Precise management of kidney cancer requires the identification of prognostic factors. hPG80 (circulating progastrin) is a tumor promoting peptide present in the blood of patients with various cancers, including renal cell carcinoma (RCC). In this study, we evaluated the prognostic value of plasma hPG80 in 143 prospectively collected patients with metastatic RCC (mRCC). The prognostic impact of hPG80 levels on overall survival (OS) in mRCC patients after controlling for hPG80 levels in non-cancer age matched controls was determined and compared to the International Metastatic Database Consortium (IMDC) risk model (good, intermediate, poor). ROC curves were used to evaluate the diagnostic accuracy of hPG80 using the area under the curve (AUC). Our results showed that plasma hPG80 was detected in 94% of mRCC patients. hPG80 levels displayed high predictive accuracy with an AUC of 0.93 and 0.84 when compared to 18-25 year old controls and 50-80 year old controls, respectively. mRCC patients with high hPG80 levels (>4.5 pM) had significantly lower OS compared to patients with low hPG80 levels (<4.5 pM) (12 versus 31.2 months, respectively; p = 0.0031). Adding hPG80 levels (score of 1 for patients having hPG80 levels > 4.5 pM) to the six variables of the IMDC risk model showed a greater and significant difference in OS between the newly defined good-, intermediate- and poor-risk groups (p = 0.0003 compared to p = 0.0076). Finally, when patients with IMDC intermediate-risk group were further divided into two groups based on hPG80 levels within these subgroups, increased OS were observed in patients with low hPG80 levels (<4.5 pM). In conclusion, our data suggest that hPG80 could be used for prognosticating survival in mRCC alone or integrated to the IMDC score (by adding a variable to the IMDC score or by substratifying the IMDC risk groups), be a prognostic biomarker in mRCC patients.
Cancers. 2021 Jan 20*** epublish ***
Manish Kohli, Winston Tan, Bérengère Vire, Pierre Liaud, Mélina Blairvacq, Frederic Berthier, Daniel Rouison, George Garnier, Léa Payen, Thierry Cousin, Dominique Joubert, Alexandre Prieur
Division of Oncology, Department of Medicine, Huntsman Cancer Institute, 2000 Circle of Hope Dr., Salt Lake City, UT 84112, USA., Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL 32224, USA., Eurobiodev, 2040 Avenue du Père Soulas, 34000 Montpellier, France., Centre Hospitalier Princesse Grace, 1 Avenue Pasteur, Principauté de Monaco, 98000 Monaco, Monaco., Laboratoire de Biochimie et Biologie Moleculaire, CITOHL, Centre Hospitalier Lyon-Sud, 69310 Pierre-Bénite, France., ECS-Progastrin, Chemin de la Meunière 12, 1008 Prilly, Switzerland.