title: STRAP is a strong predictive marker of adjuvant chemotherapy benefit in colorectal cancer.
abstract: BACKGROUND
  Molecular predictors for the effectiveness of adjuvant chemotherapy in colorectal cancer are of considerable clinical interest. To this aim, we analyzed the serine threonine receptor-associated protein (STRAP), an inhibitor of TGF-beta signaling, with regard to prognosis and prediction of adjuvant 5-FU chemotherapy benefit.
  
  
  METHODS
  The gene copy status of STRAP was determined using quantitative real-time polymerase chain reaction in 166 colorectal tumor biopsies, which had been collected from a randomized multicenter trial of 5-fluorouracil (5-FU)/mitomycin C (MMC) adjuvant chemotherapy of the Swiss Group for Clinical Cancer Research (SAKK).
  
  
  RESULTS
  Amplification of STRAP was found in 22.8% of the tumors. When left without adjuvant chemotherapy, patients bearing tumors with a STRAP amplification had a significantly better prognosis (hazard ratio for death: 0.26; P=.004). Interestingly, these patients, when receiving adjuvant treatment, had a worse survival (hazard ratio for death: 3.48; P=.019) than without chemotherapy, whereas patients carrying tumors with diploidy or deletion of STRAP benefited from the treatment (hazard ratio for death: 0.44; P=.052). This suggests the amplification of STRAP as a strong predictor of an unfavorable effect of 5-FU-based adjuvant chemotherapy.
  
  
  CONCLUSIONS
  If confirmed, the STRAP gene copy status might provide a parameter to decide about the use of 5-FU-based adjuvant chemotherapy.
authors.affiliation: Department of Oncology, University Hospital of Basel, Basel CH-4031, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Buess
authors.forename: Luigi
authors.initials: L
authors.lastname: Terracciano
authors.forename: Jurgen
authors.initials: J
authors.lastname: Reuter
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Ballabeni
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Boulay
authors.forename: Urban
authors.initials: U
authors.lastname: Laffer
authors.forename: Urs
authors.initials: U
authors.lastname: Metzger
authors.forename: Richard
authors.initials: R
authors.lastname: Herrmann
authors.forename: Christoph
authors.initials: C
authors.lastname: Rochlitz
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002352:Carrier Proteins / Q000096:biosynthesis* / Q000235:genetics; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D018628:Gene Dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D011379:Prognosis
chemical_list: D000964:Antimetabolites, Antineoplastic; D014408:Biomarkers, Tumor; D002352:Carrier Proteins; C434146:Strap protein; D016685:Mitomycin; D005472:Fluorouracil
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