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BAP1 protein expression independent biomarker in low-risk clear-cell RCC
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The loss of BAP1 protein expression is associated with an increased risk for death in patients with low-risk clear-cell renal cell carcinoma, according to study results.
BAP1 mutations — which are associated with loss of BAP1 protein expression — have been associated with poor outcomes in patients with clear-cell renal cell carcinoma (ccRCC), according to background information in the study.
Researchers used an immunohistochemistry assay to evaluate BAP1 expression in 1,479 patients who underwent nephrectomy. Of these, 1,410 were included in the analysis.
Results indicated that 10.5% of the tumors were BAP1-negative, 84.8% were BAP1-positive and 4.6% were ambiguous for BAP1 expression.
BAP1 negativity was associated with an increased risk for death from ccRCC (HR=3.06; 95% CI, 2.28-4.1).
After adjusting results for the UCLA integrated staging system, BAP1 expression remained significantly associated with prognosis (HR=1.67; 95% CI, 1.24-2.25).
Researchers also adjusted for Mayo Clinic stage, size, grade and necrosis scores.
They found BAP1 negativity was associated with an increased risk for ccRCC-related death in 813 low-risk patients with scores ≤3 (HR=3.24; 95% CI, 1.26-8.33).
Although BAP1 expression was not associated with prognosis in patients with scores between 4 and 7 or scores ≥7, the researchers said these patients only accounted for 16% of the study population.
“Even among this group of low-risk patients where deaths from ccRCC are rare, BAP1 expression helps identify patients wrongly classified as having low-risk disease,” the researchers wrote. “Our data suggest that BAP1 identified the most aggressive forms of ccRCC (even among those with low-risk tumors) and as such, we advocate for the use of BAP1 staining to better inform postsurgical management for patients with clinically localized ccRCC.”
Disclosure: The researchers report no relevant financial disclosures.
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