Abstract

Approximately half of the colorectal cancer (CRC) patients develop metastatic disease. Fluoropyrimidine-based chemotherapy forms the backbone of treatment in these patients. However, the response to this therapy varies between individuals. Therefore, an important challenge in CRC research is to identify biomarkers that are predictive of this response. In this study, we explored the potential of miRNAs, and the miRNA producing protein Dicer, as biomarkers that can predict chemo-sensitivity to fluoropyrimidine chemotherapy in patients with metastatic colorectal cancer (mCRC). We analyzed the levels of 22 miRNAs and the Dicer protein in primary tumors from patients with mCRC who were treated with first-line capecitabine monotherapy within the CAIRO trial of the Dutch Colorectal Cancer Group. Correlation between the expression status of miRNAs or Dicer in primary tumors and the progression free survival (PFS) were investigated. Patients with low expression of miR-143 in their primary tumor had increased median PFS compared to those with high expression of miR-143. Furthermore, FXYD3, an ion transport regulator and a putative target of miR-143, also showed an association with PFS. These findings warrant further studies to investigate the relationship between miR-143, FXYD3 and fluoropyrimidines, and the clinical utility of miR-143 as biomarker.

Highlights

  • Colorectal cancer (CRC) is worldwide one of the most common types of cancer, and a leading cause of cancer death for both men and women

  • Immunohistochemical (IHC) analysis was performed to study the influence of Dicer expression on progression free survival (PFS) of metastatic CRC (mCRC) patients who received fluoropyrimidine-based chemotherapy

  • Comparison of miRNA expression in primary tumors and matched normal tissue We investigated the predictive potential of miRNAs for patients with mCRC who received fluoropyrimidine-based chemotherapy

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Summary

Introduction

Colorectal cancer (CRC) is worldwide one of the most common types of cancer, and a leading cause of cancer death for both men and women (http://globocan. iarc.fr). Colorectal cancer (CRC) is worldwide one of the most common types of cancer, and a leading cause of cancer death for both men and women Half of the CRC patients develop metastatic disease, either at diagnosis or during followup [1]. For over 40 years fluoropyrimidine-based chemotherapy (5-fluorouracil, capecitabine) has been used in the treatment of patients with metastatic CRC (mCRC), and significantly prolongs survival [2]. Not all patients respond to treatment [3]. Biomarkers that can differentiate patients into responders and non-responders would optimize health care

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