Gene Score IDs Prognosis in Metastatic Neuroblastoma
(HealthDay News) – For children with metastatic MYCN-nonamplified neuroblastoma (NBL-NA) diagnosed at age ≥18 months, increased expression of tumor-associated inflammatory genes seems to correlate with poor prognosis.
Shahab Asgharzadeh, MD, of Children's Hospital of Los Angeles, and colleagues examined whether genes related to tumor-associated inflammatory cells correlate with differences in survival by age at diagnosis. Immunohistochemical studies were conducted on tumor-associated macrophages (TAMs) from 71 localized and metastatic neuroblastomas. The prediction of progression-free survival was examined based on expression of 44 tumor and inflammatory genes which were evaluated in 133 metastatic NBL-NAs. The results were validated in tumors from 91 high-risk patients enrolled in two additional studies.
The researchers observed an increase in infiltration of TAMs in metastatic neuroblastomas vs. locoregional tumors. Patients aged ≥18 months at diagnosis had increased expression of inflammation-related genes compared with those diagnosed at a younger age. Twenty-five percent of the accuracy of a novel 14-gene tumor classification score was due to expression of five genes representing TAMs. For children diagnosed with NBL-NA at ≥18 months, the progression-free survival at five years was significantly higher for those with a low- vs. high-risk score, in each of the three independent clinical trials.
"Our study reports the first evidence of a role for intratumor inflammation in metastatic neuroblastomas and provides a validated prognostic signature for children with metastatic NBL-NA," the authors write.
The study was supported in part by a grant from Amgen.