Evidence map›Paper›PMID 29973197›Full record

ArticleJournal of translational medicine2018

Nuclear Klf4 accumulation is associated with cetuximab drug-resistance and predicts poor prognosis of nasopharyngeal carcinoma.

Xiqing Li, Zunlan Zhao, Shijiang Yi, Lei Ma, Ming Li, Mingyue Liu, Yaping Zhang, Guangzhi Liu

Open access · goldAbstract read
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Article in Journal of translational medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.2field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 2 countries.

Xiqing LiHenan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China.ORCID 0000-0001-9176-736X
Zunlan ZhaoThe Health Sciences Biomedical Research Facility II, University of California San Diego, La Jolla, CA, 92121, USA.
Shijiang YiAffiliated Hospital of Guilin Medical University, 1 Lequn Road, Guilin, 541004, Guangxi, China.
Lei MaCancer Hospital of Guangzhou Medical University, 78 Hengzhigang Road, Guangzhou, 510060, Guangdong, China.
Ming LiHarvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
Mingyue LiuHenan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China.
Yaping ZhangUniversity of Illinois at Chicago College of Medicine, 1835 W Polk St, Chicago, IL, 60612, USA.
Guangzhi LiuHenan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China. guangzhi72@126.com.
Henan Provincial People's Hospital · CNGuangzhou Medical University Cancer Hospital · CNGuilin Medical University · CNHarvard University · USUniversity of California San Diego · USUniversity of Illinois Chicago · US

Funding

National Natural Science Foundation of China (CN) U1504820
6 · The paper itself

Abstract

backgroundThe functions of the protein expressed in the nucleus and cytoplasm were different or opposite. The previous study found that oncogene Klf4 played a role of tumor suppressor in the nasopharyngeal cytoplasm. Cetuximab targeted epidermal growth factor receptor (EGFR) for the treatment of nasopharyngeal carcinoma.

methodsA cohort of 231 cases of advanced nasopharyngeal carcinoma (7th AJCC III-IVa) samples was assessed by immunohistochemistry (IHC), of which, 63 cases were treated with basic treatment without cetuximab, the basic treatment include chemotherapy and radiotherapy, the regent of the chemotherapy include cisplatin and fluorouracil and 168 cases were treated with cetuximab in addition to the basic treatment. The expression of the KLF4 protein was detected in nucleus and cytoplasm, c-Met protein and nuclear EGFR protein (nEGFR) by IHC, and H-Ras and PI3K mutations by an arms-PCR method in vivo. KLF4 was found to specifically express in the cytoplasm by deleting the NES, while H-Ras and PI3K genes were mutated in the nasopharyngeal carcinoma 5-8F and HONE1cell line. The cetuximab resistance in differentially mutated 5-8F and HONE1 cells was analyzed.

resultsThe expression of Klf4 in the nucleus was associated with prognosis in 168 patients with cetuximab-treated nasopharyngeal carcinoma, which was found by retrospective analysis. The KLF4 expression in the nucleus was not significantly correlated with the prognosis in 63 nasopharyngeal carcinoma patients treated with basic treatment (P = 0.261). The expression of Klf4 in the nucleus was correlated with mutations of H-Ras and PI3K in 168 cases of nasopharyngeal carcinoma with cetuximab treatment. In vitro experiments showed that Klf4 was specifically expressed in the nucleus of 5-8F and HONE1 cells as assessed by deleting nuclear export signal, which led to cetuximab resistance. H-Ras and PI3K mutations in 5-8F and HONE1 cells also led to the expression of Klf4 in the nucleus and resistance to cetuximab. In HONE1 cells, Klf4 was specifically localized in the cytoplasm by deleting the NES, and the H-Ras and PI3K mutations did not result in an increased expression of Klf4 in the nucleus and cetuximab resistance.

conclusionThe prognosis of nasopharyngeal carcinoma was not significantly improved by cetuximab treatment when the Klf4 was highly expressed in the nucleus of nasopharyngeal carcinoma tissues. The expression of Klf4 in the nucleus can be used as a biomarker for predicting the effects of cetuximab treatment in nasopharyngeal carcinoma, which might be attributed to the H-RAS and PI3K mutations, leading to cetuximab resistance.

Indexed as

Cell Line, TumorCell NucleusCetuximabDrug Resistance, NeoplasmErbB ReceptorsFemaleHumansKruppel-Like Factor 4Kruppel-Like Transcription FactorsMaleMiddle AgedMultivariate AnalysisMutationNasopharyngeal CarcinomaPhosphatidylinositol 3-KinasesPrognosisCetuximabEGFR protein, humanErbB ReceptorsHRAS protein, humanKLF4 protein, humanKruppel-Like Factor 4Kruppel-Like Transcription FactorsPhosphatidylinositol 3-KinasesProto-Oncogene Proteins c-metProto-Oncogene Proteins p21(ras)CetuximabDrug-resistanceKlf4Nasopharyngeal carcinomaPrognosis

Identifiers

PMID29973197
PMCPMC6030795
OpenAlexW2810197409

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.