The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
Click here to participate in the public defence
Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture – time and place
Adjudication committee
- First opponent: Professor Per Pfeiffer, Department of Clinical Research, University of Southern Denmark
- Second opponent: Senior Scientist Trude Eid Robsahm, Department of Research, Cancer Registry of Norway
- Third member and chair of the evaluation committee: Associate Professor Anita Sveen, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor Trygve Holmøy, Faculty of Medicine, University of Oslo
Principal Supervisor
Professor II Anne Hansen Ree, Faculty of Medicine, University of Oslo
Summary
Colorectal cancer (CRC) is the second leading cause of cancer-related death in both sexes. The majority of patients are treated with a combination of chemotherapy agents as a complement to surgery. In addition, in high-risk rectal cancer tumors, radiation to the rectum is frequently recommended. This multimodal cancer management approach is often at the limit of patient tolerability. Hence, such treatments are in need of biological markers that reflect efficacy and severe side effects.
The overall aim of this thesis was to assess potential circulating biomarkers of prediction and prognosis in patients with advanced CRC. Blood samples from patients included in three different clinical trials were obtained throughout treatment and follow-up. Blood factors, with specific attention denoted to vitamin D, and the immune-stimulating proteins FLT3LG and HMGB1, were analyzed with regard to clinicopathological features and disease outcome.
Similar with a large amount of population-based evidence on CRC, the results showed that patients with low vitamin D at the time of diagnosis presented with large tumors that responded insufficiently to therapy and caused heightened risk of death from the disease. More men than women had vitamin D deficiency with an unfavorable immune status.
Oxaliplatin is a chemotherapy agent with known cytotoxic treatment effect in CRC. In addition, it is suggested to induce an advantageous immune response that contributes to improved outcome. The researchers observed that patients treated with oxaliplatin were alive more than 5 years after treatment completion, if they experienced increased levels of FLT3LG or HMGB1–both blood markers reflecting immune system activation. Their interpretation was that immune system activation early in the treatment course, by the use of oxaliplatin, contributed to the excellent outcome.
Altogether, this research has led to new insights into immune responses and the improved treatment outcome of high-risk and advanced CRC.
Additional information
Contact the research support staff.