dc.contributor.author | Hektoen, Helga H | |
dc.contributor.author | Flatmark, Kjersti | |
dc.contributor.author | Andersson, Yvonne | |
dc.contributor.author | Dueland, Svein | |
dc.contributor.author | Redalen, Kathrine R | |
dc.contributor.author | Ree, Anne H | |
dc.date.accessioned | 2015-10-20T12:46:06Z | |
dc.date.available | 2015-10-20T12:46:06Z | |
dc.date.issued | 2015 | |
dc.identifier.citation | BMC Cancer. 2015 Jul 24;15(1):543 | |
dc.identifier.uri | http://hdl.handle.net/10852/47317 | |
dc.description.abstract | Background
Locally advanced rectal cancer (LARC) comprises heterogeneous tumours with predominant hypoxic components. The hypoxia-inducible metabolic shift causes microenvironmental acidification generated by carbonic anhydrase IX (CAIX) and facilitates metastatic progression, the dominant cause of failure in LARC.
Methods
Using a commercially available immunoassay, circulating CAIX was assessed in prospectively archived serial serum samples collected during combined-modality neoadjuvant treatment of LARC patients and correlated to histologic tumour response and progression-free survival (PFS).
Results
Patients who from their individual baseline level displayed serum CAIX increase above a threshold of 224 pg/ml (with 96 % specificity and 39 % sensitivity) after completion of short-course neoadjuvant chemotherapy (NACT) prior to long-course chemoradiotherapy and definitive surgery had significantly better 5-year PFS (94 %) than patients with below-threshold post-NACT versus baseline alteration (PFS rate of 56 %; p < 0.01). This particular CAIX parameter, ΔNACT, was significantly correlated with histologic ypT0–2 and ypN0 outcome (p < 0.01) and remained an independent PFS predictor in multivariate analysis wherein it was entered as continuous variable (p = 0.04).
Conclusions
Our results indicate that low ΔNACT, i.e., a weak increase in serum CAIX level following initial neoadjuvant treatment (in this case two cycles of the Nordic FLOX regimen), might be used as risk-adapted stratification to postoperative therapy or other modes of intensification of the combined-modality protocol in LARC.
Trial registration
ClinicalTrials.gov
NCT00278694 | |
dc.language.iso | eng | |
dc.rights | Hektoen et al; licensee BioMed Central Ltd. | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.title | Early increase in circulating carbonic anhydrase IX during neoadjuvant treatment predicts favourable outcome in locally advanced rectal cancer | |
dc.type | Journal article | |
dc.date.updated | 2015-10-20T12:46:07Z | |
dc.creator.author | Hektoen, Helga H | |
dc.creator.author | Flatmark, Kjersti | |
dc.creator.author | Andersson, Yvonne | |
dc.creator.author | Dueland, Svein | |
dc.creator.author | Redalen, Kathrine R | |
dc.creator.author | Ree, Anne H | |
dc.identifier.doi | http://dx.doi.org/10.1186/s12885-015-1557-6 | |
dc.identifier.urn | URN:NBN:no-51437 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/47317/1/12885_2015_Article_1557.pdf | |
dc.type.version | PublishedVersion | |
cristin.articleid | 543 | |