Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy

Locally advanced rectal cancer is currently treated with pre-operative radiochemotherapy (pRCT), but the response is not uniform. Identification of patients with higher likelihood of responding to pRCT is clinically relevant, as patients with resistant tumors could be spared exposure to radiation or...

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Main Authors: Anita De Rossi, Donato Nitti, Roberta Bertorelle, Gaya Spolverato, Salvatore Pucciarelli
Format: Article
Language:English
Published: MDPI AG 2011-04-01
Series:Cancers
Subjects:
Online Access:http://www.mdpi.com/2072-6694/3/2/2176/
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author Anita De Rossi
Donato Nitti
Roberta Bertorelle
Gaya Spolverato
Salvatore Pucciarelli
author_facet Anita De Rossi
Donato Nitti
Roberta Bertorelle
Gaya Spolverato
Salvatore Pucciarelli
author_sort Anita De Rossi
collection DOAJ
description Locally advanced rectal cancer is currently treated with pre-operative radiochemotherapy (pRCT), but the response is not uniform. Identification of patients with higher likelihood of responding to pRCT is clinically relevant, as patients with resistant tumors could be spared exposure to radiation or DNA-damaging drugs that are associated with adverse side effects. To highlight predictive biomarkers of response to pRCT, a systematic search of PubMed was conducted with a combination of the following terms: “rectal”, “predictive”, “radiochemotherapy”, “neoadjuvant”, “response” and “biomarkers”. Genetic polymorphisms in epithelial growth factor receptor (EGFR) and thymidylate synthase (TS) genes, the expression of several markers, such as EGFR, bcl-2/bax and cyclooxygenase (COX)-2, and circulating biomarkers, such as serum carcinoembryonic antigen (CEA) level, are promising as predictor markers, but need to be further evaluated. The majority of the studies did not support the predictive value of p53, while the values of Ki-67, TS and p21 is still controversial. Gene expression profiles of thousands of genes using microarrays, microRNA studies and the search for new circulating molecules, such as human telomerase reverse transcriptase mRNA and cell-free DNA, are providing interesting results that might lead to the identification of new useful biomarkers. Evaluation of biomarkers in larger, prospective trials are required to guide therapeutic strategies.
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spelling doaj.art-f3128ca22eac4750aa08252d9dda14292023-08-02T02:15:19ZengMDPI AGCancers2072-66942011-04-01322176219410.3390/cancers3022176Predictive Factors of the Response of Rectal Cancer to Neoadjuvant RadiochemotherapyAnita De RossiDonato NittiRoberta BertorelleGaya SpolveratoSalvatore PucciarelliLocally advanced rectal cancer is currently treated with pre-operative radiochemotherapy (pRCT), but the response is not uniform. Identification of patients with higher likelihood of responding to pRCT is clinically relevant, as patients with resistant tumors could be spared exposure to radiation or DNA-damaging drugs that are associated with adverse side effects. To highlight predictive biomarkers of response to pRCT, a systematic search of PubMed was conducted with a combination of the following terms: “rectal”, “predictive”, “radiochemotherapy”, “neoadjuvant”, “response” and “biomarkers”. Genetic polymorphisms in epithelial growth factor receptor (EGFR) and thymidylate synthase (TS) genes, the expression of several markers, such as EGFR, bcl-2/bax and cyclooxygenase (COX)-2, and circulating biomarkers, such as serum carcinoembryonic antigen (CEA) level, are promising as predictor markers, but need to be further evaluated. The majority of the studies did not support the predictive value of p53, while the values of Ki-67, TS and p21 is still controversial. Gene expression profiles of thousands of genes using microarrays, microRNA studies and the search for new circulating molecules, such as human telomerase reverse transcriptase mRNA and cell-free DNA, are providing interesting results that might lead to the identification of new useful biomarkers. Evaluation of biomarkers in larger, prospective trials are required to guide therapeutic strategies.http://www.mdpi.com/2072-6694/3/2/2176/rectal cancerneoadjuvant therapybiomarkers
spellingShingle Anita De Rossi
Donato Nitti
Roberta Bertorelle
Gaya Spolverato
Salvatore Pucciarelli
Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy
Cancers
rectal cancer
neoadjuvant therapy
biomarkers
title Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy
title_full Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy
title_fullStr Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy
title_full_unstemmed Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy
title_short Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy
title_sort predictive factors of the response of rectal cancer to neoadjuvant radiochemotherapy
topic rectal cancer
neoadjuvant therapy
biomarkers
url http://www.mdpi.com/2072-6694/3/2/2176/
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AT robertabertorelle predictivefactorsoftheresponseofrectalcancertoneoadjuvantradiochemotherapy
AT gayaspolverato predictivefactorsoftheresponseofrectalcancertoneoadjuvantradiochemotherapy
AT salvatorepucciarelli predictivefactorsoftheresponseofrectalcancertoneoadjuvantradiochemotherapy