SPINK4 Expression as a Predictive Biomarker for Radiolabeled Immune Modulator Therapy in Advanced Colorectal Cancer

Colorectal cancer (CRC) remains a significant factor contributing to the morbidity and mortality rates linked with cancer throughout the world, especially in its stages of progression. Increasingly attractive therapeutic options include immune modulation combined with preoperative chemotherapy and radiation therapy (CRT). Recent studies have revealed that the protein serine peptidase inhibitor Kazal type 4 (SPINK4), which is abundantly expressed in gastrointestinal tract tissues, plays a role in immune evasion and treatment resistance in cancers. This meta-analysis aims to assess the relationship between SPINK4 expression levels and the therapeutic effectiveness of radiolabeled immune modulators in patients with advanced CRC who are undergoing preoperative chemotherapy and radiation treatment. The degree of SPINK4 expression and a lower objective response to radiolabeled immune modulators showed a statistically significant link. Conversely, patients with low SPINK4 expression have more favorable treatment responses and ongoing clinical improvement following CRT. High SpINK4 expression can act as a negative prognostic biomarker for radiolabeled immune control in advanced CRC.