutive series of 61 LARC cases undergoing nCRT. Potential lncRNA predictors in responders and non-responders to nCRT were identified with LASSO regression, and a model was optimized using k-fold cross-validation after selection of the three most informative lncRNA. 11 lncRNAs were differentially expressed with false discovery rate < 0.01 between responders and non-responders to NACT. We identified lnc-KLF7-1, lnc-MAB21L2-1, and LINC00324 as the most promising variable subset for classification building. Overall sensitivity and specificity were 0.91 and 0.94 respectively, with an AUC of our ROC curve = 0.93. Our study shows for the first time that lncRNAs can accurately predict response in LARC undergoing nCRT. Our three-lncRNA based signature must be independently validated and further analyses must be conducted to fully understand the biological role of the identified signature, but our results suggest lncRNAs may be an ideal biomarker for response prediction in the studied setting.
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Affiliation(s)
- Lorenzo Ferrando
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
| | - Gabriella Cirmena
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
| | - Anna Garuti
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
| | | | - Federica Grillo
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
- Department of Integrated Surgical and Diagnostic Sciences, Università degli Studi di Genova, Genova, Italy
| | - Luca Mastracci
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
- Department of Integrated Surgical and Diagnostic Sciences, Università degli Studi di Genova, Genova, Italy
| | - Edoardo Isnaldi
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
| | - Ciro Marrone
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
| | - Roberta Gonella
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Roberto Fiocca
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
- Department of Integrated Surgical and Diagnostic Sciences, Università degli Studi di Genova, Genova, Italy
| | | | - Alberto Ballestrero
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
- * E-mail: (AB); (GZ)
| | - Gabriele Zoppoli
- Department of Internal Medicine, Università degli Studi di Genova, Genova, Italy
- IRCSS Ospedale Policlinico San Martino, Genova, Italy
- * E-mail: (AB); (GZ)
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Abstract
Bevacizumab is a monoclonal antibody that binds and neutralizes vascular endothelial growth factor (VEGF)-A, a key player in the angiogenesis pathway. Despite benefits of bevacizumab in cancer therapy, it is clear that the VEGF pathway is complex, involving multiple isoforms, receptors, and alternative ligands such as VEGF-B, and placental growth factor, which could enable escape from VEGF-A-targeted angiogenesis inhibition. Recently developed therapies have targeted other ligands in the VEGF pathway (eg, aflibercept, known as ziv-aflibercept in the United States), VEGF receptors (eg, ramucirumab), and their tyrosine kinase signaling (ie, tyrosine kinase inhibitors). The goal of the current review was to identify comparative preclinical data for the currently available VEGF-targeted therapies. Sources were compiled using PubMed searches (2007 to 2012), using search terms including, but not limited to: “bevacizumab,” “aflibercept,” “ramucirumab,” and “IMC-18F1.” Two preclinical studies were identified that compared bevacizumab and the newer agent, aflibercept. These studies identified some important differences in binding and pharmacodynamic activity, although the potential clinical relevance of these findings is not known. Newer antiangiogenesis therapies should help further expand treatment options for colorectal and other cancers. Comparative preclinical data on these agents is currently lacking.
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