Three-year monitoring of serum p53 antibody during chemotherapy and surgery for stage IV rectal cancer

Usefulness of Serum Anti-p53 Antibody Measurement in Patients Undergoing Hepatectomy for Colorectal Liver Metastases

BACKGROUND

While anti-p53 antibody (p53-Ab) is a potential marker for early detection of colorectal cancer, its clinical utility in patients with advanced colorectal cancer remains unknown.

METHODS

The clinical significance of p53-Ab was investigated by analyzing the data of 206 patients who underwent curative resection for colorectal liver metastases.

RESULTS

Of the 206 patients, 60 (29%) were seropositive and 146 were seronegative for p53-Ab before the surgery. The preoperative serum p53-Ab level showed no significant correlation with the serum CEA or serum CA19-9 levels. The perioperative changes in serum p53-Ab positivity were significantly correlated with the preoperative serum p53-Ab levels and multivariate analysis confirmed that a higher preoperative p53-Ab level was independently associated with a worse recurrence-free survival (hazard ratio [HR], 1.07; 95% CI, 1.01-1.13; P = 0.033 per + 100 U/mL), even after adjustments for other oncological factors, including the preoperative serum CEA level.

CONCLUSION

Higher preoperative p53-Ab levels were associated with a higher risk of recurrence after curative resection of colorectal liver metastases.

Possible predictive significance of serum RalA autoantibodies on relapse-free survival in patients with colorectal cancer

RalA protein, a member of the Ras superfamily of small GTPases, is a tumor antigen that induces serum RalA antibodies (s-RalA-Abs). The present study explored the clinicopathological and prognostic significance of s-RalA-Abs in patients with colorectal cancer. Serum samples were obtained from 314 patients with colorectal cancer at stage 0/I (n=71), stage II (n=86), stage III (n=78), stage IV (n=64) and recurrence (n=15). Samples were analyzed for the presence of s-RalA-Abs using ELISA. The cutoff optical density value was fixed at 0.324 (mean of heathy controls + 3 standard deviations). The overall positive rate for serum anti-RalA antibodies was 14%. The presence of s-RalA-Abs was not significantly associated with clinicopathological characteristic factors. Additionally, the s-RalA-Abs(+) group demonstrated significantly poor relapse-free survival rates. The s-RalA-Abs (+)/carcinoembryonic antigen (CEA)(+) group exhibited the worst prognosis and s-RalA-Abs(+)/CEA(+) was an independent risk factor for poor relapse-free survival. Although the positive rate was not high, s-RalA-Abs may be a useful predictor of poor relapse-free survival in patients with colorectal cancer.

Serum anti-p53 autoantibodies in angiosarcoma

There is no biomarker for detecting the status of angiosarcoma patients. Studies have reported that serum anti-p53 antibody (Ab) levels are often high in patients with various types of malignant tumors, suggesting the potential use of this Ab as a biomarker for various tumors, including angiosarcoma. The aim of this study was to assess the usefulness of serum anti-p53 Ab as a potent angiosarcoma biomarker. Nineteen angiosarcoma patients were included. All patients had histologically been diagnosed with cutaneous angiosarcoma. We compared p53 protein expression and serum p53 Ab levels between angiosarcoma in the scalp patients (n = 19) and normal controls (n = 30). We evaluated Ab levels before and after therapy. Increased p53 expression was detected in angiosarcoma skin tissues compared with that observed in normal skin tissues. We evaluated serum from angiosarcoma patients and controls for the presence of the anti-p53 Ab. Serum anti-p53 Ab levels were significantly higher in angiosarcoma patients than in controls．Serum anti-p53 Ab levels of patients who showed disease progression after therapy increased in correlation with the medical condition. The Ab levels of three patients, who showed partial response after therapy, decreased in correlation with the medical condition. The Ab levels of the other three patients were low at all time points. Anti-p53 Ab levels were significantly higher in angiosarcoma patients than in the controls. We demonstrated that serum anti-p53 Ab levels would reflect the clinical course of angiosarcoma patients, suggesting that serum anti-p53 Ab can be a potent diagnostic and prognostic biomarker of angiosarcoma.

Circulating Biomarkers for Response Prediction of Rectal Cancer to Neoadjuvant Chemoradiotherapy

Rectal cancer response to neoadjuvant Chemoradiotherapy (pCRT) is highly variable. In fact, it has been estimated that only about 21 % of patients show pathologic Complete Response (pCR) after therapy, while in most of the patients a partial or incomplete tumour regression is observed. Consequently, patients with a priori chemoradioresistant tumour should not receive the treatment, which is associated with substantial adverse effects and does not guarantee any clinical benefit. For Locally Advanced Rectal Cancer Patients (LARC), a standardized neoadjuvant treatment protocol is applied, the identification and the usefulness of prognostic or predictive biomarkers can improve the antitumoural treatment strategy, modifying the sequence, dose, and combination of radiotherapy, chemotherapy and surgical resection. For these reasons, a growing number of studies are actually focussed on the discovery and investigation of new predictive biomarkers of response to pCRT. In this review, we have selected the most recent literature (2012-2017) regarding the employment of blood-based biomarkers potentially predicting pCR in LARC patients and we have critically discussed them to highlight their real clinical benefit and the current limitations of the proposed methodological approaches.

Unusually high levels of serum p53 antibody in recurrent gastric cancer

Serum tumor markers in patients with cancer assist with establishing diagnosis, estimating prognosis, monitoring treatment, and detecting tumor recurrence. Changes in the p53 tumor suppressor gene are the most common genetic abnormalities in many different human malignancies. Several studies have demonstrated that serum p53 antibodies (S-p53Ab) comprise an early marker of malignant disease, a marker for treatment effects and a prognostic factor for patients with several types of tumors. We recently reported that S-p53Ab is useful for patients with gastric cancer. We describe a rare situation in which unusually high serum p53 antibodies helped to detect recurrent gastric cancer in the small intestine after gastrectomy. Further studies are required to gain a more precise understanding of the clinical impact of S-p53Ab titer monitoring in gastric cancer.

Negative conversion of high serum p53 antibody titers in a patient with gastric cancer at 31 months after surgery

We performed distal gastrectomy with D2 lymph node dissection, pathological stage was Stage IB (T2N0M0), in a 68-year-old male with gastric adenocarcinoma. We then monitored serum p53 antibody titers for 5 years and found it consistently decreased, without disease recurrence. Although the s-p53-Ab titer remained positive even after 2 years, it decreased to 16.5, 4.45, 2.66, 1.55, and 1.18 U/ml at 3 months, 7 months, 1 year, 2 years and 3 years after surgery, respectively. The s-p53-Ab titer finally converted from positive to negative at 31 months postoperatively without any sign of recurrence by computed tomography examination at 5 years after surgery. This case report shows that the changing pattern of s-p53-Ab titer after surgery may be useful to identify patients without recurrence. Further studies are required to gain a more precise understanding of the clinical impact of s-p53-Ab titer monitoring in gastric adenocarcinoma.