Gene expression of vitamin D (VitD) pathway markers and survival in patients (Pts) with metastatic colorectal cancer (mCRC): CALGB/SWOG 80405 (Alliance).

Authors

null

Christine G Kohn

Beth Israel Deaconess Medical Center, Boston, MA

Christine G Kohn , Fang-Shu Ou , Chao Ma , Nicholas B Larson , Tyler J. Zemla , Chen Yuan , Donna Niedzwiecki , Bruce W. Hollis , Andrew B. Nixon , Heinz-Josef Lenz , Charles David Blanke , Richard M. Goldberg , Robert J. Mayer , Alan P. Venook , Eileen Mary O'Reilly , Jeffrey A. Meyerhardt , Kimmie Ng

Organizations

Beth Israel Deaconess Medical Center, Boston, MA, Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, Alliance Statistics and Data Management Center and Department of Biostatistics and Bioinformations, Duke University, Durham, NC, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, Department of Medicine, Duke University, Durham, NC, Division of Medical Oncology, Keck School of Medicine, University of Southern California, Los Angeles, CA, Division of Hematology and Medical Oncology, Oregon Health and Science University, and SWOG Group Chair’s Office, Portland, OR, Department of Medicine, West Virginia University, Morgantown, WV, University of California, San Francisco, CA, Memorial Sloan Kettering Cancer Center, New York, NY, Dana-Farber Cancer Institute, Boston, MA

Research Funding

Other

Background: Higher levels of plasma 25-hydroxyvitamin D [25(OH)D)] are associated with better outcomes in mCRC, but underlying biologic mechanisms are unknown. Key components of the VitD metabolic pathway include CYP27B1 (encodes 1-α-hydroxylase, converts 25(OH)D to active calcitriol), VitD receptor (VDR), and CYP24A1 (encodes 24-hydroxylase, degrades calcitriol and 25(OH)D into excreted metabolites). Since these factors may affect 25(OH)D levels and potentially mediate VitD activity in mCRC, we examined the relationship between tumoral gene expression (GEx) of CYP27B1, VDR, and CYP24A and pt outcome in a study nested in a randomized phase III trial of first-line chemotherapy plus biologics in mCRC pts, CALGB/SWOG 80405. Methods: We determined GEx of CYP27B1, VDR, and CYP24A1 by RNA sequencing (RNA-Seq) of archival tumor samples using the Illumina TruSeq platform. Primary endpoints were overall (OS) and progression-free survival (PFS). Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for prognostic and molecular characteristics. Results: 562 pts with RNA-Seq data were included. Pts with higher CYP27B1 expression (>median) were less likely to have BRAF wild type (WT) (79% vs 90%) compared to pts with lower expression (p=0.0007). Pts with higher VDR expression (>quartile 1 [Q1]) were younger (median age 59 vs 62 years; p=0.03), more likely to have left-sided (63% vs 46%; p=0.0005) and BRAF WT tumors (89% vs 70%; p<0.0001), and less likely to have RAS WT tumors (70% vs 80%; p=0.02) compared to pts with lower VDR. Pts with higher CYP24A1 expression (>median) were more likely to have left-sided tumors compared to pts with lower expression (63% vs 54%; p=0.03). On multivariable analysis, pts with higher CYP27B1 expression had significantly improved OS (HR 0.84; 95% CI, 0.75-0.93; p=0.002) and PFS (HR 0.89; 95% CI, 0.80-0.99; p=0.04). Higher VDR expression (up to Q1) was associated with significantly improved PFS (HR 0.69; 95% CI, 0.53-0.91; p=0.007) but not OS (HR 0.85; 95% CI, 0.66-1.09; p=0.20). Above Q1, this improvement attenuated. Higher CYP24A1 GEx was not associated with improved OS (HR 0.98; 95% CI, 0.88-1.08; p=0.66) or PFS (HR 0.98; 95% CI, 0.89-1.08; p=0.68). We found no significant interactions between GEx of CYP27B1, VDR, or CYP24A with baseline plasma 25(OH)D levels (p for interaction ≥0.10 for all). Conclusions: Our findings suggest an association between GEx of VitD pathway markers, particularly CYP27B1 and VDR, and survival in pts with mCRC, lending biologic plausibility to a role of VitD in CRC pathogenesis. Future studies are needed to confirm these findings and elucidate underlying mechanisms of action. Clinical trial information: NCT00265850.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 3553)

DOI

10.1200/JCO.2022.40.16_suppl.3553

Abstract #

3553

Poster Bd #

347

Abstract Disclosures