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Plasma Biomarker Enrichment of Clinical Prognostic Indices in Malignant Pleural Mesothelioma.
- Source :
-
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2016 Jun; Vol. 11 (6), pp. 900-9. Date of Electronic Publication: 2016 Feb 21. - Publication Year :
- 2016
-
Abstract
- Objectives: Prognostic models for malignant pleural mesothelioma (MPM) are needed to prevent potentially futile outcomes. We combined MPM plasma biomarkers with validated clinical prognostic indices to determine whether stratification of risk for death in 194 patients with MPM improved.<br />Methods: Individuals were recruited from three different centers: a discovery cohort (83 patients with MPM) created by combining patients from two U.S. centers and a separate, independent cohort from Canada (111 patients with MPM). Univariable and multivariable analyses were performed on the initial discovery and independent cohorts separately. In the multivariable analyses, prognostic factors were adjusted for the European Organisation for Research and Treatment of Cancer (EORTC) prognostic index (PI) of mesothelioma. The prognostic significance of adding plasma biomarker data to the PI was determined by using the likelihood ratio test, comparing models with and without the addition of biomarker to the clinical PI. The predictive ability of the biomarker was then assessed formally using Harrell's C-index by applying the fitted model variables of the discovery cohort to the second, independent cohort, including and not including the biomarker with the PI.<br />Results: Higher levels of osteopontin and mesothelin were individually associated with worse prognosis after adjusting for the PI. In the independent cohort, incorporating either plasma osteopontin or mesothelin into the baseline predictive PI model substantively and statistically significantly improved Harrell's C-statistic. In the final prognostic model, log-osteopontin, EORTC clinical prognostic index, and hemoglobin remained as independently significant predictors and the entire prognostic model improved the optimism-corrected Harrell's C-index significantly, from 0.718 (0.67-0.77) to 0.801 (0.77-0.84).<br />Conclusions: These data suggest a possible role for preoperative plasma biomarkers to improve the prognostic capability of the EORTC PI of MPM.<br /> (Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Lung Neoplasms therapy
Male
Mesothelioma therapy
Mesothelioma, Malignant
Middle Aged
Neoplasm Staging
Pleural Neoplasms therapy
Prognosis
Prospective Studies
Retrospective Studies
Biomarkers metabolism
Lung Neoplasms blood
Lung Neoplasms pathology
Mesothelioma blood
Mesothelioma pathology
Pleural Neoplasms blood
Pleural Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1556-1380
- Volume :
- 11
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 26903362
- Full Text :
- https://doi.org/10.1016/j.jtho.2016.02.006