'Gene Signature' Predicts Survival in Four Cancer Types

Survival predicted for breast cancer, medulloblastoma, lung cancer, prostate cancer

WEDNESDAY, Jan. 17 (HealthDay News) -- A "gene signature" is effective at predicting overall and metastasis-free survival in patients with breast cancer, medulloblastoma, lung cancer and prostate cancer, researchers report in the Jan. 18 issue of the New England Journal of Medicine.

Michael F. Clarke, M.D., of the University of Michigan in Ann Arbor, and colleagues developed an "invasiveness gene signature" consisting of 186 genes that were differentially expressed in normal breast epithelium and a subset of breast cancer cells that were CD44-positive and low-to-negative for CD24. The gene signature's ability to predict survival was assessed in 581 patients with high-risk early breast cancer or other types of cancer.

There was an association between the gene signature and overall and metastasis-free survival for breast cancer, independent of clinical and pathological factors, as well as medulloblastoma, lung cancer and prostate cancer. Combining the gene signature with National Institutes of Health prognostic criteria showed that breast cancer patients with a good prognosis had an 81 percent chance of 10-year metastasis-free survival compared with only 57 percent for those with a poor prognosis. The predictive value increased when combined with the wound-response signature.

"These are exciting results, but the disconcerting reality is that gene sets in the various studies are largely non-overlapping, raising questions about their biologic significance and clinical implications," Joan Massague, Ph.D., of the Memorial Sloan-Kettering Cancer Center in New York City, writes in an accompanying editorial.

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