Abstract
Introduction
Germ cell tumours (GCTs) of the testis show exquisite sensitivity to treatment with cisplatin. Despite the high cure rates provided by platinum-based chemotherapy, 10–20% of patients die from progressive disease. Although various cellular pathways may influence cisplatin efficacy, their actual impact has not been comprehensively investigated in advanced GCTs. The objective of the present study was to clarify the role of the expression status of proteins involved in the Rb and p53 tumour suppressor pathways in sensitivity and resistance of GCTs to cisplatinbased chemotherapy.
Materials and methods
Paraffin-embedded tumour tissues from 84 patients with advanced GCT treated with cisplatinbased chemotherapy were analysed. Immunohistochemical expression of proteins p53 and mdm2, and the G1-phase cyclins D1 and D2 (CD1 and CD2) was assessed and correlated with the clinical course.
Results
The percentages of positive expression of p53, mdm2, CD1 and CD2 were 56, 57, 37.5 and 55%, respectively. From univariate analysis, there was no significant association between p53, mdm2 or CD1 expression and outcome. Instead, positive CD2 expression was found to be marginally associated with shorter median duration of progression-free survival (PFS) (p=0.06). In multivariate analysis, none of the molecular markers retained statistical significance with treatment response or survival.
Conclusions
Tissular expression of p53, mdm2 and CD1 is not associated with prognosis or treatment response in patients with advanced GCT. Aberrant CD2 expression appears to further determine a shorter PFS. Larger and further studies are required to validate CD2 as a marker of cisplatin resistance.
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References
Ries LAG, Eisner MP, Kosary CL et al (eds) (2003) SEER Cancer Statistics Review, 1975–2000. National Cancer Institute, Bethesda, MD, http://seer.cancer.gov/csr/1975_2000
Sant M, Aareleid T, Berrino F et al and the EUROCARE Working Group (2004) EUROCARE-3: survival of cancer patients diagnosed 1990-94, results and commentary. Ann Oncol 14[Suppl 5]: v61–v118
Bosl GJ, Motzer RJ (1997) Testicular germ-cell cancer. N Engl J Med 337:242–253
Mayer F, Honeker F, Looijenga LHJ et al (2003) Towards an understanding of biological basis of response to cisplatin based chemotherapy in germ cell tumors. Ann Oncol 14:825–832
Chaganti RSK, Rodríguez E, Bosl GJ (1993) Cytogenetics of male germ cell tumors. Urol Clin North Am 20:55–66
Durán I, Garcia-Velasco A, Ballestín C et al (2010) Expression of EGFR, HER-2/neu and KIT in germ cell tumours. Clin Transl Oncol 12:443–449
Kersemaekers AM, Mayer F, Molier M et al (2002) Role of p53 and MDM2 in treatment response of human germ cell tumors. J Clin Oncol 20:1551–1561
Chaganti RSK, Houldsworth J (1988) The cytogenetic theory of the pathogenesis of human adult male germ cell tumors. Acta Pathol Microbiol Immunol Scand 106:80–84
Korkola JE, Houldsworth J, Bosl GJ, Chaganti RS (2009) Molecular events in germ cell tumours: linking chromosome-12 gain, acquisition of pluripotency and response to cisplatin. BJU Int 104:1334–1338
May M, Peters G (1996) Genetic alterations of cyclins, cyclin dependent kinases, and cdk inhibitors in human cancer. Adv Can Res 68:67–108
Di Pietro A, De Vries EGE, Gietema JA et al (2005) Testicular germ cell tumors: the paradigm of chemo-sensitive solid tumors. Int J Biochem Cell Biol 37:2437–2456
Mostofi FK, Sesterhenn IA (2005) Histological typing of testis tumors. WHO International Histological Classification of Tumors, 2nd edn. Springer, Berlin
Bosl GJ, Bajorin D, Sheinfeld J, Motzer R (1995) Cancer of the testis. In: De-Vita VT, Hellman S, Rosenberg S (eds) Cancer, principles and practice of oncology, 5th edn. J.B. Lippincot, Philadelphia, pp 1397–1425
Keyomarsi K, Tucker SL, Buchholz TA et al (2002) Cyclin E and survival in patients with breast cancer. N Engl J Med 347:1566–1575
Guillou L, Estreicher A, Chaubert P et al (1996) Germ cell tumors of the testis over-express wildtype p53. Am J Pathol 149:1221–1228
Kerley-Hamilton JS, Pike AM, Li N et al (2005) A p53-dominant transcriptional response to cisplatin in testicular germ cell tumor-derived human embryonal carcinoma. Oncogene 24:6090–6100
Voorhoeve PM, le Sage C, Schrier M et al (2005) A genetic screen implicates mi-RNA-372 and miRNA-373 as oncogenes in testicular germ cell tumors. Cell 124:1169–1181
Bartkova J, Bartek J, Lucas J et al (1991) p53 protein alterations in human testicular cancer including pre-invasive intratubular germ cell neoplasia. Int J Cancer 49:196–202
Eid H, Van Der Loou M, Institoris E et al (1997) Is p53 expression, detected by immunohistochemistry, an important parameter of response to treatment in testis cancer? Anticancer Res 17:2663–2670
Ulbright TM, Orazi A, deRiese W et al (1994) The correlation of p53 protein expression with proliferative activity and occult metastases in clinical stage I non-seminomatous germ cell tumors of the testis. Mod Pathol 7:64–68
Eid H, Geczi L, Magori A et al (1998) Drug resistance and sensitivity of germ cell testicular tumors: evaluation of clinical relevance of MDR1/Pgp, p53 and metallothionein (MT) proteins. Anticancer Res 18:3059–3064
Eid H, Institoris E, Geczi L et al (1999) Mdm-2 expression in human testicular germ-cell tumors and its clinical value. Anticancer Res 19:3485–3490
Kukoski R, Blonigen B, Macri E et al (2003) p27 and CyclinE/D2 associations in testicular germ cell tumors. Appl Immunohistochem Mol Morphol 11:138–143
Bai M, Tsanou E, Agnantis NJ et al (2004) Proliferation profile of classical Hodgkin’s lymphomas. Increased expression of the protein cyclin D2 in Hodgkin’s and Reed Sternberg cells. Mod Pathol 17:1338–1345
Noel EE, Yeste-Velasco M, Mao X et al (2010) The association of CCND1 overexpression and cisplatin resistance in testicular germ cell tumors and other cancers. Am J Pathol 176:2607–2615
Bartkova J, Rajpert-De Meyts E, Skakkebæk NE et al (1999) D-Type cyclins in adult human testis and testicular cancer: relation to cell type, proliferation, differentiation, and malignancy. J Pathol 187:573–581
Houldsworth J, Reuter V, Bosl GJ et al (1997) Aberrant expression of cyclin D2 is an early event in human male germ cell tumorigenesis. Cell Growth Differ 8:293–299
Schmidt BA, Rose A, Steinhoff C et al (2001) Up-regulation of cyclin-dependent kinase 4/cyclin D2 expression but down-regulation of cyclindependent kinase 2/cyclin E in testicular germ cell tumors. Cancer Res 61:4124–4221
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García-Velasco, A., Durán, I., García, E. et al. Biological markers of cisplatin resistance in advanced testicular germ cell tumours. Clin Transl Oncol 14, 452–457 (2012). https://doi.org/10.1007/s12094-012-0823-1
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DOI: https://doi.org/10.1007/s12094-012-0823-1