Tumor Biology

, Volume 36, Issue 12, pp 9599–9609 | Cite as

Association between mismatch repair gene and irinotecan-based chemotherapy in metastatic colon cancer

  • Junli Ma
  • Yan Zhang
  • Hong Shen
  • Linda Kapesa
  • Wenqiang Liu
  • Mengsi Zeng
  • Shan Zeng
Research Article


Mismatch repair (MMR) gene is closely related to the pathogenesis of colon cancer. This study aimed to evaluate the association between MMR status and efficacy of irinotecan-based chemotherapy. As a target of 5-FU, thymidylate synthase (TS) expression level might be influenced by irinotecan. Understanding whether this influence of TS is related with MMR status is helpful to the further exploration of the mechanism of irinotecan sensitivity in metastatic colon cancer with different MMR status. One hundred eighty-four patients with metastatic colon cancer receiving irinotecan-based chemotherapy for the first-line treatment were included. Correlations between MMR and clinicopathological characteristics and prognosis were determined. Two pairs of colon cancer cell lines (HCT-116-hMLH1Vector (deficient MMR, dMMR) versus HCT-116-hMLH1+ (proficient MMR, pMMR); SW480-shRNA-hMLH1 (dMMR) versus SW480-shRNA-Control (pMMR)) were established by regulating MMR status. Sensitivity of these cell lines to irinotecan was determined by MTT assay. Regulation of TS by irinotecan was evaluated by western blotting and quantitative real-time PCR assay. dMMR accounted for 18.5 % and was related with proximal colon cancer (p = 0.005), poorly differentiated tumors (p = 0.018) and favorable efficacy with a higher disease control rate (DCR), a longer progression-free survival (PFS) and a trend of longer overall survival (OS). dMMR colon cancer cells were more sensitive to irinotecan. TS expression level was reduced more in dMMR cells after irinotecan treatment (p < 0.05). Our study favors an increased sensitivity of irinotecan in colon cancer with dMMR status. MMR status may be a predictive biomarker of response to irinotecan-based chemotherapy in metastatic colon cancer.


Colon cancer Mismatch repair gene Irinotecan 5-Fluorouracil Thymidylate synthase 



This study was supported by the grants from the National Nature Science Foundation of China (nos. 30770971, 81172470, 81070362, and 81372629).

Compliance with ethical standards

The manuscript has been performed with the approval of the ethics of Xiangya Hospital, Central South University. Informed consent was obtained from all the patients before enrollment in the study. This study was prospectively performed and approved by the institutional Ethics Committees of our hospital and conducted in accordance with the ethical guidelines of the Declaration of Helsinki.

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

13277_2015_3723_Fig6_ESM.gif (24 kb)
Supplementary Fig. S1

Two hundred nineteen patients with metastatic colon cancer receiving irinotecan-based chemotherapy as the first-line treatment were randomly collected at first. Exclusion criteria: combined chemotherapy with targeted agents (n=17); insufficiency of tumor tissues (n=11); prior cytotoxic or radiation therapy (n=5); severe cardiopulmonary disease or other systematic diseases precluding standard chemotherapy (n=2). At last 184 subjects were finally included (170 cases for FOLFIRI, 1 for XELIRI and 13 for irinotecan only) (GIF 24 kb)

13277_2015_3723_MOESM1_ESM.tif (1.2 mb)
High Resolution Image (TIFF 1185 kb)
13277_2015_3723_Fig7_ESM.gif (30 kb)
Supplementary Fig. S2

MMR status of the two colon cells HCT-116 and SW480 were checked by Western blot and qRT-PCR before the cytological experiment. hMLH1 was expressed normally in SW480 cells while absent in HCT-116 cells (p<0.001) (GIF 30 kb)

13277_2015_3723_MOESM2_ESM.tif (787 kb)
High Resolution Image (TIFF 787 kb)
13277_2015_3723_MOESM3_ESM.docx (14 kb)
Supplementary Table S1 (DOCX 13 kb)
13277_2015_3723_MOESM4_ESM.docx (14 kb)
Supplementary Table S2 (DOCX 13 kb)


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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Junli Ma
    • 1
  • Yan Zhang
    • 1
  • Hong Shen
    • 2
  • Linda Kapesa
    • 1
  • Wenqiang Liu
    • 1
  • Mengsi Zeng
    • 1
  • Shan Zeng
    • 1
  1. 1.Department of Oncology, Xiangya HospitalCentral South UniversityChangshaChina
  2. 2.Institute of Medical Sciences, Xiangya HospitalCentral South UniversityChangshaChina

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