Predictive biomarkers for response of esophageal cancer to chemo(radio)therapy: A systematic review and meta-analysis

Yang Li; He-Cheng Huang; Long-Qi Chen; Li-Yan Xu; En-Min Li; Jian-Jun Zhang

doi:10.1016/j.suronc.2017.09.003

Predictive biomarkers for response of esophageal cancer to chemo(radio)therapy: A systematic review and meta-analysis

Surg Oncol. 2017 Dec;26(4):460-472. doi: 10.1016/j.suronc.2017.09.003. Epub 2017 Sep 14.

Authors

Yang Li¹, He-Cheng Huang², Long-Qi Chen³, Li-Yan Xu⁴, En-Min Li⁵, Jian-Jun Zhang⁶

Affiliations

¹ Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, 515041 Shantou, China; Department of Preventive Medicine, Shantou University Medical College, 515041 Shantou, China; Department of Biochemistry and Molecular Biology, Shantou University Medical College, 515041 Shantou, China.
² Department of Oncologic Radiotherapy, Shantou Central Hospital, Affiliated Shantou Hospital of Sun Yat-Sen University, 515041 Shantou, China.
³ Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
⁴ Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, 515041 Shantou, China; Department of Pathology, Shantou University Medical College, 515041 Shantou, China.
⁵ Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, 515041 Shantou, China; Department of Biochemistry and Molecular Biology, Shantou University Medical College, 515041 Shantou, China. Electronic address: nmli@stu.edu.cn.
⁶ Key Laboratory of Molecular Biology in High Cancer Incidence Coastal Chaoshan Area of Guangdong Higher Education Institutes, Shantou University Medical College, 515041 Shantou, China; Department of Preventive Medicine, Shantou University Medical College, 515041 Shantou, China. Electronic address: zhangjj@stu.edu.cn.

PMID: 29113666
DOI: 10.1016/j.suronc.2017.09.003

Abstract

Background: Esophageal cancer remains a major public health issue worldwide. In clinical practice, chemo(radio)therapy is an important approach to patients with esophageal cancer. Only the part of patients who respond to chemo(radio)therapy achieve better long-term outcome. In this case, predictive biomarkers for response of esophageal cancer patients treated with chemo(radio)therapy are of importance. Meta-analysis of P53 for predicting esophageal cancer response has been reported before and is not included in our study. We performed a systematic review and meta-analysis to summarize and evaluate the biomarkers for predicting response to chemo(radio)therapy.

Method: PubMed, Web of Science and the Ovid databases were searched to identify eligible studies published in English before March 2017. The risk ratio (or relative risk, RR) was retrieved in articles regarding biomarkers for predicting response of esophageal cancer patients treated with neoadjuvant therapy or chemo(radio)therapy. Fixed and random effects models were used to undertake the meta-analysis as appropriate.

Result: Forty-six articles reporting 56 biomarkers correlated with the response were finally included. Meta-analyses were carried out when there was more than one study related to the reported biomarker. Results indicated that low expression of (or IHC-negative) COX2, miR-200c, ERCC1 and TS was individually associated with prediction of response. The RR was 1.64 (n = 202, 95% CI 1.22-2.19, P < 0.001), 1.96 (n = 162, 95% CI 1.36-2.83, P < 0.001), 2.55 (n = 206, 95% CI 1.80-3.62, P < 0.001) and 1.69 (n = 144, 95% CI 1.10-2.61, P = 0.02), respectively. High expression of (or IHC-positive) CDC25B and p16 was individually related to prediction of response. The RR was 0.62 (n = 159, 95% CI 0.43-0.89, P = 0.01) and 0.62 (n = 142, 95% CI 0.43-0.91, P = 0.01), respectively.

Conclusion: Low expression of (or IHC-negative) COX2, miR-200c, ERCC1 and TS, or high expression of (or IHC-positive) CDC25B and p16 are potential biomarkers for predicting the response of esophageal cancer patients treated with chemo(radio)therapy.

Keywords: Chemo(radio)therapy; Esophageal cancer; Meta-analysis; Pathology response; Predictive biomarkers.

Publication types

Review
Systematic Review

MeSH terms

Biomarkers, Tumor / metabolism*
Chemoradiotherapy*
Esophageal Neoplasms / metabolism
Esophageal Neoplasms / pathology*
Esophageal Neoplasms / therapy
Humans
Predictive Value of Tests
Prognosis

Substances

Biomarkers, Tumor