NF-κB Signaling Pathway and Efficacy of Bortezomib-Based Combination Chemotherapy in Patients with Non-Hodgkin's Lymphoma

Background and Objective: The efficacy of bortezomib-based chemotherapy on Non-Hodgkin's Lymphoma (NHL) patients has been a controversial question. Therefore, in this study, we evaluated whether a different efficacy of chemotherapy in patients with a variety of NHL subtypes. Materials and Methods: We reviewed the electronic medical records of West China Hospital of Sichuan University from January, 2004-2014 and included 48 NHL patients treated with at least two cycles of bortezomib-based chemotherapy. Results: On immunostaining, 18 (35.7%) and 16 (33.3%) presented p65 and RelB nuclear staining patterns, respectively. After treatment, 4 patients (13.3%) with p65-negative were complete remission and 8 (44.4%) with p65-positive were complete remission. The complete remission rate in patients with p65-positive was higher than those with negative (p<0.0001). NF-kappa B-activated p65 was related to a high rate of complete remission (OR: 4.80, 95% CI: 1.173, 19.6) for bortezomib treatment, the activated Relb was related with a high risk of inefficacy (OR:0.045, 95%CI: 0.05, 0.395) for bortezomib treatment. NF-kappa B and Relb activation should be monitored for helping bortezomib therapy selection. Conclusion: We found that the positive expression of p65 after nuclear staining and the negative expression of RelB after nuclear staining tended to indicate an effective treatment of bortezomib-based combination chemotherapy. However, due to the limited number of participants, further large scale, well-designed, prospective studies are warranted to confirm our findings.

Automated summary

This study evaluated the efficacy of bortezomib-based chemotherapy in different subtypes of NHL. The results showed that patients with p65-positive expression had a higher complete remission rate, and the activation of NF-kappa B p65 was associated with a higher remission rate, while the activation of RelB was associated with a higher risk of inefficacy. Monitoring the activation of NF-kappa B and RelB can help in selecting bortezomib therapy.