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miRNA-ISH for Cancer of Unknown Primary

miRNA-ISH for Cancer of Unknown Primary

Summary:

World-wide approximately 5% of all cancers are determined to have an occult or unknown primary location, upon initial assessment, prior to completing a full pathology report. [Oien] Unfortunately in 20-50% of CUP cases the primary tumor is never found. These cancers of unknown primary (CUP) result from metastasis. Occult cancer is most frequent in individuals around 60 years of age and an estimated 31,480 cases of CUP will be diagnosed in the US in 2019, making up around 2% of all US cancers. [Siegel] People with a family history of lung, kidney, or colorectal cancer are more likely than average to develop occult cancer. [Hemminki] Median survival time is 8-12 months, 80% of patients live only 6 months after diagnosis. [Losa]

Conclusion:

Patients with metastatic cancer are often recruited to clinical trials using investigational drugs due to a lack of effective market approved treatment options. CUPs are most often found in the liver, lung, bone, brain; lymph nodes; and peritoneal and pleural serous cavities. [Oien] Once a tumor has been discovered, in order to provide a working diagnosis for the treating oncologist, a detailed pathology report must be prepared. A crucial component of this report is a microRNA in situ hybridization (miRNA-ISH) based classification of the tumor to aide categorization and for determining the site of origin.

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Integrated analysis in cancer diagnostics: why miRNA is better than mRNA?

Cancer networks are specific, contextual, dynamic and interactive! The best way to delineate complex cancer networks is to integrate both transcriptomics (mRNA) expression profile as well as miRNA expression profile – this imparts both the functional and regulatory messages in a cancer context.  However, recent spate of miRNA analysis in the elucidation of cancer networks suggests specific and distinct advantages of miRNA profiling over mRNA signatures – both biological and technical.

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Promising Tool for Prognostication - BioGenex US

By Marcos Arribas-Layton, PhD. June 7, 2016

Like many cancers, breast cancers are highly diverse with a range of distinct clinical outcomes. Breast cancers dependent on hormone signaling (ER/PR) or on EGF-receptor (HER2/neu) typically have the most positive prognosis. Tumors lacking these receptors expression, referred to as Triple Negative Breast Cancer (TNBC), currently have no targeted therapies available. Five-year survival rates plummet from nearly 99% for localized tumors to 24% in late stage cancers and therefore correct identification of breast cancer subtypes at early stage is critical for treatment effectiveness.

Researchers speculate that miRNAs are potential biomarker candidates for early detection and prognosis prediction, because dysregulation of miRNA has been widely reported in cancers1. Recent studies have tested miRNAs as predictive biomarkers for determining TNBC patient’s prognosis. A four-miRNA signature (miR-16, miR-125b, miR-155 and miR374a) correlated with shorter overall patient survival1. A different panel of four miRNAs (miR-27a, -30e, -155, and -493) could separate TNBC into two distinct subgroups, high risk “core basal” tumors (basal CK5/6-and/or EGFR-positive) compared to lower risk “5 negative” tumors (negative for all five markers; ER, PR, HER2, CK5/6 and EGFR) 1-2. These results may help doctors decide which TNBC patient may require more aggressive treatment.

 

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