Gene expression profile algorithm for calculating a recurrence score for a patient with kidney cancer
The present invention provides algorithm-based molecular assays that involve measurement of expression levels of genes from a biological sample obtained from a kidney cancer patient. The present invention also provides methods of obtaining a quantitative score for a patient with kidney cancer based on measurement of expression levels of genes from a biological sample obtained from a kidney cancer patient. The genes may be grouped into functional gene subsets for calculating the quantitative score and the gene subsets may be weighted according to their contribution to cancer recurrence.
1. A method for obtaining a recurrence score (RS) result for a patient with kidney cancer, comprising:
measuring a level of an RNA transcript of each of a set of genes consisting of: APOLD1, EDNRB, NOS3, PPAP2B, EIF4EBP1, LMNB1, TUBB2A, CCL5, CEACAM1, CX3CL1, and IL-6, and at least one reference gene in a tumor sample obtained from the patient;
normalizing the level of the RNA transcripts against a level of an RNA transcript of the at least one reference gene in the tumor sample to provide a normalized level of the RNA transcript of each of APOLD1, EDNRB, NOS3, PPAP2B, EIF4EBP1, LMNB1, TUBB2A, CCL5, CEACAM1, CX3CL1, and IL-6;
calculating a recurrence score (RS) result for the patient using the following algorithm:
RS=−0.45×vascular normalization gene group score
−0.31×Immune response gene group score
+0.27×cell growth/division gene group score
+0.04×IL6
where:
vascular normalization gene group score=(0.5APOLD1+0.5EDNRB+NOS3+PPAP2B)/4
cell growth/division gene group score=(EIF4EBP1+1.3LMNB1+TUBB2A)/3; and
immune response gene group score=(0.5CCL5+CEACAM1+CX3CL1)/3; and
creating a report comprising the RS.
2. The method of claim 1 , wherein the level of the RNA transcripts is determined by quantitative RT-PCR.
3. A method for obtaining a recurrence score (RS) result for a patient with kidney cancer, comprising:
extracting RNA from a tumor sample obtained from the patient;
reverse transcribing an RNA transcript of each of a set of genes consisting of: APOLD1, EDNRB, NOS3, PPAP2B, EIF4EBP1, LMNB1, TUBB2A, CCL5, CEACAM1, CX3CL1, and IL-6, and at least one reference gene in the tumor sample, to produce cDNA of the genes;
amplifying the cDNA to produce amplicons of the RNA transcripts of the genes;
assaying a level of the amplicon of the genes;
normalizing the level of the amplicons of the genes against the level of an amplicon of an RNA transcript of the at least one reference gene in the tumor sample to provide normalized amplicon levels of the genes;
calculating a recurrence score (RS) result for the patient using the following algorithm:
RS=−0.45×vascular normalization gene group score
−0.31×Immune response gene group score
+0.27×cell growth/division gene group score
+0.04×IL6
where:
vascular normalization gene group score=(0.5APOLD1+0.5EDNRB+NOS3+PPAP2B)/4
cell growth/division gene group score=(EIF4EBP1+1.3LMNB1+TUBB2A)/3; and
immune response gene group score=(0.5CCL5+CEACAM1+CX3CL1)/3; and
generating a report comprising the RS result.
4. The method of claim 1 , wherein the kidney cancer is renal cell carcinoma (RCC).
5. The method of claim 4 , wherein the RCC is clear cell renal cell carcinoma (ccRCC).
6. The method of claim 1 , wherein the tumor sample is obtained from a biopsy.
7. The method of claim 1 , wherein the tumor sample is fresh, frozen, or paraffin-embedded and fixed.
8. The method of claim 1 , further comprising calculating a scaled RS score result using the following algorithm:
RS(scaled)=(RS(unscaled)+3.7)×26.4
where:
If RS=<0, then RS=0; and
If RS=>100, then RS=100.
9. The method of claim 3 , wherein the kidney cancer is renal cell carcinoma (RCC).
10. The method of claim 9 , wherein the RCC is clear cell renal cell carcinoma (ccRCC).
11. The method of claim 3 , wherein the tumor sample is obtained from a biopsy.
12. The method of claim 3 , wherein the tumor sample is fresh, frozen, or paraffin-embedded and fixed.
13. The method of claim 3 , further comprising calculating a scaled RS score result using the following algorithm:
RS(scaled)=(RS(unscaled)+3.7)×26.4
where:
If RS=<0, then RS=0; and
If RS=>100, then RS=100.
14. The method of claim 3 , wherein the level of the RNA transcripts is determined by quantitative RT-PCR.
15. A method of treating a patient with kidney cancer, comprising:
administering active surveillance to the patient, wherein prior to the active surveillance, a recurrence score (RS) result for the patient had been obtained for the patient by a method comprising
measuring a level of an RNA transcript of each of a set of genes consisting of: APOLD1, EDNRB, NOS3, PPAP2B, EIF4EBP1, LMNB1, TUBB2A, CCL5, CEACAM1, CX3CL1, and IL-6, and at least one reference gene in a tumor sample obtained from the patient;
normalizing the level of the RNA transcripts against a level of an RNA transcript of the at least one reference gene in the tumor sample to provide a normalized level of the RNA transcript of each of APOLD1, EDNRB, NOS3, PPAP2B, EIF4EBP1, LMNB1, TUBB2A, CCL5, CEACAM1, CX3CL1, and IL-6;
calculating a recurrence score (RS) result for the patient using the following algorithm:
RS=−0.45×vascular normalization gene group score
−0.31×Immune response gene group score
+0.27×cell growth/division gene group score
+0.04×IL6
where:
vascular normalization gene group score=(0.5 APOLD1+0.5 EDNRB+NOS3+PPAP2B)/4
cell growth/division gene group score=(EIF4EBP1+1.3 LMNB1+TUBB2A)/3; and
immune response gene group score=(0.5 CCL5+CEACAM1+CX3CL1)/3; and
creating a report comprising the RS result.
16. The method of claim 15 , wherein the kidney cancer is renal cell carcinoma (RCC).
17. The method of claim 16 , wherein the RCC is clear cell renal cell carcinoma (ccRCC).