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Comprehensive Genetic Search to Clarify the Molecular Mechanism of Drug Resistance Identifies ASCL2-LEF1/TSPAN8 Axis in Colorectal Cancer

Toshimichi Tanaka MD, Keita Kojima MD, PhD, Kazuko Yokota MD, Yoko Tanaka MD, Yosuke Ooizumi MD, Satoru Ishii MD, PhD, Nobuyuki Nishizawa MD, PhD, Keigo Yokoi MD, PhD, Hideki Ushiku MD, PhD, Mariko Kikuchi MD, PhD, Ken Kojo MD, PhD, Naoko Minatani MD, PhD, Hiroshi Katoh MD, PhD, Takeo Sato MD, PhD, Takatoshi Nakamura MD, PhD, Masakazu Sawanobori MD, PhD, Masahiko Watanabe MD, PhD, FACS, Keishi Yam
Gastrointestinal Oncology
Volume 26, Issue 5 / May , 2019



Treatment-resistance genes limiting anticancer therapy have not been well clarified in colorectal cancer (CRC). We explored gene expression profiles to identify biomarkers for predicting treatment resistance to an anticancer drug in CRC.


Six CRC cell lines were treated with phenylbutyrate (PB). The gene expression profiles were then compared using microarrays (harboring 54,675 genes), and genes associated with PB resistance were identified. Candidate genes were functionally examined in cell lines and clinically validated for treatment resistance in clinical samples.


Both DLD1 and HCT15 cells were PB resistant, while HCT116 cells were identified as PB sensitive. On microarray analysis, among the PB resistance-related genes, the expression of the genes ASCL2, LEF1, and TSPAN8 was clearly associated with PB resistance. PB-sensitive cells transfected with one of these three genes exhibited significant (Pā€‰<ā€‰0.001) augmentation of PB resistance; ASCL2 induced expression of both LEF1 and TSPAN8, while neither LEF1 nor TSPAN8 induced ASCL2. RNA interference via ASCL2 knockdown made PB-resistant cells sensitive to PB and inhibited both genes. ASCL2 knockdown also played a critical role in sensitivity to treatment by 5-fluorouracil and radiotherapy in addition to PB. Finally, ASCL2 expression was significantly correlated with histological grade of rectal cancer with preoperative chemoradiation therapy.


ASCL2 was identified as a causative gene involved in therapeutic resistance against anticancer treatments in CRC.

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