The predictive and prognostic potential of plasma telomerase reverse transcriptase (TERT) RNA in rectal cancer patients

Enrica Rampazzo, Paola Del Bianco, Roberta Bertorelle, Caterina Boso, Alessandro Perin, Giovanna Spiro, Francesca Bergamo, Claudio Belluco, Angela Buonadonna, Elisa Palazzari, Sara Leonardi, Antonino De Paoli, Salvatore Pucciarelli, Anita De Rossi

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Preoperative chemoradiotherapy (CRT) followed by surgery is the standard care for locally advanced rectal cancer, but tumour response to CRT and disease outcome are variable. The current study aimed to investigate the effectiveness of plasma telomerase reverse transcriptase (TERT) levels in predicting tumour response and clinical outcome.

METHODS: 176 rectal cancer patients were included. Plasma samples were collected at baseline (before CRT=T0), 2 weeks after CRT was initiated (T1), post-CRT and before surgery (T2), and 4-8 months after surgery (T3) time points. Plasma TERT mRNA levels and total cell-free RNA were determined using real-time PCR.

RESULTS: Plasma levels of TERT were significantly lower at T2 (P<0.0001) in responders than in non-responders. Post-CRT TERT levels and the differences between pre- and post-CRT TERT levels independently predicted tumour response, and the prediction model had an area under curve of 0.80 (95% confidence interval (CI) 0.73-0.87). Multiple analysis demonstrated that patients with detectable TERT levels at T2 and T3 time points had a risk of disease progression 2.13 (95% CI 1.10-4.11)-fold and 4.55 (95% CI 1.48-13.95)-fold higher, respectively, than those with undetectable plasma TERT levels.

CONCLUSIONS: Plasma TERT levels are independent markers of tumour response and are prognostic of disease progression in rectal cancer patients who undergo neoadjuvant therapy.

Original languageEnglish
Pages (from-to)878-886
Number of pages9
JournalBritish Journal of Cancer
Issue number6
Publication statusPublished - Mar 20 2018


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