NBN gain is predictive for adverse outcome following image-guided radiotherapy for localized prostate cancer.

NBN gain is predictive for adverse outcome following image-guided radiotherapy for localized prostate cancer.
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DOI:
10.18632/oncotarget.2404
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发表时间:
2014-11-30
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影响因子:
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通讯作者:
Bristow RG
Bristow RG
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其他
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作者:
Berlin A;Lalonde E;Sykes J;Zafarana G;Chu KC;Ramnarine VR;Ishkanian A;Sendorek DH;Pasic I;Lam WL;Jurisica I;van der Kwast T;Milosevic M;Boutros PC;Bristow RG

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尽管使用了临床预后因素(PSA、T分类和Gleason评分),但20-60%的局限性前列腺癌(PCa)未能通过主要的局部治疗。在此,我们确定了DNA损伤反应(DDR)的主要传感器:MRE 11 A,RAD 50,NBN,ATM,ATR和PRKDC的预后重要性。我们研究了DDR基因拷贝数的改变,在局部PCa治疗与图像引导放射治疗(IGRT; n=139)与根治性前列腺切除术(RadP; n=154)。在两个队列中,NBN增加是最常见的基因组改变(分别为14.4%和11%的病例),并与总体肿瘤基因组不稳定性相关(p<0.0001)。NBN增加是IGRT后5年生化无复发率(bRFR)的唯一显著预测因素(46% vs 77%; p=0.00067)。在多变量分析中,调整已知临床预后变量后,NBN增益仍然是bRFR的显著独立预测因子(HR=3.28,95% CI 1.56-6.89,Wald p值=0.0017)。在RadP队列中没有DDR敏感基因是预后的。体外研究表明NBN基因过表达与PCa细胞辐射抗性相关。总之,NBN增益可预测IGRT患者的bRFR降低,但在RadP患者中则不然。如果得到独立验证,那么Nitrile增益可能是第一个PCa预测生物标志物,以促进使用手术或放疗的精确医学方法进行局部治疗决策。
Despite the use of clinical prognostic factors (PSA, T-category and Gleason score), 20-60% of localized prostate cancers (PCa) fail primary local treatment. Herein, we determined the prognostic importance of main sensors of the DNA damage response (DDR): MRE11A, RAD50, NBN, ATM, ATR and PRKDC. We studied copy number alterations in DDR genes in localized PCa treated with image-guided radiotherapy (IGRT; n=139) versus radical prostatectomy (RadP; n=154). In both cohorts, NBN gains were the most frequent genomic alteration (14.4 and 11% of cases, respectively), and were associated with overall tumour genomic instability (p<0.0001). NBN gains were the only significant predictor of 5yrs biochemical relapse-free rate (bRFR) following IGRT (46% versus 77%; p=0.00067). On multivariate analysis, NBN gain remained a significant independent predictor of bRFR after adjusting for known clinical prognostic variables (HR=3.28, 95% CI 1.56–6.89, Wald p-value=0.0017). No DDR-sensing gene was prognostic in the RadP cohort. In vitro studies correlated NBN gene overexpression with PCa cells radioresistance. In conclusion, NBN gain predicts for decreased bRFR in IGRT, but not in RadP patients. If validated independently, Nibrin gains may be the first PCa predictive biomarker to facilitate local treatment decisions using precision medicine approaches with surgery or radiotherapy.
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