Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer

Detalhes bibliográficos
Autor(a) principal: Bruun, J
Data de Publicação: 2018
Outros Autores: Sveen, A, Barros, R, Eide, P, Eilertsen, I, Kolberg, M, Pellinen, T, David, L, Svindland, A, Kallioniemi, O, Guren, M, Nesbakken, A, Almeida, R, Lothe, R
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://hdl.handle.net/10216/127062
Resumo: We aimed to refine the value of CDX2 as an independent prognostic and predictive biomarker in colorectal cancer (CRC) according to disease stage and chemotherapy sensitivity in preclinical models. CDX2 expression was evaluated in 1045 stage I–IV primary CRCs by gene expression (n = 403) or immunohistochemistry (n = 642) and in relation to 5-year relapse-free survival (RFS), overall survival (OS), and chemotherapy. Pharmacogenomic associations between CDX2 expression and 69 chemotherapeutics were assessed by drug screening of 35 CRC cell lines. CDX2 expression was lost in 11.6% of cases and showed independent poor prognostic value in multivariable models. For individual stages, CDX2 was prognostic only in stage IV, independent of chemotherapy. Among stage I–III patients not treated in an adjuvant setting, CDX2 loss was associated with a particularly poor survival in the BRAF-mutated subgroup, but prognostic value was independent of microsatellite instability status and the consensus molecular subtypes. In stage III, the 5-year RFS rate was higher among patients with loss of CDX2 who received adjuvant chemotherapy than among patients who did not. The CDX2-negative cell lines were significantly more sensitive to chemotherapeutics than CDX2-positive cells, and the multidrug resistance genes MDR1 and CFTR were significantly downregulated both in CDX2-negative cells and in patient tumors. Loss of CDX2 in CRC is an adverse prognostic biomarker only in stage IV disease and appears to be associated with benefit from adjuvant chemotherapy in stage III. Early-stage patients not qualifying for chemotherapy might be reconsidered for such treatment if their tumor has loss of CDX2 and mutated BRAF.
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spelling Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancerWe aimed to refine the value of CDX2 as an independent prognostic and predictive biomarker in colorectal cancer (CRC) according to disease stage and chemotherapy sensitivity in preclinical models. CDX2 expression was evaluated in 1045 stage I–IV primary CRCs by gene expression (n = 403) or immunohistochemistry (n = 642) and in relation to 5-year relapse-free survival (RFS), overall survival (OS), and chemotherapy. Pharmacogenomic associations between CDX2 expression and 69 chemotherapeutics were assessed by drug screening of 35 CRC cell lines. CDX2 expression was lost in 11.6% of cases and showed independent poor prognostic value in multivariable models. For individual stages, CDX2 was prognostic only in stage IV, independent of chemotherapy. Among stage I–III patients not treated in an adjuvant setting, CDX2 loss was associated with a particularly poor survival in the BRAF-mutated subgroup, but prognostic value was independent of microsatellite instability status and the consensus molecular subtypes. In stage III, the 5-year RFS rate was higher among patients with loss of CDX2 who received adjuvant chemotherapy than among patients who did not. The CDX2-negative cell lines were significantly more sensitive to chemotherapeutics than CDX2-positive cells, and the multidrug resistance genes MDR1 and CFTR were significantly downregulated both in CDX2-negative cells and in patient tumors. Loss of CDX2 in CRC is an adverse prognostic biomarker only in stage IV disease and appears to be associated with benefit from adjuvant chemotherapy in stage III. Early-stage patients not qualifying for chemotherapy might be reconsidered for such treatment if their tumor has loss of CDX2 and mutated BRAF.Wiley20182018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10216/127062eng1574-789110.1002/1878-0261.12347Bruun, JSveen, ABarros, REide, PEilertsen, IKolberg, MPellinen, TDavid, LSvindland, AKallioniemi, OGuren, MNesbakken, AAlmeida, RLothe, Rinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T14:02:02Zoai:repositorio-aberto.up.pt:10216/127062Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T23:53:01.341116Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
title Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
spellingShingle Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
Bruun, J
title_short Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
title_full Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
title_fullStr Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
title_full_unstemmed Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
title_sort Prognostic, predictive, and pharmacogenomic assessments of CDX2 refine stratification of colorectal cancer
author Bruun, J
author_facet Bruun, J
Sveen, A
Barros, R
Eide, P
Eilertsen, I
Kolberg, M
Pellinen, T
David, L
Svindland, A
Kallioniemi, O
Guren, M
Nesbakken, A
Almeida, R
Lothe, R
author_role author
author2 Sveen, A
Barros, R
Eide, P
Eilertsen, I
Kolberg, M
Pellinen, T
David, L
Svindland, A
Kallioniemi, O
Guren, M
Nesbakken, A
Almeida, R
Lothe, R
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Bruun, J
Sveen, A
Barros, R
Eide, P
Eilertsen, I
Kolberg, M
Pellinen, T
David, L
Svindland, A
Kallioniemi, O
Guren, M
Nesbakken, A
Almeida, R
Lothe, R
description We aimed to refine the value of CDX2 as an independent prognostic and predictive biomarker in colorectal cancer (CRC) according to disease stage and chemotherapy sensitivity in preclinical models. CDX2 expression was evaluated in 1045 stage I–IV primary CRCs by gene expression (n = 403) or immunohistochemistry (n = 642) and in relation to 5-year relapse-free survival (RFS), overall survival (OS), and chemotherapy. Pharmacogenomic associations between CDX2 expression and 69 chemotherapeutics were assessed by drug screening of 35 CRC cell lines. CDX2 expression was lost in 11.6% of cases and showed independent poor prognostic value in multivariable models. For individual stages, CDX2 was prognostic only in stage IV, independent of chemotherapy. Among stage I–III patients not treated in an adjuvant setting, CDX2 loss was associated with a particularly poor survival in the BRAF-mutated subgroup, but prognostic value was independent of microsatellite instability status and the consensus molecular subtypes. In stage III, the 5-year RFS rate was higher among patients with loss of CDX2 who received adjuvant chemotherapy than among patients who did not. The CDX2-negative cell lines were significantly more sensitive to chemotherapeutics than CDX2-positive cells, and the multidrug resistance genes MDR1 and CFTR were significantly downregulated both in CDX2-negative cells and in patient tumors. Loss of CDX2 in CRC is an adverse prognostic biomarker only in stage IV disease and appears to be associated with benefit from adjuvant chemotherapy in stage III. Early-stage patients not qualifying for chemotherapy might be reconsidered for such treatment if their tumor has loss of CDX2 and mutated BRAF.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://hdl.handle.net/10216/127062
url https://hdl.handle.net/10216/127062
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1574-7891
10.1002/1878-0261.12347
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dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
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