Comprehensive validation of published immunohistochemical prognostic biomarkers of prostate cancer -what has gone wrong? A blueprint for the way forward in biomarker studies.
- Huber F Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
- Montani M Institute of Surgical Pathology, University of Bern, Bern, Switzerland.
- Sulser T Department of Urology, University Hospital Zurich, Zurich, Switzerland.
- Jaggi R Department of Clinical Research, University of Bern, Bern, Switzerland.
- Wild P Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
- Moch H Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland.
- Gevensleben H Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Germany.
- Schmid M Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Germany.
- Wyder S Department of Clinical Research, University of Bern, Bern, Switzerland.
- Kristiansen G Institute of Pathology, University Hospital of Bonn, Bonn, Germany.
- 2014-11-26
Published in:
- British journal of cancer. - 2015
Aged
Biomarkers, Tumor
Cohort Studies
Disease Progression
Humans
Immunohistochemistry
Male
Middle Aged
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prostatic Neoplasms
English
BACKGROUND
Treatment planning of localised prostate cancer remains challenging. Besides conventional parameters, a wealth of prognostic biomarkers has been proposed so far. None of which, however, have successfully been implemented in a routine setting so far. The aim of our study was to systematically verify a set of published prognostic markers for prostate cancer.
METHODS
Following an in-depth PubMed search, 28 markers were selected that have been proposed as multivariate prognostic markers for primary prostate cancer. Their prognostic validity was examined in a radical prostatectomy cohort of 238 patients with a median follow-up of 60 months and biochemical progression as endpoint of the analysis. Immunohistochemical evaluation was performed using previously published cut-off values, but allowing for optimisation if necessary. Univariate and multivariate Cox regression were used to determine the prognostic value of biomarkers included in this study.
RESULTS
Despite the application of various cut-offs in the analysis, only four (14%) markers were verified as independently prognostic (AKT1, stromal AR, EZH2, and PSMA) for PSA relapse following radical prostatectomy.
CONCLUSIONS
Apparently, many immunohistochemistry-based studies on prognostic markers seem to be over-optimistic. Codes of best practice, such as the REMARK guidelines, may facilitate the performance of conclusive and transparent future studies.
Treatment planning of localised prostate cancer remains challenging. Besides conventional parameters, a wealth of prognostic biomarkers has been proposed so far. None of which, however, have successfully been implemented in a routine setting so far. The aim of our study was to systematically verify a set of published prognostic markers for prostate cancer.
METHODS
Following an in-depth PubMed search, 28 markers were selected that have been proposed as multivariate prognostic markers for primary prostate cancer. Their prognostic validity was examined in a radical prostatectomy cohort of 238 patients with a median follow-up of 60 months and biochemical progression as endpoint of the analysis. Immunohistochemical evaluation was performed using previously published cut-off values, but allowing for optimisation if necessary. Univariate and multivariate Cox regression were used to determine the prognostic value of biomarkers included in this study.
RESULTS
Despite the application of various cut-offs in the analysis, only four (14%) markers were verified as independently prognostic (AKT1, stromal AR, EZH2, and PSMA) for PSA relapse following radical prostatectomy.
CONCLUSIONS
Apparently, many immunohistochemistry-based studies on prognostic markers seem to be over-optimistic. Codes of best practice, such as the REMARK guidelines, may facilitate the performance of conclusive and transparent future studies.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1038/bjc.2014.588
- PMID 25422912
- Persistent URL
- https://sonar.ch/global/documents/138951
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