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Offermans K, Jenniskens JCA, Simons CCJM, Samarska I, Fazzi GE, Smits KM, Schouten LJ, Weijenberg MP, Grabsch HI, van den Brandt PA. Association between individual Warburg-related proteins and prognosis in colorectal cancer. J Pathol Clin Res 2025; 11:e70016. [PMID: 40017054 PMCID: PMC11868443 DOI: 10.1002/2056-4538.70016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 12/06/2024] [Accepted: 12/19/2024] [Indexed: 03/01/2025]
Abstract
We previously showed that Warburg subtyping (low/moderate/high), based on the expression of six glycolytic proteins and transcriptional regulators [glucose transporter 1 (GLUT1), pyruvate kinase M2 (PKM2), lactate dehydrogenase A (LDHA), monocarboxylate transporter 4 (MCT4), p53, and PTEN], holds independent prognostic value in colorectal cancer (CRC) patients. The present study aimed to investigate whether the expression level of one of the proteins (GLUT1, PKM2, LDHA, MCT4, p53, and PTEN) can act as a proxy for our previously identified six protein-based Warburg subtypes. Protein expression levels for individual Warburg-related proteins were available for 2,251 CRC patients from the Netherlands Cohort Study. Kaplan-Meier curves and Cox regression were used to explore associations between individual Warburg-related proteins and CRC-specific and overall survival. Previously identified associations between Warburg subtypes and CRC-specific and overall survival were adjusted for individual proteins, showing a significant association with survival in the current study. Multivariable-adjusted analyses showed that the expression of GLUT1, LDHA, MCT4, PKM2, or p53 was associated with neither CRC-specific nor overall survival. Decreasing PTEN expression was associated with significantly poorer overall survival (p-trendcategories = 0.026). Additional adjustment for PTEN expression had minimal impact on the previously identified association between Warburg subtypes and survival, and the six protein-based Warburg-high subtype remained a statistically significant predictor of overall survival (hazard ratio 1.15; 95% CI 1.01-1.32). In conclusion, our results emphasise that individual Warburg-related proteins cannot serve as a proxy or surrogate marker for Warburg subtyping, thereby highlighting the importance of combining the expression levels of multiple Warburg-related proteins when examining the prognostic significance of a complex biological pathway such as the Warburg effect.
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Affiliation(s)
- Kelly Offermans
- Department of EpidemiologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Josien CA Jenniskens
- Department of EpidemiologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Colinda CJM Simons
- Department of EpidemiologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Iryna Samarska
- Department of PathologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Gregorio E Fazzi
- Department of PathologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Kim M Smits
- Department of PathologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Leo J Schouten
- Department of EpidemiologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Matty P Weijenberg
- Department of EpidemiologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
| | - Heike I Grabsch
- Department of PathologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
- Pathology and Data AnalyticsLeeds Institute of Medical Research at St James's, University of LeedsLeedsUK
| | - Piet A van den Brandt
- Department of EpidemiologyGROW – Research Institute for Oncology and Reproduction, Maastricht University Medical Center+MaastrichtThe Netherlands
- Department of EpidemiologyCare and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+MaastrichtThe Netherlands
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2
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Su H, Liao D, Huang C, Liu Q, Yu L. Low Serum Cholinesterase Levels Predict Poor Prognosis in Patients with Ovarian Cancer. Int J Gen Med 2025; 18:1023-1033. [PMID: 40026805 PMCID: PMC11871952 DOI: 10.2147/ijgm.s509718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2024] [Accepted: 02/18/2025] [Indexed: 03/05/2025] Open
Abstract
Objective Previous studies reported that low cholinesterase (ChE) levels were associated with poor prognosis in various cancers, including bladder, pancreatic, lung, and colorectal cancers. This study aimed to evaluate the clinical significance of serum ChE levels as a prognostic biomarker in ovarian cancer. Materials and Methods A retrospective cohort analysis was conducted on 168 patients diagnosed with epithelial ovarian cancer at the Suzhou Ninth People's Hospital from 2019 to 2020. Serum ChE levels were measured before initiating treatment and stratified into low and high groups based on the median level (7600 U/L). Clinical and pathological data, such as FIGO stage, age, tumor histological type, and survival outcomes, were collected. Kaplan-Meier analysis and Cox proportional hazards regression were used to assess the relationship between ChE levels and overall survival and disease-free survival. Results ChE levels were significantly correlated with clinicopathological features of epithelial ovarian cancer, including FIGO stage (p < 0.001), surgery completeness (p = 0.001), and platinum-resistant (p = 0.001). Kaplan-Meier analysis demonstrated that patients in the low ChE group had significantly worse overall survival (p = 0.003) and disease-free survival (p = 0.005) than those in the high ChE group. Multivariate Cox regression analysis identified low serum ChE levels as an independent predictor of poor overall survival and disease-free survival. Conclusion Low serum ChE levels are independently associated with poor prognosis in ovarian cancer patients, reflecting systemic inflammation, malnutrition, and potential hepatic dysfunction. These findings suggest that ChE could serve as a cost-effective and non-invasive biomarker for risk stratification and prognosis in clinical practice.
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Affiliation(s)
- Hailan Su
- Department of Gynecology, Suzhou Ninth People’s Hospital, Suzhou, People’s Republic of China
| | - Danfeng Liao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People’s Republic of China
| | - Chaolin Huang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People’s Republic of China
| | - Qin Liu
- Department of Emergency Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, People’s Republic of China
| | - Lingfang Yu
- Department of Gynecology, Suzhou Ninth People’s Hospital, Suzhou, People’s Republic of China
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Froicu EM, Oniciuc OM, Afrăsânie VA, Marinca MV, Riondino S, Dumitrescu EA, Alexa-Stratulat T, Radu I, Miron L, Bacoanu G, Poroch V, Gafton B. The Use of Artificial Intelligence in Predicting Chemotherapy-Induced Toxicities in Metastatic Colorectal Cancer: A Data-Driven Approach for Personalized Oncology. Diagnostics (Basel) 2024; 14:2074. [PMID: 39335752 PMCID: PMC11431340 DOI: 10.3390/diagnostics14182074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2024] [Revised: 08/31/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Machine learning models learn about general behavior from data by finding the relationships between features. Our purpose was to develop a predictive model to identify and predict which subset of colorectal cancer patients are more likely to experience chemotherapy-induced toxicity and to determine the specific attributes that influence the presence of treatment-related side effects. METHODS The predictor was general toxicity, and for the construction of our data training, we selected 95 characteristics that represent the health state of 74 patients prior to their first round of chemotherapy. After the data were processed, Random Forest models were trained to offer an optimal balance between accuracy and interpretability. RESULTS We constructed a machine learning predictor with an emphasis on assessing the importance of numerical and categorical variables in relation to toxicity. CONCLUSIONS The incorporation of artificial intelligence in personalizing colorectal cancer management by anticipating and overseeing toxicities more effectively illustrates a pivotal shift towards more personalized and precise medical care.
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Affiliation(s)
- Eliza-Maria Froicu
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- 2nd Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Oriana-Maria Oniciuc
- Faculty of Computer Science, "Alexandru Ioan Cuza" University, 700506 Iasi, Romania
| | - Vlad-Adrian Afrăsânie
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihai-Vasile Marinca
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Silvia Riondino
- Department of Systems Medicine, Medical Oncology, Tor Vergata Clinical Center, University of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Elena Adriana Dumitrescu
- Department of Oncology, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Institute of Oncology Prof. Dr. Alexandru Trestioreanu, Șoseaua Fundeni, 022328 Bucharest, Romania
| | - Teodora Alexa-Stratulat
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Iulian Radu
- First Surgical Oncology Unit, Department of Surgery, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Surgery, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Lucian Miron
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gema Bacoanu
- 2nd Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Palliative Care, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Vladimir Poroch
- 2nd Internal Medicine Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Palliative Care, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Bogdan Gafton
- Department of Medical Oncology, Regional Institute of Oncology, 700483 Iasi, Romania
- Department of Oncology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
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Abd El Fattah YK, Abulsoud AI, AbdelHamid SG, AbdelHalim S, Hamdy NM. CCDC144NL-AS1/hsa-miR-143-3p/HMGA2 interaction: In-silico and clinically implicated in CRC progression, correlated to tumor stage and size in case-controlled study; step toward ncRNA precision. Int J Biol Macromol 2023; 253:126739. [PMID: 37690651 DOI: 10.1016/j.ijbiomac.2023.126739] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 09/12/2023]
Abstract
Unravel the regulatory mechanism of lncRNA CCDC144NL-AS1 in CRC hsa-miR-143-3p, downstream protein HMGA2 interaction arm, association with clinicopathological characteristics. Using peripheral blood as liquid biopsy from 60 CRC patients and 30 controls. The expression levels of CCDC144NL-AS1 and hsa-miR-143-3p detected by qRT-PCR. CCDC144NL-AS1 expression was significantly upregulated in CRC patients' sera, associated with worse CRC clinicopathological features regarding the depth of tumor invasion and highly significant difference between tumor stages 3 and 4 and tumor stages 2 and 4. While, hsa-miR-143-3p expression was downregulated in CRC patients by 4.5-fold change when compared to the control subjects (p < 0.0001) and HMGA2 increased in CRC patients than controls 19.59 ng/μL and 5.377 ng/μL, respectively (p < 0.0001) with significant difference between tumor stages 3 and 4 as well as tumor stages 2 and 4. CRC patients with large tumor size showed upregulation in CCDC144NL-AS1 expression and HMGA2 levels compared to those with small tumor size (p-value = 0.0365 and 0.013, respectively). CCDC144NL-AS1 and HMGA2 were positively correlated, whereas lncRNA CCDC144NL-AS1 and hsa-miR-143-3p were negatively correlated. Conclusion: As an interaction arm CCDC144NL-AS1/hsa-miR-143-3p/HMGA2 were correlated to CRC stages 2-4. Therefore, this interaction arm expression clinically and in silico approved, would direct treatment precision in the near future.
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Affiliation(s)
- Yasmine K Abd El Fattah
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, El Salam City, 11785, Cairo, Egypt
| | - Ahmed I Abulsoud
- Biochemistry Department, Faculty of Pharmacy, Heliopolis University, El Salam City, 11785, Cairo, Egypt; Biochemistry Department, Faculty of Pharmacy (Boy's Branch), Al-Azhar University, Nasr City, 11884, Cairo, Egypt
| | - Sherihan G AbdelHamid
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Abbassia, 11566, Cairo, Egypt
| | - Sherif AbdelHalim
- Department of General surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nadia M Hamdy
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Abbassia, 11566, Cairo, Egypt.
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Marques D, Costa AL, Mansinho A, Quintela A, Pratas E, Brito-da-Silva J, Cruz J, Félix J, Rodrigues J, Mota M, Teixeira AR, Dâmaso S, Pinheiro S, Andreozzi V, Costa L, Barros AG. The REWRITE Study - REal-WoRld effectIveness of TrifluridinE/tipiracil in Patients with Previously Treated Metastatic Colorectal Cancer. Clin Oncol (R Coll Radiol) 2023; 35:665-672. [PMID: 37487914 DOI: 10.1016/j.clon.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023]
Abstract
AIMS In the pivotal RECOURSE trial, trifluridine/tipiracil improved survival outcomes in refractory metastatic colorectal cancer (mCRC), while demonstrating an acceptable toxicity profile. Routine clinical practice evidence is important to support the ongoing value of recently approved medicines. Our objective was to assess the utilisation patterns and real-world effectiveness of trifluridine/tipiracil in previously treated mCRC patients. MATERIALS AND METHODS This was a retrospective observational study including consecutive patients who started trifluridine/tipiracil between 1 April 2018 and 30 September 2019 in the medical oncology departments of three major public hospitals in Portugal. The primary outcome measure was overall survival. Associations between overall survival and patient and tumour characteristics were assessed using multivariate Cox regression analyses. RESULTS In total, 111 patients were included in the study, with a mean age of 64 years. From these, 45.9% received two prior lines of treatment, 47.8% had three or more previous lines of treatment and 83.6% had Eastern Cooperative Oncology Group (ECOG) performance status 0-1 at baseline. The median duration of trifluridine/tipiracil treatment was 3.7 cycles (95% confidence interval 3.4-4.1). Most patients (80.4%) remained on their planned dose throughout the trifluridine/tipiracil treatment period, fulfilling 100% relative dose intensity. The median overall survival in the total study cohort was 7.9 months (95% confidence interval 6.4-9.8) and the median progression-free survival was 3.4 months (95% confidence interval 3.2-3.9). The median overall survival was significantly higher in patients with a normal serum lactate dehydrogenase (LDH) level (median overall survival 11.2 months for [135, 205] IU/l LDH [95% confidence interval 8.2-NR] and 13.6 months for [205, 251] IU/l LDH [95% confidence interval 8.2-NR]) and in better fitted (ECOG = 0-1) patients (median overall survival 8.0 months; 95% confidence interval 6.7-10.0). The median time to worsening performance status was 6.2 months (95% confidence interval 5.0-8.0). Treatment discontinuation due to adverse events was low (3.1%). CONCLUSION Our study confirms the effectiveness of trifluridine/tipiracil in real-life mCRC patients. Overall survival and progression-free survival outcomes are consistent with the efficacy profile reported in the earlier randomised RECOURSE clinical trial. Like other real-world studies, we found no additional safety concerns in the use of trifluridine/tipiracil.
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Affiliation(s)
- D Marques
- Department of Medical Oncology, Portuguese Oncology Institute, Porto, Portugal
| | - A L Costa
- Department of Medical Oncology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Mansinho
- Department of Medical Oncology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A Quintela
- Department of Medical Oncology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - E Pratas
- Department of Medical Oncology, University Hospital of Coimbra, Coimbra, Portugal
| | - J Brito-da-Silva
- Department of Medical Oncology, Portuguese Oncology Institute, Porto, Portugal
| | - J Cruz
- Department of Medical Oncology, University Hospital of Coimbra, Coimbra, Portugal
| | - J Félix
- Exigo Consultores, Lisbon, Portugal
| | - J Rodrigues
- Department of Medical Oncology, University Hospital of Coimbra, Coimbra, Portugal
| | - M Mota
- Exigo Consultores, Lisbon, Portugal
| | - A R Teixeira
- Department of Medical Oncology, Portuguese Oncology Institute, Porto, Portugal
| | - S Dâmaso
- Department of Medical Oncology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - S Pinheiro
- Department of Medical Oncology, University Hospital of Coimbra, Coimbra, Portugal
| | | | - L Costa
- Department of Medical Oncology, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - A G Barros
- Department of Medical Oncology, University Hospital of Coimbra, Coimbra, Portugal
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Shu XP, Xiang YC, Liu F, Cheng Y, Zhang W, Peng D. Effect of serum lactate dehydrogenase-to-albumin ratio (LAR) on the short-term outcomes and long-term prognosis of colorectal cancer after radical surgery. BMC Cancer 2023; 23:915. [PMID: 37770882 PMCID: PMC10537469 DOI: 10.1186/s12885-023-11446-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 09/25/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Whether serum lactate dehydrogenase-to-albumin ratio (LAR) influenced the outcomes of colorectal cancer (CRC) patients after radical surgery remained unclear. Therefore, this study sought to examine how LAR influences the short-term and long-term outcomes of CRC patients who have undergone radical surgery. METHODS This study retrospectively included CRC patients who underwent radical resection between January 2011 and January 2020. We compared short-term outcomes, as well as overall survival (OS) and disease-free survival (DFS), among various groups. Both univariate and multivariate logistic regression analyses were utilized to pinpoint independent risk factors associated with overall complications and major complications. Moreover, Cox regression analysis were conducted for OS and DFS. Odds ratio (OR) and Hazard ratio (HR) were adjusted. RESULTS This study encompassed a cohort of 3868 patients. 3440 patients were in the low LAR group and 428 patients constituted the high LAR group. In the high LAR group, patients experienced significantly longer operative times (p < 0.01), larger intraoperative blood loss (p < 0.01), and extended postoperative hospital stays (p < 0.01). Additionally, the incidence of both overall complications (p < 0.01) and major complications (p < 0.01) was higher in the high LAR group compared to the low LAR group. Furthermore, LAR was emerged as an independent prognostic factor for overall complications [OR/95% CI: (1.555/1.237 to 1.954), p < 0.01] and major complications [OR/95% CI: (2.178/1.279 to 3.707), p < 0.01]. As for long-term survival, the high LAR group had worse OS in stage II (p < 0.01) and stage III (p < 0.01). In both stage II (p < 0.01) and stage III (p < 0.01), the high LAR group exhibited poorer DFS. Additionally, according to Cox regression analysis, LAR was identified as an independent predictor for both OS [HR/95% CI: (1.930/1.554 to 2.398), p < 0.01] and DFS [HR/95% CI: (1.750/1.427 to 2.146), p < 0.01]. CONCLUSION LAR emerged as an independent predictor not only for overall complications and major complications but also for both OS and DFS, highlighting its significance and deserving the attention of surgeons.
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Affiliation(s)
- Xin-Peng Shu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Ying-Chun Xiang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Fei Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yong Cheng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wei Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Dong Peng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Pîrvu EE, Severin E, Pătru RI, Niță I, Toma SA, Macarie RR, Cocioabă CE, Florescu I, Coniac S. Correlations between Demographic, Clinical, and Paraclinical Variables and Outcomes in Patients with KRAS-Mutant or KRAS Wild-Type Metastatic Colorectal Cancer-A Retrospective Study from a Tertiary-Level Center in Romania. Diagnostics (Basel) 2023; 13:2930. [PMID: 37761297 PMCID: PMC10528401 DOI: 10.3390/diagnostics13182930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/16/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Colorectal cancer (CRC) is a significant global public health concern and its characteristics in Eastern Europe are underexplored. In this retrospective study, data of 225 patients with metastatic colorectal cancer (mCRC) from the Colțea Clinical Hospital's Oncology Department in Bucharest were analyzed between 2015 and 2023. They were divided into two groups based on the presence of KRAS mutation. The primary objective of the study was to investigate whether the presence of KRAS mutations influenced the prognosis of mCRC and to identify any demographic, clinical, or paraclinical factors associated with KRAS mutations in stage IV CRC. The overall survival for the entire study population was 29 months. There was a trend towards increased survival in the KRAS wild-type group (31 months) compared to the KRAS-mutant group (26 months), but this difference did not reach statistical significance. We found that lower levels of education, advanced T stage, advanced N stage, and M1 stage at diagnosis negatively impacted prognosis. Real-world data are crucial in shaping public policy strategies to better support patients with metastatic CRC. Understanding the correlations between the demographic, clinical, and paraclinical variables and the outcomes in mCRC patients with KRAS-mutant and KRAS wild-type colorectal cancer is essential for improving patient care and treatment strategies in Romania and beyond.
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Affiliation(s)
- Edvina Elena Pîrvu
- Department of Genetics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Medical Oncology, “Coltea” Clinical Hospital, 030167 Bucharest, Romania
| | - Emilia Severin
- Department of Genetics, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Raluca Ileana Pătru
- Department of Medical Oncology, “Coltea” Clinical Hospital, 030167 Bucharest, Romania
| | - Irina Niță
- Department of Medical Oncology, Medicover Hospital, 020331 Bucharest, Romania
| | - Stefania Andreea Toma
- Department of Medical Oncology, Ponderas Academic Hospital, 014142 Bucharest, Romania
| | - Roxana Rodica Macarie
- Department of Medical Oncology, “Coltea” Clinical Hospital, 030167 Bucharest, Romania
| | | | - Ioana Florescu
- Department of Medical Oncology, “Coltea” Clinical Hospital, 030167 Bucharest, Romania
| | - Simona Coniac
- Department of Medical Oncology, “Coltea” Clinical Hospital, 030167 Bucharest, Romania
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8
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Ali MA, Qin Z, Dou S, Huang A, Wang Y, Yuan X, Zhang Y, Ni Q, Azmat R, Zeng C. Cryopreservation Induces Acetylation of Metabolism-Related Proteins in Boar Sperm. Int J Mol Sci 2023; 24:10983. [PMID: 37446160 DOI: 10.3390/ijms241310983] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Cryodamage affects the normal physiological functions and survivability of boar sperm during cryopreservation. Lysine acetylation is thought to be an important regulatory mechanism in sperm functions. However, little is known about protein acetylation and its effects on cryotolerance or cryodamage in boar sperm. In this study, the characterization and protein acetylation dynamics of boar sperm during cryopreservation were determined using liquid chromatography-mass spectrometry (LC-MS). A total of 1440 proteins were identified out of 4705 modified proteins, and 2764 quantifiable sites were elucidated. Among the differentially modified sites, 1252 were found to be upregulated compared to 172 downregulated sites in fresh and frozen sperms. Gene ontology indicated that these differentially modified proteins are involved in metabolic processes and catalytic and antioxidant activities, which are involved in pyruvate metabolism, phosphorylation and lysine degradation. In addition, the present study demonstrated that the mRNA and protein expressions of SIRT5, IDH2, MDH2 and LDHC, associated with sperm quality parameters, are downregulated after cryopreservation. In conclusion, cryopreservation induces the acetylation and deacetylation of energy metabolism-related proteins, which may contribute to the post-thawed boar sperm quality parameters.
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Affiliation(s)
- Malik Ahsan Ali
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
- Department of Theriogenology, Faculty of Veterinary Science, University of Agriculture, Faisalabad 38000, Pakistan
| | - Ziyue Qin
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
| | - Shan Dou
- College of Life Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Anqi Huang
- College of Life Science, Sichuan Agricultural University, Ya'an 625014, China
| | - Yihan Wang
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
| | - Xiang Yuan
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
| | - Yan Zhang
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
| | - Qingyong Ni
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
| | - Rameesha Azmat
- Department of Biochemistry, Faculty of Science and Technology, Government College Women University, Faisalabad 38000, Pakistan
| | - Changjun Zeng
- Key Laboratory of Livestock and Poultry Multi-Omics, Ministry of Agriculture and Rural Affairs, Sichuan Agricultural University, Chengdu 611130, China
- Farm Animal Genetic Resources Exploration and Innovation Key Laboratory of Sichuan Province, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu 611130, China
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9
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Meng G, Yang S, Chen F. Survival for patients with metastatic colon cancer underwent cytoreductive colectomy in the era of rapid development of anticancer drugs: A real-world analysis based on updated population dataset of 2004-2018. Front Pharmacol 2022; 13:983092. [PMID: 36339570 PMCID: PMC9627288 DOI: 10.3389/fphar.2022.983092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/07/2022] [Indexed: 11/19/2022] Open
Abstract
Objective: Metastatic colon cancer (mCC) poses a great threat to the survival of patients suffering from it. In the past decade, many clinical trials have been carried out to improve the prognosis of patients with mCC. Numerous treatments have emerged, and satisfactory efficacy has been demonstrated in randomized phase III trials in highly selective patients with mCC. Our present study aims to investigate whether these therapeutic advances can be reflected to the broader mCC patients who performed cytoreductive colectomy. Method: General and prognostic data for patients diagnosed with mCC who underwent cytoreductive colectomy between 2004-2018 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Survival was analyzed using the Kaplan-Meier method and Cox proportional hazards model. The hazard ratio (HR) and its 95% confidence interval (CI) were used to evaluate the influence of risk factors on prognosis. Results: A total of 26,301 patients diagnosed with mCC treated with cytoreductive colectomy were included in this study. The median overall survival was 19 months (range, 17-23). The good prognosis was associated with patients diagnosed at the most recent year, younger age, non-black race, female, married, without previous history of malignancy, no second malignancy onset, descending/sigmoid/splenic flexure colon tumor, normal CEA levels at diagnosis, low primary tumor burden, T1/T2 stage, N0 stage, single organ metastasis, underwent surgical resection of synchronous distant metastatic lymph nodes or organs, a high number of lymph-node examinations, low positive lymph-node ratio and received adjuvant chemotherapy. The proportion of patients surviving for ≥24 months increased from 37% in 2004 to 44.2% in 2016 (p < 0.001), especially in ≤49 years patients [46.8% in 2004 to 57.8% in 2016 (p < 0.001)]. The percentage of patients who died within 3 months decreased between 2004 and 2018 (from 19.6% to 15.7%; p < 0.001). Conclusion: Over a span of 15 years, the long-term survival has improved in real-world mCC patients who were treated with cytoreductive colectomy, especially among younger patients. However, the median overall survival remains not substantial.
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Affiliation(s)
- Guangran Meng
- Department of General Surgery, The Fifth Hospital of Wuhan, Wuhan, Hubei, China
| | - Shengtao Yang
- Department of Anesthesiology, The Fifth Hospital of Wuhan, Wuhan, Hubei, China
| | - Feixiang Chen
- Department of General Surgery, The Fifth Hospital of Wuhan, Wuhan, Hubei, China
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10
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Zou Z, Chai Y, Li Q, Lin X, He Q, Xiong Q. Establishment of lactate-metabolism-related signature to predict prognosis and immunotherapy response in patients with colon adenocarcinoma. Front Oncol 2022; 12:958221. [PMID: 36185199 PMCID: PMC9515658 DOI: 10.3389/fonc.2022.958221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
The outcome of colon adenocarcinoma (COAD) patients remains dismal, and lactate metabolism has been characterized to promote tumor development and immune evasion. Based on the above background, it is worthwhile to explore novel prognostic and therapeutic biomarkers for COAD patients from the aspect of lactate metabolism. Above all, 228 available lactate-metabolism-related genes (LMRGs) were acquired, and the landscape of copy number variation and the expression difference of mRNA levels between colon normal and tumor samples were investigated among these LMRGs. Importantly, eight overall survival (OS)-involved LMRGs were then distinguished by means of univariate Cox regression analysis in both GSE40967 and TCGA-COAD data sets. Subsequently, prognostic risk scores were established, integrating seven OS-related LMRGs by LASSO Cox regression analysis in the GSE40967 set, and then verified in the TCGA-COAD cohort. From the comprehensive analyses, COAD patients with high risk had comparatively more inferior survival probability in all populations of the study, and they tended to have more severe clinicopathological features with the risk score increasing. Moreover, by integrating age, AJCC T and pathological stage, and risk score, we constructed a prognostic nomogram that demonstrated great prediction effectiveness for OS of COAD patients. Furthermore, the potential effect of various risk score on tumor immune was assessed from enrichment of immune-related pathways, tumor-infiltrating immune cells, and expression levels of immune checkpoints separately. We could draw a conclusion that COAD patients with higher lactate-metabolism-related risk scores may acquire an immunosuppressive tumor microenvironment, which subsequently led to immune escapes and poor prognoses. Conclusively, all findings in the present study illustrate a great prognostic value of the lactate-metabolism-related risk signature, providing more in-depth insights into the indispensable function of lactate metabolism in prognosis and tumor immunity of COAD.
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Affiliation(s)
- Zhengrong Zou
- Department of Emergency Trauma Center, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yongjie Chai
- Department of Anorectal Surgery, Zhucheng People’s Hospital, Zhucheng, China
| | - Qi Li
- Basic Medicine Department of Chuxiong Medical and Pharmaceutical College, Chuxiong, China
| | - Xuan Lin
- Department of Emergency Trauma Center, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qingfang He
- Department of General Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Qiusheng Xiong
- Department of General Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- *Correspondence: Qiusheng Xiong,
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11
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Ran H, Ma J, Cai L, Zhou H, Yuan Z, Chen Y, Chang W, Huang Y, Xiao Y. Serum cholinesterase may independently predict prognosis in non-small-cell lung cancer. BMC Cancer 2022; 22:93. [PMID: 35062903 PMCID: PMC8783506 DOI: 10.1186/s12885-022-09212-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 01/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background Serum cholinesterase (ChE) was found to be involved in cancer initiation and progression. However, the survival association between serum ChE and non-small cell lung cancer (NSCLC) has not been extensively discussed. In the present study, we aim to elevate the role of ChE in overall survival (OS) of NSCLC patients. Methods A total of 961 histologically confirmed NSCLC patients diagnosed between 2013 and 2018 in a provincial cancer hospital in southwestern China were retrospectively selected. Relevant information, such as histological type, clinical stage, chemotherapy, smoking status, body mass index (BMI), important serum indicators (albumin, neutrophil-to-lymphocyte ratio, ChE), date of death of the patients was extracted from the computerized hospital information system. Univariate and multivariate Cox proportional hazards models were used to determine the association between baseline serum ChE measured at the diagnosis and the OS of NSCLC patients. Results The median of baseline ChE (7700 units/liter) was used as a cut-off to dichotomize NSCLC patients. After controlling for possible confounding factors, serum ChE at diagnosis was significantly associated with OS of NSCLC: patients with higher level of ChE were observed a better prognosis (hazard ratio, HR: 0.77, 95% CI: 0.67–0.93, p = 0.006). Subgroup analysis revealed significant ChE-OS association for NSCLC patients: with lower systemic inflammation level (baseline NLR < 2.95, HR: 0.71, 95% CI: 0.56–0.89, p = 0.003), of adenocarcinoma (HR: 0.66, 95% CI: 0.54–0.80, p < 0.001), in advanced stage (HR: 0.77, 95% CI: 0.66–0.92, p < 0.01), and received chemotherapy (HR: 0.75, 95% CI: 0.59–0.96, p < 0.02). Conclusion Baseline ChE may have independent prognostic value for NSCLC patients. Longitudinal studies should be performed to corroborate this finding. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09212-0.
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12
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Li W, Cui X, Chen Z. Screening of lactate dehydrogenase inhibitor from bioactive compounds in natural products by electrophoretically mediated microanalysis. J Chromatogr A 2021; 1656:462554. [PMID: 34571279 DOI: 10.1016/j.chroma.2021.462554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 12/26/2022]
Abstract
Lactate dehydrogenase (LDH) is a key enzyme in the glycolysis, which has been reported that the expression of LDH is elevated in a variety of cancer types and can promote tumor invasion and metastasis. Therefore, LDH has come to be an emerging therapeutic target for cancer. In this work, we described a new strategy for rapid screening of LDH inhibitors from natural products by integrating electrophoretically mediated microanalysis (EMMA), transverse diffusion of laminar flow profiles (TDLFP) and rapid pressure direction switching. LDH activity could be assayed by the quantification of the peak area of the produced β-Nicotinamide adenine dinucleotide hydrate (NAD+) and the inhibitory effect on LDH was reflected by the reduction of NAD+ peak area. Parameters affecting CE separation and enzymatic reaction were evaluated, including the pH of background electrolyte, incubation time, methanol percentage and enzyme concentration. The Michaelis-Menten constant (Km) determined on-line by EMMA method were 226.9 μM and 31.8 μM for substrates sodium pyruvate and NADH, respectively and the half-maximal inhibitory concentration (IC50) for the known positive inhibitor gossypol was determined to be 9.269 μM, which was comparable with the previous literature. Then the inhibitory activity of 12 bioactive compounds from natural products on LDH was investigated by employing the developed method. Three compounds including quercetin, luteolin, ursolic acid had potential inhibitory effect on LDH. Molecular docking study was implemented and well supported the experimental results. This study provides a potential tool for the preliminary screening of LDH inhibitors from bioactive compounds in natural products by capillary electrophoresis.
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Affiliation(s)
- Wen Li
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Hubei Province Engineering and Technology Research Center for Fluorinated Pharmaceuticals, and Wuhan University School of Pharmaceutical Sciences, Wuhan, 430071, China; State Key Laboratory of Transducer Technology, Chinese Academy of Sciences, Beijing 10080, China
| | - Xinyue Cui
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Hubei Province Engineering and Technology Research Center for Fluorinated Pharmaceuticals, and Wuhan University School of Pharmaceutical Sciences, Wuhan, 430071, China
| | - Zilin Chen
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Hubei Province Engineering and Technology Research Center for Fluorinated Pharmaceuticals, and Wuhan University School of Pharmaceutical Sciences, Wuhan, 430071, China; State Key Laboratory of Transducer Technology, Chinese Academy of Sciences, Beijing 10080, China.
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13
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Bai L, Lin ZY, Lu YX, Chen Q, Zhou H, Meng Q, Lin CP, Huang WL, Wan YL, Pan ZZ, Wang DS. The prognostic value of preoperative serum lactate dehydrogenase levels in patients underwent curative-intent hepatectomy for colorectal liver metastases: A two-center cohort study. Cancer Med 2021; 10:8005-8019. [PMID: 34636145 PMCID: PMC8607270 DOI: 10.1002/cam4.4315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/18/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022] Open
Abstract
Background The prognostic value of lactate dehydrogenase (LDH) in colorectal cancer patients has remained inconsistent between nonmetastatic and metastatic settings. So far, very few studies have included LDH in the prognostic analysis of curative‐intent surgery for colorectal liver metastases (CRLM). Patients and Methods Five hundred and eighty consecutive metastatic colorectal cancer patients who underwent curative‐intent CRLM resection from Sun Yat‐sen University Cancer Center (434 patients) and Sun Yat‐sen University Sixth Affiliated Hospital (146 patients) in 2000–2019 were retrospectively collected. Overall survival (OS) was the primary end point. Cox regression model was performed to identify the prognostic values of preoperative serum LDH levels and other clinicopathology variables. A modification of the established Fong CRS scoring system comprising LDH was developed within this Chinese population. Results At the median follow‐up time of 60.5 months, median OS was 59.5 months in the pooled cohort. In the multivariate analysis, preoperative LDH >upper limit of normal (250 U/L) was the strongest independent prognostic factor for OS (HR 1.73, 95% confidence interval [CI], 1.22–2.44; p < 0.001). Patients with elevated LDH levels showed impaired OS than patients with normal LDH levels (27.6 months vs. 68.8 months). Five‐year survival rates were 53.7% and 22.5% in the LDH‐normal group and LDH‐high group, respectively. Similar results were also confirmed in each cohort. In the subgroup analysis, LDH could distinguish the survival regardless of most established prognostic factors (number and size of CRLM, surgical margin, extrahepatic metastases, CEA, and CA19‐9 levels, etc.). Integrating LDH into the Fong score contributed to an improvement in the predictive value. Conclusion Our study implicates serum LDH as a reliable and independent laboratory biomarker to predict the clinical outcome of curative‐intent surgery for CRLM. Composite of LDH and Fong score is a potential stratification tool for CRLM resection. Prospective, international studies are needed to validate these results across diverse populations.
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Affiliation(s)
- Long Bai
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China.,Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China.,Department of VIP region, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Ze-Yu Lin
- Department of Hepatobiliary Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yun-Xin Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China.,Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China.,Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Qin Chen
- Department of Hepatobiliary Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Han Zhou
- Department of Medical Administration, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qi Meng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China.,Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China.,Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Chun-Ping Lin
- Department of Oncology, Jieyang Affiliated Hospital, Sun Yat-sen University, Jieyang, China
| | - Wan-Lan Huang
- Department of Oncology, Jieyang Affiliated Hospital, Sun Yat-sen University, Jieyang, China
| | - Yun-Le Wan
- Department of Hepatobiliary Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhi-Zhong Pan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China.,Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China.,Department of Colorectal Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - De-Shen Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China.,Research Unit of Precision Diagnosis and Treatment for Gastrointestinal Cancer, Chinese Academy of Medical Sciences, Guangzhou, China.,Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
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14
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van der Kruijssen DEW, Elias SG, Vink GR, van Rooijen KL, 't Lam-Boer J, Mol L, Punt CJA, de Wilt JHW, Koopman M. Sixty-Day Mortality of Patients With Metastatic Colorectal Cancer Randomized to Systemic Treatment vs Primary Tumor Resection Followed by Systemic Treatment: The CAIRO4 Phase 3 Randomized Clinical Trial. JAMA Surg 2021; 156:1093-1101. [PMID: 34613339 DOI: 10.1001/jamasurg.2021.4992] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance The role of primary tumor resection (PTR) in synchronous patients with metastatic colorectal cancer (mCRC) who had unresectable metastases and few or absent symptoms of their primary tumor is unclear. Studying subgroups with low postoperative mortality may identify patients who potentially benefit from PTR. Objective To determine the difference in 60-day mortality between patients randomized to systemic treatment only vs PTR followed by systemic treatment, and to explore risk factors associated with 60-day mortality. Design, Setting, and Participants CAIRO4 is a randomized phase 3 trial initiated in 2012 in which patients with mCRC were randomized to systemic treatment only or PTR followed by systemic treatment with palliative intent. This multicenter study was conducted by the Danish and Dutch Colorectal Cancer Group in general and academic hospitals in Denmark and the Netherlands. Patients included between August 2012 and December 2019 with histologically proven colorectal cancer, unresectable metastases, and a primary tumor with few or absent symptoms were eligible. Interventions Systemic treatment, consisting of fluoropyrimidine-based chemotherapy with bevacizumab vs PTR followed by fluoropyrimidine-based chemotherapy with bevacizumab. Main Outcomes and Measures The aim of the current analysis was to compare 60-day mortality rates in both treatment arms. A secondary aim was the identification of risk factors for 60-day mortality in the treatment arms. These aims were not predefined in the study protocol. Results A total of 196 patients were included in the intention-to-treat analysis (112 [57%] men; median [IQR] age, 65 [59-70] years). Sixty-day mortality was 3% (95% CI, 1%-9%) in the systemic treatment arm and 11% (95% CI, 6%-19%) in the PTR arm (P = .03). In a per-protocol analysis, 60-day mortality was 2% (95% CI, 1%-7%) vs 10% (95% CI, 5%-18%; P = .048). Patients with elevated serum levels of lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and/or neutrophils who were randomized to PTR had a significantly higher 60-day mortality than patients without these characteristics. Conclusions and Relevance Patients with mCRC who were randomized to PTR followed by systemic treatment had a higher 60-day mortality than patients randomized to systemic treatment. Especially patients randomized to the PTR arm with elevated serum levels of lactate dehydrogenase, neutrophils, aspartate aminotransferase, and/or alanine aminotransferase were at high risk of postoperative mortality. Final study results on overall survival have to be awaited. Trial Registration ClinicalTrials.gov Identifier: NCT01606098.
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Affiliation(s)
- Dave E W van der Kruijssen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Sjoerd G Elias
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Geraldine R Vink
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Karlijn L van Rooijen
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jorine 't Lam-Boer
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Linda Mol
- Clinical Research Department, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Cornelis J A Punt
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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15
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Guo E, Guo L, An C, Zhang C, Song K, Wang G, Duan C, Zhang X, Yang X, Yuan Z, Guo J, Sun J, Meng H, Chang R, Li X, Xiu C, Mao X, Miao S. Prognostic Significance of Lactate Dehydrogenase in Patients Undergoing Surgical Resection for Laryngeal Squamous Cell Carcinoma. Cancer Control 2021; 27:1073274820978795. [PMID: 33297727 PMCID: PMC8480349 DOI: 10.1177/1073274820978795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The aim is to estimate the prognostic value of lactate dehydrogenase (LDH) in patients undergoing surgical resection for laryngeal squamous cell carcinoma (LSCC). A total of 640 resected LSCC patients were included. Preoperative lactate dehydrogenase (LDH) was assessed. Kaplan-Meier survival analysis and Cox regression analysis were conducted for overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier analysis, univariate analysis and multivariate analysis demonstrated significant prognostic value for preoperative LDH. Although LDH was predictor of OS, it failed to be a predictor of RFS. The univariate HR and 95% CI of LDH were 0.484 and 0.357-0.658 (P < 0.0001). The multivariate analysis showed that LDH (HR = 0.518, 95% CI: 0.380-0.705, p < 0.0001) was related to OS. Elevated preoperative LDH >132 IU/L was significantly associated with better survival. Preoperative LDH might be an independent prognostic marker of OS in LSCC patients undergoing surgical resection.
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Affiliation(s)
- Erliang Guo
- Department of Surgery, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150081, China.,* These two authors have contributed equally to the work
| | - Lunhua Guo
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China.,* These two authors have contributed equally to the work
| | - Changming An
- Department of Head and Neck Surgery, Chinese National Cancer Center & Chinese Academy of Medical Sciences Cancer Hospital. Beijing 100000, China
| | - Cong Zhang
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Kaibin Song
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Guohui Wang
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Chunbin Duan
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Xiwei Zhang
- Department of Head and Neck Surgery, Chinese National Cancer Center & Chinese Academy of Medical Sciences Cancer Hospital. Beijing 100000, China
| | - Xianguang Yang
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Zhennan Yuan
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Junnan Guo
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Ji Sun
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Hongxue Meng
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Rui Chang
- Department of Head and Neck Surgery, Anyang Cancer Hospital, Anyang 455000, China
| | - Xiaomei Li
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Cheng Xiu
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Xionghui Mao
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
| | - Susheng Miao
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China
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16
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Mahmood RD, Shaw D, Descamps T, Zhou C, Morgan RD, Mullamitha S, Saunders M, Mescallado N, Backen A, Morris K, Little RA, Cheung S, Watson Y, O'Connor JPB, Jackson A, Parker GJM, Dive C, Jayson GC. Effect of oxaliplatin plus 5-fluorouracil or capecitabine on circulating and imaging biomarkers in patients with metastatic colorectal cancer: a prospective biomarker study. BMC Cancer 2021; 21:354. [PMID: 33794823 PMCID: PMC8017714 DOI: 10.1186/s12885-021-08097-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 03/24/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Patients with metastatic colorectal cancer are treated with cytotoxic chemotherapy supplemented by molecularly targeted therapies. There is a critical need to define biomarkers that can optimise the use of these therapies to maximise efficacy and avoid unnecessary toxicity. However, it is important to first define the changes in potential biomarkers following cytotoxic chemotherapy alone. This study reports the impact of standard cytotoxic chemotherapy across a range of circulating and imaging biomarkers. METHODS A single-centre, prospective, biomarker-driven study. Eligible patients included those diagnosed with colorectal cancer with liver metastases that were planned to receive first line oxaliplatin plus 5-fluorouracil or capecitabine. Patients underwent paired blood sampling and magnetic resonance imaging (MRI), and biomarkers were associated with progression-free survival (PFS) and overall survival (OS). RESULTS Twenty patients were recruited to the study. Data showed that chemotherapy significantly reduced the number of circulating tumour cells as well as the circulating concentrations of Ang1, Ang2, VEGF-A, VEGF-C and VEGF-D from pre-treatment to cycle 2 day 2. The changes in circulating concentrations were not associated with PFS or OS. On average, the MRI perfusion/permeability parameter, Ktrans, increased in response to cytotoxic chemotherapy from pre-treatment to cycle 2 day 2 and this increase was associated with worse OS (HR 1.099, 95%CI 1.01-1.20, p = 0.025). CONCLUSIONS In patients diagnosed with colorectal cancer with liver metastases, treatment with standard chemotherapy changes cell- and protein-based biomarkers, although these changes are not associated with survival outcomes. In contrast, the imaging biomarker, Ktrans, offers promise to direct molecularly targeted therapies such as anti-angiogenic agents.
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Affiliation(s)
- Reem D Mahmood
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK.
| | - Danielle Shaw
- The Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | - Tine Descamps
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, University of Manchester, Alderley Park, Macclesfield, UK
| | - Cong Zhou
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, University of Manchester, Alderley Park, Macclesfield, UK
| | - Robert D Morgan
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
| | - Saifee Mullamitha
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
| | - Mark Saunders
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
| | - Nerissa Mescallado
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
| | - Alison Backen
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
| | - Karen Morris
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, University of Manchester, Alderley Park, Macclesfield, UK
| | - Ross A Little
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
| | - Susan Cheung
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
| | - Yvonne Watson
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
| | - James P B O'Connor
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
| | - Alan Jackson
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, University of Manchester, Manchester, UK
| | - Geoff J M Parker
- Division of Informatics, Imaging and Data Sciences, School of Health Sciences, University of Manchester, Manchester, UK
- Bioxydyn Limited, Manchester, UK
- Department of Computer Science, Centre for Medical Image Computing, University College London, London, UK
| | - Caroline Dive
- Cancer Research UK Manchester Institute Cancer Biomarker Centre, University of Manchester, Alderley Park, Macclesfield, UK
| | - Gordon C Jayson
- Christie NHS Foundation Trust, Wilmslow Road, Withington, Manchester, M20 4BX, UK
- Division of Cancer Sciences, School of Medicine, University of Manchester, Manchester, UK
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17
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Uludag SS, Sanli AN, Zengin AK, Ozcelik MF. Systemic Inflammatory Biomarkers as Surrogate Markers for Stage in Colon Cancer. Am Surg 2021; 88:1256-1262. [PMID: 33596111 DOI: 10.1177/0003134821995059] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND This study aimed to investigate whether the systemic inflammatory parameters currently in use in staging the disease can be used as biomarker tests operated colon cancer patients. Neutrophil, lymphocyte, monocyte, platelet, neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR), neutrophil/monocyte ratio (NMR), CRP, albumin, lymphocyte/CRP ratio, CRP/albumin ratio, and neutrophil/albumin ratio as systemic inflammatory biomarkers and prognostic nutritional index (PNI) were evaluated. METHODS This retrospective study included 592 patients. Patients with colon cancer in the cohort were divided into 2 subgroups: Tumor, nodes, metastases (TNM) stage 0, TNM stage 1, and TNM stage 2; early stage (n: 332) and TNM stage 3 and TNM stage 4; late stage (n: 260) colon cancer patients. RESULTS LDH (P < .001), NLR (P < .001), PLR (P < .05), CRP/albumin (P < .01), and neutrophil/albumin (P < .01) were significantly higher, while monocyte count (P < .05) and PNI (P < .01) were found to be significantly lower in late stage colon cancer patients than in early stage colon cancer patients. Moderate negative correlation was found between the PNI and the neutrophil/albumin ratio in late stage colon cancer patients (r: -.568, P < .001). CONCLUSIONS Our data suggest that high serum LDH, NLR, PLR, CRP/albumin, and neutrophil/albumin may be useful predictive markers for advanced stage in colon cancer. According to the receiver operating characteristic analysis results, CRP/albumin ratio can be used to discriminate early from late stage. Preoperative low monocyte count and PNI are associated with postoperative staging patients with colon cancer.
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Affiliation(s)
- Server Sezgin Uludag
- Department of Surgery, Cerrahpasa Medicine Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Necati Sanli
- Department of Surgery, Cerrahpasa Medicine Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Abdullah Kagan Zengin
- Department of Surgery, Cerrahpasa Medicine Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mehmet Faik Ozcelik
- Department of Surgery, Cerrahpasa Medicine Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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18
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Ubels J, Schaefers T, Punt C, Guchelaar HJ, de Ridder J. RAINFOREST: a random forest approach to predict treatment benefit in data from (failed) clinical drug trials. Bioinformatics 2020; 36:i601-i609. [PMID: 33381829 DOI: 10.1093/bioinformatics/btaa799] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
MOTIVATION When phase III clinical drug trials fail their endpoint, enormous resources are wasted. Moreover, even if a clinical trial demonstrates a significant benefit, the observed effects are often small and may not outweigh the side effects of the drug. Therefore, there is a great clinical need for methods to identify genetic markers that can identify subgroups of patients which are likely to benefit from treatment as this may (i) rescue failed clinical trials and/or (ii) identify subgroups of patients which benefit more than the population as a whole. When single genetic biomarkers cannot be found, machine learning approaches that find multivariate signatures are required. For single nucleotide polymorphism (SNP) profiles, this is extremely challenging owing to the high dimensionality of the data. Here, we introduce RAINFOREST (tReAtment benefIt prediction using raNdom FOREST), which can predict treatment benefit from patient SNP profiles obtained in a clinical trial setting. RESULTS We demonstrate the performance of RAINFOREST on the CAIRO2 dataset, a phase III clinical trial which tested the addition of cetuximab treatment for metastatic colorectal cancer and concluded there was no benefit. However, we find that RAINFOREST is able to identify a subgroup comprising 27.7% of the patients that do benefit, with a hazard ratio of 0.69 (P = 0.04) in favor of cetuximab. The method is not specific to colorectal cancer and could aid in reanalysis of clinical trial data and provide a more personalized approach to cancer treatment, also when there is no clear link between a single variant and treatment benefit. AVAILABILITY AND IMPLEMENTATION The R code used to produce the results in this paper can be found at github.com/jubels/RAINFOREST. A more configurable, user-friendly Python implementation of RAINFOREST is also provided. Due to restrictions based on privacy regulations and informed consent of participants, phenotype and genotype data of the CAIRO2 trial cannot be made freely available in a public repository. Data from this study can be obtained upon request. Requests should be directed toward Prof. Dr. H.J. Guchelaar (h.j.guchelaar@lumc.nl). SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Joske Ubels
- Center for Molecular Medicine, UMC Utrecht, Utrecht, The Netherlands.,Erasmus MC Cancer Institute, ErasmusMC, Rotterdam, The Netherlands.,SkylineDx, Rotterdam, The Netherlands.,Oncode Institute, Utrecht, The Netherlands
| | - Tilman Schaefers
- Center for Molecular Medicine, UMC Utrecht, Utrecht, The Netherlands.,Oncode Institute, Utrecht, The Netherlands
| | - Cornelis Punt
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht,The Netherlands
| | - Henk-Jan Guchelaar
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen de Ridder
- Center for Molecular Medicine, UMC Utrecht, Utrecht, The Netherlands.,Oncode Institute, Utrecht, The Netherlands
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19
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Chu Y, Chang Y, Lu W, Sheng X, Wang S, Xu H, Ma J. Regulation of Autophagy by Glycolysis in Cancer. Cancer Manag Res 2020; 12:13259-13271. [PMID: 33380833 PMCID: PMC7767644 DOI: 10.2147/cmar.s279672] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Autophagy is a critical cellular process that generally protects cells and organisms from harsh environment, including limitations in adenosine triphosphate (ATP) availability or a lack of essential nutrients. Metabolic reprogramming, a hallmark of cancer, has recently gained interest in the area of cancer therapy. It is well known that cancer cells prefer to utilize glycolysis rather than oxidative phosphorylation (OXPHOS) as their major energy source to rapidly generate ATP even in aerobic environment called the Warburg effect. Both autophagy and glycolysis play essential roles in pathological processes of cancer. A mechanism of metabolic changes to drive tumor progression is its ability to regulate autophagy. This review will elucidate the role and the mechanism of glycolysis in regulating autophagy during tumor growth. Indeed, understanding how glycolysis can modulate cellular autophagy will enable more effective combinatorial therapeutic strategies.
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Affiliation(s)
- Ying Chu
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
| | - Yi Chang
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
| | - Wei Lu
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
| | - Xiumei Sheng
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
| | - Shengjun Wang
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
| | - Huaxi Xu
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
| | - Jie Ma
- Department of Immunology, Jiangsu Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang212013, People’s Republic of China
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20
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Aday U, Böyük A, Akkoç H. The prognostic significance of serum lactate dehydrogenase-to-albumin ratio in colorectal cancer. Ann Surg Treat Res 2020; 99:161-170. [PMID: 32908848 PMCID: PMC7463043 DOI: 10.4174/astr.2020.99.3.161] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/20/2020] [Accepted: 07/16/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose The purpose of our study was initially to explore the prognostic role of LDH-to-albumin ratio in patients with colorectal carcinoma (CRC) undergoing curative resection. Methods The retrospective study included 295 CRC patients that underwent curative resection. According to time-dependent receiver operating characteristics (ROC) analysis, the optimal cutoff value for pretreatment LDH-to-albumin ratio was 52.7. Cox regression univariate and multivariate analyses were utilized to analyze the prognostic factors for disease-free survival (DFS) and overall survival (OS). Results The 295 participants included 117 women (39.7%) and had an overall mean age of 55.8 ± 14.1 years. The median follow-up period was 31.8 ± 21 months (range, 6–78 months) and 53 patients (18.0%) died from cancer during the follow-up period. The 5-year DFS and OS rates were 65.4% and 68.5% in patients with LDH-to-albumin ratio <52.7 (n = 152), and were 55.2% and 55.4% in patients with LDH-to-albumin ratio ≥52.7 (n = 143), respectively. Kaplan-Meier curves showed that LDH-to-albumin ratio ≥52.7 was significantly associated with worse DFS and OS (P = 0.003 and P < 0.001, respectively). Multivariate analyses revealed that LDH-to-albumin ratio was an independent predictor of resectable CRC (odds ratio, 2.104; 95% confidence interval, 1.112–3.982; P = 0.022). Conclusion Our study revealed that high pretreatment LDH-to-albumin ratio level was an unfavorable prognosticator in patients with CRC undergoing curative resection. LDH-to-albumin ratio is a candidate to be a prognostic biomarker in clinical practice.
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Affiliation(s)
- Ulaş Aday
- Department of Gastrointestinal Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Abdullah Böyük
- Department of Gastrointestinal Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Hasan Akkoç
- Department of Gastrointestinal Surgery, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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21
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The albumin-bilirubin (ALBI) grade as a significant prognostic factor in colorectal cancer patients with liver metastases. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.597751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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22
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Prognostic value of nomogram based on pre-treatment inflammatory markers in patients with pulmonary-only synchronous metastases from colorectal cancer. Int Immunopharmacol 2019; 77:106001. [PMID: 31734191 DOI: 10.1016/j.intimp.2019.106001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The inflammatory markers were important factors affecting proliferation, invasiveness and metastasis of tumors. However, the prognostic value of inflammatory markers and related nomogram in patients with pulmonary-only synchronous metastases (POSM) from colorectal cancer has not been reported. MATERIALS AND METHODS A total of 98 POSM patients undergoing resection of colorectal cancer were included. The Kaplan-Meier survival analysis and Cox regression analysis were used to estimate the overall survival (OS) and progression-free survival (PFS). The nomogram was built based on multivariate Cox analysis model and evaluated by calibration curve, concordance index (C-index) and receiver operating characteristics (ROC). RESULTS The multivariate analysis showed that neutrophil-to-lymphocyte ratio (NLR) was prognostic factor of OS (HR = 2.73, 95%CI: 1.54-4.84) and PFS (HR = 1.78, 95%CI: 1.13-2.82). Elevated alkaline phosphatase (ALP) also was predictor of poor OS (HR = 1.99, 95%CI: 1.12-3.51) and PFS (HR = 2.23, 95%CI: 1.40-3.55). The early N stage and solitary pulmonary metastases had significant survival benefit for OS, while advanced T stage was independently related with worse PFS. Nomograms were consist of above significant risk factors, with C-index of 0.742 for OS and 0.656 for PFS. The calibration curves showed non-significant deviations between predicted and actual probability of OS and PFS. CONCLUSIONS Pre-treatment NLR and ALP were independently associated with OS and PFS in POSM patients. The nomograms involving inflammatory markers and clinicopathological factors were practical in predicting survival, which may help to guide use of therapeutic strategy and cancer surveillance.
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23
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Lactate Dehydrogenases as Metabolic Links between Tumor and Stroma in the Tumor Microenvironment. Cancers (Basel) 2019; 11:cancers11060750. [PMID: 31146503 PMCID: PMC6627402 DOI: 10.3390/cancers11060750] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/20/2019] [Accepted: 05/23/2019] [Indexed: 02/07/2023] Open
Abstract
Cancer is a metabolic disease in which abnormally proliferating cancer cells rewire metabolic pathways in the tumor microenvironment (TME). Molecular reprogramming in the TME helps cancer cells to fulfill elevated metabolic demands for bioenergetics and cellular biosynthesis. One of the ways through which cancer cell achieve this is by regulating the expression of metabolic enzymes. Lactate dehydrogenase (LDH) is the primary metabolic enzyme that converts pyruvate to lactate and vice versa. LDH also plays a significant role in regulating nutrient exchange between tumor and stroma. Thus, targeting human lactate dehydrogenase for treating advanced carcinomas may be of benefit. LDHA and LDHB, two isoenzymes of LDH, participate in tumor stroma metabolic interaction and exchange of metabolic fuel and thus could serve as potential anticancer drug targets. This article reviews recent research discussing the roles of lactate dehydrogenase in cancer metabolism. As molecular regulation of LDHA and LDHB in different cancer remains obscure, we also review signaling pathways regulating LDHA and LDHB expression. We highlight on the role of small molecule inhibitors in targeting LDH activity and we emphasize the development of safer and more effective LDH inhibitors. We trust that this review will also generate interest in designing combination therapies based on LDH inhibition, with LDHA being targeted in tumors and LDHB in stromal cells for better treatment outcome.
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24
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Feng W, Wang Y, Zhu X. Baseline serum lactate dehydrogenase level predicts survival benefit in patients with metastatic colorectal cancer receiving bevacizumab as first-line chemotherapy: a systematic review and meta-analysis of 7 studies and 1,219 patients. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:133. [PMID: 31157254 DOI: 10.21037/atm.2019.02.45] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Bevacizumab, a humanized monoclonal antibody against vascular epithelial growth factor, plays a significant role in first-line, second-line, beyond-progression, and maintenance treatment of patients with metastatic colorectal carcinoma (mCRC). Nevertheless, there are currently no biomarkers available to predict patient response or resistance to bevacizumab, which would be useful in clinical trials. Methods Using PRISMA guidelines, we conducted a systematic review and meta-analysis of the association between serum lactate dehydrogenase (LDH) level and progression-free survival (PFS), overall survival (OS), and objective response rate in mCRC patients treated with bevacizumab-based first-line chemotherapy. A comprehensive, computerized literature search of PubMed, the Web of Science, Scopus, Ovid, and the gray literature was performed. Only studies conforming to specific eligibility criteria were included. Pooled hazard ratios (HRs) were estimated using random-effects or fixed-effects models according to heterogeneity between studies. Sensitivity analysis was conducted to evaluate the stability of the results by removing each individual study from the meta-analysis. Results Seven eligible studies of 1,219 total patients were included in the analysis. Meta-analysis of all studies revealed that high serum LDH level is associated with shorter PFS (HR: 1.43, 95% CI: 1.05-1.94; P=0.023) and OS (HR: 1.667, 95% CI: 1.230-2.259; P=0.001) times in mCRC patients treated with bevacizumab-based first-line chemotherapy. However, there was no significant association between serum LDH and objective response rate. Conclusions High serum LDH level is significantly associated with shorter PFS and OS time and may have utility as a prognostic factor for mCRC patients receiving bevacizumab as first-line chemotherapy and as a predictive factor for those receiving bevacizumab-based therapy at other times.
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Affiliation(s)
- Wanjing Feng
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yue Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.,Department of Urology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Xiaodong Zhu
- Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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25
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Considering tumour volume for motion corrected DWI of colorectal liver metastases increases sensitivity of ADC to detect treatment-induced changes. Sci Rep 2019; 9:3828. [PMID: 30846790 PMCID: PMC6405765 DOI: 10.1038/s41598-019-40565-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 02/12/2019] [Indexed: 01/20/2023] Open
Abstract
ADC is a potential post treatment imaging biomarker in colorectal liver metastasis however measurements are affected by respiratory motion. This is compounded by increased statistical uncertainty in ADC measurement with decreasing tumour volume. In this prospective study we applied a retrospective motion correction method to improve the image quality of 15 tumour data sets from 11 patients. We compared repeatability of ADC measurements corrected for motion artefact against non-motion corrected acquisition of the same data set. We then applied an error model that estimated the uncertainty in ADC repeatability measurements therefore taking into consideration tumour volume. Test-retest differences in ADC for each tumour, was scaled to their estimated measurement uncertainty, and 95% confidence limits were calculated, with a null hypothesis that there is no difference between the model distribution and the data. An early post treatment scan (within 7 days of starting treatment) was acquired for 12 tumours from 8 patients. When accounting for both motion artefact and statistical uncertainty due to tumour volumes, the threshold for detecting significant post treatment changes for an individual tumour in this data set, reduced from 30.3% to 1.7% (95% limits of agreement). Applying these constraints, a significant change in ADC (5th and 20th percentiles of the ADC histogram) was observed in 5 patients post treatment. For smaller studies, motion correcting data for small tumour volumes increased statistical efficiency to detect post treatment changes in ADC. Lower percentiles may be more sensitive than mean ADC for colorectal metastases.
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26
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Chalmin F, Bruchard M, Vegran F, Ghiringhelli F. Regulation of T cell antitumor immune response by tumor induced metabolic stress. Cell Stress 2018; 3:9-18. [PMID: 31225495 PMCID: PMC6551678 DOI: 10.15698/cst2019.01.171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Adaptive T cell immune response is essential for tumor growth control. The efficacy of immune checkpoint inhibitors is regulated by intratumoral immune response. The tumor microenvironment has a major role in adaptive immune response tuning. Tumor cells generate a particular metabolic environment in comparison to other tissues. Tumors are characterized by glycolysis, hypoxia, acidosis, amino acid depletion and fatty acid metabolism modification. Such metabolic changes promote tumor growth, impair immune response and lead to resistance to therapies. This review will detail how these modifications strongly affect CD8 and CD4 T cell functions and impact immunotherapy efficacy.
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Affiliation(s)
- Fanny Chalmin
- Cancer Biology Research Platform, Centre Georges-François Leclerc, Dijon, France.,Université de Bourgogne-Franche Comté.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,INSERM UMR1231, Dijon, France
| | - Mélanie Bruchard
- Cancer Biology Research Platform, Centre Georges-François Leclerc, Dijon, France.,Université de Bourgogne-Franche Comté.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,INSERM UMR1231, Dijon, France
| | - Frederique Vegran
- Cancer Biology Research Platform, Centre Georges-François Leclerc, Dijon, France.,Université de Bourgogne-Franche Comté.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,INSERM UMR1231, Dijon, France
| | - Francois Ghiringhelli
- Cancer Biology Research Platform, Centre Georges-François Leclerc, Dijon, France.,Université de Bourgogne-Franche Comté.,GIMI Genetic and Immunology Medical Institute, Dijon, France.,INSERM UMR1231, Dijon, France
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27
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Marquez J, Kratchmarova I, Akimov V, Unda F, Ibarretxe G, Clerigué AS, Osinalde N, Badiola I. NADH dehydrogenase complex I is overexpressed in incipient metastatic murine colon cancer cells. Oncol Rep 2018; 41:742-752. [PMID: 30483808 PMCID: PMC6313061 DOI: 10.3892/or.2018.6892] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 10/12/2018] [Indexed: 01/08/2023] Open
Abstract
Colon cancer is one of the most frequently occurring types of cancers in the world. Primary tumours are treated very efficiently, but the metastatic cases are known to have severe outcomes. Therefore, the aim of the present study was to obtain a greater understanding of the transformation of primary colon cancer cells into metastatic phenotypes. Small changes in protein expression provoke the metastatic phenotype transformation. More sensitive methods to detect small variations are required. A murine colon cancer cell line with metastatic characteristics in a very early phase was created in order to investigate the first steps of transformation using a murine liver metastasis model. The protein expression patterns of metastatic and non-metastatic cells were compared using the stable isotope labelling by amino acids in cell culture method in combination with mass spectrometry. Quantitative proteomics data indicated that nicotinamide adenine dinucleotide hydride (NADH) dehydrogenase complex I was overexpressed in metastatic cells with respect to non-metastatic cells. Since the NADH dehydrogenase complex catalyses the oxidation of NADH to NAD+, the functionality of the complex was studied by measuring the amount of NADH. The results revealed that metastatic cells accumulate more NADH and reactive oxygen species. In addition, the mitochondrial membrane potential of metastatic cells was lower than that of non-metastatic cells, indicating that the activity of NADH dehydrogenase and the mitochondrial oxidative chain were decreased in metastatic cells. During the incipient transformation of primary cancer cells, NADH dehydrogenase complex I was overexpressed but then became inactive due to the Warburg effect, which inhibits mitochondrial activity. In the first step of transformation, the high energy demand required in an adverse environment is fulfilled by overexpressing components of the respiratory chain, a fact that should be considered for future anti-metastatic therapies.
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Affiliation(s)
- Joana Marquez
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Irina Kratchmarova
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, 5230 Odense M, Denmark
| | - Vyacheslav Akimov
- Department of Biochemistry and Molecular Biology, University of Southern Denmark, 5230 Odense M, Denmark
| | - Fernando Unda
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Gaskon Ibarretxe
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Basque Country (UPV/EHU), 48940 Leioa, Spain
| | | | - Nerea Osinalde
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, UPV/EHU, 01006 Vitoria‑Gasteiz, Spain
| | - Iker Badiola
- Department of Cell Biology and Histology, Faculty of Medicine and Nursing, University of Basque Country (UPV/EHU), 48940 Leioa, Spain
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Gan J, Wang W, Yang Z, Pan J, Zheng L, Yin L. Prognostic value of pretreatment serum lactate dehydrogenase level in pancreatic cancer patients: A meta-analysis of 18 observational studies. Medicine (Baltimore) 2018; 97:e13151. [PMID: 30431587 PMCID: PMC6257391 DOI: 10.1097/md.0000000000013151] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Several studies were conducted to investigate the prognostic value of pretreatment serum lactate dehydrogenase (LDH) level in pancreatic cancer (PC), but the results were inconsistent. This study aims to comprehensively assess the prognostic value of pretreatment serum LDH level in PC patients by combining the data of the published literatures on this topic. METHODS Embase, PubMed, and Web of Science were completely retrieved until June, 2018. The observational studies focusing on the prognostic value of pretreatment serum LDH level in PC patients were eligible. STATA version 12.0 was used to undertake the statistical analysis. RESULTS Eighteen studies with a total of 3345 patients were included in this meta-analysis. The meta-analysis was conducted to generate pooled hazard ratios (HRs) and 95% confidence interval (CI) for overall survival (OS). Our analysis results suggested that high serum LDH level predicted worse OS (HR 1.57, 95% CI 1.30-1.90, P < .001) in PC patients. Moreover, for patients with advanced PC, the prognostic relevance of pretreatment serum LDH level not only existed in those receiving palliative chemotherapy (HR 1.72, 95% CI 1.35-2.18, P < .001), but also in those who were precluded from chemotherapy (HR 1.91, 95% CI 1.4219-2.58, P < .001). CONCLUSION The meta-analysis results demonstrated that pretreatment serum LDH level is closely associated with OS, and it may be a useful biomarker for assessing the prognosis of PC patients.
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Lacroix R, Rozeman EA, Kreutz M, Renner K, Blank CU. Targeting tumor-associated acidity in cancer immunotherapy. Cancer Immunol Immunother 2018; 67:1331-1348. [PMID: 29974196 PMCID: PMC11028141 DOI: 10.1007/s00262-018-2195-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/29/2018] [Indexed: 12/21/2022]
Abstract
Checkpoint inhibitors, such as cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) and programmed cell death-1 (PD-1) monoclonal antibodies have changed profoundly the treatment of melanoma, renal cell carcinoma, non-small cell lung cancer, Hodgkin lymphoma, and bladder cancer. Currently, they are tested in various tumor entities as monotherapy or in combination with chemotherapies or targeted therapies. However, only a subgroup of patients benefit from checkpoint blockade (combinations). This raises the question, which all mechanisms inhibit T cell function in the tumor environment, restricting the efficacy of these immunotherapeutic approaches. Serum activity of lactate dehydrogenase, likely reflecting the glycolytic activity of the tumor cells and thus acidity within the tumor microenvironment, turned out to be one of the strongest markers predicting response to checkpoint inhibition. In this review, we discuss the impact of tumor-associated acidity on the efficacy of T cell-mediated cancer immunotherapy and possible approaches to break this barrier.
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Affiliation(s)
- Ruben Lacroix
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands
| | - Elisa A Rozeman
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marina Kreutz
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Kathrin Renner
- Department of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany
| | - Christian U Blank
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
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30
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Hu K, Wang Z, Lin P, Wen Z, Ren H, Sun L, Li H, Li B, Wang S, Zhou X, Tengwang S, Xu L, Ye Z. Three hematological indexes that may serve as prognostic indicators in patients with primary, high-grade, appendicular osteosarcoma. Oncotarget 2018; 8:43130-43139. [PMID: 28562345 PMCID: PMC5522133 DOI: 10.18632/oncotarget.17811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/19/2017] [Indexed: 11/25/2022] Open
Abstract
Background Although alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) are considered effective prognostic factors of osteosarcoma, useful prognostic biomarkers for patients with osteosarcoma are still lacking. Methods A retrospective study of 106 patients with primary, high-grade, appendicular osteosarcoma obtained between 2006 and 2011 was performed to assess the prognostic value of serum ALP, LDH and fibrinogen (FBG) levels, as well as their decrease rates in osteosarcoma. The Kaplan-Meier method was employed to analyze overall survival. The Cox proportional hazard model was used to determine the significance of these prognostic biomarkers on survival distribution. Results Patients with pre-ct (before neoadjuvant chemotherapy) LDH>210U/L, post-ct (after neoadjuvant chemotherapy, but before surgery) LDH>215U/L, post-ct FBG>2.8g/L, FBG DR (Decrease Rate)≤10% tended to have a poorer prognosis. Conclusions High pre-ct and post-ct peripheral serum LDH level, high serum post-ct FBG level and low decrease rate of serum FBG were related to poor survival in patients with osteosarcoma. Fibrinogen was found to be a new valuable predictor of 5-year survival in patients with osteosarcoma for the first time.
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Affiliation(s)
- Keqi Hu
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Zhan Wang
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Peng Lin
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Zuojun Wen
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Haiyong Ren
- Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, 310000, China
| | - Lingling Sun
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Hengyuan Li
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Binghao Li
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Shengdong Wang
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Xingzhi Zhou
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Siyuan Tengwang
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Langhai Xu
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Zhaoming Ye
- Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
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Abstract
BACKGROUNDS A large number of studies have reported the relationships between serum lactate dehydrogenase (LDH) and prognosis of osteosarcoma. However, the result is still controversial and no consensus has been reached. Therefore, we performed a meta-analysis to evaluate the prognostic role of serum LDH in osteosarcoma patients. METHODS We performed the systematic computerized search for eligible articles from PubMed, Embase, and Cochrane databases until December 21, 2017. The pooled hazard ratio (HR) and 95% confidence intervals (CIs) of overall survival (OS) and event-free survival (EFS) were obtained to assess the prognostic value of serum LDH. RESULTS A total of 18 studies with 2543 osteosarcoma patients were included. Overall, 15 studies assessed the elevated serum LDH level on OS and the pooled HR was 1.87 (95% CI = 1.58-2.20). Meanwhile, the pooled HR to evaluate the relationship between serum LDH and EFS in 9 studies was 1.78 (95% CI = 1.51-2.10). The same results were acquired when these studies were stratified by Enneking stage, geographic region, and sample size. No heterogeneity existed between these subgroups (P > .05). Begg's funnel plot and Egger's test (OS: P = .04; EFS: P = .34) showed that possible publication bias might exist in OS studies. Sensitivity analysis suggested the pooled HR was robust. CONCLUSIONS This meta-analysis demonstrates that elevated serum LDH level is apparently associated with lower EFS rate and serum LDH could be a prognostic biomarker for osteosarcoma patients.
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Affiliation(s)
- Yucheng Fu
- Department of Surgical Intensive Care Unit (SICU), The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Tao Lan
- Department of Spine Surgery, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province
| | - Hongliu Cai
- Department of Surgical Intensive Care Unit (SICU), The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Anwei Lu
- Department of Surgical Intensive Care Unit (SICU), The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province
| | - Wei Yu
- Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
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Sakae H, Kanzaki H, Nasu J, Akimoto Y, Matsueda K, Yoshioka M, Nakagawa M, Hori S, Inoue M, Inaba T, Imagawa A, Takatani M, Takenaka R, Suzuki S, Fujiwara T, Okada H. The characteristics and outcomes of small bowel adenocarcinoma: a multicentre retrospective observational study. Br J Cancer 2017; 117:1607-1613. [PMID: 28982111 PMCID: PMC5729438 DOI: 10.1038/bjc.2017.338] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/23/2017] [Accepted: 09/01/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Small bowel adenocarcinoma (SBA) is a rare malignancy that accounts for 1-2% of gastrointestinal tumours. We investigated the clinical characteristics, outcomes, and prognostic factors of primary SBA. METHODS We retrospectively analysed the characteristics and clinical courses of 205 SBA patients from 11 institutions in Japan between June 2002 and August 2013. RESULTS The primary tumour was in the duodenum and jejunum/ileum in 149 (72.7%) and 56 (27.3%) patients, respectively. Sixty-four patients (43.0%) with duodenal adenocarcinoma were asymptomatic and most cases were detected by oesophagogastroduodenoscopy (EGD), which was not specifically performed for the detection or surveillance of duodenal tumours. In contrast, 47 patients (83.9%) with jejunoileal carcinoma were symptomatic. The 3-year survival rate for stage 0/I, II, III, and IV cancers was 93.4%, 73.1%, 50.9%, and 15.1%, respectively. Multivariate analysis revealed performance status 3-4, high carcinoembryonic antigen, high lactate dehydrogenase (LDH), low albumin, symptomatic at diagnosis, and stage III/IV disease were independent factors for overall survival (OS). Ten patients (18.5%) with stage IV disease were treated with a combination of resection of primary tumour, local treatment of metastasis, and chemotherapy; this group had a median OS of 36.9 months. CONCLUSIONS Although most SBA patients were diagnosed with symptomatic, advanced stage disease, some patients with duodenal carcinoma were detected in early stage by EGD. High LDH and symptomatic at diagnosis were identified as novel independent prognostic factors for OS. The prognosis of advanced SBA was poor, but combined modality therapy with local treatment of metastasis might prolong patient survival.
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Affiliation(s)
- Hiroyuki Sakae
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan
| | - Hiromitsu Kanzaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan
| | - Junichiro Nasu
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan
- Department of Internal Medicine, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-Ku, Okayama 700-8511, Japan
| | - Yutaka Akimoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan
| | - Masao Yoshioka
- Department of Internal Medicine, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-Ku, Okayama 700-8511, Japan
| | - Masahiro Nakagawa
- Department of Endoscopy, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Naka-Ku, Hiroshima 730-8518, Japan
| | - Shinichiro Hori
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, 160 Kou, Minamiumemoto-machi, Matsuyama, Ehime 791-0280, Japan
| | - Masafumi Inoue
- Department of Gastroenterology, Japanese Red Cross Okayama Hospital, 2-1-1 Aoe, Kita-Ku, Okayama 700-8607, Japan
| | - Tomoki Inaba
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, 5-4-6 Ban-cho, Takamatsu, Kagawa 760-8557, Japan
| | - Atsushi Imagawa
- Department of Gastroenterology, Mitoyo General Hospital, 708 Himehama, Kanonji, Kagawa 769-1695, Japan
| | - Masahiro Takatani
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji, Hyogo 670-8540, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama 708-0848, Japan
| | - Seiyu Suzuki
- Department of Internal Medicine, Sumitomo Besshi Hospital, 3-1 Ouji-cho, Niihama, Ehime 792-8543, Japan
| | - Toshiyoshi Fujiwara
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-Ku, Okayama 700-8558, Japan
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Yong CS, Abba Moussa D, Cretenet G, Kinet S, Dardalhon V, Taylor N. Metabolic orchestration of T lineage differentiation and function. FEBS Lett 2017; 591:3104-3118. [PMID: 28901530 DOI: 10.1002/1873-3468.12849] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/04/2017] [Accepted: 09/06/2017] [Indexed: 12/14/2022]
Abstract
T cells are stimulated by the engagement of antigen, cytokine, pathogen, and hormone receptors. While research performed over many years has focused on deciphering the molecular components of these pathways, recent data underscore the importance of the metabolic environment in conditioning responses to receptor engagement. The ability of T cells to undergo a massive proliferation and cytokine secretion in response to receptor signals requires alterations to their bioenergetic homeostasis, allowing them to meet new energetic and biosynthetic demands. The metabolic reprogramming of activated T cells is regulated not only by changes in intracellular nutrient uptake and utilization but also by nutrient and oxygen concentrations in the extracellular environment. Notably, the extracellular environment can be profoundly altered by pathological conditions such as infections and tumors, thereby perturbing the metabolism and function of antigen-specific T lymphocytes. This review highlights the interplay between diverse metabolic networks and the transcriptional/epigenetic states that condition T-cell differentiation, comparing the metabolic features of T lymphocytes with other immune cells. We further address recent discoveries in the metabolic pathways that govern T-cell function in physiological and pathological conditions.
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Affiliation(s)
- Carmen S Yong
- IGMM, CNRS, Univ. Montpellier, Montpellier, France
- Cancer Immunology Program, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia
| | | | | | | | | | - Naomi Taylor
- IGMM, CNRS, Univ. Montpellier, Montpellier, France
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First-line FOLFIRI and bevacizumab in patients with advanced colorectal cancer prospectively stratified according to serum LDH: final results of the GISCAD (Italian Group for the Study of Digestive Tract Cancers) CENTRAL (ColorEctalavastiNTRiAlLdh) trial. Br J Cancer 2017; 117:1099-1104. [PMID: 28926529 PMCID: PMC5674092 DOI: 10.1038/bjc.2017.234] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/12/2017] [Accepted: 06/28/2017] [Indexed: 12/27/2022] Open
Abstract
Background: Previous findings suggested that bevacizumab might be able to improve response rate (RR) in colorectal cancer patients with high lactic dehydrogenase (LDH) basal levels. Methods: We conducted a phase II trial to prospectively ascertain whether bevacizumab in combination with FOLFIRI could have an improved clinical activity in patients with high LDH serum levels. Primary end point of the study was RR; secondary end points were median overall survival and median progression-free survival (mPFS). Results: A total of 81 patients were enrolled. No difference in terms of ORR (39% vs 31% for low vs high LDH level stratum, P=0.78) and mPFS (14.16 vs 10.29 months, HR: 1.07, 95% CI: 0.51–2.24, P=0.83) between the strata was observed, whereas overall survival (OS) was significantly longer for patients with low LDH (24.85 vs 15.14 months, HR: 4.08, 95% CI: 1.14–14.61, P=0.0004). In a not-pre-planned exploratory analysis using different cut-off ranges for LDH, we observed RR up to 70%, with no improvement in progression-free survival or OS. Conclusions: The CENTRAL trial failed to demonstrate that high LDH levels were related to a significantly improved RR in patients receiving first-line FOLFIRI and bevacizumab. The LDH serum levels should then no further be investigated as a predictive factor in this setting.
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Tang P, Xu J, Oliveira CL, Li ZJ, Liu S. A mechanistic kinetic description of lactate dehydrogenase elucidating cancer diagnosis and inhibitor evaluation. J Enzyme Inhib Med Chem 2017; 32:564-571. [PMID: 28114833 PMCID: PMC6010104 DOI: 10.1080/14756366.2016.1275606] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
As a key enzyme for glycolysis, lactate dehydrogenase (LDH) remains as a topic of great interest in cancer study. Though a number of kinetic models have been applied to describe the dynamic behavior of LDH, few can reflect its actual mechanism, making it difficult to explain the observed substrate and competitor inhibitions at wide concentration ranges. A novel mechanistic kinetic model is developed based on the enzymatic processes and the interactive properties of LDH. Better kinetic simulation as well as new enzyme interactivity information and kinetic properties extracted from published articles via the novel model was presented. Case studies were presented to a comprehensive understanding of the effect of temperature, substrate, and inhibitor on LDH kinetic activities for promising application in cancer diagnosis, inhibitor evaluation, and adequate drug dosage prediction.
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Affiliation(s)
- Peifeng Tang
- a Department of Paper and Bioprocess Engineering , SUNY ESF , Syracuse , NY , USA.,b Biologics Process Development, Global Manufacturing and Supply , Bristol-Myers Squibb Company , Devens , MA , USA
| | - Jianlin Xu
- b Biologics Process Development, Global Manufacturing and Supply , Bristol-Myers Squibb Company , Devens , MA , USA
| | - Christopher L Oliveira
- b Biologics Process Development, Global Manufacturing and Supply , Bristol-Myers Squibb Company , Devens , MA , USA
| | - Zheng Jian Li
- b Biologics Process Development, Global Manufacturing and Supply , Bristol-Myers Squibb Company , Devens , MA , USA
| | - Shijie Liu
- a Department of Paper and Bioprocess Engineering , SUNY ESF , Syracuse , NY , USA
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Spindler KLG. Methodological, biological and clinical aspects of circulating free DNA in metastatic colorectal cancer. Acta Oncol 2017; 56:7-16. [PMID: 28010185 DOI: 10.1080/0284186x.2016.1253861] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Circulating DNA can be used to measure the total cell-free DNA (cfDNA) and for detection and quantification of tumor-specific genetic alterations in the peripheral blood, and the broad clinical potential of circulating DNA has attracted increasing focus over the past decade. Concentrations of circulating DNA are high in metastatic colorectal cancer (CRC), and the total levels of cfDNA have been reported to hold strong prognostic value. Colorectal tumors are characterized by a high frequency of well known, clinically relevant genetic alteration, which is readily detected in the cfDNA and holds potential for tailoring of palliative therapy and for monitoring during treatment. This review aims to present the current literature which has specifically reported data on the potential utility of cfDNA and on tumor-specific mutations in metastatic colorectal cancer (mCRC). METHOD Methodological, biological and clinical aspects are discussed based on the most recent development in this specific setting, and eligible studies were identified by systematic literature searched from Pubmed and EMBASE in addition to conference papers and communications. RESULTS The literature regarding cfDNA in CRC is broad and heterogeneous concerning aims, nomenclature, methods, cohorts and clinical endpoints and consequently difficult to include in a single systematic search. However, the available data underline a strong clinical value of measuring both total cfDNA levels and tumor-specific mutations in the plasma of patients with mCRC, pre- and during systemic therapy. CONCLUSION This paper had gathered the most recent literature on several aspects of cfDNA in mCRC, including methodological, biological and clinical aspects, and discussed the large clinical potential in this specific setting, which needs to be validated in carefully designed prospective studies in statistically relevant cohorts.
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Affiliation(s)
- Karen-Lise G Spindler
- a Department of Oncology , Aarhus University Hospital, Institute of Clinical Medicine, Aarhus University , Aarhus , Denmark
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