Abstract C33: Prognostic value of C-myc overexpression in patients with resectable pancreatic cancer.

Abstract

Abstract Purpose: Pancreatic cancer is one of the leading causes of cancer-related mortality and it is well known for extremely aggressive tumor growth rate, high incidence of metastasis and high metabolic rate. The aim of this study is to determine the value of metabolic gene expression as prognostic markers in patients with resectable pancreatic cancer. We also investigate the possible association among clinical parameters, 18F-2-fluoro-2-deoxyglucose positron emission tomography (FDG PET) and metabolic markers. Materials and Methods: We retrospectively reviewed the medical records of 49 pancreatic cancer patients who underwent curative resection. Using formalin fixed paraffin embedded tissues of primary tumors, immunohistochemistry (IHC) was done for GLUT1, hexokinase (HK), p53, IDH, pmTOR, PKM2, CMYC, and AMPK. Kaplan meier analysis and Cox-regression was used for univariate and multivariate analysis to examine the prognostic impact of each marker on survival. Also, Fisher's exact test was performed to examine correlation between metabolic makers and FDG uptake. Results: Median overall survival (OS) of all patients was 27.3 months (95% CI, 15.9 - 38.6). In univariate analysis, longer overall survival was seen in patients with c-myc overexpression, higher FDG uptake, and poorly differentiated histology. Multivariate analysis revealed that c-myc overexpression was an independent poor prognostic factor after adjustment of higher FDG uptake and tumor differentiation. No association was found between clinical parameters, FGD uptake, and metabolic markers. However, higher FDG uptake was correlated with low AMPK expression (P=0.017). Conclusions: Our study demonstrated that the c-myc overexpression identified by IHC is an independent prognostic factor in pancreatic cancer patients who underwent curative resection. Future studies are required to explore the underlying mechanism how c-myc overexpression contributes to the progression of pancreatic cancer in consideration with cancer metabolism. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):C33. Citation Format: Seungtaek Lim, Hye Jin Choi, Jae-hoon Lee, Soohyeon Lee. Prognostic value of C-myc overexpression in patients with resectable pancreatic cancer. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr C33.