Prognostic role of the LCS6 KRAS variant in locally advanced rectal cancer: results of the EXPERT-C trial.

Background: Lethal-7 (let-7) is a tumour suppressor miRNA which acts by down-regulating several oncogenes including KRAS. A single-nucleotide polymorphism (rs61764370, T > G base substitution) in the let-7 complementary site 6 (LCS-6) of KRAS mRNA has been shown to predict prognosis in early-stage colorectal cancer (CRC) and benefit from anti-epidermal growth factor receptor monoclonal antibodies in metastatic CRC. Patients and methods: We analysed rs61764370 in EXPERT-C, a randomised phase II trial of neoadjuvant CAPOX followed by chemoradiotherapy, surgery and adjuvant CAPOX plus or minus cetuximab in locally advanced rectal cancer. DNA was isolated from formalin-fixed paraffin-embedded tumour tissue and genotyped using a PCR-based commercially available assay. Kaplan–Meier method and Cox regression analysis were used to calculate survival estimates and compare treatment arms. Results: A total of 155/164 (94.5%) patients were successfully analysed, of whom 123 (79.4%) and 32 (20.6%) had the LCS-6 TT and LCS-6 TG genotype, respectively. Carriers of the G allele were found to have a statistically significantly higher rate of complete response (CR) after neoadjuvant therapy (28.1% versus 10.6%; P = 0.020) and a trend for better 5-year progression-free survival (PFS) [77.4% versus 64.5%: hazard ratio (HR) 0.56; P = 0.152] and overall survival (OS) rates (80.3% versus 71.9%: HR 0.59; P = 0.234). Both CR and survival outcomes were independent of the use of cetuximab. The negative prognostic effect associated with KRAS mutation appeared to be stronger in patients with the LCS-6 TT genotype (HR PFS 1.70, P = 0.078; HR OS 1.79, P = 0.082) compared with those with the LCS-6 TG genotype (HR PFS 1.33, P = 0.713; HR OS 1.01, P = 0.995). Conclusion: This analysis suggests that rs61764370 may be a biomarker of response to neoadjuvant treatment and an indicator of favourable outcome in locally advanced rectal cancer possibly by mitigating the poor prognosis of KRAS mutation. In this setting, however, this polymorphism does not appear to predict cetuximab benefit.

The Soviet Union and the International Brigades, 1936-1939

The International Brigades are typically viewed as a fighting force whose impetus came from the Comintern, and thus from within the walls of the Kremlin. If the assumption is essentially correct, the broader relation between Stalin’s USSR and the IB has received little attention. This chapter constitutes an empirically-based study of the Soviet role not only in the formation of the IB, but of the Red Army’s collaboration with IB units, and Moscow’s role in the climax and denouement of the brigadistas’ Spanish experience. This study’s principal conclusion is twofold: First, that the creation and sustenance of the IB was part of Stalin’s goal of linking the Loyalist cause with that of the Soviet Union and international communism, a component of a larger geo-strategic gamble which sought to create united opposition to the fascist menace, one which might eventually bring Moscow and the West into a closer alliance. The second conclusion is that the IB, like the broader projection of Soviet power and influence into the Spanish theater, was an overly ambitious operational failure whose abortive retreat is indicative of the basic weakness of the Stalinist regime in the years prior to the Second World War.

The Long Aftermath: Cultural Legacies of Europe at War, 1936-2016

In its totality, the “Long Second World War”—extending from the beginning of the Spanish Civil War to the end of hostilities in 1945—has exerted enormous influence over European culture. Bringing together leading historians, sociologists, and literary and film scholars, this broadly interdisciplinary volume investigates Europeans’ individual and collective memories and the ways in which they have shaped the continent’s cultural heritage. Focusing on the major combatant nations—Spain, Britain, France, Italy, Germany, Poland, and Russia—it offers thoroughly contextualized explorations of novels, memoirs, films, and a host of other cultural forms to illuminate European public memory.