title: Identification of CREB3L1 as a Biomarker Predicting Doxorubicin Treatment Outcome.
abstract: BACKGROUND
  Doxorubicin has been shown to inhibit proliferation of cancer cells through proteolytic activation of CREB3L1 (cAMP response element binding protein 3-like 1), a transcription factor synthesized as a membrane-bound precursor. Upon doxorubicin treatment, CREB3L1 is cleaved so that the N-terminal domain of the protein can reach the nucleus where it activates transcription of genes that inhibit cell proliferation. These results suggest that the level of CREB3L1 in cancer cells may determine their sensitivity to doxorubicin.
  
  
  METHODS
  Mice transplanted with 6 lines of renal cell carcinoma (RCC) were injected with doxorubicin to observe the effect of the chemotherapy on tumor growth. Immunohistochemistry and bioinformatics analyses were performed to compare CREB3L1 levels in types of cancer known to respond to doxorubicin versus those resistant to doxorubicin.
  
  
  RESULTS
  Higher levels of CREB3L1 protein are correlated with increased doxorubicin sensitivity of xenograft RCC tumors (p = 0.017 by Pearson analysis). From patient tumor biopsies we analyzed, CREB3L1 was expressed in 19% of RCC, which is generally resistant to doxorubicin, but in 70% of diffuse large B-cell lymphoma that is sensitive to doxorubicin. Doxorubicin is used as the standard treatment for cancers that express the highest levels of CREB3L1 such as osteosarcoma and malignant fibrous histiocytoma but is not generally used to treat those that express the lowest levels of CREB3L1 such as RCC.
  
  
  CONCLUSIONS
  Identification of CREB3L1 as the biomarker for doxorubicin sensitivity may markedly improve the doxorubicin response rate by applying doxorubicin only to patients with cancers expressing CREB3L1.
authors.affiliation: Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Bray
authors.initials: B
authors.lastname: Denard
authors.affiliation: Department of Internal Medicine, Hematology-Oncology Division, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America; Department of Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pavia-Jimenez
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Weina
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Noelle S
authors.initials: NS
authors.lastname: Williams
authors.affiliation: Department of Internal Medicine, Hematology-Oncology Division, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Harris
authors.initials: H
authors.lastname: Naina
authors.affiliation: Department of Internal Medicine, Hematology-Oncology Division, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Robert
authors.initials: R
authors.lastname: Collins
authors.affiliation: Department of Internal Medicine, Hematology-Oncology Division, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America; Department of Developmental Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America; Kidney Cancer Program in Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Brugarolas
authors.affiliation: Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, Texas 75390, United States of America.
authors.forename: Jin
authors.initials: J
authors.lastname: Ye
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D045744:Cell Line, Tumor; D049109:Cell Proliferation / Q000187:drug effects; D017362:Cyclic AMP Response Element-Binding Protein / Q000378:metabolism*; D004317:Doxorubicin / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D051379:Mice; D009368:Neoplasm Transplantation; D009419:Nerve Tissue Proteins / Q000378:metabolism*; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; C119923:Creb3l1 protein, mouse; D017362:Cyclic AMP Response Element-Binding Protein; D009419:Nerve Tissue Proteins; D004317:Doxorubicin