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Emmprin expression predicts response and survival following cisplatin containing chemotherapy for bladder cancer: A validation study
Department of Surgical Sciences, Uppsala University, Uppsala.
Department of Surgical Sciences, Uppsala University, Uppsala.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Urology in Östergötland. Department of Surgical Sciences, Uppsala University, Uppsala.
Department of Surgical Sciences, Uppsala University, Uppsala.
2015 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 194, no 6, 1575-1581 p.Article in journal (Refereed) Published
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Abstract [en]

Purpose Neoadjuvant chemotherapy before cystectomy is recommended. To our knowledge the subset of patients likely to benefit has not been identified. We validate emmprin and survivin as markers of chemotherapy response. Materials and Methods Tumor specimens were obtained before therapy from a total of 250 patients with T1-T4 bladder cancer enrolled in 2 randomized trials comparing neoadjuvant chemotherapy before cystectomy with a surgery only arm. Protein expression was determined by immunohistochemistry. Results Expression was categorized according to predefined cutoffs reported in the literature. Data were analyzed with the Kaplan-Meier method and Cox models. Patients in the chemotherapy cohort with negative emmprin expression had significantly higher down staging overall survival than those with positive expression (71% vs 38%, p <0.001). The values for cancer specific survival were 76% and 56%, respectively (p <0.027). In the cystectomy only cohort emmprin expression was not associated with overall survival (46% vs 35%, p = 0.23) or cancer specific survival (55% vs 51%, p = 0.64). Emmprin negative patients had an absolute risk reduction of 25% in overall survival (95% CI 11-40) and a number needed to treat of 4 (95% CI 2.5-9.3). Survivin expression was not useful as a biomarker in this study. Limitations were the retrospective design and heterogeneity coupled with the time difference between the trials. Conclusions Patients with emmprin negative tumors have a better response to neoadjuvant chemotherapy before cystectomy than those with positive expression. © 2015 American Urological Association Education and Research, Inc.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 194, no 6, 1575-1581 p.
Keyword [en]
antigens, biological markers, CD147, cystectomy, drug therapy, urinary bladder neoplasms, CD147 antigen, cisplatin, doxorubicin, methotrexate, survivin, adult, Article, bladder cancer, cancer adjuvant therapy, cancer patient, cancer specific survival, cancer surgery, cancer survival, controlled study, female, human, immunohistochemistry, intermethod comparison, major clinical study, male, multiple cycle treatment, overall survival, priority journal, protein expression, randomized controlled trial, retrospective study, risk reduction, treatment response, validation study
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
URN: urn:nbn:se:liu:diva-126666DOI: 10.1016/j.juro.2015.06.085ISI: 000365985900012PubMedID: 26119672Scopus ID: 2-s2.0-84947230630OAI: oai:DiVA.org:liu-126666DiVA: diva2:916147
Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2017-02-20

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Hemdan, TammerMalmström, Per-UnoJahnson, StaffanSegersten, Ulrika
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Division of Clinical SciencesFaculty of Medicine and Health SciencesDepartment of Urology in Östergötland
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