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MicroRNA profiling and prediction of recurrence/relapse-free survival in stage I lung cancer

ABSTRACT: Despite surgical treatment of stage I non-small cell lung cancer (NSCLC), one third of patients will eventually have a recurrence. Robust prognostic markers are required to better manage therapy options. MicroRNAs play important roles in human cancers. The purpose of this study is to identify miRNA expression profiles that would better predict prognosis. Small RNAs extracted from formalin-fixed and paraffin-embedded (FFPE) tumor tissues of 357 stage I NSCLC patients were profiled on the human MicroRNA expression profiling V2 panel (Illumina). The expression differences between cancer subtypes were compared by t tests. The association of miRNA expression profile with recurrence free survival (RFS) was assessed using partial Cox regression models. Two miRNA signatures that are highly predictive of RFS were identified. The first contained 32 miRNAs derived from 357 stage I NSCLC patients independent of cancer subtype; while the second containing 27 miRNAs was adenocarcinoma specific. Both of them were validated using FFPE and/or fresh frozen tissues in independent data set with 170 stage I patients. This has important prognostic or therapeutic implications for the management of patients. The identified miRNAs hold great potential as targets for histology-specific treatment or prevention and treatment of recurrent disease.

ORGANISM(S): Homo sapiens

PROVIDER: GSE29135 | GEO | 2012/03/27

SECONDARY ACCESSION(S): PRJNA140455

REPOSITORIES: GEO

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Project description:BACKGROUND & AIMS: Sorafenib is the standard systemic therapy for advanced hepatocellular carcinoma (HCC). In early-stage HCC, survival benefits of resection/local ablation are compromised by high recurrence rates (70% at 5-years). In this setting, the phase-3 STORM-trial did not achieve its primary end-point of improving recurrence-free-survival (RFS) comparing sorafenib to placebo as adjuvant treatment. Herein we present results of the biomarker companion study BIOSTORM in which we define predictors of recurrence prevention with sorafenib and prognostic factors with B-level of evidence. METHODS: Tumor tissue from 188 patients randomized to receive sorafenib (83) or placebo (105) in the STORM trial was collected. Analyses included gene-expression profiling, targeted exome sequencing (18 known onco-drivers), immunohistochemistry (pERK, pVEGFR2, Ki67), FISH (VEGFA) and immunome. A gene signature capturing improved RFS in sorafenib-treated patients was generated. All 70 RFS events were recurrences, thus time-to-recurrence equaled RFS. Predictive and prognostic value was assessed using Cox regression models and interaction test. RESULTS: BIOSTORM recapitulates clinical and pathological characteristics of STORM patients. None of the biomarkers tested that are known to be related to angiogenesis and proliferation, or previously proposed gene-signatures, or mutations predicted sorafenib benefit. A newly generated 146-gene signature identifying 30% of patients captured benefit to sorafenib in terms of RFS (p-of-interaction=0.04). These sorafenib responders were significantly enriched in CD4+ T, B, and cytolytic Natural Killer cells, and showed absence of activated macrophages and other components of adaptive immunity. Hepatocytic pERK (HR=2.41; p=0.012) and microvascular invasion (HR=2.09; p=0.017) were independent prognostic factors. CONCLUSIONS: In BIOSTORM, hepatocytic pERK and microvascular invasion predicted poor RFS. No mutation, gene amplification or previously proposed gene-signatures predicted sorafenib benefit. A newly generated multi-gene signature associated with improved RFS on sorafenib warrants further validation. KEYWORDS: sorafenib; tyrosine-kinase inhibitor; trial enrichment; stratification.

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MicroRNA profiling and prediction of recurrence/relapse-free survival in stage I lung cancer

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