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Salvermoser L, Goldberg SN, Alunni-Fabbroni M, Kazmierczak PM, Gröper MN, Schäfer JN, Öcal E, Burkard T, Corradini S, Ben Khaled N, Petrera A, Wildgruber M, Ricke J, Stechele M. CT-guided high dose rate brachytherapy can induce multiple systemic proteins of proliferation and angiogenesis predicting outcome in HCC. Transl Oncol 2024; 43:101919. [PMID: 38401507 PMCID: PMC10906383 DOI: 10.1016/j.tranon.2024.101919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/28/2024] [Accepted: 02/17/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND AND PURPOSE To determine the potential prognostic value of proliferation and angiogenesis plasma proteins following CT-guided high dose rate brachytherapy (HDR-BT) of hepatocellular carcinoma (HCC). MATERIALS AND METHODS For this prospective study, HDR-BT (1 × 15 Gy) was administered to 24 HCC patients. Plasma was obtained and analyzed using an Olink proteomics Target-96 immuno-oncology-panel that included multiple markers of angiogenesis and proliferation. Fold-change (FC) ratios were calculated by comparing baseline and 48 h post HDR-BT paired samples. Patients were classified as responders (n = 12) if they had no local progression within 6 months or systemic progression within 2 years. Non-responders (n = 12) had recurrence within 6 months and/or tumor progression or extrahepatic disease within 2 years. RESULTS Proliferation marker EGF was significantly elevated in non-responders compared to responders (p = 0.0410) while FGF-2, HGF, and PlGF showed no significant differences. Angiogenesis markers Angiopoietin-1 and PDGF-B were likewise significantly elevated in non-responders compared to responders (p = 0.0171, p = 0.0462, respectively) while Angiopoietin-2, VEGF-A, and VEGFR-2 did not differ significantly. Kaplan-Meier analyses demonstrated significantly shorter time to systemic progression in patients with increased EGF and Angiopoietin-1 (p = 0.0185, both), but not in patients with one of the remaining proteins elevated (all p > 0.1). Pooled analysis for these 9 proteins showed significantly shorter time to systemic progression for FC ≥1.3 and ≥1.5 for at least 3 proteins elevated (p = 0.0415, p = 0.0193, respectively). CONCLUSION Increased plasma levels of EGF and Angiopoietin-1 after HDR-BT for HCC are associated with poor response and may therefore function as predictive biomarkers of outcome.
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Affiliation(s)
- Lukas Salvermoser
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Shraga Nahum Goldberg
- Department of Radiology, Goldyne Savad Institute of Gene Therapy and Division of Image-guided Therapy and Interventional Oncology, Hadassah Hebrew University Medical Center, Jerusalem 12000, Israel
| | - Marianna Alunni-Fabbroni
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | | | - Moritz Nikolaus Gröper
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Jan Niklas Schäfer
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Elif Öcal
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Tanja Burkard
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Najib Ben Khaled
- Department of Medicine II, University Hospital, LMU Munich Marchioninistr. 15, Munich 81377, Germany
| | - Agnese Petrera
- Metabolomics and Proteomics Core, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), Ingolstädter Landstr. 1, Neuherberg 85764, Germany
| | - Moritz Wildgruber
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany
| | - Matthias Stechele
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, Munich 81377, Germany.
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