A multigene predictor of outcome in glioblastoma.
Only a subset of patients with newly diagnosed glioblastoma (GBM) exhibit a response to standard therapy. To date, a biomarker panel with predictive power to distinguish treatment sensitive from treatment refractory GBM tumors does not exist. An analysis was performed using GBM microarray data from 4 independent data sets. An examination of the genes consistently associated with patient outcome, revealed a consensus 38-gene survival set. Worse outcome was associated with increased expression of genes associated with mesenchymal differentiation and angiogenesis. Application to formalin fixed-paraffin embedded (FFPE) samples using real-time reverse-transcriptase polymerase chain reaction assays resulted in a 9-gene subset which appeared robust in these samples. This 9-gene set was then validated in an additional independent sample set. Multivariate analysis confirmed that the 9-gene set was an independent predictor of outcome after adjusting for clinical factors and methylation of the methyl-guanine methyltransferase promoter. The 9-gene profile was also positively associated with markers of glioma stem-like cells, including CD133 and nestin. In sum, a multigene predictor of outcome in glioblastoma was identified which appears applicable to routinely processed FFPE samples. The profile has potential clinical application both for optimization of therapy in GBM and for the identification of novel therapies targeting tumors refractory to standard therapy.
Colman
Howard
H
Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77401, USA.
Zhang
Li
L
Sulman
Erik P
EP
McDonald
J Matthew
JM
Shooshtari
Nasrin Latif
NL
Rivera
Andreana
A
Popoff
Sonya
S
Nutt
Catherine L
CL
Louis
David N
DN
Cairncross
J Gregory
JG
Gilbert
Mark R
MR
Phillips
Heidi S
HS
Mehta
Minesh P
MP
Chakravarti
Arnab
A
Pelloski
Christopher E
CE
Bhat
Krishna
K
Feuerstein
Burt G
BG
Jenkins
Robert B
RB
Aldape
Ken
K
D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics*; D001932:Brain Neoplasms / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D020869:Gene Expression Profiling; D005909:Glioblastoma / Q000235:genetics* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D020411:Oligonucleotide Array Sequence Analysis; D011878:Radiotherapy; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor