Abstract

Retinol plays a significant role in several physiological processes through their nuclear receptors, whose expression depends on retinol cytoplasmic concentration. Loss of expression of nuclear receptors and low retinol levels have been correlated with lung cancer development. Stimulated by retinoic acid 6 (STRA6) is the only described cell membrane receptor for retinol uptake. Some chronic diseases have been linked with specific polymorphisms in STRA6. This study aimed to evaluate four STRA6 single nucleotide polymorphisms (SNPs) (rs4886578, rs736118, rs351224, and rs97445) among 196 patients with locally-advanced and metastatic non-small cell lung cancer (NSCLC) patients. Genotyping, through a validated SNP assay and determined using real time-PCR, was correlated with clinical features and outcomes. NSCLC patients with a TT SNP rs4886578 and rs736118 genotype were more likely to be >60 years, non-smokers, and harboring EGFR mutations. Patients with a TT genotype compared with a CC/CT SNP rs974456 genotype had a median progression-free survival (PFS) of 3.2 vs. 4.8 months, p = 0.044, under a platinum-based regimen in the first-line. Furthermore, patients with a TT rs351224 genotype showed a prolonged overall survival (OS), 47.5 months vs. 32.0 months, p = 0.156. This study showed a correlation between clinical characteristics, such as age, non-smoking history, and EGFR mutational status and oncological outcomes depending on STRA6 SNPs. The STRA6 TT genotype SNP rs4886578 and rs736118 might be potential biomarkers in locally-advanced and metastatic NSCLC patients.

Highlights

  • Lung cancer is the leading cause of cancer-related deaths worldwide and is currently responsible for 1.8 million deaths per year; it will soon represent around 30% of all cancer-related deaths [1]

  • This study aims to analyze four Stimulated by retinoic acid 6 (STRA6) single nucleotide polymorphisms (SNPs) and their association with clinical features, progression-free survival (PFS), and overall survival (OS) in locally-advanced and metastatic non-small cell lung cancer (NSCLC) patients

  • One hundred ninety-six patients with confirmed NSCLC patients treated in the Thoracic Oncology Unit at the Instituto Nacional de Cancerologıá (INCan) in Mexico City from January 2015 to December 2016, were eligible

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Summary

Introduction

Lung cancer is the leading cause of cancer-related deaths worldwide and is currently responsible for 1.8 million deaths per year; it will soon represent around 30% of all cancer-related deaths [1]. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Retinoids are a family of signaling molecules related to vitamin A (retinol), and play a significant role in several cellular processes, such as embryogenesis, cell proliferation, differentiation, and apoptosis [7]. Retinoids have been demonstrated to stop carcinogenesis in breast, lung, prostate, bladder, and lung cancer [7,8,9,10]. Evidence indicates NSCLC patients overexpress RXRa and RARg; RARb suppression exists, suggesting an imbalance in the receptors’ expression that could play an essential role in cancer genesis [12]. Preclinical and clinical studies demonstrated that retinoids might reverse premalignant epithelial lesions and preventing secondary neoplasms

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