The ESMO Congress is the largest European cross-indication cancer congress. It serves to improve the quality of cancer treatment, cancer prevention and diagnosis as well as palliative care and aftercare for patients. The latest findings on the kidneys, liver and intestines were compiled and presented in several highlight posters.
The improved survival of kidney transplant recipients has led to an increased risk of cancer, including colorectal cancer. It was therefore hypothesized that impaired immune surveillance allows the progression of sessile serrated lesions (SSL). This leads to a higher incidence of immunogenic mismatch repair-deficient (dMMR) but not mismatch repair-proficient (pMMR) colorectal cancer [1]. Kidney transplant patients were compared with controls in a 1:4 ratio based on age, gender and year of screening. 1 kidney transplant patients were identified in 2018. The average age of the recipients was 48 years and 60% were male. 218 tumors were observed, resulting in an SIR of 1.11. In the 162 transplant patients in whom MMR status was determined, dMMR occurred more frequently compared to the general population. Polyps were identified in 488 kidney transplant patients and compared with 1952 patients without kidney transplantation. SSL with dysplasia occurred more frequently in the transplant cohort. All in all, the population-based study indicates an increased risk of developing dMMR carcinoma at all stages after a kidney transplant, but not pMMR carcinoma. In addition, an increased incidence of dysplasia was observed in SSL in which dMMR occurs frequently. This illustrates that uncontrolled immune surveillance in transplant patients is clinically visible in precancerous and cancerous lesions. These findings could change the way CRC is screened and treated in kidney transplant patients.
Influence of diet on colorectal cancer
Colorectal cancer (CRC) is the result of a combination of genetic changes and environmental risk factors. Several lines of evidence suggest that diet may play a role in the prevention and progression of colorectal cancer, but further research is needed to clarify the heterogeneity of the links between diet and colorectal cancer. For this purpose, patient-derived xenografts (PDX) were generated by subcutaneous implantation of human colorectal carcinomas at various stages in immunodeficient mice and by feeding them a normal control diet (ND) and a classical Western diet (WD) [2]. Tumor phenotype, transcriptomics, genetics and metabolomics were analyzed. The response to WD was heterogeneous for all PDXs generated. Only one out of three PDX showed greater growth in mice fed with WD. Specifically, WD induced transcriptomic perturbations of several genes related to epigenetic regulation and tumor progression, remodeling the tumor microenvironment, promoting mucin secretion, mitochondrial dysfunction and metabolic reprogramming. Interestingly, the three PDX responded to the same WD with a different metabolic profile. Analysis of patient organoids developed from PDX fed with humanized diets revealed that the altered metabolic reprogramming acquired in vivo is maintained in vitro without any stimulus, suggesting a metabolic memory of cancer cells.
Biomarkers in liver cancer
Galectin-3 plays a decisive role in the adhesion, proliferation and differentiation of tumor cells. Recent data suggest that galectin-3 plays a role in the development of hepatocellular carcinoma (HCC), but its prognostic value has not yet been validated. The aim of one study was to investigate the clinical and prognostic value of galectin-3 in HCC patients [3]. In 767 HCC patients, the median overall survival (OS) was 14.2 months. It was significantly associated with clinicopathologic features, including tumor node metastasis (TNM) staging, Child-Pugh score (CPS), cirrhosis, metastasis, and alpha-fetoprotein (AFP) levels. At the time of analysis, the one-year OS rate was 45% in patients with high galectin-3 levels and 59% in patients with low galectin-3 levels. Higher galectin-3 levels were significantly associated with a higher risk of death.
Congress: ESMO 2023
Literature:
- Zwart K, et al: Risk of colorectal cancer and premalignant lesions after kidney transplantation. 561P. 22.10.2023. ESMO congress 2023.
- Rizzo G, et al: Patient-derived xenograft approach to explore differential responses to diet dependent on genotypic or phenotypic characteristics of colorectal cancer. 647P. 22.10.2023. ESMO congress 2023.
- Chamseddine S, et al: Blood circulating Galectin-3 is a prognostic biomarker in hepatocellular carcinoma. 961P. 23.10.2023. ESMO congress 2023.
InFo ONCOLOGY & HEMATOLOGY 2023; 11(6): 24 (published on 16.12.23, ahead of print)
