Prognostic and predictive value of AXL and C-MET in patients with rectal cancer

Carmen Australia Paredes Marcondes  Ribas; Martin  Gasser; Thomas  Boeldicke; Osvaldo Malafaia; Reinhard Lissner; Buelent  Polat; Sudipta Tripathi; Efstathia N  Doelken; Jurandir Marcondes  Ribas-Filho; Ana Maria  Waaga-Gasser

doi:10.1590/0102-67202025000049e1918

##article.authors##

Carmen Australia Paredes Marcondes Ribas Evangelical Theological Faculty https://orcid.org/0000-0002-6195-046X
- Conceptualization
- Investigation
- Data Curation
- Writing – Review & Editing
Martin Gasser Universitätsklinikum Würzburg https://orcid.org/0000-0002-0797-169X
- Investigation
- Data Curation
Thomas Boeldicke Helmholtz Centre for Infection Research https://orcid.org/0000-0003-2869-1133
- Data Curation
- Methodology
Osvaldo Malafaia Mackenzie Evangelical Faculty of Paraná https://orcid.org/0000-0002-1829-7071
- Writing – Original Draft Preparation
- Writing – Review & Editing
Reinhard Lissner Universitätsklinikum Würzburg
- Methodology
- Data Curation
Buelent Polat Universitätsklinikum Würzburg https://orcid.org/0000-0003-4677-424X
- Methodology
- Data Curation
Sudipta Tripathi University of Massachusetts Chan Medical School https://orcid.org/0000-0001-7729-9002
- Data Curation
- Methodology
Efstathia N Doelken Universitätsklinikum Würzburg
- Methodology
- Data Curation
Jurandir Marcondes Ribas-Filho Evangelical Theological Faculty https://orcid.org/0000-0002-5251-7672
- Data Curation
- Methodology
- Writing – Review & Editing
Ana Maria Waaga-Gasser Universitätsklinikum Würzburg https://orcid.org/0000-0001-5437-716X
- Conceptualization
- Writing – Original Draft Preparation

DOI:

https://doi.org/10.1590/0102-67202025000049e1918

Keywords:

Rectal cancer, Biomarkers, Protein-Tyrosine Kinases, Neoplastic Stem Cells, Chemoradiotherapy

Abstract

Background: Rectal cancer remains a significant clinical challenge with demand for conclusive biomarkers, essential in prognostication and therapy monitoring of neoadjuvant and adjuvant treatment strategies.

Aims: The aim of the study was to evaluate AXL and cellular mesenchymal-epithelial transition factor (C-MET) biomarkers for cancer stem cells and to correlate them with clinicopathological characteristics and patient outcome data with respect to neoadjuvant chemoradiotherapy.

Methods: Serum levels of soluble surface markers AXL and C-MET were retrospectively analyzed in 164 rectal cancer patients with additional immunofluorescent analyses of their primary tumor tissues.

Results: Kaplan-Meier analysis confirmed the prognostic significance of Union for International Cancer Control stages, but with no significant correlation between investigated markers with patient age, gender, or tumor stage. In contrast, tumor tissues demonstrated stage-dependently increased marker expression. While AXL was detected at low levels, C-MET exhibited a bimodal distribution, with elevated levels seen in most patients, particularly post-neoadjuvant therapy and non-significantly in the subgroup with poorer response to neoadjuvant therapy (p=0.074).

Conclusion: AXL serum levels in the rectal cancer cohort were significantly different from healthy subjects but did not correlate with tumor stage or survival during and after neoadjuvant/adjuvant therapy. Soluble C-MET levels in the blood, influenced by neoadjuvant chemoradiotherapy, may serve as a predictive marker for treatment response.