Human equilibrative nucleoside transporter 1 expression is a strong independent prognostic factor in UICC T3-T4 pancreatic cancer patients treated with preoperative gemcitabine-based chemoradiotherapy.

Abstract

BACKGROUND/PURPOSE:

We aimed to determine the relationship between the intratumoral expression of human equilibrative nucleoside transporter (hENT1), the main gemcitabine transporter into cells, and the outcome of gemcitabine-based chemoradiotherapy (Gem-CRT) in patients with International Union Against Cancer (UICC) T3-T4 pancreatic adenocarcinoma.

METHODS:

The expressions of hENT1, thymidylate synthase (TS), and dihydropyrimidine dehydrogenase were immunohistochemically analyzed using the resected specimens from 55 patients (T3, 38 and T4, 17) who had received curative-intent resection after Gem-CRT.

RESULTS:

The status of hENT1 expression (positive in 39 and negative in 16) was significantly associated with "clinical efficacy" (defined as more than 50% reduction of the serum carbohydrate antigen [CA] 19-9 level with stable disease [SD] or partial response [PR] according to the Response Evaluation Criteria in Solid Tumors [RECIST]) for Gem-CRT. The 1- and 3-year overall survival (OS) rates were significantly higher in the positive hENT1 expression group (82.9, 39.5%) than in the negative expression group (42.9, 14.3%) (p = 0.0037). According to combination analysis of hENT1 and TS expressions, the 1- and 3-year OS rates were significantly higher in the positive-low combination (89.1, 51.0%) group than in the negative-high group (66.7, 0%) (p = 0.023). Multivariate analysis revealed that positive hENT1 expression and R0 resection were significant prognostic factors for OS.

CONCLUSIONS:

The hENT1 expression in pancreatic adenocarcinoma strongly influences the outcome of preoperative Gem-CRT treatment. This biomarker could become a useful predictor of therapeutic effect for gemcitabine-based therapy in pancreatic cancer patients.

• Authors: Yasuhiro Murata, Takashi Hamada, Masashi Kishiwada, Ichiro Ohsawa, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai, Masami Tabata, Noriko Ii, Hiroyuki Inoue, Taizo Shiraishi, Shuji Isaji
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 19 Issue 4 Pg. 413-25 (Jul 2012) ISSN: 1868-6982 [Electronic] Japan
• PMID: 21898089 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• CA-19-9 Antigen
• Equilibrative Nucleoside Transporter 1
• SLC29A1 protein, human
• Dihydrouracil Dehydrogenase (NADP)
• Thymidylate Synthase

Topics

• Adenocarcinoma (metabolism, mortality, pathology, surgery, therapy)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers (analysis)
• CA-19-9 Antigen (blood)
• Chemoradiotherapy, Adjuvant
• Dihydrouracil Dehydrogenase (NADP) (metabolism)
• Equilibrative Nucleoside Transporter 1 (metabolism)
• Female
• Gene Expression Regulation, Neoplastic
• Humans
• Immunohistochemistry
• Male
• Middle Aged
• Multivariate Analysis
• Neoadjuvant Therapy
• Neoplasm Staging
• Nutrition Assessment
• Pancreatic Neoplasms (metabolism, mortality, pathology, surgery, therapy)
• Prognosis
• Survival Analysis
• Thymidylate Synthase (metabolism)
• Treatment Outcome