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Focal adhesion kinase: predictor of tumour response and risk factor for recurrence after neoadjuvant chemoradiation in rectal cancer
Authors:Maria Jesús Fernández‐Aceñero  Aurea Borrero‐Palacios  Laura del Puerto‐Nevado  Javier Martínez‐Useros  Juan Pablo Marín‐Arango  Cristina Caramés  Ricardo Vega‐Bravo  María Rodríguez‐Remírez  Marlid Cruz‐Ramos  Félix Manzarbeitia  Jesús García‐Foncillas
Affiliation:1. Pathology Department, Oncohealth Institute, Health Research Institute FJD‐UAM, University Hospital “Fundacion Jimenez Diaz”, Madrid, Spain;2. Translational Oncology Division, Oncohealth Institute, Health Research Institute FJD‐UAM, University Hospital “Fundacion Jimenez Diaz”, Madrid, Spain
Abstract:Rectal cancer represents about 30% of colorectal cancers, being around 50% locally advanced at presentation. Chemoradiation (CRT) followed by total mesorectal excision is the standard of care for these locally advanced stages. However, it is not free of adverse effects and toxicity and the complete pathologic response rate is between 10% and 30%. This makes it extremely important to define factors that can predict response to this therapy. Focal adhesion kinase (FAK) expression has been correlated with worse prognosis in several tumours and its possible involvement in cancer radio‐ and chemosensitivity has been suggested; however, its role in rectal cancer has not been analysed yet. To analyse the association of FAK expression with tumour response to CRT in locally advanced rectal cancer. This study includes 73 patients with locally advanced rectal cancer receiving standard neoadjuvant CRT followed by total mesorectal excision. Focal adhesion kinase protein levels were immunohistochemically analysed in the pre‐treatment biopsies of these patients and correlated with tumour response to CRT and patients survival. Low FAK expression was significantly correlated with local and distant recurrence (P = 0.013). Low FAK expression was found to be a predictive marker of tumour response to neoadjuvant therapy (P = 0.007) and patients whose tumours did not express FAK showed a strong association with lower disease‐free survival (P = 0.01). Focal adhesion kinase expression predicts neoadjuvant CRT response in rectal cancer patients and it is a clinically relevant risk factor for local and distant recurrence.
Keywords:rectal cancer  chemoradiotherapy  focal adhesion kinase  predictive marker  risk factor  neoadjuvant therapy
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