European Study Finds Chromosome 1q Gain Linked to Poorer Outcome in Wilms Tumor Treated With Preoperative Chemotherapy
In a study reported in the Journal of Clinical Oncology, Chagtai et al of the International Society of Paediatric Oncology (SIOP) Renal Tumours Study Group found that chromosome 1q gain was associated with poorer event-free survival in patients with Wilms tumor treated with preoperative chemotherapy. Gain of 1q may be a potentially valuable prognostic biomarker in Wilms tumor.
The study involved analysis of nephrectomy samples from 586 patients from the SIOP WT 2001 trial. Samples were analyzed using a multiplex ligation–dependent probe amplification assay.
Association With Outcome
Overall, 167 (28%) of 586 Wilms tumors had chromosome 1q gain. Five-year event-free survival was 75.0% in patients with chromosome 1q gain and 88.2% in those without chromosome 1q gain. Overall survival was 88.4% vs 94.4%, respectively.
In univariate analysis, chromosome 1q gain was associated with shorter event-free (hazard ratio [HR] = 2.33, P < .001) and overall survival (HR = 2.16, P = .01). In multivariate analysis adjusting for chromosomes 1p and 16q loss, sex, disease stage, age, and histologic risk group, chromosome 1q gain remained significantly associated with poorer event-free survival (HR = 1.98, P = .002) but not overall survival (HR = 1.61, P = .16). Gain of 1q was significantly associated with poorer event-free survival among patients with intermediate-risk localized disease (HR = 1.92, P = .04) and those with nonanaplastic localized disease (HR = 2.0, P = .02), with associations with overall survival not being significant in either subgroup. Other factors associated with poorer event-free survival included MYCN gain and TP53 loss.
The investigators concluded: “Gain of 1q is a potentially valuable prognostic biomarker in [Wilms tumor], in addition to histologic response to preoperative chemotherapy and tumor stage.”
The study was supported by Cancer Research UK, the European Network for Cancer Research in Children and Adolescents, P-medicine Project, and many others.
Kathy Pritchard-Jones, MD, of the University College London Institute of Child Health, is the corresponding author of the Journal of Clinical Oncology article.
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