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Kommoss S, McConechy MK, Kommoss F, Leung S, Bunz A, Magrill J, Britton H, Kommoss F, Grevenkamp F, Karnezis A, Yang W, Lum A, Krämer B, Taran F, Staebler A, Lax S, Brucker SY, Huntsman DG, Gilks CB, McAlpine JN, Talhouk A. Final validation of the ProMisE molecular classifier for endometrial carcinoma in a large population-based case series. Ann Oncol 2019; 29:1180-1188. [PMID: 29432521 DOI: 10.1093/annonc/mdy058] [Citation(s) in RCA: 375] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background We have previously developed and confirmed a pragmatic molecular classifier for endometrial cancers; ProMisE (Proactive Molecular Risk Classifier for Endometrial Cancer). Inspired by the Cancer Genome Atlas, ProMisE identifies four prognostically distinct molecular subtypes and can be applied to diagnostic specimens (biopsy/curettings) enabling earlier informed decision-making. We have strictly adhered to the Institute of Medicine (IOM) guidelines for the development of genomic biomarkers, and herein present the final validation step of a locked-down classifier before clinical application. Patients and methods We assessed a retrospective cohort of women from the Tübingen University Women's Hospital treated for endometrial carcinoma between 2003 and 2013. Primary outcomes of overall, disease-specific, and progression-free survival were evaluated for clinical, pathological, and molecular features. Results Complete clinical and molecular data were evaluable from 452 women. Patient age ranged from 29 to 93 (median 65) years, and 87.8% cases were endometrioid histotype. Grade distribution included 282 (62.4%) G1, 75 (16.6%) G2, and 95 (21.0%) G3 tumors. 276 (61.1%) patients had stage IA disease, with the remaining stage IB [89 (19.7%)], stage II [26 (5.8%)], and stage III/IV [61 (13.5%)]. ProMisE molecular classification yielded 127 (28.1%) MMR-D, 42 (9.3%) POLE, 55 (12.2%) p53abn, and 228 (50.4%) p53wt. ProMisE was a prognostic marker for progression-free (P = 0.001) and disease-specific (P = 0.03) survival even after adjusting for known risk factors. Concordance between diagnostic and surgical specimens was highly favorable; accuracy 0.91, κ 0.88. Discussion We have developed, confirmed, and now validated a pragmatic molecular classification tool (ProMisE) that provides consistent categorization of tumors and identifies four distinct prognostic molecular subtypes. ProMisE can be applied to diagnostic samples and thus could be used to inform surgical procedure(s) and/or need for adjuvant therapy. Based on the IOM guidelines this classifier is now ready for clinical evaluation through prospective clinical trials.
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Affiliation(s)
- S Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - M K McConechy
- Department of Human Genetics, Research Institute of the McGill University Health Network, McGill University, Montreal, Canada
| | - F Kommoss
- Institute of Pathology, Im Medizin Campus Bodensee, Friedrichshafen, Germany
| | - S Leung
- Genetic Pathology Evaluation Center, Vancouver
| | - A Bunz
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - J Magrill
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - H Britton
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - F Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany; Institute of Pathology, Heidelberg University, Heidelberg
| | - F Grevenkamp
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - A Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - W Yang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - A Lum
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - B Krämer
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - F Taran
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - A Staebler
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - S Lax
- Institute of Pathology, LKH Graz West, Graz, Austria
| | - S Y Brucker
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - D G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - C B Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - J N McAlpine
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver.
| | - A Talhouk
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
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Kommoss F, Grevenkamp F, Taran FA, Fend F, Brucker S, Wallwiener D, Schönfisch B, Lax S, Kommoss F, Staebler A, Kommoss S. L1CAM als wichtiger Prognosefaktor für Endometriumkarzinome mit niedrigem/intermediärem Risikoprofil. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Grevenkamp F, Kommoss FKF, Kommoss FGM, Lax S, Fend F, Wallwiener D, Schönfisch B, Krämer B, Brucker S, Taran FA, Staebler A, Kommoss S. Stellenwert einer spezialisierten gynäkopathologischen Zweitbegutachtung in der Behandlung des Endometriumkarzinoms. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Grevenkamp F, Kommoss F, Taran FA, Lax S, Kommoss F, Wallwiener D, Brucker S, Fend F, Kommoss S, Staebler A. Konsensuspanel zur histopathologische Begutachtung von Endometriumkarzinomen: Klinische Bedeutung und Stellenwert im Rahmen translationaler Forschungsprojekte. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kommoss F, Grevenkamp F, Fend F, Taran FA, Brucker S, Wallwiener D, Kommoss F, Lax S, Staebler A, Kommoss S. L1CAM-Immunhistochemie: Prüfung einer vielversprechenden Option im Management früher Typ 1 Endometriumkarzinome. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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