Circulating hsa-miR-29c-3p and VEGF-A levels predict the response to FOLFIRI plus aflibercept in elderly metastatic colorectal cancer patients

BackgroundMetastatic colorectal cancer (mCRC) patients who progress on oxaliplatin-based chemotherapy benefit from second-line treatment with FOLFIRI plus the antiangiogenic drug aflibercept. However, the absence of validated biomarkers for antiangiogenic therapies remains a challenge. In this conte...

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Detalles Bibliográficos
Autores: Toledano-Fonseca, M, Cano-Osuna, MT, Elez, E, Soto-Alsar, J, Paáez, D, Fernández-Montes, A, Graña, B, Salud, A, Yubero, A, Macías, I, Quintero, G, López-López, C, Fernández-Rodríguez, T, García-Ortiz, MV, Sastre, J, García-Alfonso, P, Rodríguez-Ariza, A, Aranda, E
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p21096
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21096
Access Level:acceso abierto
Palabra clave:aflibercept
antiangiogenic therapy
circulating miRNAs
FOLFIRI
metastatic colorectal cancer
VEGF-A
Descripción
Sumario:BackgroundMetastatic colorectal cancer (mCRC) patients who progress on oxaliplatin-based chemotherapy benefit from second-line treatment with FOLFIRI plus the antiangiogenic drug aflibercept. However, the absence of validated biomarkers for antiangiogenic therapies remains a challenge. In this context, we previously reported that combining plasma VEGF-A levels, a circulating microRNA profile, and patient clinical characteristics predicts outcomes in FOLFIRI plus aflibercept treatment. In the present study, we now report biomarkers of response to FOLFIRI plus aflibercept in elderly mCRC patients who progressed after first-line oxaliplatin-based chemotherapy.MethodsThe study included 154 mCRC patients over 70 years of age enrolled in the clinical phase II trial AFEMA. Plasma samples were obtained before FOLFIRI plus aflibercept treatment, and circulating levels of VEGF-A and 13 miRNAs were analysed.ResultsThe levels of VEGF-A and five of these 13 miRNAs (miR-193-3b, miR-432-5p, miR-29c-3p, miR-93-5p, miR-30a-3p) enabled the stratification of patients based on progression-free survival and time-to-treatment failure. Specifically, combining miR-29c-3p with VEGF-A improved prognostic accuracy.ConclusionOur study underscores the value of integrating miR-29c-3p analysis with VEGF-A as a biomarker strategy to advance the management of elderly mCRC patients receiving FOLFIRI plus aflibercept, improving outcome predictions and enabling more personalised therapeutic strategies.