The SWENOTECA-MIR prospective multicenter study aims to assess the clinical value of miR-371a-3p as a novel marker in metastatic germ cell tumor patients undergoing retroperitoneal lymph node dissection (RPLND), to predict the presence of viable residual tumor.
A total of 114 patients (86 nonseminomas, 28 seminomas) who underwent surgery for presumed metastatic disease pre-chemotherapy (primary RPLND), and post-chemotherapy RPLND were included. The expression of miR-371a-3p was evaluated using RT-digital droplet PCR before and after RPLND. Pre- and post-operative miR-371a-3p levels were statistically compared, and optimism-corrected performance calculations compared with conventional serum tumor markers. Associations were evaluated by logistic regression. Patients who underwent primary RPLND were categorized into seminoma and nonseminoma groups.
Among the seminoma patients (n = 24) undergoing primary RPLND, all had normal conventional markers. Six patients received adjuvant treatment before surgery. miR-371a-3p exhibited a sensitivity of 74%, specificity of 100%, PPV of 100% and NPV of 21% for viable tumor. The levels of miR-371a-3p significantly decreased after surgery. In the nonseminoma group (n = 18) treated with primary RPLND, 22% had elevated conventional markers, and 3 had received prior adjuvant treatment. miR-371a-3p showed a sensitivity of 34%, specificity of 88%, PPV of 67% and NPV of 62% for the primary nonseminoma patients. No association was observed between stage or prior adjuvant treatment, and the outcome of the miR-test. In the post-chemotherapy group (n = 72), the miR-371a-3p sensitivity was 9%, reducing to 0 when excluding patients with seminoma (n = 4). Teratomas and benign histology were essentially negative.
Our study highlights miR-371a-3p as a fairly sensitive and highly specific marker for pre-chemotherapy seminomas, outperforming conventional markers. However, in pre-chemotherapy non-seminomas as well as in post-chemotherapy patients, we observed low sensitivity and no significant differences in miR-371a-3p levels before and after surgery, suggesting limited utility for miR-371a-3p in this context.
The Journal of urology. 2024 Jul 25 [Epub ahead of print]
Anna Thor, Mette Pernille Myklebust, Anna Grenabo Bergdahl, Per-Olof Lundgren, Viktor Skokic, Bjarte Almås, Hege Sagstuen Haugnes, Torgrim Tandstad, Olof Akre, Gabriella Cohn-Cedermark, Olav Dahl, Anders Kjellman
Division of Urology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden., Mohn Cancer Research Laboratory, Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway., Department of Urology, Gothenburg University, Gothenburg, Sweden., Department of Urology, Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden., Department of Urology, Haukeland University Hospital, Bergen, Norway., Department of Oncology, University Hospital of North Norway, Tromsø, Norway., The Cancer Clinic, St. Olavs University Hospital, Trondheim, Norway., Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden., Department of Oncology, Haukeland University Hospital, Bergen, Norway.