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The relationship between density values of CD8+ And FOXP3+ as predictive factors for neoadjuvant folfox6 chemotherapy response in patients with locally advanced rectal cancer

  • Anton Sugianto ,
  • Tomy Lesmana ,
  • Edwin Danardono ,
  • Denny Denny Septarendra ,
  • Alphania Rahniayu ,


Introduction: Colorectal cancer ranks as the third most prevalent globally, with 1.9 million new cases and 900,000 deaths recorded. In Indonesia, 2020 witnessed 16,059 new rectal cancer cases, predominantly locally advanced rectal cancer (LARC) in those over 50. Annual incidents have risen by 2-8% in those under 50. Neoadjuvant therapy, particularly FOLFOX (folinic acid, fluorouracil, and oxaliplatin) or FOLFOX6 chemotherapy, is the primary treatment for LARC, aiming to downsize and downstage tumors. While previous studies explored overall TIL density, this research focuses on specific subsets (CD8+, CD4+, FOXP3+) crucial for neoadjuvant chemotherapy response. Examining CD8+, FOXP3+, and T-lymphocytes, this study aims to provide potent predictive markers for LARC patients undergoing neoadjuvant FOLFOX6 chemotherapy.

Methods: This is an observational analytic cross-sectional research design to establish the connection between the density of CD8+ and FOXP3+ regarding radiological response following neoadjuvant Folfox6 chemotherapy in patients with Locally Advanced Rectal Cancer.

Results: The study includes 60 subjects, with 53.3% showing positive chemotherapy response. The study reveals a significant association between high CD8 expression and positive chemotherapy response (p=0.02; OR=4). Additionally, a significant association is found between low FOXP3+ expression and positive chemotherapy response (p=0.01; OR=0.345). In subjects with positive chemotherapy response, 84.2% exhibit low CD8 and FOXP3+ expression, while 63.6% with high CD8 and low FOXP3 show positive response. High CD8 and FOXP3 expression in positive response is observed in 36.8%. No significant associations are found between CD8/FOXP3 combinations and response (p=0.06). No significant associations are observed between CD8/FOXP3 expression and tumor node metastasis (TNM) staging (p=0.608).

Conclusion: The study supports the hypothesis, indicating significant differences in chemotherapy response based on CD8+ and FOXP3+ expressions in locally advanced rectal cancer patients undergoing neoadjuvant FOLFOX6.


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How to Cite

Sugianto, A., Lesmana, T. ., Danardono, E. ., Denny Septarendra, D., & Rahniayu, A. . (2024). The relationship between density values of CD8+ And FOXP3+ as predictive factors for neoadjuvant folfox6 chemotherapy response in patients with locally advanced rectal cancer. Bali Medical Journal, 13(1), 548–551.




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