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Medical Oncology

, 35:83 | Cite as

Hemoglobin level and XRCC1 polymorphisms to select patients with locally advanced rectal cancer candidate for neoadjuvant chemoradiotherapy with concurrent capecitabine and a platinum salt

  • Vincenzo FormicaEmail author
  • Michaela Benassi
  • Giovanna Del Vecchio Blanco
  • Elena Doldo
  • Laura Martano
  • Ilaria Portarena
  • Antonella Nardecchia
  • Jessica Lucchetti
  • Cristina Morelli
  • Emilia Giudice
  • Piero Rossi
  • Alessandro Anselmo
  • Pierpaolo Sileri
  • Giuseppe Sica
  • Augusto Orlandi
  • Riccardo Santoni
  • Mario Roselli
Original Paper
  • 184 Downloads

Abstract

A platinum salt (oxaliplatin or cisplatin) is widely used to enhance chemoradation (CRT) response. The potential of cisplatin in neoadjuvant CRT for locally advanced rectal cancer (LARC) has not been fully investigated. Consecutive patients with histologically confirmed LARC were treated with standard pelvic radiotherapy and concurrent cisplatin plus capecitabine (CisCape CRT). Surgery and eight cycles of adjuvant FOLFOX4 were offered to all patients after CRT. Common biochemical variables and key germline genetic polymorphisms were analyzed as predictors of pathological complete response (pCR). Fifty-one patients were enrolled. pCR (regression AJCC grade 0) was documented in 7 patients (14%), nearly complete response (AJCC grade 1) in 10 pts. There was a strong association between disease-free survival and AJCC grade (p 0.0047). Grade 3–4 toxicities (mainly diarrhea) was observed in 41% of patients. Among all analyzed variables, baseline hemoglobin (Hb) was significantly associated with AJCC grade 0–1 response (p 0.027). As for the pharmacogenetic analysis, XRCC1 rs25487 polymorphism was significantly associated with AJCC grade 0–1, Odds Ratio 25.8, p 0.049. AJCC grade 0–1 response rate for patients with high Hb and/or XRCC1 rs25487 G/G genotype was as high as 57%. Baseline Hb and XRCC1 polymorphisms are valuable selection criteria for the CisCape CRT regimen, given its otherwise meaningful toxicity.

Keywords

Locally advanced rectal cancer Neoadjuvant chemoradiotherapy XRCC1 Cisplatin 

Notes

Compliance with ethical standards

Conflict of interest

All authors disclose no financial and personal relationships with other people or organisations that could inappropriately influence (bias) the present work.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Vincenzo Formica
    • 1
    Email author
  • Michaela Benassi
    • 2
  • Giovanna Del Vecchio Blanco
    • 3
  • Elena Doldo
    • 4
  • Laura Martano
    • 1
  • Ilaria Portarena
    • 1
  • Antonella Nardecchia
    • 1
  • Jessica Lucchetti
    • 1
  • Cristina Morelli
    • 1
  • Emilia Giudice
    • 2
  • Piero Rossi
    • 5
  • Alessandro Anselmo
    • 5
  • Pierpaolo Sileri
    • 5
  • Giuseppe Sica
    • 5
  • Augusto Orlandi
    • 4
  • Riccardo Santoni
    • 2
  • Mario Roselli
    • 1
  1. 1.Medical Oncology Unit, Department of Systems Medicine, Tor Vergata Clinical Center University HospitalTor Vergata University HospitalRomeItaly
  2. 2.Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and RadiotherapyTor Vergata University HospitalRomeItaly
  3. 3.Gastrointestinal Unit, Department of Systems MedicineTor Vergata University HospitalRomeItaly
  4. 4.Anatomic Pathology Institute, Department of Biomedicine and PreventionTor Vergata University HospitalRomeItaly
  5. 5.Department of SurgeryTor Vergata University HospitalRomeItaly

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