Combined analysis of KRAS mutation and p16INK4a and p14ARF methylation status in locally advanced rectal carcinoma treated with preoperative chemoradiotherapy

Authors

  • Bojana R. Kožik Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0002-2983-4151
  • Milena M. Krajnović Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0001-5638-2042
  • Nikola S. Kokanov Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0002-2380-2028
  • Snežana P. Jovanović-Ćupić Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0002-3389-7278
  • Ana M. Božović Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0002-6487-6365
  • Lidija B. Todorović Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0003-0672-0693
  • Vesna Lj. Mandušić Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, Laboratory for Radiobiology and Molecular Genetics, University of Belgrade, Mike Petrovića Alasa 12-14, Belgrade 11000, Serbia https://orcid.org/0000-0002-2221-3707

DOI:

https://doi.org/10.2298/ABS220222011K

Keywords:

Rectal carcinoma; KRAS; p16INK4a; p14ARF; biomarkers

Abstract

Paper description:

  • Patient responses to standard treatment of advanced stages of rectal carcinoma are variable, which emphasizes the need to define reliable predictive and prognostic molecular parameters.
  • We propose a model of simultaneous analysis of KRAS gene mutation status and p16INK4a and p14ARF gene promoter methylation status in pre-treatment tumor biopsies.
  • The simultaneous presence of p14ARF methylation and KRAS mutation was associated with more aggressive tumor behavior. The concurrent presence of alterations in all three examined genes was associated with shorter overall survival.
  • Combined analysis of examined gene alterations revealed patient subgroups with a distinct pattern of tumor response and disease outcome.

Abstract: Current management of locally advanced rectal carcinoma (LARC) involves preoperative chemoradiotherapy (preCRT) before surgery. Despite improved local control rate, the response to preCRT of individual patients is variable and may reflect heterogeneous biological properties among tumors of the same clinical stage. Identifying novel molecular parameters with predictive and/or prognostic value is of great clinical importance for a personalized therapeutic approach. In this study, KRAS mutation status was analyzed by direct sequencing, while methylation-specific polymerase chain reaction (MSP) was used to examine p16INK4a and p14ARF gene methylation status in pretreatment tumor biopsies of 60 patients with LARC. The examined molecular changes of KRAS, p16INK4a and p14ARF genes were mutually independent (p16INK4a/KRAS, P=0.272; p14ARF/KRAS, P=0.923; p16INK4a/p14ARF, P=0.715). However, the simultaneous presence of p14ARF methylation and KRAS mutation was associated with a more frequent appearance of local recurrences and distant metastasis (P=0.027). Moreover, patients with the simultaneous presence of p16INK4a and p14ARF methylation and KRAS mutation had significantly shorter overall survival (P=0.011). The obtained results strongly suggest that combined analyses of examined genetic and epigenetic molecular alterations could contribute to the identification of LARC patient subgroups with more aggressive tumor behavior and worse disease outcome.

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References

Kokelaar RF, Evans MD, Davies M, Harris DA, Beynon J. Locally advanced rectal cancer: management challenges. Onco Targets Ther. 2016;9:6265-72. https://doi.org/10.2147/OTT.S100806

Feeney G, Sehgal R, Sheehan M, Hogan A, Regan M, Joyce M, Kerin M. Neoadjuvant radiotherapy for rectal cancer management. World J Gastroenterol. 2019;25(33):4850-69. https://doi.org/10.3748/wjg.v25.i33.4850

Brown KGM, Solomon MJ. Progress and future direction in the management of advanced colorectal cancer. Br J Surg. 2018;105(6):615-7. https://doi.org/10.1002/bjs.10759

Cuyle PJ, Prenen H. Current and future biomarkers in the treatment of colorectal cancer. Acta Clin Belg. 2017;72(2):103-15. https://doi.org/10.1080/17843286.2016.1262996

Meng M, Zhong K, Jiang T, Liu Z, Kwan HY, Su T. The current understanding on the impact of KRAS on colorectal cancer. Biomed Pharmacother. 2021;140:111717. https://doi.org/10.1016/j.biopha.2021.111717

Ng JM, Yu J. Promoter hypermethylation of tumour suppressor genes as potential biomarkers in colorectal cancer. Int J Mol Sci. 2015;16(2):2472-96. https://doi.org/10.3390/ijms16022472

Quelle DE, Zindy F, Ashmun RA, Sherr CJ. Alternative reading frames of the INK4a tumor suppressor gene encode two unrelated proteins capable of inducing cell cycle arrest. Cell. 1995;83(6):993-1000. https://doi.org/10.1016/0092-8674(95)90214-7

Sharpless NE, DePinho RA. The INK4A/ARF locus and its two gene products. Curr Opin Genet Dev. 1999;9(1):22-30. https://doi.org/10.1016/S0959-437X(99)80004-5

Velho S, Moutinho C, Cirnes L, Albuquerque C, Hamelin R, Schmitt F, Carneiro F, Oliveira C, Seruca R. BRAF, KRAS and PIK3CA mutations in colorectal serrated polyps and cancer: primary or secondary genetic events in colorectal carcinogenesis? BMC Cancer. 2008;8:255. https://doi.org/10.1186/1471-2407-8-255

Burri N, Shaw P, Bouzourene H, Sordat I, Sordat B, Gillet M, Schorderet D, Bosman FT, Chaubert P. Methylation silencing and mutations of the p14ARF and p16INK4a genes in colon cancer. Lab Invest. 2001;81(2):217-29. https://doi.org/10.1038/labinvest.3780230

Serra RW, Fang M, Park SM, Hutchinson L, Green MR. A KRAS-directed transcriptional silencing pathway that mediates the CpG island methylator phenotype. Elife. 2014;12;3:e02313. https://doi.org/10.7554/eLife.02313

Bennecke M, Kriegl L, Bajbouj M, Retzlaff K, Robine S, Jung A, Arkan MC, Kirchner T, Greten FR. Ink4a/Arf and oncogene-induced senescence prevent tumor progression during alternative colorectal tumorigenesis. Cancer Cell. 2010;18(2):135-46. https://doi.org/10.1016/j.ccr.2010.06.013

Palmero I, Pantoja C, Serrano M. p19ARF links the tumour suppressor p53 to Ras. Nature. 1998;395(6698):125-6. https://doi.org/10.1038/25870

Krajnović M, Marković B, Knežević-Ušaj S, Nikolić I, Stanojević M, Nikolić V, Šiljić M, Jovanović Ćupić S, Dimitrijević B. Locally advanced rectal cancers with simultaneous occurrence of KRAS mutation and high VEGF expression show invasive characteristics. Pathol Res Pract. 2016;212(7):598-603. https://doi.org/10.1016/j.prp.2016.02.018

Kožik B, Kokanov N, Knežević-Ušaj S, Nikolić I, Davidović R, Jovanović Ćupić S, Krajnović M. Methylation status of p16 and p14 genes in locally advanced rectal cancer: potential clinical implication. Arch Biol Sci. 2018;70(4):681-90. https://doi.org/10.2298/ABS180316030K

Brown KGM, Solomon MJ. Progress and future direction in the management of advanced colorectal cancer. Br J Surg. 2018;105(6):615-7. https://doi.org/10.1002/bjs.10759

Tan Y, Fu D, Li D, Kong X, Jiang K, Chen L, Yuan Y, Ding K. Predictors and Risk Factors of Pathologic Complete Response Following Neoadjuvant Chemoradiotherapy for Rectal Cancer: A Population-Based Analysis. Front Oncol. 2019;9:497. https://doi.org/10.3389/fonc.2019.00497

Burri N, Shaw P, Bouzourene H, Sordat I, Sordat B, Gillet M, Schorderet D, Bosman FT, Chaubert P. Methylation silencing and mutations of the p14ARF and p16INK4a genes in colon cancer. Lab Invest. 2001;81(2):217-29. https://doi.org/10.1038/labinvest.3780230

Dominguez G, Silva J, Garcia JM, Silva JM, Rodriguez R, Muñoz C, Chacón I, Sanchez R, Carballido J, Colás A, España P, Bonilla F. Prevalence of aberrant methylation of p14ARF over p16INK4a in some human primary tumors. Mutat Res. 2003;530(1-2):9-17. https://doi.org/10.1016/S0027-5107(03)00133-7

Lind GE, Thorstensen L, Løvig T, Meling GI, Hamelin R, Rognum TO, Manel Esteller M, Lothe RA. A CpG island hypermethylation profile of primary colorectal carcinomas and colon cancer cell lines. Mol Cancer. 2004;3:28. https://doi.org/10.1186/1476-4598-3-28

Kaneda A, Yagi K. Two groups of DNA methylation markers to classify colorectal cancer into three epigenotypes. Cancer Sci. 2011;102(1):18-24. https://doi.org/10.1111/j.1349-7006.2010.01712.x

Sideris M, Moorhead J, Diaz-Cano S, Bjarnason I, Haji A, Papagrigoriadis S. KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer. Anticancer Res. 2016;36(10):5315-24. https://doi.org/10.21873/anticanres.11104

Sideris M, Moorhead J, Diaz-Cano S, Haji A, Papagrigoriadis S. KRAS Mutant Status May Be Associated with Distant Recurrence in Early-stage Rectal Cancer. Anticancer Res. 2017;37(3):1349-57. https://doi.org/10.21873/anticanres.11454

Sherr CJ. Ink4-Arf locus in cancer and aging. Wiley Interdiscip Rev Dev Biol. 2012;(5):731-41. https://doi.org/10.1002/wdev.40

Aguirre AJ, Bardeesy N, Sinha M, Lopez L, Tuveson DA, Horner J, Redston MS, DePinho RA. Activated Kras and Ink4a/Arf deficiency cooperate to produce metastatic pancreatic ductal adenocarcinoma. Genes Dev. 2003;17(24):3112-26. https://doi.org/10.1101/gad.1158703

Lai IL, You JF, Chern YJ, Tsai WS, Chiang JM, Hsieh PS, Hung HY, Hsu YJ. The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision. World J Surg Oncol. 2021;19(1):116. https://doi.org/10.1186/s12957-021-02223-4

Martins SF, Garcia EA, Luz MA, Pardal F, Rodrigues M, Filho AL. Clinicopathological correlation and prognostic significance of VEGF-A, VEGF-C, VEGFR-2 and VEGFR-3 expression in colorectal cancer. Cancer Genomics Proteomics. 2013;10(2):55-67.

Konstantinidou G, Ramadori G, Torti F, Kangasniemi K, Ramirez RE, Cai Y, Behrens C, Dellinger MT, Brekken RA, Wistuba II, Heguy A, Teruya-Feldstein J, Scaglioni PP. RHOA-FAK is a required signaling axis for the maintenance of KRAS-driven lung adenocarcinomas. Cancer Discov. 2013;3(4):444-57. https://doi.org/10.1158/2159-8290.CD-12-0388

Sewastianik T, Jiang M, Sukhdeo K, Patel SS, Roberts K, Kang Y, Alduaij A, Dennis PS, Lawney B, Liu R, Song Z, Xiong J, Zhang Y, Lemieux ME, Pinkus GS, Rich JN, Weinstock DM, Mullighan CG, Sharpless NE, Carrasco RD. Constitutive Ras signaling and Ink4a/Arf inactivation cooperate during the development of B-ALL in mice. Blood Adv. 2017;1(25):2361-74. https://doi.org/10.1182/bloodadvances.2017012211

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Published

2022-06-27

How to Cite

1.
Kožik BR, Krajnović MM, Kokanov NS, Jovanović-Ćupić SP, Božović AM, Todorović LB, Mandušić VL. Combined analysis of KRAS mutation and p16INK4a and p14ARF methylation status in locally advanced rectal carcinoma treated with preoperative chemoradiotherapy. Arch Biol Sci [Internet]. 2022Jun.27 [cited 2024Nov.22];74(2):127-34. Available from: https://serbiosoc.org.rs/arch/index.php/abs/article/view/7519

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