Predicting Survival in Patients with Metastatic Kidney Cancer by Gene-Expression Profiling in the Primary Tumor

• Published in: Proceedings of the National Academy of Sciences - PNAS Vol. 100; no. 12; pp. 6958 - 6963
• Main Authors: Vasselli, James R., Shih, Joanna H., Iyengar, Shuba R., Maranchie, Jodi, Riss, Joseph, Worrell, Robert, Torres-Cabala, Carlos, Tabios, Ray, Mariotti, Andra, Stearman, Robert, Merino, Maria, Walther, McClellan M., Simon, Richard, Klausner, Richard D., Linehan, W. Marston
• Format: Journal Article
• Language: English
• Published: United States National Academy of Sciences 10.06.2003; National Acad Sciences
• Subjects: Adult; Aged; Biological Sciences; Cancer; Carcinoma, Renal Cell - genetics; Carcinoma, Renal Cell - mortality; Carcinoma, Renal Cell - secondary; Complementary DNA; Female; Gene expression; Gene Expression Profiling; Genes; Health outcomes; Humans; Kidney cells; Kidney Neoplasms - genetics; Kidney Neoplasms - mortality; Kidneys; Male; Messenger RNA; Middle Aged; Molecular biology; Oligonucleotide Array Sequence Analysis; Prognosis; RNA; Survival Rate; Tumors; United States - epidemiology; Vascular Cell Adhesion Molecule-1 - genetics; United States
• ISSN: 0027-8424; 1091-6490
• DOI: 10.1073/pnas.1131754100

To identify potential molecular determinants of tumor biology and possible clinical outcomes, global gene-expression patterns were analyzed in the primary tumors of patients with metastatic renal cell cancer by using cDNA microarrays. We used grossly dissected tumor masses that included tumor, blood vessels, connective tissue, and infiltrating immune cells to obtain a gene-expression "profile" from each primary tumor. Two patterns of gene expression were found within this uniformly staged patient population, which correlated with a significant difference in overall survival between the two patient groups. Subsets of genes most significantly associated with survival were defined, and vascular cell adhesion molecule-1 (VCAM-1) was the gene most predictive for survival. Therefore, despite the complex biological nature of metastatic cancer, basic clinical behavior as defined by survival may be determined by the gene-expression patterns expressed within the compilation of primary gross tumor cells. We conclude that survival in patients with metastatic renal cell cancer can be correlated with the expression of various genes based solely on the expression profile in the primary kidney tumor.