Our study’s aim was to evaluate the clinicopathological profile of colorectal cancer (CRC) patients from North-East Romania in relation to the Kirsten rat sarcoma viral oncogene homolog (KRAS). We designed a retrospective study on 108 CRC patients using the fully automated real-time PCR-based molecular testing system, Idylla^TMKRAS Mutation Test (Biocartis, Mechelen, Belgium). Of the patients, 64 (59.3%) were men and 62 (57.4%) were older than the group average, with left bowel location in 38 cases (35.2%), adenocarcinoma NOS in 102 cases (94.4%), mixed histological pattern in 65 cases (60.2%), T3 in 60 patients (55.6%), N2 in 46 patients (42.6%), and 7–12 tumour buds registered in 58 tumours (53.7%). A total of 54 tumour samples (50%) showed KRAS mutation. Statistical comparative analyses associated KRAS mutations with the histopathological pattern (p = 0.018), tumour grade (p = 0.030), depth of invasion (pT) (p < 0.001), lymph node involvement (pN) (p < 0.001), venous vascular invasion (p = 0.048), and tumour buds’ number (p = 0.007). Our results demonstrate the relationship between KRAS mutation and clinicopathological features, with possible impact in clinical tumour stratification and therapeutic management.

Background: The effectiveness of neoadjuvant chemoradiotherapy (nCRT) is variable in locally advanced rectal cancer (LARC) patients, the ypT3 stage having a minimal or moderate response. The aim of our study was the evaluation of the association between CD133 (Prominin1) and CD166 (ALCAM) expression, survival parameters, and clinicopathological characteristics of a subgroup of LARC patients who achieved ypT3, showing post-nCRT and TME tumor fragmentation response and the assessment of these CSCs biomarkers value as indicators of the nCRT tumor response. Methods: Our study group comprised 60 LARC patients who achieved ypT3 status and exhibited a tumor fragmentation pattern following nCRT. Clinicopathological parameter and survival evaluations, along with CD133 and CD166 immunohistochemistry and scoring, were performed and the associations between different parameters were tested. Results: High CD133 expression was significantly associated with ypN category (p = 0.018), lymphovascular invasion (LVI) (p = 0.009), perineural invasion (PnI) (p = 0.006), and tumor grading (p = 0.047), while high CD166 expression was significantly associated with LVI (p = 0.020) and PnI (p = 0.028). Tumors with high CD133 and CD166 expressions were associated with decreased overall survival (OS) (p = 0.004 and p = 0.006). Cox regression analysis identified high CD133 and CD166 expression as independent factors associated with reduced survival (HR = 3.237, p = 0.014 and HR = 2.866, p = 0.020). Conclusions: Our results support the hypothesis that CD133 and CD166 are putative CSC biomarkers associated with aggressive behavior and a poor prognosis in LARC, offering opportunities for personalized targeted therapies.

Annexin A1 (ANXA1), a calcium-dependent phospholipid-binding protein, is considered a key modulator of cancer biology. Numerous pieces of evidence support its multifaceted involvement in tumor progression, metastatic dissemination, immune escape, and resistance to therapy in various malignancies, such as melanoma, along with liver, lung, and digestive tract tumors, including stomach and colorectal cancer (CRC). Although colon and rectal cancer (RC) exhibit overlapping characteristics, they are classified as separate clinical entities due to differences in tumor biology and therapy approaches. Moreover, locally advanced rectal cancer (LARC) raises clinical challenges due to variable treatment responses and its therapy resistance, preventing successful treatment and patients’ recovery. Considering ANXA1’s involvement in chemoresistance, further investigation is currently focused on ANXA1-targeted therapies. This review aims to update the knowledge on ANXA1, as a CRC predictive and prognostic biomarker, with involvement in therapy resistance, highlighting its significance in LARC patients. Through emerging evidence, our research provides valuable insights into the potential of ANXA1’s clinical utility and its prospective value as a target in chemoresistance approaches.

The prediction of the therapeutic response and of the patient outcome following neoadjuvant chemoradiotherapy (nCRT) in rectal cancer (RC) is still a challenging issue. The role of Annexin 1 (ANXA1) in the modulation of the tumor cells’ growth and metastasis has been recently demonstrated, being associated with aggressive pathological features and poor outcome in specific malignancies. The present study aimed to evaluate the association between ANXA1 expression, survival, and clinicopathological parameters of a group of patients diagnosed with ypT3 locally advanced rectal cancer (LARC) following nCRT. The study group consisted of 60 LARC patients with ypT3 tumor stage showing a tumor fragmentation pattern following nCRT. The clinicopathological characteristics and survival parameters in relation to ANXA1 immunohistochemistry characteristics and its scoring were evaluated. ANXA1 expression in tumor cells showed variable intense luminal membrane or combined luminal membrane and cytoplasmic location, excepting three negative cases. The statistical analysis demonstrated a significant association between high ANXA1 expression and ypN category (p < 0.001), perineural invasion (PnI) (p = 0.002), and lymphovascular invasion (LVI) (p = 0.021). Survival analysis showed that high ANXA1 expression is associated with a reduced overall survival (OS) (p = 0.001), while univariate Cox regression confirmed ANXA1 value as an independent predictor of prognosis (H = 5.922, p = 0.004). Our results support ANXA1 value as a potential biomarker of aggressive tumor behavior and poor prognosis in ypT3 LARC patients, with potential implications in diagnosis stratification, opening the prospective to apply precision oncology strategies. However, further studies are required to certify ANXA1 diagnostic and therapeutic relevance in RC patients.

The anthracyclines, represented by Doxorubicin, Epirubicin or Idarubicin, are paramount in Oncology due to their antitumoral efficacy in a multitude of solid cancers, making them essential in breast cancer treatment. The biggest disadvantage of anthracyclines, cardiotoxicity, happens as a direct effect of the oncologic treatment on the anatomy and the physiology of the heart and acts also as an element which advances pre-existent cardiovascular disease(2). We are presenting the case of a 51-year-old lady, clinically, with imagistic and biopsy diagnosis of breast cancer cT3N3M0, negative HR, HER 2neu-3+, that was treated with neoadjuvant chemotherapy consisting of anthracyclines and biological therapy with Herceptin (Trastuzumab – monoclonal humanized IgG1 antibodies, administered in HER2 + breast cancer). By cumulating the current clinical data with the therapeutic challenges of the anthracyclines (antitumoral effect vs cardiotoxicity), we are trying to encourage the multidisciplinary approach (oncology and cardiology), in order to reach the best therapeutic decision for each patient.