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Genetic variants associated with colorectal brain metastases susceptibility and survival

Abstract

Colorectal brain metastases (BM) are rare (1–2%) and a late-stage disease manifestation. Molecular mechanisms for BM development are not well understood. We tested whether variants within genes involved in overcoming the blood–brain barrier (BBB) are associated with BM susceptibility and survival in patients with BM. Germline single-nucleotide polymorphisms (SNPs, n=17) in seven genes (CXCR4, MMP9, ST6GALNAC5, ITGAV, ITGB1, ITGB3, KLF4) were analyzed from germline DNA in patients with resected BM (n=70) or no clinical evidence of BM after at least 24 months from diagnosis (control group, n=45). SNPs were evaluated for association with BM susceptibility and overall survival (OS) from BM diagnosis. ST6GALNAC5 rs17368584 and ITGB3 rs3809865 were significantly associated with BM susceptibility. In multivariable analysis adjusted for patient characteristics, KLF4 rs2236599, ITGAV rs10171481, ST6GALNAC5 rs1883778, CXCR4 rs2680880 and ITGB3 rs5918 were significant for OS. This study shows for the first time that variants within genes involved in breaching the BBB are associated with BM susceptibility and survival. These findings warrant further validation to develop better screening guidelines and to identify novel therapy targets for patients with BM.

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References

  1. Schouten LJ, Rutten J, Huveneers HA, Twijnstra A . Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer 2002; 94: 2698–2705.

    Article  PubMed  Google Scholar 

  2. Venook A, Niedzwiecki D, Lenz HJ, Innocenti F, Mahoney MR, O'Neil BH et al. CALGB/SWOG 80405: Phase III trial of irinotecan/5-FU/leucovorin (FOLFIRI) or oxaliplatin/5-FU/leucovorin (mFOLFOX6) with bevacizumab (BV) or cetuximab (CET) for patients (pts) with KRAS wild-type (wt) untreated metastatic adenocarcinoma of the colon or rectum (MCRC). J Clin Oncol 2014; 32: 35s (suppl; abstr LBA2013).

    Article  Google Scholar 

  3. Magni E, Santoro L, Ravenda PS, Leonardi MC, Bonomo G, Monfardini L et al. Brain metastases from colorectal cancer: main clinical factors conditioning outcome. Int J Colorectal Dis 2014; 29: 201–208.

    Article  PubMed  Google Scholar 

  4. Tajes M, Ramos-Fernandez E, Weng-Jiang X, Bosch-Morato M, Guivernau B, Eraso-Pichot A et al. The blood-brain barrier: structure, function and therapeutic approaches to cross it. Mol Membr Biol 2014; 31: 152–167.

    Article  CAS  PubMed  Google Scholar 

  5. Preusser M, Capper D, Ilhan-Mutlu A, Berghoff AS, Birner P, Bartsch R et al. Brain metastases: pathobiology and emerging targeted therapies. Acta Neuropathol 2012; 123: 205–222.

    Article  CAS  PubMed  Google Scholar 

  6. Berghoff AS, Bartsch R, Wohrer A, Streubel B, Birner P, Kros JM et al. Predictive molecular markers in metastases to the central nervous system: recent advances and future avenues. Acta Neuropathol 2014; 128: 879–891.

    Article  CAS  PubMed  Google Scholar 

  7. Bos PD, Zhang XH, Nadal C, Shu W, Gomis RR, Nguyen DX et al. Genes that mediate breast cancer metastasis to the brain. Nature 2009; 459: 1005–1009.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Carbonell WS, Ansorge O, Sibson N, Muschel R . The vascular basement membrane as "soil" in brain metastasis. PloS One 2009; 4: e5857.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Lorger M, Krueger JS, O'Neal M, Staflin K, Felding-Habermann B . Activation of tumor cell integrin alphavbeta3 controls angiogenesis and metastatic growth in the brain. Proc Natl Acad Sci USA 2009; 106: 10666–10671.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Paratore S, Banna GL, D'Arrigo M, Saita S, Iemmolo R, Lucenti L et al. CXCR4 and CXCL12 immunoreactivities differentiate primary non-small-cell lung cancer with or without brain metastases. Cancer Biomark 2011; 10: 79–89.

    Article  CAS  PubMed  Google Scholar 

  11. Mendes O, Kim HT, Stoica G . Expression of MMP2, MMP9 and MMP3 in breast cancer brain metastasis in a rat model. Clin Exp Metastasis 2005; 22: 237–246.

    Article  CAS  PubMed  Google Scholar 

  12. Candelario-Jalil E, Yang Y, Rosenberg GA . Diverse roles of matrix metalloproteinases and tissue inhibitors of metalloproteinases in neuroinflammation and cerebral ischemia. Neuroscience 2009; 158: 983–994.

    Article  CAS  PubMed  Google Scholar 

  13. Okuda H, Xing F, Pandey PR, Sharma S, Watabe M, Pai SK et al. miR-7 suppresses brain metastasis of breast cancer stem-like cells by modulating KLF4. Cancer Res 2013; 73: 1434–1444.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Fu F, Wang C, Chen LM, Huang M, Huang HG . The influence of functional polymorphisms in matrix metalloproteinase 9 on survival of breast cancer patients in a Chinese population. DNA Cell Biol 2013; 32: 274–282.

    Article  CAS  PubMed  Google Scholar 

  15. Lee PH, Shatkay H . FSNP: computationally predicted functional SNPs for disease association studies. Nucleic Acids Res 2008; 36: D820–D824.

    Article  CAS  PubMed  Google Scholar 

  16. Xu Z, Taylor JA . SNPinfo: integrating GWAS and candidate gene information into functional SNP selection for genetic association studies. Nucleic Acids Res 2009; 37: W600–W605.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Flicek P, Amode MR, Barrell D, Beal K, Billis K, Brent S et al. Ensembl 2014. Nucleic Acids Res 2014; 42: D749–D755.

    Article  CAS  PubMed  Google Scholar 

  18. Rathinam R, Alahari SK . Important role of integrins in the cancer biology. Cancer Metastasis Rev 2010; 29: 223–237.

    Article  CAS  PubMed  Google Scholar 

  19. Schwartz MA, Ginsberg MH . Networks and crosstalk: integrin signalling spreads. Nat Cell Biol 2002; 4: E65–E68.

    Article  CAS  PubMed  Google Scholar 

  20. Berghoff AS, Kovanda AK, Melchardt T, Bartsch R, Hainfellner JA, Sipos B et al. alphavbeta3, alphavbeta5 and alphavbeta6 integrins in brain metastases of lung cancer. Clin Exp Metastasis 2014; 31: 841–851.

    Article  CAS  PubMed  Google Scholar 

  21. Vonlaufen A, Wiedle G, Borisch B, Birrer S, Luder P, Imhof BA . Integrin alpha(v)beta(3) expression in colon carcinoma correlates with survival. Mod Pathol 2001; 14: 1126–1132.

    Article  CAS  PubMed  Google Scholar 

  22. Berghoff AS, Rajky O, Winkler F, Bartsch R, Furtner J, Hainfellner JA et al. Invasion patterns in brain metastases of solid cancers. Neuro Oncol 2013; 15: 1664–1672.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bohanes P, Yang D, Loupakis F, LaBonte MJ, Gerger A, Ning Y et al. Integrin genetic variants and stage-specific tumor recurrence in patients with stage II and III colon cancer. Pharmacogenomics J 2014; 15: 226–234.

    Article  PubMed  Google Scholar 

  24. Wu YJ, Muldoon LL, Gahramanov S, Kraemer DF, Marshall DJ, Neuwelt EA . Targeting alphaV-integrins decreased metastasis and increased survival in a nude rat breast cancer brain metastasis model. J Neuro Oncol 2012; 110: 27–36.

    Article  CAS  Google Scholar 

  25. Jia J, Starodub A, Cushman I, Liu Y, Marshall DJ, Hurwitz HI et al. Dual inhibition of alphaV integrins and Src kinase activity as a combination therapy strategy for colorectal cancer. Anticancer Drugs 2013; 24: 237–250.

    Article  CAS  PubMed  Google Scholar 

  26. Shim H, Oishi S, Fujii N . Chemokine receptor CXCR4 as a therapeutic target for neuroectodermal tumors. Semin Cancer Biol 2009; 19: 123–134.

    Article  CAS  PubMed  Google Scholar 

  27. Muller A, Homey B, Soto H, Ge N, Catron D, Buchanan ME et al. Involvement of chemokine receptors in breast cancer metastasis. Nature 2001; 410: 50–56.

    Article  CAS  PubMed  Google Scholar 

  28. Sison EA, Magoon D, Li L, Annesley CE, Rau RE, Small D et al. Plerixafor as a chemosensitizing agent in pediatric acute lymphoblastic leukemia: efficacy and potential mechanisms of resistance to CXCR4 inhibition. Oncotarget 2014; 5: 8947–8958.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Leng Z, Tao K, Xia Q, Tan J, Yue Z, Chen J et al. Kruppel-like factor 4 acts as an oncogene in colon cancer stem cell-enriched spheroid cells. PloS One 2013; 8: e56082.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Bendardaf R, Buhmeida A, Hilska M, Laato M, Syrjanen S, Syrjanen K et al. MMP-9 (gelatinase B) expression is associated with disease-free survival and disease-specific survival in colorectal cancer patients. Cancer Invest 2010; 28: 38–43.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Stefan Stremitzer is a recipient of an Erwin Schrödinger fellowship of the Austrian Science Fund (J 3501-B13). Ana Sebio is a recipient of a Rio Hortega Research Grant from the Insituto de Salud Carlos III (CM11/00102). Sebastian Stintzing is supported by a postdoctoral fellowship from the German Cancer Aid (Mildred-Scheel Foundation). Martin D. Berger is supported by a grant from the Swiss Cancer League (BIL KLS-3334-02-2014). Peter Birner is supported by the Theodor Kery Stiftung. Heinz-Josef Lenz receives financial support by the P30CA014089 NIH grant, and the Daniel Butler Research Fund.

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Correspondence to H-J Lenz.

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Stremitzer, S., Berghoff, A., Volz, N. et al. Genetic variants associated with colorectal brain metastases susceptibility and survival. Pharmacogenomics J 17, 29–35 (2017). https://doi.org/10.1038/tpj.2015.86

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