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Gene expression levels influenced prostate cancer outcomes
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2010 Genitourinary Cancers Symposium
Patients with prostate cancer who received androgen deprivation therapy prior to prostatectomy had lower levels of hypoxia inducible factor 1a, and higher expression of VEGF-A and VEGF-C was associated with superior outcomes, according to results presented at the 2010 Genitourinary Cancers Symposium.
Researchers found that higher VEGF-A expression levels were associated with better OS (HR=0.49 for levels >4.25). Additionally, the risk for developing clinical recurrence was lower when VEGF-C levels were higher (HR=0.4 for levels >0.18).
Tanya B. Dorff, assistant professor of clinical medicine at USC/Norris Comprehensive Cancer Center, said the VEGF results do not have immediate clinical utility, but are controversial because VEGF amplification in solid tumors is usually associated with worse outcomes.
“High levels of VEGF were associated with improved outcomes, specifically OS and clinical recurrence,” she said in an interview. “It was a bit of a surprising result. A lot more work needs to be done to understand the role of angiogenesis in early-stage prostate cancer. In castration-resistant metastatic prostate cancer, high serum VEGF was shown to correlate with an inferior prognosis, but they are different diseases and VEGF may play a different role early in the disease.”
Researchers collected radical prostatectomy specimens from 138 patients with lymph node positive prostate cancer from the University of Southern California prostatectomy database. Thirty percent of patients received preoperative ADT and 23% received postoperative ADT.
Researchers determined gene expression levels by quantitative reverse transcription-polymerase chain reaction, and stratified specimens into three groups for each gene based on gene expression levels.
Dorff said there was a significant correlation in expression levels amongst androgen receptor and pro-angiogenic genes. Patients treated with preoperative ADT had significantly lower hypoxia inducible factor 1a expression (mean=2.64; 95% CI, 2.34-2.94) compared with patients who did not have ADT (mean=3.25; 95% CI 2.97,-3.53) after adjusting for age, pre-operative PSA, Gleason score and stage.
For more information:
- Dorff TB. #17.Presented at: the 2010 Genitourinary Cancers Symposium; March 5-7, 2010; San Francisco.
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