Response to chemotherapy (irinotecan plus 5-fluorouracil) in colorectal carcinoma can be predicted by tumour DNA content

Oncology. 2004;66(1):46-52. doi: 10.1159/000076334.

Abstract

Objective: The aim of this study was to identify markers that might predict response to chemotherapy. Postoperative chemotherapy improves the outcome in stage III colon cancer and is widely accepted as a standard therapy, but there are currently no reliable predictors to identify and select patients that will benefit.

Methods: Using DNA image cytometry, the DNA content was determined from the isolated nuclei of 56 primary colorectal carcinomas of patients who received chemotherapy (either irinotecan or irinotecan plus 5-fluorouracil and folinic acid) for advanced disease. Response to chemotherapy could be reliably evaluated in 53 patients.

Results: The modal DNA content (ploidy status) of the tumour correlated with the observed response to chemotherapy (p = 0.01). An objective response was observed in 56% of patients whose tumour histograms displayed tetraploid, peri-tetraploid or multiploid patterns of peaks, compared with 19% in patients with diploid, peri-diploid or aneuploid peaks. Notably, 86% (6/7) of patients whose tumours displayed a multiploid peak pattern showed an objective response and 1 patient had stable disease.

Conclusions: This study suggests that modal DNA content can be used to predict a patient's response to chemotherapy in advanced colorectal carcinoma. This may help in identifying patients who will benefit most from therapy for advanced colorectal cancer.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology*
  • Biomarkers, Tumor / analysis*
  • Camptothecin / analogs & derivatives*
  • Camptothecin / pharmacology
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / surgery
  • DNA, Neoplasm / analysis*
  • DNA, Neoplasm / drug effects*
  • Female
  • Fluorouracil / pharmacology
  • Humans
  • Irinotecan
  • Leucovorin / pharmacology
  • Male
  • Middle Aged
  • Ploidies
  • Predictive Value of Tests
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Irinotecan
  • Leucovorin
  • Fluorouracil
  • Camptothecin