5 protein-based signature for resectable lung squamous cell carcinoma improves the prognostic performance of the TNM staging
Por:
Martinez-Terroba, E, Behrens, C, Agorreta, J, Monso, E, Millares, L, Felip, E, Rosell, R, Ramirez, JL, Remirez, A, Torre, W, Gil-Bazo, I, Idoate, MA, de-Torres, JP, Pio, R, Wistuba, II, Pajares, MJ and Montuenga, LM
Publicada:
1 abr 2019
Ahead of Print:
24 nov 2018
Categoría:
Pulmonary and respiratory medicine
Resumen:
Introduction Prognostic biomarkers have been very elusive in the lung squamous cell carcinoma (SCC) and none is currently being used in the clinical setting. We aimed to identify and validate the clinical utility of a protein-based prognostic signature to stratify patients with early lung SCC according to their risk of recurrence or death.
Methods Patients were staged following the new International Association for the Study of Lung Cancer (IASLC) staging criteria (eighth edition, 2018). Three independent retrospective cohorts of 117, 96 and 105 patients with lung SCC were analysed to develop and validate a prognostic signature based on immunohistochemistry for five proteins.
Results We identified a five protein-based signature whose prognostic index (PI) was an independent and significant predictor of disease-free survival (DFS) (p<0.001; HR=4.06, 95% CI 2.18 to 7.56) and overall survival (OS) (p=0.004; HR=2.38, 95% CI 1.32 to 4.31). The prognostic capability of PI was confirmed in an external multi-institutional cohort for DFS (p=0.042; HR=2.01, 95% CI 1.03 to 3.94) and for OS (p=0.031; HR=2.29, 95% CI 1.08 to 4.86). Moreover, PI added complementary information to the newly established IASLC TNM 8th edition staging system. A combined prognostic model including both molecular and anatomical (TNM) criteria improved the risk stratification in both cohorts (p<0.05).
Conclusion We have identified and validated a clinically feasible protein-based prognostic model that complements the updated TNM system allowing more accurate risk stratification. This signature may be used as an advantageous tool to improve the clinical management of the patients, allowing the reduction of lung SCC mortality through a more accurate knowledge of the patient's potential outcome.
Filiaciones:
Martinez-Terroba, E:
CIMA, Program Solid Tumors, Pamplona, Spain
Univ Navarra, Sch Med, Dept Pathol Anat & Physiol, Pamplona, Spain
Behrens, C:
Univ Texas MD Anderson Canc Ctr, Dept Thorac Head & Neck Med Oncol, Houston, TX 77030 USA
Agorreta, J:
CIMA, Program Solid Tumors, Pamplona, Spain
Univ Navarra, Sch Med, Dept Pathol Anat & Physiol, Pamplona, Spain
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
Monso, E:
Parc Tauli Univ Hosp, Neumol Serv, Sabadell, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Millares, L:
Parc Tauli Univ Hosp, Neumol Serv, Sabadell, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain
Felip, E:
Vall dHebron Univ Hosp, Inst Oncol, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Catalan Inst Oncol, Badalona, Spain
:
Hosp Badalona Germans Trias & Pujol, Catalan Inst Oncol, Badalona, Spain
Remirez, A:
CIMA, Program Solid Tumors, Pamplona, Spain
Torre, W:
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Clin Univ Navarra, Dept Thorac Surg, Pamplona, Spain
Gil-Bazo, I:
CIMA, Program Solid Tumors, Pamplona, Spain
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
Clin Univ Navarra, Dept Oncol, Pamplona, Spain
Idoate, MA:
Univ Navarra, Sch Med, Dept Pathol Anat & Physiol, Pamplona, Spain
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
Clin Univ Navarra, Dept Pathol, Pamplona, Spain
de-Torres, JP:
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
Clin Univ Navarra, Dept Neumol, Pamplona, Spain
Pio, R:
CIMA, Program Solid Tumors, Pamplona, Spain
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
Univ Navarra, Sch Sci, Dept Biochem & Genet, Pamplona, Spain
Wistuba, II:
Univ Texas MD Anderson Canc Ctr, Dept Thorac Head & Neck Med Oncol, Houston, TX 77030 USA
Univ Texas MD Anderson Canc Ctr, Dept Translat Mol Pathol, Houston, TX 77030 USA
Pajares, MJ:
CIMA, Program Solid Tumors, Pamplona, Spain
Univ Navarra, Sch Med, Dept Pathol Anat & Physiol, Pamplona, Spain
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
Montuenga, LM:
CIMA, Program Solid Tumors, Pamplona, Spain
Univ Navarra, Sch Med, Dept Pathol Anat & Physiol, Pamplona, Spain
Navarra Hlth Res Inst IDISNA, Pamplona, Spain
Ctr Invest Biomed Red Canc CIBERONC, Madrid, Spain
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