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Weekly measurement of HMGB1 during neoadjuvant chemoradiotherapy in rectal cancer patients: correlations with MRI response and ctDNA Cover

Weekly measurement of HMGB1 during neoadjuvant chemoradiotherapy in rectal cancer patients: correlations with MRI response and ctDNA

Radiology and Oncology
Volume 60 (2026): Issue 2 (June 2026)
By: ,  ,  ,  ,  ,  ,  ,   and    
Open Access
|Jun 2026
Figures & tables

Figures & Tables

FIGURE 1.

Initial High Mobility Group Box 1 protein (HMGB1) levels of the pre-therapeutic sample on day 1 of treatment were correlated with the corresponding mean allele frequency (AF) of cell-free tumor DNA (ctDNA) grouped according to the median of HMGB1 (A) and absolute values (B). In Figure 1C and 1D HMGB1 levels were correlated with the initial tumor volumes in magnetic resonance imaging (MRI), respectively.

FIGURE 2.

Individual relative dynamics of High Mobility Group Box 1 (HMGB1; normalized to the initial concentration) during the course of neoadjuvant chemoradiotherapy. Four patients showed mainly ascending values of HMGB1 (indicated in red boxes), two patients had HMGB1 decline (yellow frame), one patient showed undulating levels but decline at the end of therapy (green) and several patients had undulating HMGB1 concentrations in the plasma with ascent towards the end of treatment (blue).

FIGURE 3.

The dynamics of High Mobility Group Box 1 (HMGB1) measures were compared to the corresponding magnetic resonance imaging (MRI) at the end of week 2 of neoadjuvant treatment. We evaluated dynamics at the beginning of week 3 or - if not available, considered week 2. Levels normalized to the pre-treatment concentrations were considered as “stable” if they were in the range of + / - 0.2. Patients with decline of HMGB1 values showed enhanced relative MRI tumor regression (%) (A) and a trend regarding absolute tumour volume decrease (B).

Side effects during chemoradiation and HMGB1

PatientToxicity (CTC)Infection / complicationHMGB1 during treatment
1011° (skin)upper extremity venous thrombosisundulation / ascent***
1021° (skin)urinary tract infectionundulation / ascent***
1032° (skin) undulation / ascent***
1042° (skin) undulation / ascent***
1053° (proctitis, diarrhea) undulation / ascent***
1061° (skin) undulation / ascent***
1072° (skin) undulation / decline****
1082° (diarrhea)rosacea / psoriasis exacerbation*undulation / ascent***
1090 Decline
1101° (skin) undulation / ascent***
1111° (skin) undulation / ascent***
1121° (skin)pulmonary embolism (after week 4**)undulation / ascent***
1130 undulation / ascent***
1152° (skin) Ascent
1161° (skin) Ascent
1171° (skin) decline
1181° (skin) undulation / ascent***
1192° (skin) ascent
1202° (skin) ascent
DOI: https://doi.org/10.2478/raon-2026-0033 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 294 - 300
Submitted on: Feb 24, 2026
Accepted on: May 7, 2026
Published on: Jun 26, 2026
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Keywords:
High Mobility Group Box 1 (HMGB1) protein,
radiotherapy,
immunogenic cell death,
magnetic resonance imaging,
organ preservation,
cell-free tumor DNA
Related subjects:
Medicine,
Clinical medicine,
Radiology

© 2026 Franziska Eckert, Vlatko Potkrajcic, Stephan Clasen, Elgin Hoffmann, Julian Taugner, Olga Seibel-Kelemen, Christopher Schroeder, Maximilian Niyazi, Kerstin Clasen, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 60 (2026): Issue 2 (June 2026)
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