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评估血管生成相关基因多态性作为舒尼替尼治疗转移性肾细胞癌患者的预测和预后标志物。

Evaluation of polymorphisms in angiogenesis-related genes as predictive and prognostic markers for sunitinib-treated metastatic renal cell carcinoma patients.

作者信息

Dornbusch Juana, Walter Martina, Gottschalk Andrea, Obaje Alice, Junker Kerstin, Ohlmann Carsten-Henning, Meinhardt Matthias, Zacharis Aristeidis, Zastrow Stefan, Schoffer Olaf, Grimm Marc-Oliver, Klug Stefanie J, Wirth Manfred P, Fuessel Susanne

机构信息

Department of Urology, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Department of Urology, University Hospital of Jena, Lessingstr. 1, 07743, Jena, Germany.

出版信息

J Cancer Res Clin Oncol. 2016 Jun;142(6):1171-82. doi: 10.1007/s00432-016-2137-0. Epub 2016 Mar 3.

Abstract

PURPOSE

Single nucleotide polymorphisms (SNPs) in angiogenesis-associated genes might play an important role in activity of the tyrosine kinase inhibitor sunitinib and could affect survival of cancer patients treated with this drug. The aim of this retrospective study was to elucidate the role of 10 known SNPs in VEGFA, VEGFR1, VEGFR2 and VEGFR3 as potential prognostic and predictive markers in an independent cohort of patients with metastatic renal cell carcinoma (mRCC).

METHODS

DNA from 121 mRCC patients treated with sunitinib was used to analyze SNPs by TaqMan genotyping assays. Disease control rate was evaluated according to RECIST. Adverse effects of sunitinib were registered from medical records. The results of Cox and logistic regression were verified by correction for multiple testing.

RESULTS

Kaplan-Meier analysis revealed a reduced progression-free survival in patients with the wild-type (WT) allele of the VEGFA SNP rs699947 compared to variant alleles. Patients with the AA/AC-alleles of the VEGFR1 SNP rs9582036 had an improved median overall survival compared to those with the CC-WT allele what could be confirmed by multivariable Cox proportional hazard regression analyses. No statistically significant associations between the analyzed SNPs and higher risk for adverse effects were observed.

CONCLUSIONS

The results of this study suggest that most of the selected SNPs in angiogenesis-related genes are not associated with survival of mRCC patients after sunitinib therapy or with adverse effects. Only the VEGFR1 SNP rs9582036 showed a statistically significant association with overall survival. The potential of SNPs as prognostic and predictive markers for sunitinib-treated mRCC patients should be finally assessed by prospective studies.

摘要

目的

血管生成相关基因中的单核苷酸多态性(SNP)可能在酪氨酸激酶抑制剂舒尼替尼的活性中起重要作用,并可能影响接受该药物治疗的癌症患者的生存期。这项回顾性研究的目的是阐明血管内皮生长因子A(VEGFA)、血管内皮生长因子受体1(VEGFR1)、血管内皮生长因子受体2(VEGFR2)和血管内皮生长因子受体3(VEGFR3)中10个已知SNP作为转移性肾细胞癌(mRCC)独立患者队列中潜在预后和预测标志物的作用。

方法

采用TaqMan基因分型分析法,对121例接受舒尼替尼治疗的mRCC患者的DNA进行SNP分析。根据实体瘤疗效评价标准(RECIST)评估疾病控制率。从病历中记录舒尼替尼的不良反应。通过多重检验校正来验证Cox和逻辑回归的结果。

结果

Kaplan-Meier分析显示,与变异等位基因相比,VEGFA SNP rs699947野生型(WT)等位基因患者的无进展生存期缩短。VEGFR1 SNP rs9582036的AA/AC等位基因患者的中位总生存期较CC-WT等位基因患者有所改善,这一点可通过多变量Cox比例风险回归分析得到证实。未观察到所分析的SNP与更高不良反应风险之间存在统计学显著关联。

结论

本研究结果表明,血管生成相关基因中大多数选定的SNP与舒尼替尼治疗后mRCC患者的生存期或不良反应无关。只有VEGFR1 SNP rs9582036显示出与总生存期存在统计学显著关联。SNP作为舒尼替尼治疗mRCC患者的预后和预测标志物的潜力最终应通过前瞻性研究进行评估。

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