A signature of circulating microRNAs predicts the response to treatment with FOLFIRI plus aflibercept in metastatic colorectal cancer patients
Author
Toledano-Fonseca, Marta
Gómez-España, M. Auxiliadora
Élez, E.
Grávalos, C.
García-Alfonso, P.
Rodríguez, R.
Losa, F.
Alés Díaz, I.
Dopico Graña, Miguel
Valladares-Ayerbes, Manuel
García-Ortiz, M.V.
Polo, E.
Salgado, M.
Rivera, Fernando
Safont, M. J.
Salud, A.
Ruiz-Casado, A.
Tabernero, J. M.
Riesco, M. C.
Rodríguez-Ariza, Antonio
Aranda Aguilar, Enrique
Publisher
ElsevierDate
2023Subject
BiomarkersCirculating miRNAs
Colorectal cancer
Aflibercept
Antiangiogenic therapy
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Show full item recordAbstract
The benefit of adding the antiangiogenic drug aflibercept to FOLFIRI regime in metastatic colorectal cancer (CRC) patients resistant to or progressive on an oxaliplatin-based therapy has been previously demonstrated. However, the absence of validated biomarkers to predict greater outcomes is a major challenge encountered when using antiangiogenic therapies. In this study we investigated profiles of circulating microRNAs (miRNAs) to build predictive models of response to treatment and survival. Plasma was obtained from 98 metastatic CRC patients enrolled in a clinical phase II trial before receiving FOLFIRI plus aflibercept treatment, and the circulating levels of 754 individual miRNAs were quantified using real-time PCR. A distinct signature of circulating miRNAs differentiated responder from non-responder patients. Remarkably, most of these miRNAs were found to target genes that are involved in angiogenic processes. Accordingly, some of these miRNAs had predictive value and entered in predictive models of response to therapy, progression of disease, and survival of patients treated with FOLFIRI plus aflibercept. Among these miRNAs, circulating levels of hsa-miR-33b-5p efficiently discriminated between responder and non-responder patients and predicted the risk of disease progression. Moreover, the combination of circulating VEGF-A and miR-33b-5p levels improved clinical stratification of metastatic CRC patients who were to receive FOLFIRI plus aflibercept treatment. In conclusion, our study supports circulating miRNAs as valuable biomarkers for predicting better outcomes in metastatic CRC patients treated with FOLFIRI plus aflibercept.