Hofman I J F, van Duin M, De Bruyne E, Fancello L, Mulligan G, Geerdens E, Garelli E, Mancini C, Lemmens H, Delforge M, Vandenberghe P, Wlodarska I, Aspesi A, Michaux L, Vanderkerken K, Sonneveld P, De Keersmaecker K
KU Leuven - University of Leuven, Department of Oncology, LKI - Leuven Cancer Institute, Leuven, Belgium.
Department of Hematology, Erasmus Medical Center, Rotterdam, The Netherlands.
Leukemia. 2017 Aug;31(8):1706-1714. doi: 10.1038/leu.2016.370. Epub 2016 Dec 2.
Chromosomal region 1p22 is deleted in ⩾20% of multiple myeloma (MM) patients, suggesting the presence of an unidentified tumor suppressor. Using high-resolution genomic profiling, we delimit a 58 kb minimal deleted region (MDR) on 1p22.1 encompassing two genes: ectopic viral integration site 5 (EVI5) and ribosomal protein L5 (RPL5). Low mRNA expression of EVI5 and RPL5 was associated with worse survival in diagnostic cases. Patients with 1p22 deletion had lower mRNA expression of EVI5 and RPL5, however, 1p22 deletion status is a bad predictor of RPL5 expression in some cases, suggesting that other mechanisms downregulate RPL5 expression. Interestingly, RPL5 but not EVI5 mRNA levels were significantly lower in relapsed patients responding to bortezomib and; both in newly diagnosed and relapsed patients, bortezomib treatment could overcome their bad prognosis by raising their progression-free survival to equal that of patients with high RPL5 expression. In conclusion, our genetic data restrict the MDR on 1p22 to EVI5 and RPL5 and although the role of these genes in promoting MM progression remains to be determined, we identify RPL5 mRNA expression as a biomarker for initial response to bortezomib in relapsed patients and subsequent survival benefit after long-term treatment in newly diagnosed and relapsed patients.
在≥20%的多发性骨髓瘤(MM)患者中,染色体区域1p22发生缺失,提示存在一个尚未明确的肿瘤抑制基因。我们利用高分辨率基因组分析,在1p22.1上划定了一个58 kb的最小缺失区域(MDR),该区域包含两个基因:异位病毒整合位点5(EVI5)和核糖体蛋白L5(RPL5)。在诊断病例中,EVI5和RPL5的低mRNA表达与较差的生存率相关。1p22缺失的患者EVI5和RPL5的mRNA表达较低,然而,在某些情况下,1p22缺失状态并不能很好地预测RPL5的表达,这表明存在其他机制下调RPL5的表达。有趣的是,在对硼替佐米有反应的复发患者中,RPL5而非EVI5的mRNA水平显著降低;在新诊断和复发患者中,硼替佐米治疗均可通过提高无进展生存期,使其与RPL5高表达患者相当,从而克服其不良预后。总之,我们的遗传学数据将1p22上的MDR限定为EVI5和RPL5,尽管这些基因在促进MM进展中的作用尚待确定,但我们确定RPL5 mRNA表达可作为复发患者对硼替佐米初始反应以及新诊断和复发患者长期治疗后生存获益的生物标志物。