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Emerging Role of Biomarkers in Testicular Germ Cell Tumors

  • Genitourinary Cancers (DP Petrylak and JW Kim, Section Editors)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review will focus on biomarkers in testicular germ cell tumors (TGCT), focusing on microRNAs with high potential clinical application to drive management of TGCT. We explore the mechanism of action of microRNAs, literature to date, and how microRNAs may be incorporated into clinical practice in the near future.

Recent Findings

MicroRNAs are small non-coding RNAs found in blood which play an important role in post-transcriptional gene regulation and have been explored in TGCT for the past 15 years. More recently, results show they are promising biomarkers for diagnosis with impressive sensitivity and specificity, while also being cost-effective.

Summary

MicroRNAs will likely play a critical role in areas of unmet need in GCT in the next decade, as they have many of the characteristics of an ideal biomarker. Ongoing prospective clinical trials evaluating microRNA-371 will be eagerly awaited and will help inform decision-making in real-world application.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49. https://doi.org/10.3322/caac.21660.

    Article  PubMed  Google Scholar 

  2. Einhorn LH, Cancer E. Chemotherapy of disseminated germ cell tumors. Cancer. 1987;60(S3):570–3.

    Article  CAS  PubMed  Google Scholar 

  3. Warde P, Specht L, Horwich A, Oliver T, Panzarella T, Gospodarowicz M, et al. Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol. 2002;20(22):4448–52. https://doi.org/10.1200/JCO.2002.01.038.

    Article  PubMed  Google Scholar 

  4. Boormans JL, Mayor de Castro J, Marconi L, Yuan Y, Laguna Pes MP, Bokemeyer C, et al. Testicular tumour size and rete testis invasion as prognostic factors for the risk of relapse of clinical stage I seminoma testis patients under surveillance: a systematic review by the testicular cancer guidelines panel. Eur Urol. 2018;73(3):394–405. https://www.sciencedirect.com/science/article/pii/S0302283817308266

  5. Roth BJ. Management of clinical stage I germ cell tumors. Urol Clin North Am. 2019;46(3):353–62. https://www.sciencedirect.com/science/article/pii/S0094014319300187

  6. Albers P, Siener R, Kliesch S, Weissbach L, Krege S, Sparwasser C, et al. Risk factors for relapse in clinical stage I nonseminomatous testicular germ cell tumors: results of the German Testicular Cancer Study Group Trial. J Clin Oncol. 2003;21(8):1505–12. https://doi.org/10.1200/JCO.2003.07.169.

    Article  PubMed  Google Scholar 

  7. Tarin TV, Sonn G, Shinghal R. Estimating the risk of cancer associated with imaging related radiation during surveillance for stage I testicular cancer using computerized tomography. J Urol. 2009;181(2):627–33. https://doi.org/10.1016/j.juro.2008.10.005.

    Article  PubMed  Google Scholar 

  8. Rustin GJ, Mead GM, Stenning SP, Vasey PA, Aass N, Huddart RA, et al. Randomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197—The National Cancer Research Institute Testis Cancer. JCO. 2007;25(11):1310–5. https://doi.org/10.1200/JCO.2006.08.4889.

    Article  Google Scholar 

  9. •• Charytonowicz D, Aubrey H, Bell C, Ferret M, Tsui K, Atfield R, et al. Cost analysis of noninvasive blood-based MicroRNA testing versus CT scans for follow-up in patients with testicular germ-cell tumors. Clin Genitourin Cancer. 2019;17(4):e733–44. https://doi.org/10.1016/j.clgc.2019.03.015This paper demonstrates the potential cost savings that microRNA testing can provide to the US healthcare system.

  10. Gilligan T, Lin DW, Aggarwal R, Chism D, Cost N, Derweesh IH, et al. Testicular cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw J Natl Compr Canc Netw. 2019;17(12):1529–54. https://jnccn.org/view/journals/jnccn/17/12/article-p1529.xml

  11. Beyer J, Kataja V, Guidelines E, Group W. Clinical Practice Guidelines for diagnosis, treatment clinical practice guidelines. ESMO Updat Clin Pract Guidel. 2013;24(25):32. https://doi.org/10.1093/annonc/mdt304.

    Article  Google Scholar 

  12. Laguna MP, Albers P, Algaba F, Bokemeyer C, Boormans JL, Fischer S, Fizazi K, Gremmels H, Leão R, Nicol D, Nicolai N, Oldenburg J, EAU. Guidelines on testicular cancer. Presented at the EAU Annual Congress Milan 2021. ISBN 978–94–92671–14–1.

  13. Jovanovski A, Zugna D, Di Cuonzo D, Lista P, Ciuffreda L, Merletti F, et al. Quality of life among germ-cell testicular cancer survivors: the effect of time since cancer diagnosis. PLoS ONE. 2021;16(10):e0258257. https://doi.org/10.1371/journal.pone.0258257.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Chovanec M, Abu Zaid M, Hanna N, El-Kouri N, Einhorn LH, Albany C. Long-term toxicity of cisplatin in germ-cell tumor survivors. Ann Oncol. 2017;28(11):2670–9. https://www.sciencedirect.com/science/article/pii/S0923753419345855

  15. Haugnes HS, Wethal T, Aass N, Dahl O, Klepp O, Langberg CW, et al. Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20-year follow-up study. J Clin Oncol. 2010;28(30):4649–57. https://doi.org/10.1200/JCO.2010.29.9362.

    Article  PubMed  Google Scholar 

  16. Pliarchopoulou K, Pectasides D. Late complications of chemotherapy in testicular cancer. Cancer Treat Rev. 2010;36(3):262–7. https://doi.org/10.1016/j.ctrv.2009.12.011.

    Article  CAS  PubMed  Google Scholar 

  17. Horwich A, Fossa SD, Huddart R, Dearnaley DP, Stenning S, Aresu M, et al. Second cancer risk and mortality in men treated with radiotherapy for stage I seminoma. Br J Cancer. 2014;110(1):256–63. https://doi.org/10.1038/bjc.2013.551.

    Article  CAS  PubMed  Google Scholar 

  18. Ghodoussipour S, Daneshmand S. Postchemotherapy resection of residual mass in nonseminomatous germ cell tumor. Urol Clin North Am. 2019;46(3):389–98. https://www.sciencedirect.com/science/article/pii/S0094014319300217

  19. O’Brien J, Hayder H, Zayed Y, Peng C. Overview of microRNA biogenesis, mechanisms of actions, and circulation. Front Endocrinol. 2018;9:402. https://www.ncbi.nlm.nih.gov/pubmed/30123182

  20. He L, Hannon GJ. MicroRNAs: small RNAs with a big role in gene regulation. Nat Rev Genet. 2004;5(7):522–31. https://doi.org/10.1038/nrg1379.

    Article  CAS  PubMed  Google Scholar 

  21. Si W, Shen J, Zheng H, Fan W. The role and mechanisms of action of microRNAs in cancer drug resistance. Clin Epigenetics. 2019;11(1):25. https://doi.org/10.1186/s13148-018-0587-8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Reinhart BJ, Slack FJ, Basson M, Pasquinelli AE, Bettinger JC, Rougvie AE, et al. The 21-nucleotide let-7 RNA regulates developmental timing in Caenorhabditis elegans. Nature. 2000;403(6772):901–6. https://doi.org/10.1038/35002607.

    Article  CAS  PubMed  Google Scholar 

  23. Lee RC, Feinbaum RL, Ambro V. The C elegans heterochronic gene lin-4 encodes small RNAs with antisense complementarity to & II-14. Cell. 1993;75(5):843–54.

    Article  CAS  PubMed  Google Scholar 

  24. Lu J, Getz G, Miska EA, Alvarez-Saavedra E, Lamb J, Peck D, et al. MicroRNA expression profiles classify human cancers. Nature. 2005;435(7043):834–8. https://doi.org/10.1038/nature03702.

    Article  CAS  PubMed  Google Scholar 

  25. • Wang H, Peng R, Wang J, Qin Z, Xue L. Circulating microRNAs as potential cancer biomarkers: the advantage and disadvantage. Clin Epigenetics. 2018;10(1):59. https://doi.org/10.1186/s13148-018-0492-1. This paper outlines the history of microRNAs as biomarkers as well as some of the caveats to their use in the clinical setting.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Mitchell PS, Parkin RK, Kroh EM, Fritz BR, Wyman SK, Pogosova-Agadjanyan EL, et al. Circulating microRNAs as stable blood-based markers for cancer detection. Proc Natl Acad Sci. 2008;105(30):10513–10518. http://www.pnas.org/content/105/30/10513.abstract

  27. Radtke A, Hennig F, Ikogho R, Hammel J, Anheuser P, Wülfing C, et al. The novel biomarker of germ cell tumours, micro-RNA-371a-3p, has a very rapid decay in patients with clinical stage 1. Urol Int. 2018;100(4):470–5. https://pubmed.ncbi.nlm.nih.gov/29698973

  28. Voorhoeve PM, Sage C, Schrier M, Gillis AJM, Stoop H, Nagel R, et al. A genetic screen implicates miRNA-372 and miRNA-373 as oncogenes in testicular germ cell tumors. Cell. 2006;124(6):1169–81.

    Article  CAS  PubMed  Google Scholar 

  29. Murray MJ, Halsall DJ, Hook CE, Williams DM, Nicholson JC, Coleman N. Identification of microRNAs from the miR-371∼373 and miR-302 clusters as potential serum biomarkers of malignant germ cell tumors. Am J Clin Pathol. 2011;135(1):119–25. https://doi.org/10.1309/AJCPOE11KEYZCJHT.

    Article  CAS  PubMed  Google Scholar 

  30. Palmer RD, Murray MJ, Saini HK, van Dongen S, Abreu-Goodger C, Muralidhar B, et al. Malignant germ cell tumors display common microRNA profiles resulting in global changes in expression of messenger RNA targets. Cancer Res. 2010;70(7):2911 LP – 2923. http://cancerres.aacrjournals.org/content/70/7/2911.abstract

  31. Dieckmann K-P, Spiekermann M, Balks T, Flor I, Löning T, Bullerdiek J, et al. MicroRNAs miR-371–3 in serum as diagnostic tools in the management of testicular germ cell tumours. Br J Cancer. 2012;107(10):1754–60. https://www.ncbi.nlm.nih.gov/pubmed/23059743

  32. Spiekermann M, Belge G, Winter N, Ikogho R, Balks T, Bullerdiek J, et al. MicroRNA miR-371a-3p in serum of patients with germ cell tumours: evaluations for establishing a serum biomarker. Andrology. 2015;3(1):78–84. https://doi.org/10.1111/j.2047-2927.2014.00269.x.

    Article  CAS  PubMed  Google Scholar 

  33. Dieckmann K-P, Radtke A, Spiekermann M, Balks T, Matthies C, Becker P, et al. Serum levels of microRNA miR-371a-3p: a sensitive and specific new biomarker for germ cell tumours. Eur Urol. 2017;71(2):213–20. https://www.sciencedirect.com/science/article/pii/S0302283816304341

  34. •• Nappi L, Thi M, Lum A, Huntsman D, Eigl BJ, Martin C, et al. Developing a highly specific biomarker for germ cell malignancies: plasma miR371 expression across the germ cell malignancy spectrum. J Clin Oncol. 2019;37(33):3090–8. https://www.ncbi.nlm.nih.gov/pubmed/31553692. This paper describes methodology for microRNA testing and reports on its correlation with clinical outcomes in a large group of patients.

  35. Shen H, Shih J, Hollern DP, Wang L, Bowlby R, Tickoo SK, et al. Integrated molecular characterization of testicular germ cell tumors. Cell Rep. 2018;23(11):3392–406. https://pubmed.ncbi.nlm.nih.gov/29898407

  36. Belge G, Grobelny F, Matthies C, Radtke A, Dieckmann K-P. Serum level of microRNA-375–3p is not a reliable biomarker of teratoma. In Vivo. 2020;34(1):163 LP – 168. http://iv.iiarjournals.org/content/34/1/163.abstract

  37. Lafin JT, Kenigsberg AP, Meng X, Abe D, Savelyeva A, Singla N, et al. Serum small RNA sequencing and miR-375 assay do not identify the presence of pure teratoma at postchemotherapy retroperitoneal lymph node dissection. Eur Urol Suppl. 2021;26:83–7. https://doi.org/10.1016/j.euros.2021.02.003.

    Article  Google Scholar 

  38. •• Nappi L, Thi M, Adra N, Hamilton RJ, Leao R, Lavoie J-M, et al. Integrated expression of circulating miR375 and miR371 to identify teratoma and active germ cell malignancy components in malignant germ cell tumors. Eur Urol. 2021; 79(1):16–19. http://www.sciencedirect.com/science/article/pii/S0302283820308137. This paper discusses potential utility of microRNA 375 as part of a composite biomarker in teratomas.

  39. Lobo J, Gillis AJM, van den Berg A, Dorssers LCJ, Belge G, Dieckmann K-P, et al. Identification and validation model for informative liquid biopsy-based microRNA biomarkers: insights from germ cell tumor in vitro, in vivo and patient-derived data. Cells. 2019;14(8):1637–65.

    Article  Google Scholar 

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Correspondence to Lucia Nappi.

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Conflict of Interest

Maryam Soleimani has received research funding from AbbVie, Astellas, and Bayer, and has received compensation for service as a consultant from Ipsen and Pfizer. Christian Kollmannsberger has received honoraria for presentations from Ipsen, Bayer, BMS, Pfizer, and Merck, and has served on advisory boards for Pfizer, Astellas, Merck, Janssen, BMS, Eisai, Ipsen, Bayer, EMD Serono, Novartis. Lucia Nappi has received research funding from Ipsen and Janssen, and has received compensation for service as a consultant from Bayer and Ipsen.

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This article is part of the Topical Collection on Genitourinary Cancers

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Soleimani, M., Kollmannsberger, C. & Nappi, L. Emerging Role of Biomarkers in Testicular Germ Cell Tumors. Curr Oncol Rep 24, 437–442 (2022). https://doi.org/10.1007/s11912-022-01231-1

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