Department of Oncology, Mario Negri Institute for Pharmacological Research, Milano, Italy.
Eur J Cancer. 2013 Jan;49(2):520-30. doi: 10.1016/j.ejca.2012.06.026. Epub 2012 Aug 13.
The present study is aimed to identify genetic pathways correlated with chemoresistance in epithelial ovarian cancer (EOC).
We compared the molecular profiles of 23 tumour biopsies of stage III-IV (training set) at primary surgery, before chemotherapy, to the profile from the same patients at second surgery, after several lines of platinum (Pt)-based chemotherapy when the tumours were resistant. In the hypothesis that identified markers were related to Pt-resistance and to prognosis, we validated this signature in 52 EOC taken at primary surgery (validation set) selected to be either very sensitive to the first line therapy, i.e. not relapsing before one year from the end of therapy, or resistant, i.e. relapsing within 6 months from the end of therapy.
In the training set, we identified a resistance signature indicative of the activation of epithelial to mesenchymal transition (EMT) by transforming growth factor (TGF)-beta pathway. We then validated this signature in 52 EOC taken at primary surgery (validation set). Some genes involved in EMT, such as BMP and activin membrane-bound inhibitor (BAMBI), and mir-141 resulted in association with overall or progression free survival.
Some genes involved in EMT were associated to overall or progression free survival, suggesting EMT as vital to the resistance mechanisms.
本研究旨在鉴定与上皮性卵巢癌(EOC)化疗耐药相关的遗传途径。
我们比较了 23 例 III-IV 期(训练集)患者在初次手术前的肿瘤活检的分子谱,与在多次铂(Pt)类化疗后肿瘤耐药时同一患者的第二次手术的分子谱。根据所鉴定的标记物与 Pt 耐药和预后相关的假设,我们在 52 例初次手术时采集的 EOC 中验证了这一特征(验证集),这些 EOC 被选择为对一线治疗非常敏感,即治疗结束后一年内不复发,或耐药,即治疗结束后 6 个月内复发。
在训练集中,我们确定了一个耐药特征,表明 TGF-β 通路激活了上皮细胞向间充质转化(EMT)。然后,我们在 52 例初次手术时采集的 EOC 中验证了这一特征(验证集)。一些参与 EMT 的基因,如 BMP 和 activin 膜结合抑制剂(BAMBI),以及 mir-141,与总生存或无进展生存相关。
一些参与 EMT 的基因与总生存或无进展生存相关,提示 EMT 是耐药机制的关键。