Abstract
In our study we retrospectively analyzed using Next-Generation expression analysis (NanoString), the expression of a gene panel in tumor tissue from 46 consecutive patients treated with nephrectomy for non-metastatic ccRCC at two Italian Oncological Centres. Significant differences in expression levels of selected genes was sought. Additionally, we performed a univariate and a multivariate analysis on overall survival according to Cox regression model. A 17-gene expression signature of patients with a recurrence-free survival (RFS) < 1 year (unfavorable genomic signature (UGS)) and of patients with a RFS > 5 years (favorable genomic signature (FGS)) was identified and resulted in being significantly correlated with overall survival of the patients included in this analysis (HR 51.37, p < 0.0001). The identified Genomic Signatures may serve as potential biomarkers for prognosis prediction of non-metastatic RCC and could drive both follow-up and treatment personalization in RCC management.
Highlights
Renal Cell Carcinoma (RCC) accounts for approximately 3% of all malignancies [1]
According to recurrence-free survival (RFS), patients were divided in two groups: 24 patients in the group with a RFS of >5 years versus 22 patients with an RFS of < 1 year
The two study groups were well balanced in terms of sex, tumor grade, necrosis, and sarcomatoid component representation in the histology, whereas the median age, disease stage, Karnofsky performance status (PS), and surgery done were significantly different between the two groups (Table 1)
Summary
Renal Cell Carcinoma (RCC) accounts for approximately 3% of all malignancies [1]. InItaly, it causes more than 3.717 deaths/year and the incidence of new cases is estimated at approximately 12,600 new cases/year [2]. The double-blind, phase 3 trial, KEYNOTE564, showed that patients with clear-cell renal-cell carcinoma who were at high risk for recurrence after nephrectomy, with or without metastasectomy, who received adjuvant pembrolizumab therapy had significantly longer disease-free survival than placebo (diseasefree survival at 24 months, 77.3% vs 68.1%; hazard ratio for recurrence or death, 0.68; 95% confidence interval [CI], 0.53 to 0.87; p = 0.002 [two-sided]) [12]. According to this data on the role of pembrolizumab as adjuvant treatment, the identification of a prognostic gene signature could be very helpful for better selection of those patients at higher risk of recurrence who may benefit from adjuvant treatment
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