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Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2015 May 8. pii: mdv224. doi: 10.1093/annonc/mdv224. pmc: PMC4511220

Variations in genes involved in dormancy associated with outcome in patients with resected colorectal liver metastases.

Stremitzer S¹, Zhang W², Yang D³, Ning Y⁴, Stintzing S⁵, Sunakawa Y⁶, Sebio A⁷, Yamauchi S⁸, Matsusaka S⁹, Parekh A¹⁰, Barzi A¹¹, El-Khoueiry R¹², Stift J¹³, Wrba F¹⁴, Gruenberger T¹⁵, Lenz HJ¹⁶

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Abstract

BACKGROUND: Tumor dormancy has been described as a state of hibernation. Dormancy can be switched to proliferation by different pathways, which may play a critical role in tumor recurrence. In this study, we investigated genetic variations within genes involved in tumor dormancy and their association with recurrence and outcome in patients with colorectal liver metastases (CLM) who underwent neoadjuvant bevacizumab-based chemotherapy.

PATIENTS AND METHODS: Genomic DNA was extracted from resected CLM (FFPE) from 149 patients. Single-nucleotide polymorphisms (SNPs) in 14 genes associated with dormancy were analyzed by direct Sanger DNA sequencing and evaluated for response, recurrence-free survival (RFS), overall survival (OS) and recurrence patterns.

RESULTS: NME1 rs34214448 C>A was significantly associated with RFS in univariable analysis (P = 0.039) and with intrahepatic recurrence (P = 0.014). NOTCH3 rs1044009 T>C and CD44 rs8193 C>T showed a significant difference in 3-year OS rates (P = 0.004 and P = 0.042, respectively). With respect to radiological response, CD44 rs8193 C>T variant genotypes were associated with a significantly higher response rate (P = 0.033). Recursive partitioning analyses revealed that Dll4 rs12441495 C>G, NME1 rs34214448 C>A and NOTCH3 rs1044009 T>C were the dominant SNPs predicting histological response, RFS and OS, respectively.

CONCLUSION: Our data suggest that gene variations within genes involved in tumor dormancy pathways are associated with response and outcome in patients with resected CLM. These data may lead to new and more effective treatment strategies targeting tumor dormancy.

KEYWORDS: bevacizumab, colorectal liver metastases, dormancy, neoadjuvant chemotherapy, single-nucleotide polymorphisms

Publikations ID: 25957329
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