title: Screening for EGFR amplifications with a novel method and their significance for the outcome of glioblastoma patients.
abstract: Glioblastoma is a highly aggressive tumour of the central nervous system, characterised by poor prognosis irrespective of the applied treatment. The aim of our study was to analyse whether the molecular markers of glioblastoma (i.e. TP53 and IDH1 mutations, CDKN2A deletion, EGFR amplification, chromosome 7 polysomy and EGFRvIII expression) could be associated with distinct prognosis and/or response to the therapy. Moreover, we describe a method which allows for a reliable, as well as time- and cost-effective, screening for EGFR amplification and chromosome 7 polysomy with quantitative Real-Time PCR at DNA level. In the clinical data, only the patient's age had prognostic significance (continuous: HR = 1.04; p<0.01). At the molecular level, EGFRvIII expression was associated with a better prognosis (HR = 0.37; p = 0.04). Intriguingly, EGFR amplification was associated with a worse outcome in younger patients (HR = 3.75; p<0.01) and in patients treated with radiotherapy (HR = 2.71; p = 0.03). We did not observe any difference between the patients with the amplification treated with radiotherapy and the patients without such a treatment. Next, EGFR amplification was related to a better prognosis in combination with the homozygous CDKN2A deletion (HR = 0.12; p = 0.01), but to a poorer prognosis in combination with chromosome 7 polysomy (HR = 14.88; p = 0.01). Importantly, the results emphasise the necessity to distinguish both mechanisms of the increased EGFR gene copy number (amplification and polysomy). To conclude, although the data presented here require validation in different groups of patients, they strongly advocate the consideration of the patient's tumour molecular characteristics in the selection of the therapy.
authors.affiliation: Department of Molecular Pathology and Neuropathology, Chair of Oncology, Medical University of Lodz, Lodz, Poland. michal.bienkowski@gmail.com
authors.forename: Michał
authors.initials: M
authors.lastname: Bieńkowski
authors.forename: Sylwester
authors.initials: S
authors.lastname: Piaskowski
authors.forename: Ewelina
authors.initials: E
authors.lastname: Stoczyńska-Fidelus
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szybka
authors.forename: Mateusz
authors.initials: M
authors.lastname: Banaszczyk
authors.forename: Monika
authors.initials: M
authors.lastname: Witusik-Perkowska
authors.forename: Emilia
authors.initials: E
authors.lastname: Jesień-Lewandowicz
authors.forename: Dariusz J
authors.initials: DJ
authors.lastname: Jaskólski
authors.forename: Anna
authors.initials: A
authors.lastname: Radomiak-Załuska
authors.forename: Dorota
authors.initials: D
authors.lastname: Jesionek-Kupnicka
authors.forename: Beata
authors.initials: B
authors.lastname: Sikorska
authors.forename: Wielisław
authors.initials: W
authors.lastname: Papierz
authors.forename: Piotr
authors.initials: P
authors.lastname: Rieske
authors.forename: Paweł P
authors.initials: PP
authors.lastname: Liberski
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor / Q000235:genetics*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000532:radiotherapy; D002869:Chromosome Aberrations; D002897:Chromosomes, Human, Pair 7; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000235:genetics*; D056915:DNA Copy Number Variations; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D005720:Gamma Rays; D017353:Gene Deletion; D005820:Genetic Testing / Q000379:methods*; D005909:Glioblastoma / Q000188:drug therapy / Q000235:genetics* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; C512478:EGFR protein, human; D066246:ErbB Receptors