Abstract 3905
Background
Loss of caudal-type homeobox transcription factor-2 (CDX-2) expression in colorectal cancers (CRC) has recently been proposed as a predictive biomarker for response to chemotherapy and also prognosis. However, the data on relationship between alterations in CDX-2 expression and clinicopathological variables remain limited. We herein aimed to investigate the clinicopathological factors and prognostic implications associated with loss of CDX-2 expression in CRC patients.
Methods
Immunohistochemistry for CDX-2 expression was performed on formalin-fixed, paraffin-embedded tissue samples from 427 patients with CRC. Correlation between CDX-2 expression and clinicopathological characteristics were evaluated. Univariate and multivariate survival analyses were performed to reveal the prognostic value of loss of CDX-2 expression.
Results
Of 427 patients, 85% were stage I-III. Seventy six percent had left-sided primary tumors. Deficient mismatch repair (dMMR) was found in 12%. CDX-2-negative expression was identified in 18 out of 427 (4.2%) patients. Loss of CDX-2 expression was more commonly found in patient with right-sided tumors rather than left-sided tumors (9.4% vs 2.8% respectively, p = 0.005) and dMMR compared to proficient MMR (11.5% vs 3.3% respectively, p = 0.006). There was no association between CDX-2 expression and sex, stage, histologic subtype, tumor differentiation and lymphovascular/perineural invasion. By univariate analysis, patients with CDX-2 loss of expression had significantly worse overall survival (OS) and disease free survival (DFS) than those with CDX-2 positive expression (median OS 1.6 vs 11.6 months (mo), p < 0.001; median DFS 1.33 mo vs NR, p = 0.003). By multivariate analysis, loss of CDX-2 expression remained a negative prognostic factor for OS (hazard ratio 2.32; 95%CI 1.25-4.28, p = 0.007).
Conclusions
Loss of CDX-2 expression was associated with right-sided tumor and dMMR status. Moreover, loss of CDX-2 expression is a poor prognostic factor for OS, even among patients with dMMR tumors.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Faculty of Medicine Siriraj Hospital.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5887 - Factors of importance in procuring tumoroids from colorectal liver metastasis biopsies for precision medicine.
Presenter: Lars Henrik Jensen
Session: Poster Display session 2
Resources:
Abstract
2196 - FUSAFE individual patient data meta-analysis (MA) to assess the performance of dihydropyrimidine dehydrogenase (DPD) gene polymorphisms for predicting grade 4-5 fluoropyrimidine (FP) toxicity
Presenter: Marie-Christine Etienne-Grimaldi
Session: Poster Display session 2
Resources:
Abstract
2859 - Treatments (tx) after progression to first-line FOLFOXIRI + bevacizumab (bev) in metastatic colorectal cancer (mCRC) patients (pts): A pooled analysis of TRIBE and TRIBE-2 studies by GONO.
Presenter: Daniele Rossini
Session: Poster Display session 2
Resources:
Abstract
3888 - Randomized phase III study of sequential treatment with capecitabine or 5-fluorouracil (FP) plus bevacizumab (BEV) followed by the addition with oxaliplatin (OX) versus initial combination with OX+FP+ BEV in the first-line chemotherapy for metastatic colorectal cancer: The C-cubed study
Presenter: Takeshi Nagasaka
Session: Poster Display session 2
Resources:
Abstract
1065 - Early tumour shrinkage (ETS), depth of response (DpR) and associated survival outcomes in patients (pts) with RAS wild type (WT) metastatic colorectal cancer (mCRC) classified according to Köhne prognostic category: retrospective analysis of the panitumumab (Pmab) PRIME study
Presenter: Andrea Sartore-Bianchi
Session: Poster Display session 2
Resources:
Abstract
1702 - Randomized phase II trial of CAPOX with planned oxaliplatin stop-and-go strategy as adjuvant chemotherapy after curative resection of colon cancer (CCOG-1302 study)
Presenter: Hiroyuki Yokoyama
Session: Poster Display session 2
Resources:
Abstract
5104 - A metabolomic recurrence score for risk-stratification of elderly patients (pts) with early colorectal cancer (eCRC)
Presenter: Samantha Di Donato
Session: Poster Display session 2
Resources:
Abstract
5285 - RAS mutant allele fraction in plasma predicts benefit to anti-angiogenic based first line treatment in metastatic colorectal cancer
Presenter: Giulia Martini
Session: Poster Display session 2
Resources:
Abstract
1790 - Impact of prophylactic systemic antibiotics (SA) on outcome of patients (pts) with RAS-wildtype (RAS-wt) metastatic colorectal carcinoma (mCRC) treated with cetuximab-based first-line therapy. Subgroup analysis of the german non-interventional study ERBITAG
Presenter: Stephan Sahm
Session: Poster Display session 2
Resources:
Abstract
3059 - Intraoperative chemotherapy with 5-FU for colorectal cancer patients receiving curative resection (IOCCRC): A randomized, multicenter, prospective, phase III trial
Presenter: Rongxin Zhang
Session: Poster Display session 2
Resources:
Abstract