Als AB et al. (2007) Emmprin and survivin predict response and survival following cisplatin-containing chemotherapy in patients with advanced bladder cancer. Clin Cancer Res 13: 4407–4414

For patients with advanced bladder cancer, cisplatin-containing chemotherapy is the only treatment option. Despite the existence of various clinical prognostic factors that correlate with the treatment outcome in these patients, no prognostic biological markers are currently used in clinical practice. Als and coauthors identified two new molecular markers prognostic for survival in patients with bladder cancer, by use of gene-expression profiling.

The study included samples from 30 patients with locally advanced and/or metastatic bladder cancer who had received cisplatin-containing chemotherapy. Analysis of microarray data identified 55 differentially expressed genes that correlated significantly with survival after chemotherapy. Multivariate analysis showed that protein expression of EMMPRIN (BSG) and survivin (BIRC5) independently predicted poor outcome (hazard ratio [HR] 2.23, P <0.0001, and HR 2.46, P <0.0001, respectively) as did the presence of visceral metastases (HR 2.62; P <0.0001). Patients without visceral metastases who had tumors with positive expression of both EMMPRIN and survivin had a low median survival time. The 5-year survival rates of patients without visceral metastases whose tumors expressed none, one or both proteins were 44%, 21% and 0%, respectively. The response rates in patients with or without EMMPRIN expression were 39% and 74%, respectively, while the response rates in patients with or without survivin expression were 47% and 70%, respectively.

This study shows that expression of EMMPRIN and survivin can be used as prognostic factors for treatment response and survival in cisplatin-treated patients with advanced bladder cancer.