Predictive factors of the response of rectal cancer to neoadjuvant radiochemotherapy

Gaya Spolverato, Salvatore Pucciarelli, Roberta Bertorelle, Anita de Rossi, Donato Nitti

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)2176-2194
Number of pages19
JournalCancers
Volume3
Issue number2
DOIs
Publication statusPublished - Jun 2011

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Keywords

  • Biomarkers
  • Neoadjuvant therapy
  • Rectal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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