Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Low Survivin Levels Predict Poor Prostate Cancer Prognosis
Key clinical point: Reduced expression of survivin was an independent predictor of poor outcomes in prostate cancer.
Major finding: Reduced survivin was significantly more common in cancers with TMPRSS2:ERG fusions than in ERG wild-type cancers (61% vs. 32%).
Study details: The data come from histochemistry analysis of 9,492 prostate cancers.
Disclosures: The researchers had no financial conflicts to disclose.
Citation:
Büscheck F et al. Cancer Med. 2020. doi: 10.1002/cam4.2773.
Current biomarkers are inadequate for optimal prostate cancer diagnosis and for guidance of treatment selection. Survivin is a protein that acts as an inhibitor of apoptosis; therefore, it intuitively makes sense to evaluate survivin as a biomarker in cancer. Higher expression of survivin has been demonstrated to be associated with poorer outcomes in some cancers, while lower expression of survivin has been associated with poorer outcomes in other cancers. The authors evaluated a large number of prostate cancer tumors (9,492) for expression of survivin via immunohistochemistry. They evaluated whether there was an association between surviving expression and patient outcomes. Overall, lower expression of survivin in the cytoplasm was associated with a poor prognosis and, surprisingly, was not associated with Gleason score, tumor or nodal stage, or serum PSA level. Thus, survivin is likely a good candidate for further evaluation as part of a biomarker strategy in prostate cancer.—Mark A. Klein, MD