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. 2018 Mar 20;118(6):878-886.
doi: 10.1038/bjc.2017.492. Epub 2018 Feb 15.

The predictive and prognostic potential of plasma telomerase reverse transcriptase (TERT) RNA in rectal cancer patients

Enrica Rampazzo  1 , Paola Del Bianco  2 , Roberta Bertorelle  3 , Caterina Boso  4 , Alessandro Perin  5 , Giovanna Spiro  5 , Francesca Bergamo  6 , Claudio Belluco  7 , Angela Buonadonna  8 , Elisa Palazzari  9 , Sara Lonardi  6 , Antonino De Paoli  9 , Salvatore Pucciarelli  5 , Anita De Rossi  1   3
Affiliations

The predictive and prognostic potential of plasma telomerase reverse transcriptase (TERT) RNA in rectal cancer patients

Enrica Rampazzo et al. Br J Cancer. .

Erratum in

Abstract

Background: Preoperative chemoradiotherapy (CRT) followed by surgery is the standard care for locally advanced rectal cancer, but tumour response to CRT and disease outcome are variable. The current study aimed to investigate the effectiveness of plasma telomerase reverse transcriptase (TERT) levels in predicting tumour response and clinical outcome.

Methods: 176 rectal cancer patients were included. Plasma samples were collected at baseline (before CRT=T0), 2 weeks after CRT was initiated (T1), post-CRT and before surgery (T2), and 4-8 months after surgery (T3) time points. Plasma TERT mRNA levels and total cell-free RNA were determined using real-time PCR.

Results: Plasma levels of TERT were significantly lower at T2 (P<0.0001) in responders than in non-responders. Post-CRT TERT levels and the differences between pre- and post-CRT TERT levels independently predicted tumour response, and the prediction model had an area under curve of 0.80 (95% confidence interval (CI) 0.73-0.87). Multiple analysis demonstrated that patients with detectable TERT levels at T2 and T3 time points had a risk of disease progression 2.13 (95% CI 1.10-4.11)-fold and 4.55 (95% CI 1.48-13.95)-fold higher, respectively, than those with undetectable plasma TERT levels.

Conclusions: Plasma TERT levels are independent markers of tumour response and are prognostic of disease progression in rectal cancer patients who undergo neoadjuvant therapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
TERT level in responders and non-responders to neoadjuvant therapy. TERT levels in responder and non-responder patients, pre- (T0), during- (T1) and post-CRT (T2), expressed as (A) TERT copies per ml and (B) TERT copies per 103 HPRT1 copies. Differences in TERT levels in responders and non-responders, pre- and during (ΔT0–T1), pre- and post- (ΔT0–T2), during and post CRT(ΔT1–T2), expressed as (C) TERT copies per ml and (D) TERT copies per 103 HPRT1 copies. Boxes and whiskers: 25–75th and 10–90th percentiles, respectively; central line in boxes: median. TERT=telomerase reverse transcriptase.
Figure 2
Figure 2
PFS according to TERT level. Kaplan–Meier curves for PFS according to (A) detectable or undetectable TERT T2 level before surgery, (B) TERT T2 levels ⩽ or > median level (42 copies per ml) before surgery and (C) detectable or undetectable TERT T3 level after surgery. PFS=Progression-free survival; TERT=telomerase reverse transcriptase.
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