Ferroptosis and Cancer Prognosis / Advanced Breast Cancer Therapies · Journal article

Integrated Bioinformatic and Experimental Analysis of SLFN11 Expression and Clinical Significance in Locally Advanced Rectal Cancer

Biomedicines · August 13, 2026

Preliminary Why this matters to you Expert discussion

Early or partial results. Treat as a signal, not a conclusion.

AI Summary

This study interrogated public datasets and performed quantitative real-time PCR on paired LARC tissues (n=26) before and after neoadjuvant chemoradiotherapy. While SLFN11 expression increased significantly after treatment and was lower in tumours versus non-tumour tissue in public data, no significant associations emerged with survival or treatment response in the authors' cohort or most bioinformatic analyses, and the authors classify these negative findings as exploratory due to limited power.

What was studied

Bioinformatic analysis of public databases with prospective paired observational cohort validation. 26 patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy, from whom paired tumor and adjacent non-tumor tissue samples were collected before and after treatment.. Intervention: Neoadjuvant chemoradiotherapy (nCRT). n = 26.

Key findings

Public datasets demonstrated lower SLFN11 expression in rectal tumor tissues compared with non-tumor tissues SLFN11 expression increased significantly following nCRT in both tissue types in the cohort (n=26) No significant association between SLFN11 expression and survival outcomes in bioinformatic or cohort analyses

Safety

Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.

Who this may help

SLFN11 cannot currently be recommended as a prognostic or predictive biomarker for LARC based on this evidence. Clinicians should await larger, adequately powered studies before considering SLFN11 expression for treatment selection or outcome prediction in this setting.

Plain-language summary

Small single-centre cohort study with exploratory findings; authors acknowledge limited statistical power and uncertain clinical significance, warranting larger studies.

Study design

As stated by the source record.

MethodsPublicly available datasets were interrogated using UCSC Xena, GEPIA2, TNMplot, KMplot, ROC Plotter, and GEO databases. SLFN11 expression was assessed by quantitative real-time PCR in paired tumor and adjacent non-tumor tissues from 26 LARC patients collected before and after nCRT. Associations with clinicopathological characteristics, pathological response, and survival outcomes were analyzed.

DesignBioinformatic analysis of public databases with prospective paired observational cohort validation

Population26 patients with locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy, from whom paired tumor and adjacent non-tumor tissue samples were collected before and after treatment.

Sample size26

InterventionNeoadjuvant chemoradiotherapy (nCRT)

Reported figures

Quoted from the source exactly as published.

Sample size (paired LARC cohort)26

Clinical bottom line

Caveats

Authors acknowledge limited statistical power for prognostic and predictive analyses and classify these as exploratory.
No effect sizes, confidence intervals, or p-values reported for primary findings (e.g., expression changes post-nCRT).
Inconsistency between public datasets and paired cohort results not fully explained.
No hard clinical endpoints (recurrence-free survival, overall survival, pathological complete response rates) are reported with quantified effect sizes.

Evidence assessment

Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.

Study design

limited

Mixed bioinformatic analysis and small uncontrolled observational cohort without comparator arm.

Directness

moderate

Directly addresses SLFN11 expression in LARC tissues; endpoints are expression and survival, not hard clinical outcomes.

Consistency

limited

Authors report inconsistent findings: public databases show lower tumoral expression, but paired cohort shows no significant difference.

Risk of bias

limited

No blinding reported; small sample; authors acknowledge prognostic and predictive findings are exploratory.

Sample adequacy

insufficient

Cohort of 26 patients; authors explicitly state limited statistical power for prognostic and predictive analyses.

Source abstract

Background/Objectives: Schlafen 11 (SLFN11) encodes a DNA damage response protein implicated in sensitivity to DNA-damaging therapies and has been proposed as a predictive biomarker in several malignancies. This study aimed to characterize SLFN11 expression and evaluate its prognostic and predictive significance in locally advanced rectal cancer (LARC). Methods: Publicly available datasets were interrogated using UCSC Xena, GEPIA2, TNMplot, KMplot, ROC Plotter, and GEO databases. SLFN11 expression was assessed by quantitative real-time PCR in paired tumor and adjacent non-tumor tissues collected before and after neoadjuvant chemoradiotherapy (nCRT) from 26 patients with LARC. Associations with clinicopathological characteristics, pathological response, and survival outcomes were analyzed. Results: Publicly available datasets demonstrated lower SLFN11 expression in rectal tumor tissues compared with non-tumor tissues. In our cohort, no significant differences in SLFN11 expression were observed between paired tumor and adjacent non-tumor tissues either before or after nCRT. However, SLFN11 expression increased significantly following nCRT in both tissue types. Nevertheless, neither bioinformatic analyses nor our cohort demonstrated a significant association between SLFN11 expression and survival outcomes. Likewise, no significant predictive value of SLFN11 expression for response to nCRT was observed in ROC Plotter analysis, most GEO datasets, or our clinical cohort. The prognostic and predictive findings should be considered exploratory due to limited statistical power. Conclusions: Although SLFN11 expression is reduced in rectal tumor tissues and appears to be influenced by nCRT, its prognostic and predictive value in LARC remains uncertain. Larger studies are warranted to clarify its biological and clinical significance.

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Jelena Kotur StevuljevićKatarina ZeljićMarko MiladinovJelenko JelenkovicKatarina ErićJovana RosicFerroptosis and Cancer PrognosisAdvanced Breast Cancer Therapies