TY  - JOUR
AU  - Kanjanapan, Y
AU  - Deb, S
AU  - Young, RJ
AU  - Bressel, M
AU  - Mileshkin, L
AU  - Rischin, D
AU  - Hofman, MS
AU  - Narayan, K
AU  - Siva, S
Y2  - 2020/12/10
Y1  - 2017/02/01
SN  - 2405-6308
UR  - http://hdl.handle.net/11343/253591
AB  - Background/purpose: Chemoradiation (CRT) is standard therapy for locally advanced cervical cancer (LACC). However, there is a lack of biomarkers to identify patients at high relapse-risk. We examine metabolic (glucose transporter-1 [Glut-1]), hypoxic (hypoxia inducible factor [HIF-1α]; carbonic anhydrase [CA-9]) and proliferative (Ki-67) markers for prognostic utility in LACC. Materials/methods: 60 LACC patients treated with CRT had pre-treatment biopsies. Immunohistochemistry was performed for Glut-1, HIF-1a and CA-9, to generate a histoscore from intensity and percentage staining; and Ki-67 scored by percentage of positive cells. For each biomarker, treatment response and survival was compared between low and high-staining groups by logrank testing and multivariate analyses. Results: High Glut-1 expression was associated with inferior progression-free survival (PFS), (hazard ratio [HR] 2.8, p = 0.049) and overall survival (OS), (HR 5.0, p = 0.011) on multifactor analysis adjusting for stage, node positivity, tumour volume and uterine corpus invasion. High Glut-1 correlated with increased risk of distant failure (HR 14.6, p = 0.001) but not local failure. Low Glut-1 was associated with higher complete metabolic response rate on post-therapy positron emission tomography scan (odds ratio 3.4, p = 0.048). Ki-67 was significantly associated with PFS only (HR 1.19 per 10 units increase, p = 0.033). Biomarkers for hypoxia were not associated with outcome. Conclusions: High Glut-1 in LACC is associated with poor outcome post CRT. If prospectively validated, Glut-1 may help select patients for more intensive treatment regimens.
LA  - English
PB  - ELSEVIER IRELAND LTD
T1  - Glut-1 expression in small cervical biopsies is prognostic in cervical cancers treated with chemoradiation
DO  - 10.1016/j.ctro.2017.01.003
IS  - Clinical and Translational Radiation Oncology
VL  - 2
SP  - 53-58
L1  - /bitstream/handle/11343/253591/PMC5893520.pdf?sequence=1&isAllowed=y
ER  -