Utility of Serum miR-371a-3p in Predicting Relapse on Surveillance in Patients with Clinical Stage I Testicular Germ Cell Cancer.

Optimal management of clinical stage I (CSI) testicular cancer is controversial due to lack of robust prognostic factors; miRNA-371a-3p holds promise as a biomarker, although its clinical utility for identifying patients at risk of relapse is unknown.

To explore the association between serum miR-371a-3p and CSI surveillance relapse.

Serial banked sera from 151 CSI (101 seminomas and 50 nonseminomatous germ cell tumors [NSGCTs]) samples from our Princess Margaret active surveillance cohort were tested.

Using the ampTSmiR test, miR-371a-3p was assayed. Multivariate logistic regression was used to assess the association between postorchiectomy miRNA and relapse.

Thirty-four (23%) patients relapsed. There was no association between postorchiectomy miR-371a-3p (2.43 vs 2.74, p =  0.31) or percent decline from before to after orchiectomy (95.8% vs 93.1%, p =  0.14) and relapse. After adjustment for clinical prognostic factors, there remained no association between postorchiectomy miR-371a-3p and relapse (seminoma: odds ratio [OR] 1.33, 95% confidence interval [CI] 0.87-2.02, p =  0.18; NSGCT: OR 0.45, 95% CI 0.21-1.00, p =  0.05). Postorchiectomy miR-371a-3p levels rose as the date of miRNA assessment approached relapse. At relapse, serum markers alpha-fetoprotein and human chorionic gonadotropin were normal in 62%; yet, miR-371a-3p was elevated in 32/34 (94.1%). The magnitude of miR-371a-3p elevation at relapse correlated with disease burden (N1/M0 122.5 vs N2-N3/M0: 521.1; p =  0.05). Limitations include small numbers of relapses and variable time points of serum collection.

In our cohort of CSI testis cancer patients on surveillance, postorchiectomy miR-371a-3p levels were not associated with relapse, suggesting that miR-371a-3p may not be a useful biomarker for guiding adjuvant therapy. Our data suggest that miR-371a-3p holds potential as an early relapse marker and warrants a prospective study, as this may allow a window for less morbid relapse therapy.

The promising novel blood biomarker for testis cancer miR-371a-3p may not provide information at testicle removal, but serial monitoring may lead to earlier detection of relapse.

European urology oncology. 2020 Dec 04 [Epub ahead of print]

João Lobo, Ricardo Leão, Ad J M Gillis, Annette van den Berg, Lynn Anson-Cartwright, Eshetu G Atenafu, Kopika Kuhathaas, Peter Chung, Aaron Hansen, Philippe L Bedard, Michael A S Jewett, Padraig Warde, Martin O'Malley, Joan Sweet, Leendert H J Looijenga, Robert J Hamilton

Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Cancer Biology and Epigenetics Group, Portuguese Oncology Institute of Porto (IPOP), Research Center and Porto Comprehensive Cancer Center (P.CCC), Porto, Portugal; Department of Pathology, Portuguese Oncology Institute of Porto (IPOP), Porto, Portugal; Department of Pathology and Molecular Immunology, Biomedical Sciences Institute Abel Salazar, University of Porto (ICBAS-UP), Porto, Portugal., Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Hospital CUF Coimbra, Department of Urology, Hospital de Braga, Braga, Portugal; Departments of Surgery (Urology), Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada., Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands., Departments of Surgery (Urology), Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada., Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Department of Medical Imaging, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Department of Pathology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada., Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. Electronic address: ., Departments of Surgery (Urology), Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada. Electronic address: .

email news signup