How Will Gene Expression Data Inform Risk Stratification and Treatment Selection?

摘要

Over the past 15 years, the evaluation of genome-wide gene expression has provided a high-throughput "snapshot" of genomic programs operating in a cell or tissue type of interest. A number of gene-expression studies have been performed in urothelial carcinoma (UC) of the bladder with the purpose of identifying biomarkers for prognosis and therapeutic response. One early study analyzed normal urothelium and 40 bladder cancers of various stages and grades to identify a gene-expression classifier capable of discriminating the analyzed tumors.1 This group developed a 32-gene classifier capable of correctly classifying 84% of stage Ta, 50% of stage T1, and 74% of stage T2-and-above tumors in an independent cohort of 68 patients. An interesting finding from this study was that the misclassified Ta tumors showed a significantly increased progression rate (p=0.032).