Research Papers:

A gene expression signature predicts recurrence-free survival in meningioma

Adriana Olar _, Lindsey D. Goodman, Khalida M. Wani, Nicholas S. Boehling, Devi S. Sharma, Reema R. Mody, Joy Gumin, Elizabeth B. Claus, Frederick F. Lang, Timothy F. Cloughesy, Albert Lai, Kenneth D. Aldape, Franco DeMonte and Erik P. Sulman

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Oncotarget. 2018; 9:16087-16098. https://doi.org/10.18632/oncotarget.24498

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Adriana Olar1, Lindsey D. Goodman2, Khalida M. Wani3, Nicholas S. Boehling4, Devi S. Sharma5, Reema R. Mody5, Joy Gumin6, Elizabeth B. Claus7,8, Frederick F. Lang6, Timothy F. Cloughesy5, Albert Lai5, Kenneth D. Aldape9, Franco DeMonte6 and Erik P. Sulman3,10

1Medical University of South Carolina & Hollings Cancer Center, Departments of Pathology and Laboratory Medicine & Neurosurgery, Charleston, SC, USA

2Neurosciences Graduate Group, Perlman School of Medicine, University of Pennsylvania, Department of Biology, Philadelphia, PA, USA

3The University of Texas MD Anderson Cancer Center, Department of Translational Molecular Pathology, Houston, TX, USA

4St. Charles Cancer Center, Department of Radiation Oncology, Bend, OR, USA

5The University of California at Los Angeles, Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA

6The University of Texas MD Anderson Cancer Center, Department of Neurosurgery, Houston, TX, USA

7Brigham and Women’s Hospital, Harvard Medical School, Department of Neurosurgery, Boston, MA, USA

8School of Public Health, Yale University, Department of Biostatistics, New Haven, CT, USA

9MacFeeters-Hamilton Brain Tumour Centre, Princess Margaret Cancer Centre, Toronto, Ontario, Canada

10The University of Texas MD Anderson Cancer Center, Departments of Radiation Oncology and Genomic Medicine, Houston, TX, USA

Correspondence to:

Adriana Olar, email: [email protected]; [email protected]

Erik P. Sulman, email: [email protected]

Keywords: meningioma; gene expression; affymetrix; recurrence risk; predictor algorithm

Received: August 02, 2017    Accepted: February 01, 2018    Epub: February 15, 2018     Published: March 23, 2018


BACKGROUND: Meningioma is the most common primary brain tumor and has a variable risk of local recurrence. While World Health Organization (WHO) grade generally correlates with recurrence, there is substantial within-grade variation of recurrence risk. Current risk stratification does not accurately predict which patients are likely to benefit from adjuvant radiation therapy (RT). We hypothesized that tumors at risk for recurrence have unique gene expression profiles (GEP) that could better select patients for adjuvant RT.

METHODS:We developed a recurrence predictor by machine learning modeling using a training/validation approach.

RESULTS: Three publicly available AffymetrixU133 gene expression datasets (GSE9438, GSE16581, GSE43290) combining 127 primary, non-treated meningiomas of all grades served as the training set. Unsupervised variable selection was used to identify an 18-gene GEP model (18-GEP) that separated recurrences. This model was validated on 62 primary, non-treated cases with similar grade and clinical variable distribution as the training set. When applied to the validation set, 18-GEP separated recurrences with a misclassification error rate of 0.25 (log-rank p=0.0003). 18-GEP was predictive for tumor recurrence [p=0.0008, HR=4.61, 95%CI=1.89-11.23)] and was predictive after adjustment for WHO grade, mitotic index, sex, tumor location, and Simpson grade [p=0.0311, HR=9.28, 95%CI=(1.22-70.29)]. The expression signature included genes encoding proteins involved in normal embryonic development, cell proliferation, tumor growth and invasion (FGF9, SEMA3C, EDNRA), angiogenesis (angiopoietin-2), cell cycle regulation (CDKN1A), membrane signaling (tetraspanin-7, caveolin-2), WNT-pathway inhibitors (DKK3), complement system (C1QA) and neurotransmitter regulation (SLC1A3, Secretogranin-II).

CONCLUSIONS: 18-GEP accurately stratifies patients with meningioma by recurrence risk having the potential to guide the use of adjuvant RT.

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