Christian D Fankhauser1, Ailsa J Christiansen2,3, Christian Rothermundt4, Richard Cathomas5, Marian S Wettstein2, Nico C Grossmann2, Josias B Grogg2, Arnoud J Templeton6, Anita Hirschi-Blickenstorfer7, Anja Lorch8, Silke Gillessen4,9,10,11, Holger Moch3, Joerg Beyer12, Thomas Hermanns2. 1. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. cdfankhauser@gmail.com. 2. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 3. Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 4. Department of Oncology, Kantonsspital, St. Gallen, Switzerland. 5. Department of Oncology, Kantonsspital Chur, Chur, Switzerland. 6. Department of Medical Oncology, St. Claraspital Basel and Faculty of Medicine, University of Basel, Basel, Switzerland. 7. Onkozentrum Hirslanden, Klinik Hirslanden, Zürich, Switzerland. 8. Department of Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 9. EOC Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. 10. Universita della Svizzera Italiana, Lugano, Switzerland. 11. University of Bern, Bern, Switzerland. 12. Department of Medical Oncology, Inselspital, University Hospital, University of Bern, Bern, Switzerland.
Abstract
BACKGROUND: MiR-371a-3p predicts the presence of a macroscopic non-teratomatous germ cell tumour (GCT). We hypothesised that miR-371a-3p can also detect recurrence during active surveillance (AS) of stage I GCT. METHODS: We prospectively collected serum samples of 33 men. Relative expression of serum miR-371a-3p levels was determined at each follow-up visit using real-time quantitative reverse transcription-polymerase chain reaction. RESULTS: Recurrence was detected using standard follow-up investigations in 10/33 patients (30%) after a median of 7 months. Directly after orchiectomy, miR-371a-3p levels were not elevated in any of the 15 patients with available post-orchiectomy samples. However, all ten recurring patients exhibited increasing miR-371a-3p levels during follow-up, while miR-371a-3p levels remained non-elevated in all but one patient without recurrence. MiR-371a-3p detected recurrences at a median of 2 months (range 0-5) earlier than standard follow-up investigations. CONCLUSIONS: MiR-371a-3p levels immediately post orchiectomy are not predictive for recurrences and unfortunately cannot support decision-making for AS vs. adjuvant treatment. However, miR-371a-3p detects recurrences reliably and earlier than standard follow-up investigations. If this can be confirmed in larger cohorts, monitoring miR-371a-3p could replace surveillance imaging in seminomatous GCT and reduce the amount of imaging in non-seminomatous GCT. Earlier detection of disease recurrence may also reduce the overall treatment burden.
BACKGROUND: MiR-371a-3p predicts the presence of a macroscopic non-teratomatous germ cell tumour (GCT). We hypothesised that miR-371a-3p can also detect recurrence during active surveillance (AS) of stage I GCT. METHODS: We prospectively collected serum samples of 33 men. Relative expression of serum miR-371a-3p levels was determined at each follow-up visit using real-time quantitative reverse transcription-polymerase chain reaction. RESULTS: Recurrence was detected using standard follow-up investigations in 10/33 patients (30%) after a median of 7 months. Directly after orchiectomy, miR-371a-3p levels were not elevated in any of the 15 patients with available post-orchiectomy samples. However, all ten recurring patients exhibited increasing miR-371a-3p levels during follow-up, while miR-371a-3p levels remained non-elevated in all but one patient without recurrence. MiR-371a-3p detected recurrences at a median of 2 months (range 0-5) earlier than standard follow-up investigations. CONCLUSIONS: MiR-371a-3p levels immediately post orchiectomy are not predictive for recurrences and unfortunately cannot support decision-making for AS vs. adjuvant treatment. However, miR-371a-3p detects recurrences reliably and earlier than standard follow-up investigations. If this can be confirmed in larger cohorts, monitoring miR-371a-3p could replace surveillance imaging in seminomatous GCT and reduce the amount of imaging in non-seminomatous GCT. Earlier detection of disease recurrence may also reduce the overall treatment burden.
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