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Clinical Studies

Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours

British Journal of Cancer volume 126, pages 1140–1144 (2022)Cite this article

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Abstract

Background

MiR-371a-3p predicts the presence of a macroscopic non-teratomatous germ cell tumour (GCT). We hypothesised that miR-371a-3p can also detect recurrence during active surveillance (AS) of stage I GCT.

Methods

We prospectively collected serum samples of 33 men. Relative expression of serum miR-371a-3p levels was determined at each follow-up visit using real-time quantitative reverse transcription-polymerase chain reaction.

Results

Recurrence was detected using standard follow-up investigations in 10/33 patients (30%) after a median of 7 months. Directly after orchiectomy, miR-371a-3p levels were not elevated in any of the 15 patients with available post-orchiectomy samples. However, all ten recurring patients exhibited increasing miR-371a-3p levels during follow-up, while miR-371a-3p levels remained non-elevated in all but one patient without recurrence. MiR-371a-3p detected recurrences at a median of 2 months (range 0–5) earlier than standard follow-up investigations.

Conclusions

MiR-371a-3p levels immediately post orchiectomy are not predictive for recurrences and unfortunately cannot support decision-making for AS vs. adjuvant treatment. However, miR-371a-3p detects recurrences reliably and earlier than standard follow-up investigations. If this can be confirmed in larger cohorts, monitoring miR-371a-3p could replace surveillance imaging in seminomatous GCT and reduce the amount of imaging in non-seminomatous GCT. Earlier detection of disease recurrence may also reduce the overall treatment burden.

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Fig. 1: Relative miRNA expression (log 10) of miR-371a-3p compared to the housekeeper miRNA (miR-30b-5p) during follow-up, stratified by recurrence status.

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Data availability

Data are available upon request.

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Acknowledgements

We thank Davide Ardizzone and Lisa Roth for managing clinical data, our study nurses Yvonne Döring and Uta Bonitz for their support in this project and Jordi Nicola Fronzaroli for sample collection.

Funding

This study was funded by the Swiss Cancer League (KLS-4297-08-2017), Stiftung zur Krebsbekämpfung, Hanne Liebermann Stiftung, Alfred und Anneliese Sutter-Stöttner Stiftung, Dr. Hans Altschüler Stiftung, Padella Stiftung.

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Author notes

  1. These authors contributed equally: Christian D. Fankhauser, Ailsa J. Christiansen.

Authors and Affiliations

  1. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Christian D. Fankhauser, Ailsa J. Christiansen, Marian S. Wettstein, Nico C. Grossmann, Josias B. Grogg & Thomas Hermanns

  2. Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Ailsa J. Christiansen & Holger Moch

  3. Department of Oncology, Kantonsspital, St. Gallen, Switzerland

    Christian Rothermundt & Silke Gillessen

  4. Department of Oncology, Kantonsspital Chur, Chur, Switzerland

    Richard Cathomas

  5. Department of Medical Oncology, St. Claraspital Basel and Faculty of Medicine, University of Basel, Basel, Switzerland

    Arnoud J. Templeton

  6. Onkozentrum Hirslanden, Klinik Hirslanden, Zürich, Switzerland

    Anita Hirschi-Blickenstorfer

  7. Department of Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Anja Lorch

  8. EOC Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

    Silke Gillessen

  9. Universita della Svizzera Italiana, Lugano, Switzerland

    Silke Gillessen

  10. University of Bern, Bern, Switzerland

    Silke Gillessen

  11. Department of Medical Oncology, Inselspital, University Hospital, University of Bern, Bern, Switzerland

    Joerg Beyer

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  1. Christian D. Fankhauser
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Contributions

Conception and design: CDF, AJC, JB, TH and CR. Acquisition of data: AJC, CDF, CR, RC, NCG, JBG, AJT and AH-B. Analysis and interpretation of data: AJC and CDF. Drafting of the manuscript: CDF, AJC, JB, TH. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: CDF, AJC and MSW. Obtaining funding: CDF, JB, TH and CR. Administrative, technical or material support—supervision: JB, TH and CR.

Corresponding author

Correspondence to Christian D. Fankhauser.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study was approved by the local ethical committee of St. Gallen (EKSG 13/08/L). All patients provided written consent. The study was performed in accordance with the Declaration of Helsinki.

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All patients provided written consent.

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Fankhauser, C.D., Christiansen, A.J., Rothermundt, C. et al. Detection of recurrences using serum miR-371a-3p during active surveillance in men with stage I testicular germ cell tumours. Br J Cancer 126, 1140–1144 (2022). https://doi.org/10.1038/s41416-021-01643-z

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