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Expression level of thymidylate synthase mRNA reflects 5-fluorouracil sensitivity with low dose and long duration in primary colorectal cancer

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Abstract

Objectives

To investigate the prognostic marker for the adjuvant chemotherapy of primary colorectal carcinoma.

Methods

Primary colorectal cancer tissue from 24 patients was investigated to evaluate the relationship between the mRNA expression level of several 5-fluorouracil (5-FU)-related metabolic enzymes (thymidylate synthase, TS; dihydropyrimidine dehydrogenase, DPD; and thymidine phosphorylase, TP) and chemosensitivity to two different 5-FU doses and duration (1: 5-FU concentration 1.0 μg/mL (7.68 μM), 24 h exposure and 2: 5-FU concentration 0.3 μg/mL (2.30 μM), 144 h exposure). Chemosensitivity and mRNA expression levels were measured using collagen gel droplet embedded culture drug sensitivity tests and real-time quantitative reverse transcription-polymerase chain reaction. Clinicopathological features and chemosensitivity were also compared.

Results

The TS mRNA expression level was significantly higher in the 5-FU resistant group (T/C > 60%) compared with the 5-FU sensitive group (T/C < 60%) in both 5-FU regimens (1: 5.03 ± 0.92 vs. 1.58 ± 0.76, p < 0.01, 2: 4.88 ± 0.91 vs. 0.96 ± 0.20, p < 0.001). The group with the higher TS mRNA expression level (>3.83, the average) were more resistant to both 5-FU regimens than those with lower TS mRNA (<3.83) (1: T/C = 80 vs. 66%, p = 0.11, 2: T/C = 89 vs. 64%, p < 0.005). The TS mRNA expression level inversely correlated with the sensitivity to the latter 5-FU regimen (R = 0.577, p < 0.01). There were no relationships between chemosensitivity to 5-FU and the mRNA expression level of DPD and TP and clinicopathological factors.

Conclusions

The TS mRNA expression level might be a good marker of chemosensitivity to 5-FU in primary colorectal cancer, especially the sensitivity to low dose 5-FU with a long duration.

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References

  1. Moertel CG (1994) Chemotherapy for colorectal cancer. N Engl J Med 330:1136–1142

    Article  PubMed  CAS  Google Scholar 

  2. Piedbois P, Buyse M, Rustum Y, Machover D, Erlichman C, Carlson RW, Valone F, Labianca R, Doroshow JH, Petrelli N (1992) Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: evidence in terms of response rate. The advanced colorectal cancer meta-analysis project. J Clin Oncol 10:896–903

    Google Scholar 

  3. Saltz LB, Cox JV, Blanke C, Rosen LS, Fehrenbacher L, Moore ML, Maroun JA, Ackland SP, Locker PK, Pirotta N, Elfring GL, Miller LL (2000) Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. N Engl J Med 343:905–914

    Article  PubMed  CAS  Google Scholar 

  4. de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, Boni C, Cortes-Funes H, Cervantes A, Freyer G, Papamichael D, Le Bail N, Louvet C, Hendler D, de Braud F, Wilson C, Morvan F, Bonetti A (2000) Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol 18:2938–2947

    PubMed  Google Scholar 

  5. Poon MA, O’Connell MJ, Moertel CG, Wieand HS, Cullinan SA, Everson LK, Krook JE, Mailliard JA, Laurie JA, Tschetter LK, Wiesenfeld M (1989) Biochemical modulation of fluorouracil: Evidence of significant improvement of survival and quality of life in patients with advanced colorectal carcinoma. J Clin Oncol 7:1407–1418

    PubMed  CAS  Google Scholar 

  6. Petrelli N, Herrera L, Rustum Y, Burke P, Creaven P, Stulc J, Emrich LJ, Mittelman A (1987) A prospective randomized trial of 5-fluorouracil versus 5-fluorouracil and high-dose leucovorin versus 5-fluorouracil and methotrexate in previously untreated patients with advanced colorectal carcinoma. J Clin Oncol 5:1559–1565

    PubMed  CAS  Google Scholar 

  7. de Gramont A, Bosset JF, Milan C, Rouqier P, Bouche O, Etienne PL, Morvan F, Louvet C, Guillot T, Francois E, Bedenne L (1997) Randomized trial comparing monthly low-dose leucovorin and fluorouracil bolus with biomonthly high dose leucovorin and fluorouracil bolus plus continuous infusion for advanced colorectal cancer: A French intergroup study. J Clin Oncol 15:808–815

    PubMed  Google Scholar 

  8. Douillard JY, Hoff PM, Skillings JR, Eisenberg P, Davidson N, Harper P, Vincent MD, Lembersky BC, Thompson S, Maniero A, Benner SE (2002) Multicenter phase ? study of uracil/tegafur and oral leucovorin versus fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 20:3605–3616

    Article  PubMed  CAS  Google Scholar 

  9. Carmichael J, Popiela T, Radstone D, Falk S, Borner M, Oza A, Skovsgaard T, Munier S, Martin C (2002) Randomized comparative study of tegafur/uracil and oral leucovorin versus parenteral fluorouracil and leucovorin in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 20:3617–3627

    Article  PubMed  CAS  Google Scholar 

  10. Inaba M, Mitsuhashi J, Ozawa S (1990) Kinetic analysis of 5-fluorouracil action against various cancer cells. Jpn J Cancer Res 81:1039–1044

    PubMed  CAS  Google Scholar 

  11. Johnston PG, Lenz H-J, Leichman CG, Danenberg KD, Allegra CJ, Danenberg PV, Leichman L (1995) Thymidylate synthase gene and protein expression correlate and are associated with response to 5-fluorouracil in human colorectal and gastric tumors. Cancer Res 55:1407–1412

    PubMed  CAS  Google Scholar 

  12. Salonga D, Danenberg KD, Johnson M, Metzger R, Groshen S, Tsao-Wei DD, Lenz H-J, Leichman CG, Leichman L, Diasio RB, Danenberg PV (2000) Colorectal tumors responding to 5-fluorouracil have low gene expression levels of dihydropyrimidine dehydrogenase, thymidylate synthase and thymidine phosphorylase. Clin Cancer Res 6:1322–1327

    PubMed  CAS  Google Scholar 

  13. Metzger R, Danenberg K, Leichman CG, Salonga D, Schwartz EL, Wadler S, Lenz H-J, Groshen S, Leichman L, Dannenberg PV (1998) High basal level gene expression of thymidine phosphorylase (platelet-derived endothelial cell growth factor) in colorectal tumors is associated with nonresponse to 5-fluorouracil. Clin Cancer Res 4:2371–2376

    PubMed  CAS  Google Scholar 

  14. Isshi K, Sakuyama T, Gen T, Nakamura Y, Kuroda T, Katuyama T, Maekawa Y (2002) Predicting 5-FU sensitivity using human colorectal cancer specimens: comparison of tumor dihydropyrimidine dehydrogenase and orotate phosphoribosyl transferase activities with in vitro chemosensitivity to 5-FU. Int J Clin Oncol 7:335–342

    Article  PubMed  CAS  Google Scholar 

  15. Mader RM, Sieder AE, Braun J, Rizovski B, Kalipciyan M, Mueller MW, Jakesz R, Rainer H, Steger GG (1997) Transcription and activity of 5-fluorouracil converting enzymes in fluoropyrimidine resistance in colon cancer in vitro. Biochem Pharmacol 54:1233–1242

    Article  PubMed  CAS  Google Scholar 

  16. Ishikawa Y, Kubota T, Otani Y, Watanabe M, Teramato T, Kumai K, Kitajima M, Takechi T, Okabe H, Fukushima M (1999) Dihydropyrimidine dehydrogenase activity and messenger RNA level may be related to the antitumor effect of 5-fluorouracil on human tumor xenografts in nude mice. Clin Cancer Res 5:883–889

    PubMed  CAS  Google Scholar 

  17. Langenbach RJ, Danenberg PV, Heidelberger C (1972) Thymidylate synthetase: mechanism of inhibition by 5-fluoro-2’-deoxyuridylate. Biochem Biophys Res Commun 48:1565–1571

    Article  PubMed  CAS  Google Scholar 

  18. Inaba M, Tanaka T, Sawada H (1998) Increased sensitivity to long-term 5-fluorouracil exposure of human colon cancer HT-29 cells resistant to short-term exposure. Jpn J Cancer Res 89:323–327

    PubMed  CAS  Google Scholar 

  19. Matsuoka H, Ueo H, Sugimachi K, Akiyoshi T (1992) Preliminary evidence that incorporation of 5-fluorouracil into RNA correlates with antitumor response. Cancer Invest 10:265–269

    Article  PubMed  CAS  Google Scholar 

  20. Naguib FNM, el Kouni MH, Cha S (1985) Enzymes of uracil catabolism in normal and neoplastic human tissues. Cancer Res 45:5405–5412

    PubMed  CAS  Google Scholar 

  21. Heggie GD, Sommadossi JP, Cross DS, Hustler WJ, Diasio RB (1987) Clinical pharmacokinetics of 5-fluorouracil and its metabolites in plasma, urine, and bile. Cancer Res 47:2203–2206

    PubMed  CAS  Google Scholar 

  22. Harris BE, Song R, Soong SJ, Diasio R (1990) Relationship of dihydropyrimidine dehydrogenase activity and plasma 5-fluorouracil levels: Evidence for circadian variation of 5-fluorouracil levels in cancer patients receiving protracted continuous infusion. Cancer Res 50:197–201

    PubMed  CAS  Google Scholar 

  23. Ichikawa W, Uetake H, Shirota Y, Yamada H, Takahashi T, Nihei Z, Sugihara K, Sasaki Y, Hirayama R (2003) Both gene expression for orotate phosphoribosyltransferase and its ratio to dihydropyrimidine dehydrogenase influence outcome following fluoropyrimidine-based chemotherapy for metastatic colorectal cancer. British J Cancer 89:1486–1492

    Article  CAS  Google Scholar 

  24. Kobayashi H, Tanisaka K, Doi O, Kodama K, Higashiyama M, Nakagawa H, Miyake M, Taki T, Hara S, Yasutomi M, Hanatani Y, Kotake K, Kubota T (1997) An in vitro chemosensitivity test for solid human tumors using collagen gel droplet embedded cultures. Int J Oncol 11:449–455

    Google Scholar 

  25. Kobayashi H (2003) Development of a new in vitro chemosensitivity test using collagen gel droplet embedded culture and image analysis for clinical usefulness. Recent Results in Cancer Res 161:48–61

    CAS  Google Scholar 

  26. Koezuka M, Kondo N, Kobayashi H, Hara S, Yasutomi M, Nishida S, Hashimoto S, Asano H (1993) Drug sensitivity test for primary culture of human cancer cells using colagen gel embedded culture and image analysis. Int J Oncol 2:953–959

    CAS  Google Scholar 

  27. Tanigawa N, Kitaoka A, Yamakawa M, Tanisaka K, Kobayashi H (1996) In vitro chemosensitivity testing of human tumors by collagen gel droplet culture and image analysis. Anticancer Res 16:1925–1930

    PubMed  CAS  Google Scholar 

  28. Mori T, Ohnishi M, Komiyana M, Tsutsui A, Yabushita H, Okada H (2002) Prediction of cell kinetics of anticancer agents using the collagen gel droplet embedded-culture drug sensitivity test. Oncol Rep 9:301–305

    PubMed  CAS  Google Scholar 

  29. Horikoshi T, Danenberg KD, Stadlbauer THW, Volkenandt M, Shea LCC, Aigner K, Gustavsson B, Leichman L, Frosing R, Ray M, Gibson NW, Spears CP, Danenberg PV (1992) Quantitation of thymidylate synthase, dihydrofolate reductase, and DT-diaphorase gene expression in human tumors using the polymerase chain reaction. Cancer Res 52:108–116

    PubMed  CAS  Google Scholar 

  30. Meta-Analysis Group of the Japanese Society for Cancer of the Colon, Rectum and Meta-Analysis Group in Cancer (2004) Efficacy of oral adjuvant therapy after resection of colorectal cancer: 5-year results from three randomized trials. J Clin Oncol 22:484–492

    Article  Google Scholar 

  31. Lembersky BC, Wieand HS, Petrelli NJ, O’connell MJ, Colangelo LH, Smith RE, Seay TE, Giguere JK, Ernest Marshall M, Jacobs AD, Colman LK, Soran A, Yothers G, Wolmark N (2006) Oral uracil and tegafur plus leucovorin compared with intravenous fluorouracil and leucovorin in stage II and III carcinoma of the colon: results from national surgical adjuvant breast and bowel project prorocol C-06. J Clin Oncol 24:2059–2064

    Article  PubMed  CAS  Google Scholar 

  32. Okumura K, Shiomi H, Mekata E, Kaizuka M, Endo Y, Kurumi Y, Tani T (2006) Correlation between chemosensitivity and mRNA expression level of 5-fluorouracil-related metabolic enzymes during liver metastasis of colorectal cancer. Oncol Rep 15:875–882

    PubMed  CAS  Google Scholar 

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Correspondence to Kenji Okumura.

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Okumura, K., Mekata, E., Shiomi, H. et al. Expression level of thymidylate synthase mRNA reflects 5-fluorouracil sensitivity with low dose and long duration in primary colorectal cancer. Cancer Chemother Pharmacol 61, 587–594 (2008). https://doi.org/10.1007/s00280-007-0511-y

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  • DOI: https://doi.org/10.1007/s00280-007-0511-y

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