Elevated CEA Levels and Low Distance of the Tumor from the Anal Verge are Predictors of Incomplete Response to Chemoradiation in Patients with Rectal Cancer

Restivo, Angelo; Zorcolo, Luigi; Cocco, Ivana Maria Francesca; Manunza, Romina; Margiani, Carla; Marongiu, Luigi; Casula, G.

doi:10.1245/s10434-012-2669-8

Cited by 67 publications

(57 citation statements)

References 45 publications

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“…Other trials explored the same hypothesis using 5 ng/mL as a cutoff value, and confirmed pretreatment CEA as a valuable predictor of tumor response. [78][79][80][81] Wallin et al 82 investigated a different cutoff value, 3.4 ng/mL, but again demonstrated the predictive value of low baseline CEA in terms of significantly higher pCR rates, especially in the group of nonsmokers (P ¼ .002). In a smaller trial Perez et al 83 did not observe any correlation between pretreatment CEA levels and pCR or survival.…”

Section: Carcinoembryonic Antigenmentioning

confidence: 99%

Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer

Molinari

Matteucci

Caroli

et al. 2015

Clinical Colorectal Cancer

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Section: Carcinoembryonic Antigenmentioning

confidence: 99%

Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer

Molinari

Matteucci

Caroli

et al. 2015

Clinical Colorectal Cancer

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“…In rectal cancer there are several studies analyzing changing CEA levels in relation to preoperative CRT. High CEA levels pre- as well as post-therapeutical were associated with a poorer prognosis [10,11,12,13,14,15,16]. However, the clinical use of CEA as a molecular biomarker to predict pathologic complete response has its limitations and is controversially discussed [11,17].…”

Section: Introductionmentioning

confidence: 99%

Changes of Microrna Levels in Plasma of Patients with Rectal Cancer during Chemoradiotherapy

Azizian

Salendo

et al. 2017

IJMS

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Since the response to chemoradiotherapy in patients with locally advanced rectal cancer is heterogeneous, valid biomarkers are needed to monitor tumor response. Circulating microRNAs are promising candidates, however analyses of circulating microRNAs in rectal cancer are still rare. 111 patients with rectal cancer and 46 age-matched normal controls were enrolled. The expression levels of 30 microRNAs were analyzed in 17 pre-treatment patients’ plasma samples. Differentially regulated microRNAs were validated in 94 independent patients. For 52 of the 94 patients a paired comparison between pre-treatment and post-treatment samples was performed. miR-17, miR-18b, miR-20a, miR-31, and miR-193a_3p, were significantly downregulated in pre-treatment plasma samples of patients with rectal cancer (p < 0.05). miR-29c, miR-30c, and miR-195 showed a trend of differential regulation. After validation, miR-31 and miR-30c were significantly deregulated by a decrease of expression. In 52 patients expression analyses of the 8 microRNAs in matched pre-treatment and post-treatment samples showed a significant decrease for all microRNAs (p < 0.05) after treatment. Expression levels of miR-31 and miR-30c could serve as valid biomarkers if validated in a prospective study. Plasma microRNA expression levels do not necessarily represent miRNA expression levels in tumor tissue. Also, expression levels of microRNAs change during multimodal therapy.

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“…We could select treatment plan or modality based on predictions of response. Many studies focused on clinical factors and molecular profile of cancer lesion and confirmed the association of biomarker with tumor response [3,4]. Immunological host status also influenced tumor response [5].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical factors such as carcinoembryonic antigen (CEA), distance from the anal verge, and molecular profile were associated with tumor response [3,4]. Recently, in addition to the clinical factors, the relationship between host immunity and tumor response was studied.…”

Section: Introductionmentioning

confidence: 99%

Nodal tumor response according to the count of peripheral blood lymphocyte subpopulations during preoperative chemoradiotherapy in locally advanced rectal cancer

Heo

Noh

et al. 2016

Radiat Oncol J

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PurposeThe objective of this prospective study was to evaluate the relationship between the circulating lymphocyte subpopulation counts during preoperative chemoradiotherapy (CRT) and tumor response in locally advanced rectal cancer.Materials and MethodsFrom August 2015 to June 2016, 10 patients treated with preoperative CRT followed by surgery were enrolled. Patients received conventional fractionated radiotherapy (50.4 Gy) with fluorouracil-based chemotherapy. Surgical resection was performed at 4 to 8 weeks after the completion of preoperative CRT. The absolute blood lymphocyte subpopulation was obtained prior to and after 4 weeks of CRT. We analyzed the association between a tumor response and change in the lymphocyte subpopulation during CRT.ResultsAmong 10 patients, 2 (20%) had evidence of pathologic complete response. In 8 patients with clinically node positive, 4 (50%) had nodal tumor response. All lymphocyte subpopulation counts at 4 weeks after CRT were significantly lower than those observed during pretreatment (p < 0.01). A high decrease in natural killer (NK) cell, count during CRT (baseline cell count − cell count at 4 weeks) was associated with node down staging (p = 0.034).ConclusionOur results suggest that the change of lymphocyte subset to preoperative CRT may be a predictive factor for tumor response in rectal cancer.

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Elevated CEA Levels and Low Distance of the Tumor from the Anal Verge are Predictors of Incomplete Response to Chemoradiation in Patients with Rectal Cancer

Abstract: Very low tumors with a high serum CEA are very unlikely to reach a CPR. The predictive value of these easily available clinical factors should not be underestimated, and better therapeutic strategies for these tumors are needed.

Cited by 67 publications

References 45 publications

Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer

Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer

Changes of Microrna Levels in Plasma of Patients with Rectal Cancer during Chemoradiotherapy

Nodal tumor response according to the count of peripheral blood lymphocyte subpopulations during preoperative chemoradiotherapy in locally advanced rectal cancer

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