- Email: [email protected]
59-gene prognostic signature sub-stratifies high-risk neuroblastoma patients
Reflection and Reaction
If you would like to respond to an article published in The Lancet Oncology, please submit your correspondence online at: http://ees.elsevier. com/thelancetoncology
represented 21 different countries, of which 15 were Asian. Each workshop had about 40–100 attendees, and the majority of authors work in Asian hospitals. The manuscripts are a wonderful testament to the resources and expertise available in Asia, and we hope they will provide a valuable resource of information to inform practice and provide a foundation for future developments of oncology services throughout the region. David Collingridge Chair, Asian Oncology Summit, and Editor, The Lancet Oncology, 32 Jamestown Road, London, NW1 7BY, UK [email protected] I would like to thank the various chairs, committee members, advisors, workshop attendees, referees, and colleagues who have played an integral part in seeing these papers published. Additionally, I would like to express our gratitude to Benjamin Anderson, Chair and Director of the BGHI, for his commitment to this project.
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Guidelines for International Breast Health and Cancer Control. Breast J 2006; 12 (suppl 1): S1–122. Anderson BO, Yip CH, Smith RA, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. Cancer 2008; 113 (suppl): 2221–43. Wong NS, Anderson BO, Khoo KS, et al. Management of HER2-positive breast cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1077–85. Wee JT, Anderson BO, Corry J, et al. Management of the neck after chemoradiotherapy for head and neck cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1086–92. Kwong Y-K, Anderson BO, Advani R, Kim W-S, Levine AM, Lim S-T. Management of T-cell and natural-killer-cell neoplasms in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1093–1101. Soo RA, Anderson BO, Cho BC, et al. First-line systemic treatment of advanced stage non-small-cell lung cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1102–10. Poon D, Anderson BO, Chen L-T, et al. Management of hepatocellular carcinoma in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1111–18. Tangjitgamol S, Anderson BO, See HT, et al. Management of endometrial cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1119–27.
59-gene prognostic signature sub-stratifies high-risk neuroblastoma patients In the July issue of The Lancet Oncology, Volchenboum and Cohn1 commented on our article in the same issue2 that described a new molecular prognostic classifier to stratify patients with neuroblastoma. They speculate that some of the genes included in the signature are proven or suspected downstream targets of MYCN, but this does not mean that the classifier does not have additional prognostic value compared with MYCN copy number status alone. Multivariate logistic regression analysis shows that the classifier has a statistically significant independent value when tested in a model with MYCN status, amongst others, both in the first and in the validation cohort. The classifier seems to be a better prognostic tool than MYCN status, since in the backward-selected regression model MYCN status drops out and the classifier remains statistically significant. This can be explained by the fact that the signature allows more accurate prediction for more patients than MYCN status alone, since there are high-risk patients
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without MYCN amplification. Furthermore, multivariate logistic regression analysis within the group of patients currently stratified as high-risk by conventional staging and treated accordingly, shows that the signature was the only significant independent predictor for overall survival, and Kaplan–Meier survival analysis indicates that this high-risk group can be sub-stratified using the signature with respect to overall survival. Therefore, we propose to test prospectively the signature in larger cohorts to further test the clinical significance of our findings. Joëlle Vermeulen, Katleen De Preter, Geneviève Laureys, Frank Speleman, Jo Vandesompele* Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium [email protected] The authors declared no conflicts of interest. 1 2
Volchenboum SL, Cohn SL. Are molecular neuroblastoma classifiers ready for prime time? Lancet Oncol 2009; 10: 641–42. Vermeulen J, De Preter K, Naranjo A, et al. Predicting outcomes for children with neuroblastoma using a multigene-expression signature: a retrospective SIOPEN/COG/GPOH study. Lancet Oncol 2009; 10: 663–71.
www.thelancet.com/oncology Vol 10 November 2009
If you would like to respond to an article published in The Lancet Oncology, please submit your correspondence online at: http://ees.elsevier. com/thelancetoncology
represented 21 different countries, of which 15 were Asian. Each workshop had about 40–100 attendees, and the majority of authors work in Asian hospitals. The manuscripts are a wonderful testament to the resources and expertise available in Asia, and we hope they will provide a valuable resource of information to inform practice and provide a foundation for future developments of oncology services throughout the region. David Collingridge Chair, Asian Oncology Summit, and Editor, The Lancet Oncology, 32 Jamestown Road, London, NW1 7BY, UK [email protected] I would like to thank the various chairs, committee members, advisors, workshop attendees, referees, and colleagues who have played an integral part in seeing these papers published. Additionally, I would like to express our gratitude to Benjamin Anderson, Chair and Director of the BGHI, for his commitment to this project.
1 2
3
4
5
6
7
8
Guidelines for International Breast Health and Cancer Control. Breast J 2006; 12 (suppl 1): S1–122. Anderson BO, Yip CH, Smith RA, et al. Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. Cancer 2008; 113 (suppl): 2221–43. Wong NS, Anderson BO, Khoo KS, et al. Management of HER2-positive breast cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1077–85. Wee JT, Anderson BO, Corry J, et al. Management of the neck after chemoradiotherapy for head and neck cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1086–92. Kwong Y-K, Anderson BO, Advani R, Kim W-S, Levine AM, Lim S-T. Management of T-cell and natural-killer-cell neoplasms in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1093–1101. Soo RA, Anderson BO, Cho BC, et al. First-line systemic treatment of advanced stage non-small-cell lung cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1102–10. Poon D, Anderson BO, Chen L-T, et al. Management of hepatocellular carcinoma in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1111–18. Tangjitgamol S, Anderson BO, See HT, et al. Management of endometrial cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol 2009; 10: 1119–27.
59-gene prognostic signature sub-stratifies high-risk neuroblastoma patients In the July issue of The Lancet Oncology, Volchenboum and Cohn1 commented on our article in the same issue2 that described a new molecular prognostic classifier to stratify patients with neuroblastoma. They speculate that some of the genes included in the signature are proven or suspected downstream targets of MYCN, but this does not mean that the classifier does not have additional prognostic value compared with MYCN copy number status alone. Multivariate logistic regression analysis shows that the classifier has a statistically significant independent value when tested in a model with MYCN status, amongst others, both in the first and in the validation cohort. The classifier seems to be a better prognostic tool than MYCN status, since in the backward-selected regression model MYCN status drops out and the classifier remains statistically significant. This can be explained by the fact that the signature allows more accurate prediction for more patients than MYCN status alone, since there are high-risk patients
1030
without MYCN amplification. Furthermore, multivariate logistic regression analysis within the group of patients currently stratified as high-risk by conventional staging and treated accordingly, shows that the signature was the only significant independent predictor for overall survival, and Kaplan–Meier survival analysis indicates that this high-risk group can be sub-stratified using the signature with respect to overall survival. Therefore, we propose to test prospectively the signature in larger cohorts to further test the clinical significance of our findings. Joëlle Vermeulen, Katleen De Preter, Geneviève Laureys, Frank Speleman, Jo Vandesompele* Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium [email protected] The authors declared no conflicts of interest. 1 2
Volchenboum SL, Cohn SL. Are molecular neuroblastoma classifiers ready for prime time? Lancet Oncol 2009; 10: 641–42. Vermeulen J, De Preter K, Naranjo A, et al. Predicting outcomes for children with neuroblastoma using a multigene-expression signature: a retrospective SIOPEN/COG/GPOH study. Lancet Oncol 2009; 10: 663–71.
www.thelancet.com/oncology Vol 10 November 2009