PNN and KCNQ1OT1 Can Predict the Efficacy of Adjuvant Fluoropyrimidine-Based Chemotherapy in Colorectal Cancer Patients.

Abstract

The benefit of adjuvant chemotherapy in the early stages of colorectal cancer (CRC) is still disappointing and the prediction of treatment outcome quite difficult. Recently, through a transcriptomic approach, we evidenced a role of PNN and KCNQ1OT1 gene expression in predicting response to fluoropyrimidine-based adjuvant chemotherapy in stage III CRC patients. Thus, the aim of this study was to validate in an independent cohort of stages IIIII CRC patients our previous findings. PNN and KCNQ1OT1 mRNA expression levels were evaluated in 74 formalin-fixed paraffin-embedded tumor and matched normal mucosa samples obtained by stages IIIII CRC patients treated with fluoropyrimidine-based adjuvant chemotherapy. PININ, the protein encoded by PNN, was immunohistochemically evaluated in 15 tumor and corresponding normal mucosa samples, selected on the basis of a low, medium, or high mRNA expression tumor/mucosa ratio. PNN and KCNQ1OT1 mRNA mean expression levels were significantly higher in tumor compared with normal tissues. Patients with high PNN or KCNQ1OT1 tumor mRNA levels according to ROC-based cutoffs showed a shorter disease-free survival (DFS) compared with patients with low tumor mRNA gene expression. Also, patients with tumor mRNA expression values of both genes below the identified cutoffs had a significantly longer DFS compared with patients with the expression of one or both genes above the cutoffs. In a representative large cohort of stages IIIII CRC untreated patients retrieved from GEO datasets, no difference in DFS was observed between patients with high and low PNN or KCNQ1OT1 gene expression levels. These data confirm our previous findings and underscore the relevance of PNN and KCNQ1OT1 expression in predicting DFS in early stages of CRC treated with fluoropyrimidine-based adjuvant chemotherapy. If further validated in a prospective case series, both biomarkers could be used to identify patients who benefit from this treatment and to offer alternative chemotherapy regimens to potential unresponsive patients. In relation to the suggested biological role of PNN and KCNQ1OT1 in CRC, they might also be exploited as potential therapeutic targets.

• Authors: Andrea Lapucci, Gabriele Perrone, Antonello Di Paolo, Cristina Napoli, Ida Landini, Giandomenico Roviello, Laura Calosi, Antonio Giuseppe Naccarato, Alfredo Falcone, Daniele Bani, Enrico Mini, Stefania Nobili
• Journal: Oncology research (Oncol Res) Vol. 28 Issue 6 Pg. 631-644 (Mar 16 2021) ISSN: 1555-3906 [Electronic] United States
• PMID: 33208224 (Publication Type: Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Biomarkers, Tumor
• Cell Adhesion Molecules
• KCNQ1OT1 long non-coding RNA, human
• Nuclear Proteins
• PNN protein, human
• Potassium Channels, Voltage-Gated
• Pyrimidines
• RNA, Messenger
• 5-fluoropyrimidine
• Leucovorin
• Fluorouracil

Topics

• Adult
• Aged
• Antimetabolites, Antineoplastic (therapeutic use)
• Biomarkers, Tumor (genetics)
• Cell Adhesion Molecules (genetics, metabolism)
• Chemotherapy, Adjuvant (methods)
• Cohort Studies
• Colorectal Neoplasms (drug therapy, genetics, pathology)
• Disease-Free Survival
• Female
• Fluorouracil (therapeutic use)
• Gene Expression
• Humans
• Leucovorin (therapeutic use)
• Male
• Middle Aged
• Neoplasm Staging
• Nuclear Proteins (genetics, metabolism)
• Potassium Channels, Voltage-Gated (genetics, metabolism)
• Prognosis
• Pyrimidines (therapeutic use)
• RNA, Messenger (metabolism)
• Treatment Outcome