A combined ANXA2-NDRG1-STAT1 gene signature predicts response to chemoradiotherapy in cervical cancer

Marianna Buttarelli, Gabriele Babini, Giuseppina Raspaglio, Flavia Filippetti, Alessandra Battaglia, Alessandra Ciucci, Maria Gabriella Ferrandina, Marco Petrillo, Carmela Marino, Mariateresa Mancuso, Anna Saran, Maria Elena Villani, Angiola Desiderio, Chiara D'Ambrosio, Andrea Scaloni, Giovanni Scambia, Daniela Gallo

Research output: Contribution to journalArticlepeer-review


BACKGROUND: A better understanding of locally advanced cervical cancer (LACC) is mandatory for further improving the rates of disease control, since a significant proportion of patients still fail to respond or undergo relapse after concurrent chemoradiation treatment (CRT), and survival for these patients has generally remained poor.

METHODS: To identify specific markers of CRT response, we compared pretreatment biopsies from LACC patients with pathological complete response (sensitive) with those from patients showing macroscopic residual tumor (resistant) after neoadjuvant CRT, using a proteomic approach integrated with gene expression profiling. The study of the underpinning mechanisms of chemoradiation response was carried out through in vitro models of cervical cancer.

RESULTS: We identified annexin A2 (ANXA2), N-myc downstream regulated gene 1 (NDRG1) and signal transducer and activator of transcription 1 (STAT1) as biomarkers of LACC patients' responsiveness to CRT. The dataset collected through qPCR on these genes was used as training dataset to implement a Random Forest algorithm able to predict the response of new patients to this treatment. Mechanistic investigations demonstrated the key role of the identified genes in the balance between death and survival of tumor cells.

CONCLUSIONS: Our results define a predictive gene signature that can help in cervical cancer patient stratification, thus providing a useful tool towards more personalized treatment modalities.

Original languageEnglish
Pages (from-to)279
JournalJournal of experimental & clinical cancer research : CR
Issue number1
Publication statusPublished - Jun 26 2019


  • Adult
  • Aged
  • Annexin A2/genetics
  • Antineoplastic Agents/therapeutic use
  • Biomarkers, Tumor
  • Cell Cycle Proteins/genetics
  • Chemoradiotherapy
  • Cisplatin/therapeutic use
  • Female
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Intracellular Signaling Peptides and Proteins/genetics
  • Middle Aged
  • Neoadjuvant Therapy
  • Poly (ADP-Ribose) Polymerase-1/metabolism
  • Radiation Tolerance
  • STAT1 Transcription Factor/genetics
  • Transcriptome
  • Uterine Cervical Neoplasms/genetics
  • Young Adult


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