Luís Lima1,2,3,4, Daniela Oliveira1, José A Ferreira1,5, Ana Tavares1,6, Ricardo Cruz7, Rui Medeiros4,8,9,10, Lúcio Santos1,10,11. 1. Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal. 2. ICBAS, Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal. 3. Nucleo de Investigação em Farmácia - Centro de Investigação em Saúde e Ambiente (CISA), School of Allied Health Sciences - Polytechnic Institute of Oporto, Porto, Portugal. 4. LPCC, Research Department-Portuguese League Against Cancer (NRNorte), Porto, Portugal. 5. Mass Spectrometry Center of the University of Aveiro, Aveiro, Portugal. 6. Department of Pathology, Portuguese Institute of Oncology, Porto, Portugal. 7. Department of Urology, Portuguese Institute of Oncology, Porto, Portugal. 8. Molecular Oncology Group, Portuguese Institute of Oncology, Porto, Portugal. 9. Department of Pathology and Molecular Immunology, University of Porto, Porto, Portugal. 10. Health Faculty of University Fernando Pessoa, Porto, Portugal. 11. Department of Surgical Oncology, Portuguese Institute of Oncology, Porto, Portugal.
Abstract
OBJECTIVE: To evaluate the predictive value of genetic polymorphisms in the context of bacille Calmette-Guérin (BCG) immunotherapy outcome and create a predictive profile that may allow discrimination of the risk of recurrence. PATIENTS AND METHODS: In a dataset of 204 patients treated with BCG, we evaluated 42 genetic polymorphisms in 38 genes involved in the BCG mechanism of action, using Sequenom MassARRAY(®) technology. Stepwise multivariate Cox regression was used for data mining. RESULTS: In agreement with previous studies we found that gender, age, tumour multiplicity and treatment scheme were associated with BCG failure. Using stepwise multivariate Cox regression analysis we propose the first predictive profile of BCG immunotherapy outcome and a risk score based on polymorphisms in immune system molecules [single nucleotide polymorphisms in tumour necrosis factor α (TNFA)-1031T/C (rs1799964), interleukin 2 receptor α (IL2RA) rs2104286 T/C, IL17A-197G/A (rs2275913), IL17RA-809A/G (rs4819554), IL18R1 rs3771171 T/C, intercellular adhesion molecule 1 (ICAM-1) K469E (rs5498), Fas ligand (FASL)-844T/C (rs763110) and TNF-related apoptosis-inducing ligand receptor 1 (TRAILR1)-397T/G (rs79037040)] in association with clinicopathological variables. This risk score allows the categorisation of patients into risk groups: patients within the low-risk group have a 90% chance of successful treatment, whereas patients in the high-risk group present a 75% chance of recurrence after BCG treatment. CONCLUSION: We have established the first predictive score of BCG immunotherapy outcome combining clinicopathological characteristics and a panel of genetic polymorphisms. Further studies using an independent cohort are warranted. Moreover, the inclusion of other biomarkers may help to improve the proposed model.
OBJECTIVE: To evaluate the predictive value of genetic polymorphisms in the context of bacille Calmette-Guérin (BCG) immunotherapy outcome and create a predictive profile that may allow discrimination of the risk of recurrence. PATIENTS AND METHODS: In a dataset of 204 patients treated with BCG, we evaluated 42 genetic polymorphisms in 38 genes involved in the BCG mechanism of action, using Sequenom MassARRAY(®) technology. Stepwise multivariate Cox regression was used for data mining. RESULTS: In agreement with previous studies we found that gender, age, tumour multiplicity and treatment scheme were associated with BCG failure. Using stepwise multivariate Cox regression analysis we propose the first predictive profile of BCG immunotherapy outcome and a risk score based on polymorphisms in immune system molecules [single nucleotide polymorphisms in tumour necrosis factor α (TNFA)-1031T/C (rs1799964), interleukin 2 receptor α (IL2RA) rs2104286 T/C, IL17A-197G/A (rs2275913), IL17RA-809A/G (rs4819554), IL18R1rs3771171 T/C, intercellular adhesion molecule 1 (ICAM-1) K469E (rs5498), Fas ligand (FASL)-844T/C (rs763110) and TNF-related apoptosis-inducing ligand receptor 1 (TRAILR1)-397T/G (rs79037040)] in association with clinicopathological variables. This risk score allows the categorisation of patients into risk groups: patients within the low-risk group have a 90% chance of successful treatment, whereas patients in the high-risk group present a 75% chance of recurrence after BCG treatment. CONCLUSION: We have established the first predictive score of BCG immunotherapy outcome combining clinicopathological characteristics and a panel of genetic polymorphisms. Further studies using an independent cohort are warranted. Moreover, the inclusion of other biomarkers may help to improve the proposed model.
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