Open Access

ERCC overexpression associated with a poor response of cT4b colorectal cancer with FOLFOX‑based neoadjuvant concurrent chemoradiation

  • Authors:
    • Ming-Yii Huang
    • Hsin-Hua Lee
    • Ching-Wen Huang
    • Chun-Ming  Huang
    • Cheng-Jen Ma
    • Tzu-Chieh Yin
    • Hsiang-Lin Tsai
    • Chee-Yin  Chai
    • Yi-Ting Chen
    • Jaw-Yuan Wang
  • View Affiliations

  • Published online on: September 8, 2020     https://doi.org/10.3892/ol.2020.12075
  • Article Number: 212
  • Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

Colorectal cancer (CRC) of the clinical tumor stage T4b (cT4b) refers to advanced tumors with direct invasion of adjacent structures and the tumors are considered unresectable. Despite advancements in aggressive surgery and combination chemotherapy, the prognosis of cT4b CRC remains poor. Optimizing the therapeutic sequence administered to patients with cT4b CRC to improve clinical outcomes is crucial. In the present study, patients with unresectable cT4b and nodal stage N1‑2 CRC were investigated at a single institution. A total of 20 consecutive patients were treated with pre‑operative concurrent chemoradiation by using 5‑fluorouracil/leucovorin/oxaliplatin (FOLFOX) since February 2015 and were regularly followed up until March 2020. Due to their poor response to concurrent chemoradiation (CCRT) with FOLFOX, the chemotherapy regimen was changed to irinotecan plus 5‑fluorouracil/leucovorin (FOLFIRI) as the second‑line neoadjuvant treatment. Genetic alterations, such as microsatellite instability (MSI), were documented, and the expression levels of excision repair cross‑complementing group 1 (ERCC1) and ERCC2 were examined. Of the 20 patients, the tumors of 14 patients (70%) became resectable after FOLFIRI administration. The median duration between the last date of radiotherapy and surgery was 32.7 weeks (range, 10.1‑59.3 weeks). Of note, 4 of the 14 patients with resectable tumors (28.6%) achieved a pathologic complete response. The median overall survival and progression‑free survival were 27.5 months (range, 12‑39 months) and 27.5 months (range, 8‑39 months), respectively. The cancerous specimens of all of the patients (100%) exhibited ERCC2 overexpression and 18 specimens (90%) had ERCC1 overexpression. Only one tumor (5%) exhibited high MSI. The present study indicated that ERCC overexpression associated with the poor response of FOLFOX‑based CCRT and FOLFIRI after FOLFOX‑based CCRT failure may have a potential role in conversion to resectable tumors by neoadjuvant treatment in cT4b CRC. However, a further prospective study with more patients is required to improve the precision of the conclusions.
View Figures
View References

Related Articles

Journal Cover

November-2020
Volume 20 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
x
Spandidos Publications style
Huang M, Lee H, Huang C, Huang C, Ma C, Yin T, Tsai H, Chai C, Chen Y, Wang J, Wang J, et al: ERCC overexpression associated with a poor response of cT4b colorectal cancer with FOLFOX‑based neoadjuvant concurrent chemoradiation. Oncol Lett 20: 212, 2020
APA
Huang, M., Lee, H., Huang, C., Huang, C., Ma, C., Yin, T. ... Wang, J. (2020). ERCC overexpression associated with a poor response of cT4b colorectal cancer with FOLFOX‑based neoadjuvant concurrent chemoradiation. Oncology Letters, 20, 212. https://doi.org/10.3892/ol.2020.12075
MLA
Huang, M., Lee, H., Huang, C., Huang, C., Ma, C., Yin, T., Tsai, H., Chai, C., Chen, Y., Wang, J."ERCC overexpression associated with a poor response of cT4b colorectal cancer with FOLFOX‑based neoadjuvant concurrent chemoradiation". Oncology Letters 20.5 (2020): 212.
Chicago
Huang, M., Lee, H., Huang, C., Huang, C., Ma, C., Yin, T., Tsai, H., Chai, C., Chen, Y., Wang, J."ERCC overexpression associated with a poor response of cT4b colorectal cancer with FOLFOX‑based neoadjuvant concurrent chemoradiation". Oncology Letters 20, no. 5 (2020): 212. https://doi.org/10.3892/ol.2020.12075