title: Validation of genomics-based prognostic tests in malignant pleural mesothelioma.
abstract: OBJECTIVE
  Malignant pleural mesothelioma (MPM) is a highly lethal neoplasm with limited pretreatment prognostication strategies. In this report, we examine the accuracy of a previously proposed prognostic test in an independent cohort of MPM patients. This test uses simple ratios of gene expression levels to provide a novel prognostication scheme.
  
  
  METHODS
  Gene expression data using high-density oligonucleotide microarrays (approximately 22,000 genes) were obtained for a new cohort of human MPM tumors from patients undergoing similar treatments (n = 39). The relative expression levels for specific genes were also determined using real-time quantitative reverse transcription-PCR. We also used a subset of these tumors associated with widely divergent patient survival (n = 23) as a training set to identify new treatment-specific candidate prognostic molecular markers and gene ratio-based prognostic tests. The predictive nature of these newly discovered markers and gene ratio-based prognostic tests were then examined in an independent group of tumors (n = 52) using microarray data and quantitative reverse transcription-PCR.
  
  
  RESULTS
  Previously described MPM prognostic genes and gene ratio-based prognostic tests predicted clinical outcome in 39 independent MPM tumor specimens in a statistically significant manner. Newly discovered treatment-specific prognostic genes and gene ratio-based prognostic tests were highly accurate and statistically significant when examined in an independent group of 52 tumors from patients undergoing similar treatment.
  
  
  CONCLUSIONS
  The data support the use of gene ratios in translating gene expression data into easily reproducible, statistically validated clinical tests for the prediction of outcome in MPM.
authors.affiliation: Thoracic Surgery Oncology Laboratory and Division of Thoracic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ggordon@partners.org
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Gordon
authors.forename: Graham N
authors.initials: GN
authors.lastname: Rockwell
authors.forename: Paul A
authors.initials: PA
authors.lastname: Godfrey
authors.forename: Roderick V
authors.initials: RV
authors.lastname: Jensen
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Glickman
authors.forename: Beow Y
authors.initials: BY
authors.lastname: Yeap
authors.forename: William G
authors.initials: WG
authors.lastname: Richards
authors.forename: David J
authors.initials: DJ
authors.lastname: Sugarbaker
authors.forename: Raphael
authors.initials: R
authors.lastname: Bueno
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic / Q000235:genetics; D023281:Genomics / Q000379:methods*; D006801:Humans; D008654:Mesothelioma / Q000235:genetics / Q000473:pathology*; D008875:Middle Aged; D020411:Oligonucleotide Array Sequence Analysis / Q000379:methods; D010997:Pleural Neoplasms / Q000235:genetics / Q000473:pathology*; D011379:Prognosis; D015203:Reproducibility of Results; D016019:Survival Analysis