Cancer Research Center of Lyon, Lyon, France
Patricia Gifu , Sonia Brun , Guanxiong Wang , Firas Bassissi , Claude Caron de Fromentel , Philippe Merle , Philippe Halfon
Background: Hepatocellular carcinoma (HCC) is the third cause of cancer-related death. GNS561 (Genoscience Pharma, France) is a small molecule inducing apoptosis by lysosome inhibition and caspase activation. GNS561 has high hepatotropism and anti-tumorigenic capacity on tumor bulk and cancer stem cells. Its main target is a specific solute carrier transporter (SLCt). We describe here the clinical relevance of the overexpression of SLCt in HCC patients. Methods: The expression of SLCt was investigated by iQRT-PCR in surgically resected HCC tumors (T) and the matched non-tumor (NT) liver tissues (n=180) as well as healthy livers (HL) devoid of chronic or acute disease (n=10). Pearson's chi-squared test was employed for significant correlation tests while univariate and multivariate survival analysis were performed by Cox proportional hazard ratio (HR) method. Results: SLCt was overexpressed in 40.5% of T and 30.3% of NT as compared to HL. High SLCt in T was associated with microvascular emboli (p=0.034) and expression of the cancer stem cell markers Sox2 (p=0.025) and CD133 (p=0.034). High SLCt in NT correlated with cirrhosis (p=0.009) and presence of satellite nodules (p<0.001). Univariate analysis showed association between high SLCt in T and shortened overall survival (OS) (HR=1.08, p=0.020), lower progression-free survival (PFS) (HR=1.76, p=0.006) as well as early recurrence-free survival (ERFS) (within 2 years post-surgery) (HR=1.88, p=0.008). In multivariate analysis, high SLCt tended to be an independent factor for OS, and this was strongly significant for PFS and ERFS. High SLCt in NT, is quite a poor outcome factor on late recurrence-free survival (HR=2.33, p=0.056) together with cirrhosis in univariate analysis, but remained dependent of cirrhosis in multivariate analysis. Late recurrence is linked to the intrinsic tumorigenic status of the liver. Conclusions: Overexpression of the SLCt in HCC tumors is associated to stemness features and appears as a poor outcome factor impacting on early recurrence. Further, SLCt in NT is associated with development of de-novo HCC. Validation cohorts and prospective assessments are needed to define high SLCt as a potential biomarker of HCC stemness and patient outcome.
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