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Type: Journal article
Title: Identification of microRNA biomarkers of response to neoadjuvant chemoradiotherapy in esophageal adenocarcinoma using next generation sequencing
Author: Chiam, K.
Mayne, G.
Watson, D.
Woodman, R.
Bright, T.
Michael, M.
Karapetis, C.
Irvine, T.
Phillips, W.
Hummel, R.
Wang, T.
Pimlott, L.
Marri, S.
Astill, D.
Ruszkiewicz, A.
Thompson, S.
Hussey, D.
Citation: Annals of Surgical Oncology, 2018; 25(9):2731-2738
Publisher: Springer International Publishing
Issue Date: 2018
ISSN: 1068-9265
Statement of
Karen Chiam, George C. Mayne, David I. Watson, Richard J. Woodman, Tim F. Bright, Michael Z. Michael, Christos S. Karapetis, Tanya Irvine, Wayne A. Phillips, Richard Hummel, Tingting Wang, Letitia K. Pimlott, Shashikanth Marri, David StJ. Astill, Andrew R. Ruszkiewicz, Sarah K. Thompson, and Damian J. Hussey
Abstract: Background. Clinical trials report improved overall survival following neoadjuvant chemoradiotherapy in patients undergoing surgery for esophageal adenocarcinoma, with a 10–15% survival improvement. MicroRNAs (miRNAs) are small noncoding RNAs that are known to direct the behavior of cancers, including response to treatment. We investigated the ability of miRNAs to predict outcomes after neoadjuvant chemoradiotherapy. Methods. Endoscopic biopsies from esophageal adenocarcinomas were obtained before neoadjuvant chemoradiotherapy and esophagectomy. miRNA levels were measured in the biopsies using next generation sequencing and compared with pathological response in the surgical resection, and subsequent survival. miRNA ratios that predicted pathological response were identified by Lasso regression and leave-one-out crossvalidation. Association between miRNA ratio candidates and relapse-free survival was assessed using Kaplan–Meier analysis. Cox regression and Harrell’s C analyses were performed to assess the predictive performance of the miRNAs. Results. Two miRNA ratios (miR-4521/miR-340-5p and miR-101-3p/miR-451a) that predicted the pathological response to neoadjuvant chemoradiotherapy were found to be associated with relapse-free survival. Pretreatment expression of these two miRNA ratios, pretreatment tumor differentiation, posttreatment AJCC histopathological tumor regression grading, and posttreatment tumor clearance/ margins were significant factors associated with survival in Cox regression analysis. Multivariate analysis of the two ratios together with pretherapy factors resulted in a risk prediction accuracy of 85% (Harrell’s C), which was comparable with the prediction accuracy of the AJCC treatment response grading (77%). Conclusions. miRNA-ratio biomarkers identified using next generation sequencing can be used to predict disease free survival following neoadjuvant chemoradiotherapy and esophagectomy in patients with esophageal adenocarcinoma.
Keywords: Humans
Esophageal Neoplasms
Neoplasm Recurrence, Local
Neoadjuvant Therapy
Survival Rate
Follow-Up Studies
Gene Expression Profiling
Gene Expression Regulation, Neoplastic
Aged, 80 and over
Middle Aged
High-Throughput Nucleotide Sequencing
Biomarkers, Tumor
Description: Published Online: 9 July 2018
Rights: © Society of Surgical Oncology 2018
DOI: 10.1245/s10434-018-6626-z
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Surgery publications

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