Journal
ONCOLOGIST
Volume 18, Issue 6, Pages 685-686Publisher
ALPHAMED PRESS
DOI: 10.1634/theoncologist.2012-0461
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Funding
- RTOG [U10 CA21661]
- CCOP from the National Cancer Institute (NCI) [U10 CA37422]
- Pennsylvania Department of Health [4100054841]
- Ohio State University Comprehensive Cancer Center
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Background. From 1988 to 1999, the Radiation Therapy Oncology Group (RTOG) conducted four prospective studies (8802, 8903, 9506, 9706) of patients with clinical stage T2-4a muscle-invasive bladder cancer. Treatment was selective bladder preservation using transurethral surgery (TURBT) plus cisplatin-based induction and consolidation chemoradiation regimens, reserving radical cystectomy for invasive tumor recurrence. We investigated vascular endothelial growth factor (VEGF) pathway biomarkers in this unique clinical data-set (median follow-up of 3.1 years). Methods. A total of 43 patients with tissue available from the entry TURBT were included in this analysis. Expression of VEGF ligands and receptors were quantified and scored by the AQUA platform (HistoRX, now Genoptix, Carlsbad, CA) and analyzed after median split. Results. VEGF expression levels were not associated with increased rates of complete response to induction chemoradiation. Higher levels of cytoplasmic VEGF-B, VEGF-C, and VEGF-R2 were associated with decreased overall survival rates. The 3-year overall survival estimates for high and low expressers were 43.7% and 75% for VEGF-B cytoplasm (p = .01), 40.2% and 86.7% for VEGF-C cytoplasm (p = .01), and 49.7% and 66.7% for VEGF-R2 cytoplasm (p = .02). Higher expression levels of cytoplasm VEGF-B were associated with higher rates of distant failure (p = .01). [GRAPHICS] Conclusions. Although VEGF ligands and receptors do not appear to be associated with complete response to induction chemoradiation for muscle- invasive bladder cancer, we report significant associations with overall survival and distant failure for certain VEGF family members.
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