title: Genoproteomic mining of urothelial cancer suggests {gamma}-glutamyl hydrolase and diazepam-binding inhibitor as putative urinary markers of outcome after chemotherapy.
abstract: Urinary biomarkers for the detection of bladder cancer have been developed, but no similar markers exist for prediction of clinical outcomes after receiving chemotherapy. Here we evaluate an approach that combines genomic, proteomic, and therapeutic outcome datasets to identify novel putative urinary biomarkers of clinical outcome after neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC). Using this method, we identified gamma-glutamyl hydrolase (GGH), emmprin, survivin, and diazepam-binding inhibitor (DBI). Interestingly, GGH is a protein associated with methotrexate resistance, whereas emmprin, survivin, and DBI had been previously identified as predictors of outcome after platinum-containing chemotherapeutic regimens when assessed on tumor tissue. Using disease-free survival as a marker for clinical outcome, we evaluated the ability of GGH, emmprin, survivin, and DBI expression in tumor tissue to stratify 27 patients treated with neoadjuvant MVAC. DBI (P = 0.046) but not GGH (P = 0.190), emmprin (P = 0.066), or survivin (P = 0.393) successfully stratified patients. When GGH was used with DBI the significance of stratification improved (P = 0.024), whereas the addition of survivin or emmprin to this latter two-gene model reduced its significance (P = 0.036 and P = 0.040, respectively). Although these predictive results were obtained on tumor tissues, the presence of GGH and DBI in urine serves as a rationale for developing them as urinary markers of clinical outcomes for patients treated with neoadjuvant MVAC.
authors.affiliation: Department of Molecular Physiology, University of Virginia, Charlottesville, 22908, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Pollard
authors.forename: Matt
authors.initials: M
authors.lastname: Nitz
authors.forename: Alex
authors.initials: A
authors.lastname: Baras
authors.forename: Paul
authors.initials: P
authors.lastname: Williams
authors.forename: Christopher
authors.initials: C
authors.lastname: Moskaluk
authors.forename: Dan
authors.initials: D
authors.lastname: Theodorescu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000652:urine*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D057225:Data Mining; D026261:Diazepam Binding Inhibitor / Q000652:urine*; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D020869:Gene Expression Profiling; D023281:Genomics; D006801:Humans; D008727:Methotrexate / Q000627:therapeutic use; D046228:Microarray Analysis; D020360:Neoadjuvant Therapy; D040901:Proteomics; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology / Q000652:urine*; D019459:Urothelium / Q000473:pathology / Q000502:physiology / Q000503:physiopathology; D014747:Vinblastine / Q000627:therapeutic use; D011623:gamma-Glutamyl Hydrolase / Q000235:genetics / Q000652:urine*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D026261:Diazepam Binding Inhibitor; D014747:Vinblastine; D004317:Doxorubicin; D011623:gamma-Glutamyl Hydrolase; D002945:Cisplatin; D008727:Methotrexate