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Gastrin releasing peptide, receptor associated with improved colon cancer survival
Digestive Disease Week 2009
Researchers have concluded that patients with colon cancer who expressed high levels of gastrin releasing peptide and its receptor had delayed recurrence and increased survival, according to data presented at 2009 Digestive Disease Week.
The researchers examined tumor resections of 29 patients with stage II colon cancer and 21 with stage III disease treated at the Jessie Brown Veterans Administration Medical Center from 1997 to 2002. All patients were followed for at least five years.
Claudio A. Rivera, MPH, a researcher in the section of digestive diseases and nutrition at the University of Illinois at Chicago Medical Center, said patients who expressed gastrin releasing peptide (GRP) and gastrin releasing peptide-receptor (GRPR) had significantly better outcomes than those that did not.
“We have shown that patients whose colon cancers express GRP and its receptor as compared to those whose cancers do not, have improved survival, decreased cancer recurrence, decreased lymph node metastases and increased natural killer cell infiltration,” he said.
Rivera and colleagues said expression of high levels of GRPR alone or GRP and GRPR at the leading edge were associated with delayed recurrence: 14.1 months for GRPR alone and 17 months for GRP/GRPR. Expression of GRPR alone was associated with improved survival of 10.1 months, while expression of GRP/GRPR was associated with improved survival of 13.1 months. The researchers found that GRP alone was not associated with improved survival.
Expression of GRPR and GRP/GRPR was also associated with fewer lymph node metastases compared with tumors that did not express those proteins (8.4% vs. 17.8%) and an increase in the presence of CD16+ natural killer cells (8 vs. 3.7). – by Jason Harris
This is an interesting and provocative study of the potential role of GRP and GRPR in colon cancer biology. These proteins are often described as poor prognostic factors in other cancers, and as even having a role in cancer development. Here, the authors have shown that expression of the proteins in combination, or GRPR alone, is a good thing for the patient. The number of patients is relatively low and there is no capacity to stratify by the molecular or the physical characteristics of the tumors. The results might be better analyzed by considering stage, and the brief description of a relationship between lymph node number and protein expression is vague. However, even though the raw data are not presented, the P values seem indisputable.
– James Church, MD
Head of the Section of Endoscopy at Cleveland Clinic
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