Single nucleotide polymorphisms in miRNA binding sites of nucleotide excision repair-related genes predict clinical benefit of oxaliplatin in folfoxiri plus bevacizumab: Analysis of the tribe trial

Mitsukuni Suenaga, Marta Schirripa, Shu Cao, Wu Zhang, Dongyun Yang, Chiara Cremolini, Sabina Murgioni, Sara Lonardi, Yan Ning, Satoshi Okazaki, Martin D. Berger, Yuji Miyamoto, Afsaneh Barzi, Fotios Loupakis, Alfredo Falcone, Heinz Josef Lenz

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The nucleotide excision repair (NER) pathway participates in platinuminduced DNA damage repair. Single nucleotide polymorphisms (SNPs) in miRNA-binding sites in the NER genes RPA2 and GTF2H1 are associated with the risk of colorectal cancer (CRC). Here, we analyzed whether RPA2 and GTF2H1 SNPs predict the efficacy of oxaliplatin in metastatic CRC (mCRC) patients. Patients and methods: Genomic DNA was extracted from blood samples from 457 patients with mCRC enrolled in the TRIBE trial, which compared first-line FOLFOXIRI plus bevacizumab (BEV) (n = 230, discovery cohort) and first-line FOLFIRI plus BEV (n = 227, control cohort). SNPs were analyzed by PCR-based direct sequencing. Results: In the FOLFOXIRI + BEVtreated cohort expressing wild-type KRAS, progression-free survival (PFS) was shorter for the RPA2 rs7356 C/C variant subgroup than the any T allele subgroup in univariate analysis (9.1 versus 13.3 months respectively, hazard ratio (HR) 2.32, 95% confidence interval (CI): 1.07–5.03, p = 0.020) and this remained significant in multivariable analysis (HR 2.97, 95%CI: 1.27–6.94, p = 0.012). A similar trend was observed for overall survival. In contrast, patients expressing mutant RAS and RPA2 rs7356 C/C variant had longer PFS with FOLFOXIRI + BEV than with FOLFIRI + BEV (12.1 versus 7.6 months, HR 0.23, 95%CI: 0.09–0.62, p = 0.002) but no superiority of FOLFOXIRI + BEV was observed for the RAS mutant, RPA2 rs7356 any T variant subgroup (11.7 versus 9.6 months, HR 0.77, 95%CI: 0.56–1.07, p = 0.12) or the RAS wild-type, RPA2 rs7356 C/C variant subgroup. Conclusion: RPA2 SNPs may serve as predictive and prognostic markers of oxaliplatin responsiveness in a RAS status-dependent manner in mCRC patients receiving FOLFOXIRI + BEV.

Original languageEnglish
Article number1742
Pages (from-to)1-13
Number of pages13
JournalCancers
Volume12
Issue number7
DOIs
Publication statusPublished - Jun 30 2020

Keywords

  • Metastatic colorectal cancer
  • NER
  • Oxaliplatin
  • RPA2

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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