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  • 1
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 75, No. 15_Supplement ( 2015-08-01), p. 4585-4585
    Abstract: Introduction Folate-mediated one-carbon metabolism (FOCM) is a key pathway necessary for nucleotide synthesis, DNA methylation, replication and repair. Genetic variants in FOCM genes, especially the MTHFR-C677T polymorphism, have been associated with colorectal neoplasia. Moreover, FOCM is an important target for chemotherapeutic drugs for the treatment of colorectal cancer (CRC), such as 5-fluorouracil (5-FU). We performed a comprehensive assessment of FOCM-related genetic variation in relation to CRC risk and survival in an unfortified population. Methods Associations of 457 tagging and candidate SNPs in 47 FOCM-related genes with CRC risk and survival were investigated within a German population-based case-control study (the DACHS- study). Using multivariate adjusted logistic (n = 1754 incident cases and 1781 matched controls) and Cox regression (5 years follow-up of CRC cases only; 585 deceased), we evaluated co-dominant, dominant, and log-additive modes of inheritance. SNPs were genotyped using the Illumina GoldenGate Assay. Correction for multiple testing was performed using false discovery rates (FDR). Results Individuals having both variant alleles of a candidate SNP in the ADH1C gene (rs1693482) had a significantly decreased risk of developing CRC (ORhet = 0.94 [95% CI = 0.81-1.10]; ORhzv = 0.74 [95% CI = 0.59-0.92] ; p-trend = 0.013). Before correction for multiple testing, 19 nominally significant genetic main effects on CRC risk were observed. None of the studied tagging SNPs was significantly associated with risk after multiple test correction. One polymorphism in the PON1 gene (rs3917538) was significantly associated with overall survival (HRhet = 1.22 [95% CI = 1.03-1.45]; HRhzv = 2.00 [95% CI = 1.48-2.71] ; p-trend = 0.01), after correction for multiple testing. Effect modification by 5-FU chemotherapy was observed between two polymorphisms (MTHFR-rs4846047 [Int-pFDR = 0.02] and TK1-rs1811086 [Int-pFDR = 0.02] ) for the endpoint overall survival. Cases with variant alleles of these SNPs had a reduced effect of 5-FU on overall survival. Conclusion Genetic variation in FOCM appears to be associated with CRC risk and survival. Furthermore, 5-FU might interact with FOCM polymorphisms. Further large investigations are required to replicate our findings. Citation Format: Akke Botma, Katharina Buck, Yesilda Balavarca, Dominique Scherer, Nina Habermann, Reka Toth, Lina Jansen, Michael Hoffmeister, Hermann Brenner, Elisabeth J. Kap, Petra Seibold, Axel Benner, Alexis Ulrich, Barbara Burwinkel, Jenny Chang-Claude, Cornelia M. Ulrich. Folate-mediated one-carbon metabolism polymorphisms associated with risk and survival of colorectal cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4585. doi:10.1158/1538-7445.AM2015-4585
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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  • 2
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 12 ( 2020-12-01), p. 2719-2728
    Abstract: High numbers of lymphocytes in tumor tissue, including T regulatory cells (Treg), have been associated with better colorectal cancer survival. Tregs, a subset of CD4+ T lymphocytes, are mediators of immunosuppression in cancer, and therefore variants in genes related to Treg differentiation and function could be associated with colorectal cancer prognosis. Methods: In a prospective German cohort of 3,593 colorectal cancer patients, we assessed the association of 771 single-nucleotide polymorphisms (SNP) in 58 Treg-related genes with overall and colorectal cancer–specific survival using Cox regression models. Effect modification by microsatellite instability (MSI) status was also investigated because tumors with MSI show greater lymphocytic infiltration and have been associated with better prognosis. Replication of significant results was attempted in 2,047 colorectal cancer patients of the International Survival Analysis in Colorectal Cancer Consortium (ISACC). Results: A significant association of the TGFBR3 SNP rs7524066 with more favorable colorectal cancer–specific survival [hazard ratio (HR) per minor allele: 0.83; 95% confidence interval (CI), 0.74–0.94; P value: 0.0033] was replicated in ISACC (HR: 0.82; 95% CI, 0.68–0.98; P value: 0.03). Suggestive evidence for association was found with two IL7 SNPs, rs16906568 and rs7845577. Thirteen SNPs with differential associations with overall survival according to MSI in the discovery analysis were not confirmed. Conclusions: Common genetic variation in the Treg pathway implicating genes such as TGFBR3 and IL7 was shown to be associated with prognosis of colorectal cancer patients. Impact: The implicated genes warrant further investigation.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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  • 3
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 31, No. 2 ( 2022-02-01), p. 352-361
    Abstract: Associations between candidate genetic variants and treatment outcomes of oxaliplatin, a drug commonly used for colorectal cancer patients, have been reported but not robustly established. This study aimed to validate previously reported prognostic and predictive genetic markers for oxaliplatin treatment outcomes and evaluate additional putative functional variants. Methods: Fifty-three SNPs were selected based on previous reports (40 SNPs) or putative function in candidate genes (13 SNPs). We used data from 1,502 patients with stage II–IV colorectal cancer who received primary adjuvant chemotherapy, 37% of whom received oxaliplatin treatment. Multivariable Cox proportional hazards models for overall survival and progression-free survival were applied separately in stage II–III and stage IV patients. For predictive SNPs, differential outcomes according to the type of chemotherapy (oxaliplatin-based vs. others) were evaluated using an interaction term. For prognostic SNPs, the association was assessed solely in patients with oxaliplatin-based treatment. Results: Twelve SNPs were predictive and/or prognostic at P & lt; 0.05 with differential survival based on the type of treatment, in patients with stage II–III (GSTM5-rs11807, ERCC2-rs13181, ERCC2-rs1799793, ERCC5-rs2016073, XPC-rs2228000, P2RX7-rs208294, HMGB1-rs1360485) and in patients with stage IV (GSTM5-rs11807, MNAT1-rs3783819, MNAT1-rs4151330, CXCR1-rs2234671, VEGFA-rs833061, P2RX7-rs2234671). In addition, five novel putative functional SNPs were identified to be predictive (ATP8B3-rs7250872, P2RX7-rs2230911, RPA1-rs5030755, MGMT-rs12917, P2RX7-rs2227963). Conclusions: Some SNPs yielded prognostic and/or predictive associations significant at P & lt; 0.05, however, none of the associations remained significant after correction for multiple testing. Impact: We did not robustly confirm previously reported SNPs despite some suggestive findings but identified further potential predictive SNPs, which warrant further investigation in well-powered studies.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 4
    In: International Journal of Cancer, Wiley, Vol. 138, No. 12 ( 2016-06-15), p. 2993-3001
    Abstract: What's new? Oxaliplatin frequently is used in combination with 5‐fluorouracil and leucovorin as a first‐line therapy against colorectal cancer (CRC). However, the efficacy of oxaliplatin differs greatly between patients. Oxaliplatin availability to cells and its subsequent detoxification depend on the activity of certain metabolic and transporter enzymes, some of which, according to this study, carry genetic variants that alter the drug's effectiveness. The authors show that interactions between oxaliplatin and single nucleotide polymorphisms (SNPs) in multiple transporter and metabolism genes are associated with overall CRC survival. The SNPs could be used to predict the likelihood of response to oxaliplatin.
    Type of Medium: Online Resource
    ISSN: 0020-7136 , 1097-0215
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 5
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 21, No. 15 ( 2020-07-29), p. 5395-
    Abstract: An individual’s inherited genetic variation may contribute to the ‘angiogenic switch’, which is essential for blood supply and tumor growth of microscopic and macroscopic tumors. Polymorphisms in angiogenesis-related genes potentially predispose to colorectal cancer (CRC) or affect the survival of CRC patients. We investigated the association of 392 single nucleotide polymorphisms (SNPs) in 33 angiogenesis-related genes with CRC risk and survival of CRC patients in 1754 CRC cases and 1781 healthy controls within DACHS (Darmkrebs: Chancen der Verhütung durch Screening), a German population-based case-control study. Odds ratios and 95% confidence intervals (CI) were estimated from unconditional logistic regression to test for genetic associations with CRC risk. The Cox proportional hazard model was used to estimate hazard ratios (HR) and 95% CIs for survival. Multiple testing was adjusted for by a false discovery rate. No variant was associated with CRC risk. Variants in EFNB2, MMP2 and JAG1 were significantly associated with overall survival. The association of the EFNB2 tagging SNP rs9520090 (p 〈 0.0001) was confirmed in two validation datasets (p-values: 0.01 and 0.05). The associations of the tagging SNPs rs6040062 in JAG1 (p-value 0.0003) and rs2241145 in MMP2 (p-value 0.0005) showed the same direction of association with overall survival in the first and second validation sets, respectively, although they did not reach significance (p-values: 0.09 and 0.25, respectively). EFNB2, MMP2 and JAG1 are known for their functional role in angiogenesis and the present study points to novel evidence for the impact of angiogenesis-related genetic variants on the CRC outcome.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 6
    In: Epigenetics, Informa UK Limited, Vol. 14, No. 5 ( 2019-05-04), p. 477-493
    Type of Medium: Online Resource
    ISSN: 1559-2294 , 1559-2308
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2019
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  • 7
    In: Gut, BMJ, Vol. 68, No. 1 ( 2019-01), p. 101-110
    Abstract: Pathological staging used for the prediction of patient survival in colorectal cancer (CRC) provides only limited information. Design Here, a genome-wide study of DNA methylation was conducted for two cohorts of patients with non-metastatic CRC (screening cohort (n=572) and validation cohort (n=274)). A variable screening for prognostic CpG sites was performed in the screening cohort using marginal testing based on a Cox model and subsequent adjustment of the p-values via independent hypothesis weighting using the methylation difference between 34 pairs of tumour and normal mucosa tissue as auxiliary covariate. From the 1000 CpG sites with the smallest adjusted p-value, 20 CpG sites with the smallest Brier score for overall survival (OS) were selected. Applying principal component analysis, we derived a prognostic methylation-based classifier for patients with non-metastatic CRC (ProMCol classifier). Results This classifier was associated with OS in the screening (HR 0.51, 95% CI 0.41 to 0.63, p=6.2E−10) and the validation cohort (HR 0.61, 95% CI 0.45 to 0.82, p=0.001). The independent validation of the ProMCol classifier revealed a reduction of the prediction error for 3-year OS from 0.127, calculated only with standard clinical variables, to 0.120 combining the clinical variables with the classifier and for 4-year OS from 0.153 to 0.140. All results were confirmed for disease-specific survival. Conclusion The ProMCol classifier could improve the prognostic accuracy for patients with non-metastatic CRC.
    Type of Medium: Online Resource
    ISSN: 0017-5749 , 1468-3288
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    Language: English
    Publisher: BMJ
    Publication Date: 2019
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  • 8
    In: Genomics, Elsevier BV, Vol. 106, No. 6 ( 2015-12), p. 348-354
    Type of Medium: Online Resource
    ISSN: 0888-7543
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    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
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    SSG: 12
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  • 9
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 21, No. 11_Supplement ( 2012-11-01), p. 33-33
    Abstract: Background: Thymidylate synthase (TS) is a key enzyme in folate metabolism and crucial for DNA synthesis and repair. Moreover, TS is an important target for chemotherapeutic drugs, such as 5-fluorouracil (5-FU) - a universal chemotherapeutic drug used for the treatment of colorectal cancer (CRC). TS over-expression may result in resistance to chemotherapy and may thus be a promising biomarker for therapeutic success. Previous studies revealed that at least three polymorphisms in the 5'- and 3'-untranslated regions (UTR) of the TS gene are associated with altered gene expression of TS coupled with a poor response to 5-FU treatment in CRC patients. Methods: Eight tagSNPs in the TS gene as well as one insertion/deletion polymorphism located in the 3'-UTR of the gene were investigated for association with risk of CRC in 1,754 cases and 1,781 controls, and with overall survival (OS) and disease-specific survival (DSS) in 1,739 CRC cases of the German DACHS study. Patients were aged 30 years or older and diagnosed between 2003 and 2007. Associations were assessed using multiple logistic and Cox regression models. Results: After a median follow-up time of 4.1 years, of the 442 deceased patients, 324 died due to CRC. There was no association between any polymorphism and CRC risk. Individuals with the heterozygote (het), but not with the rare homozygote variant (hzv) genotype of the rs495139 polymorphism (intronic region) had a significantly increased risk for overall (HRhet=1.63, 95% confidence interval (CI)=1.29-1.74 and HRhzv=1.28, 95% CI=0.94-1.74) and disease-specific mortality (HRhet=1.65, 95% CI=1.25-2.18 and HRhzv=1.11, 95% CI=0.76-1.60). No other polymorphism was associated with OS or DSS. However, several polymorphisms were associated with CRC risk when analyses were stratified by non-steroidal anti-inflammatory drug (NSAID) use. Also, several polymorphisms were associated with OS when analyses were stratified by 5-FU treatment, tumor stage, sex, and cancer site. Conclusion: Genetic variation in the thymidylate synthase gene appears to be associated with CRC survival but not with CRC risk. Notably, effect modifications (which may be clinically relevant) were observed for several factors in the analysis of CRC risk and prognosis. Citation Format: Katharina Buck, Jolantha Beyerle, Dominique Scherer, Nina Habermann, Michael J. Paskow, Katrin Pfuetze, Swantje Richter, Petra Seibold, Lina Jansen, Katja Butterbach, Barbara Burwinkel, Michael Hoffmeister, Axel Benner, Jenny Chang-Claude, Hermann Brenner, Moritz Koch, Juergen Weitz, Cornelia M. Ulrich. Thymidylate synthase polymorphisms and colorectal cancer risk and prognosis. [abstract]. In: Proceedings of the AACR Special Conference on Post-GWAS Horizons in Molecular Epidemiology: Digging Deeper into the Environment; 2012 Nov 11-14; Hollywood, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(11 Suppl):Abstract nr 33.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2012
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  • 10
    In: Cancer Medicine, Wiley, Vol. 7, No. 7 ( 2018-07), p. 2797-2807
    Abstract: Folate‐mediated one‐carbon metabolism ( FOCM ) is a key pathway essential for nucleotide synthesis, DNA methylation, and repair. This pathway is a critical target for 5‐fluorouracil (5‐ FU ), which is predominantly used for colorectal cancer ( CRC ) treatment. A comprehensive assessment of polymorphisms in FOCM ‐related genes and their association with prognosis has not yet been performed. Within 1,739 CRC cases aged ≥30 years diagnosed from 2003 to 2007 ( DACHS study), we investigated 397 single nucleotide polymorphisms ( SNP s) and 50 candidates in 48 FOCM ‐related genes for associations with overall‐ ( OS ) and disease‐free survival ( DFS ) using multiple Cox regression (adjusted for age, sex, stage, grade, BMI , and alcohol). We investigated effect modification by 5‐ FU ‐based chemotherapy and assessed pathway‐specific effects. Correction for multiple testing was performed using false discovery rates ( FDR ). After a median follow‐up time of 5.0 years, 585 patients were deceased. For one candidate SNP in MTHFR and two in TYMS , we observed significant inverse associations with OS ( MTHFR : rs1801133, C677T: HR het  = 0.81, 95% CI : 0.67–0.97; TYMS : rs1001761: HR het  = 0.82, 95% CI : 0.68–0.99 and rs2847149: HR het  = 0.82, 95% CI : 0.68–0.99). After FDR correction, one polymorphism in paraoxonase 1 ( PON 1 ; rs3917538) was significantly associated with OS ( HR het  = 1.28, 95% CI : 1.07–1.53; HR hzv  = 2.02, 95% CI :1.46–2.80; HR logAdd  = 1.31, p FDR  = 0.01). Adjusted pathway analyses showed significant associations for pyrimidine biosynthesis ( P  = 0.04) and fluorouracil drug metabolism ( P   〈  0.01) with significant gene–chemotherapy interactions, including PON 1 rs3917538. This study supports the concept that FOCM ‐related genes could be associated with CRC survival and may modify effects of 5‐ FU ‐based chemotherapy in genes in pyrimidine and fluorouracil metabolism, which are relevant targets for therapeutic response and prognosis in CRC . These results require confirmation in additional clinical studies.
    Type of Medium: Online Resource
    ISSN: 2045-7634 , 2045-7634
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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