The Role of p53 Expression in Patients with RAS/BRAF Wild-Type Metastatic Colorectal Cancer Receiving Irinotecan and Cetuximab as Later Line Treatment.


Journal

Targeted oncology
ISSN: 1776-260X
Titre abrégé: Target Oncol
Pays: France
ID NLM: 101270595

Informations de publication

Date de publication:
07 2021
Historique:
accepted: 20 04 2021
pubmed: 11 5 2021
medline: 19 1 2022
entrez: 10 5 2021
Statut: ppublish

Résumé

Preclinical and clinical data indicate that p53 expression might modulate the activity of the epidermal growth factor receptor (EGFR), influencing response/resistance to anti-EGFR monoclonal antibodies. However, the association between p53 status and clinical outcome has not been clarified yet. In our study, we evaluated the role of p53 expression in patients with RAS/BRAF wild-type metastatic colorectal cancer (mCRC) receiving irinotecan/cetuximab in an exploratory and a validation cohort. p53 expression was analysed in patients with RAS/BRAF wild-type mCRC receiving second-line or third-line irinotecan/cetuximab. Survival distribution was assessed by the Kaplan-Meier method, while the log-rank test was used for survival comparison. Among 120 patients with RAS/BRAF wild-type mCRC included in our analysis, 52 (59%) and 19 (59%) patients showed p53 overexpression in the exploratory and validation cohort, respectively. In the exploratory cohort, low p53 expression was correlated with better median progression-free survival (hazard ratio 0.39; p < 0.0001), median overall survival (hazard ratio: 0.23; p < 0.0001) and response rate (p < 0.0001). These results were confirmed by data of the validation cohort where we observed better median progression-free survival (hazard ratio: 0.48; p = 0.0399), median overall survival (hazard ratio: 0.26; p = 0.0027) and response rate (p =0.0007) in patients with p53 normal expression mCRC. In our study, p53 overexpression was associated with anti-EGFR treatment resistance in patients with RAS/BRAF WT mCRC, as confirmed in a validation cohort. Larger studies are needed to validate the role of p53 and investigate EGFR cross-talk in these patients.

Sections du résumé

BACKGROUND
Preclinical and clinical data indicate that p53 expression might modulate the activity of the epidermal growth factor receptor (EGFR), influencing response/resistance to anti-EGFR monoclonal antibodies. However, the association between p53 status and clinical outcome has not been clarified yet.
OBJECTIVE
In our study, we evaluated the role of p53 expression in patients with RAS/BRAF wild-type metastatic colorectal cancer (mCRC) receiving irinotecan/cetuximab in an exploratory and a validation cohort.
PATIENTS AND METHODS
p53 expression was analysed in patients with RAS/BRAF wild-type mCRC receiving second-line or third-line irinotecan/cetuximab. Survival distribution was assessed by the Kaplan-Meier method, while the log-rank test was used for survival comparison.
RESULTS
Among 120 patients with RAS/BRAF wild-type mCRC included in our analysis, 52 (59%) and 19 (59%) patients showed p53 overexpression in the exploratory and validation cohort, respectively. In the exploratory cohort, low p53 expression was correlated with better median progression-free survival (hazard ratio 0.39; p < 0.0001), median overall survival (hazard ratio: 0.23; p < 0.0001) and response rate (p < 0.0001). These results were confirmed by data of the validation cohort where we observed better median progression-free survival (hazard ratio: 0.48; p = 0.0399), median overall survival (hazard ratio: 0.26; p = 0.0027) and response rate (p =0.0007) in patients with p53 normal expression mCRC.
CONCLUSIONS
In our study, p53 overexpression was associated with anti-EGFR treatment resistance in patients with RAS/BRAF WT mCRC, as confirmed in a validation cohort. Larger studies are needed to validate the role of p53 and investigate EGFR cross-talk in these patients.

Identifiants

pubmed: 33970400
doi: 10.1007/s11523-021-00816-3
pii: 10.1007/s11523-021-00816-3
pmc: PMC8266772
doi:

Substances chimiques

Tumor Suppressor Protein p53 0
Irinotecan 7673326042
Cetuximab PQX0D8J21J

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

517-527

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Auteurs

Pina Ziranu (P)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Eleonora Lai (E)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Marta Schirripa (M)

Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Marco Puzzoni (M)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Mara Persano (M)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Andrea Pretta (A)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.
Medical Oncology Unit, Sapienza University of Rome, Rome, Italy.
Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Giada Munari (G)

Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Nicole Liscia (N)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.
Medical Oncology Unit, Sapienza University of Rome, Rome, Italy.

Valeria Pusceddu (V)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Fotios Loupakis (F)

Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Laura Demurtas (L)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Michela Libertini (M)

Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.

Stefano Mariani (S)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Marco Migliari (M)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Marco Dubois (M)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy.

Riccardo Giampieri (R)

Medical Oncology Unit, University Hospital and Università Politecnica delle Marche, Ancona, Italy.

Giovanni Sotgiu (G)

Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.

Angelo Paolo Dei Tos (AP)

Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.

Sara Lonardi (S)

Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.

Alberto Zaniboni (A)

Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.

Matteo Fassan (M)

Surgical Pathology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.

Mario Scartozzi (M)

Medical Oncology Unit, University Hospital and University of Cagliari, S.S. 554 Bivio per Sestu Km 4, 500, 09042, Monserrato, Cagliari, Italy. marioscartozzi@gmail.com.

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