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Bonazzi VF, Aoude LG, Brosda S, Bradford JJ, Lonie JM, Loffler KA, Gartside MG, Patel K, Mukhopadhyay P, Keane C, Gebski V, Kench JG, Goldstein D, Waddell N, Barbour AP. C-reactive protein is a prognostic biomarker in pancreatic ductal adenocarcinoma patients. Asia Pac J Clin Oncol 2023. [PMID: 37415393 DOI: 10.1111/ajco.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 04/04/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
AIM The 5-year survival rate of pancreatic ductal adenocarcinoma (PDAC) is approximately 11% and has only improved marginally over the last three decades. For operable PDAC, resection and adjuvant FOLFIRINOX chemotherapy is standard of care. There is growing interest in perioperative regimens to improve outcomes. The non-randomized Phase II study "Gemcitabine and Abraxane for resectable Pancreatic cancer" (GAP) demonstrated the feasibility of perioperative gemcitabine/abraxane. Long-term survival in PDAC requires an effective immune response; hence, we undertook this translational study of the GAP trial cohort to identify immune-oncology biomarkers for clinical use. METHODS We combined Nanostring nCounter technology with immunohistochemistry to investigate the correlation between gene expression and overall patient survival. Findings were investigated in samples from the International Cancer Genome Consortium (ICGC, n = 88) and the Australian Pancreatic Genome Initiative (APGI, n = 227). RESULTS We confirmed that human equilibrative nucleoside transporter 1 (hENT1) expression was not a prognostic marker in PDAC but patients with high levels of hENT1 were more likely to live longer than 24 months post-surgery. Additionally, CD274 (PD-L1) and two novel biomarkers of survival, cathepsin W (CTSW) and C-reactive protein (CRP), were identified in the GAP cohort (n = 19). CRP expression was confirmed in data from the ICGC. Although PD-L1 and CTSW proteins were not significant across all three cohorts, results show that low CRP mRNA and protein expression are associated with longer overall survival in all three patient groups. CONCLUSION PDAC patients with long survival have higher hENT1 expression levels. Furthermore, CRP expression is a biomarker of poor prognosis following perioperative chemotherapy and resection in PDAC patients and thus may be useful for identifying patients who could benefit from more aggressive adjuvant strategies.
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Affiliation(s)
- Vanessa F Bonazzi
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Lauren G Aoude
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Sandra Brosda
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Julia J Bradford
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - James M Lonie
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Kelly A Loffler
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Michael G Gartside
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Kalpana Patel
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
| | | | - Colm Keane
- Mater Research Institute-UQ, South Brisbane, Queensland, Australia
| | - Val Gebski
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - James G Kench
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- University of Sydney Central Clinical School, Camperdown, New South Wales, Australia
| | - David Goldstein
- University of NSW Prince of Wales Clinical School, Randwick, New South Wales, Australia
| | - Nicola Waddell
- QIMR, Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Andrew P Barbour
- Frazer Institute, The University of Queensland, Woolloongabba, Queensland, Australia
- Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
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