2) 10 (66.7) Positive (> 20) 24 (77.4) 5 (33.3) p53 N (%)     Negative (≤ 10) 2 (6.9) 4 (26.7) Positive (> 10) 27 (93.1) 11 (73.3) Bcl-2 N (%)     Negative (≤ 5) 18 (62.1) 11 (73.3) Positive (> 5) 11 (37.9) 4 (26.7) Ki-67 N (%)     Negative (<50)

11 (37.5) 9 (60.0) Positive Selleckchem BTK inhibitor (≥ 50) 18 (62.5) 6 (40.0) Changes of survivin, p53, Bcl-2 and Ki-67 in the 13 matched liver metastases pre- and post-90Y-RE In our series of liver biopsies, 13 patients had matched valuable tissues pre and post-90Y-RE. As reported in Table 2, the 13 paired patients, included in biomarker analysis, were found to be representative of the overall cohort of the 50 patients enrolled in the SITILO clinical trial with no statistical differences between the groups for baseline parameters (sex, site of primary tumors, number of metastases, liver involvement, performance status, bevacizumab or cetuximab therapy). On the basis of this comparative analysis, we evaluated whether survivin, p53, Bcl-2 and Ki-67 expression varied pre- and post-90Y-RE therapy in our series of 13 matched patients.

Table 2 Comparison of clinical variables between the overall series of patients and the series with liver biopsies pre- and post- 90 Y-RE Baseline Characteristics Patients Age (years)* Time to RE** FU months*** Sex N° (%) PT site N° (%) Met N° (%) Liver involvement N° (%) PS N° (%) DMXAA chemical structure Pre BV N° (%) Pre CTX N° (%)         M F Colon MRT67307 Rectum ≤ 4 > 4 <25% > 25% 0 ≥ 1 No Yes No Yes Overall Series (N = 50) 64 19 14 37 13 41 9 21 29 20 7 35 15 39 11 45 5 (34–38) (6–71) (2–49) (74) (26) (82) (18) (42) (58) (40) (54) (70) (30) (78) (22) (90) (10) Pre/Post RE series (N = 13) 58 21 15 9 4 11 2 4 9 30 6 9 4 9 4 12 1 (40–75) (9–53)

(3–49) (69) (31) (85) (15) (31) (69) (60) (46) (69) (31) (69) (31) (92) (8) P value 0.11 0.50 0.99 0.49 0.99 0.54 0.54 0.99 0.49 0.99 * mean (range); ** Months from diagnosis to 90Y-RE; ***Follow up post-90Y-RE; M, male; F, female; PT, Primary Tumor; Met, Metastases; PS, Performance Status; BV, bevacizumab; CTX, cetuximab. As described in Figure 1 panel A, the IHC biomarker analysis in this subset of mCRC showed that post-90Y-RE there was a significant reduction Carnitine palmitoyltransferase II in survivin positivity (from 92% to 54% of samples; p = 0.06) and p53 nuclear accumulation (from 100% to 69%; p = 0.05) (Figure 1 panel B-a and B-b). Furthermore, we found a small, but significant, decrease in Bcl-2 positivity (from 46% to 31%; p = 0.05; Figure 1 panel B-c) and a limited, not significant, decrease in Ki-67 positivity (from 77% to 61%). Figure 1 Changes of survivin, p53, Bcl-2 and Ki-67 in liver metastases pre- and post- 90 Y-RE. A. The histogram shows the significant reduction of the positivity of survivin (from 92% to 54%; p = 0.06), p53 (from 100% to 69%; p = 0.05) and Bcl-2 (from 46% to 31%; p = 0.05) expression in liver metastases pre- and post-90Y-RE therapy.