Patients suffering from Colorectal Cancer (CRC) usually gets affected with distant organ metastases spreading the tumor to other parts of the body. Patients with unresectable or borderline resectable Colorectal liver metastases (CRLM) are given Neoadjuvant Chemotherapy (NC) to limit liver resection and to lower down the tumor burden. But the possible chances of chemotherapy-induced liver damage and associated effects do not get ruled out. Chemotherapy can potentially damage the healthy tissue surrounding the tumor.

So, the discovery of a tissue-based molecular biomarker which will only target primary tumor proved to be a ray of sunshine in the rain.

A recent study, published in the British Journal of Cancer (2019), explores the significance of prognostic and predictive enzyme pyruvate dehydrogenase isoenzyme 4 (PDK4). This will help to identify those patients who will be benefited from NC. Effect of Transcription of PDK4 was assessed on the tissue of healthy liver, corresponding CRLM, healthy colon mucosa, and corresponding tumour. 

Patients were reviewed for perioperative hepato-toxic medication. And the Neoadjuvant Chemotherapy was performed before the surgical resection of CRLM.

The clinical data collected showed that the healthy liver tissue of patients with NC showed no significant increase of histological signs, such as liver fibrosis, steatosis or steatohepatitis which can be associated with chemotherapy-induced liver damage. Tests conducted like immunohistochemistry and Western blotting confirmed the abundant levels of PDK4 proteins in healthy liver tissue than in corresponding CRLM tissue.

The increased patient survival directly propionates to a higher level of PDK4 levels. Also, PDK4 helps in enhancing the postoperative liver function as well.