Ectopic Production of Β-hCG and Loss of P16 as a Predictor of Outcome in Patients with Newly Diagnosed Osteosarcoma

Nye L, Yeldandi A, Peabody T, Attar S, Salamon MA, Gandhi M, Gursel D, Rademaker A, Hayes JP and Agulnik M

Division of Hematology/ Oncology, Robert H. Lurie Comprehensive Cancer Center Northwestern University
Feinberg School of Medicine, USA

^*Correspondance to: Agulnik M 

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Abstract:

Osteosarcoma is the most common malignant bone tumor in children and young adults and is associated with high mortality. We investigated the expression of β- hCG and P16 in osteosarcoma and correlated with outcomes.
Methods: Immunohistochemistry (IHC) for β-hCG was performed on diagnostic osteosarcoma specimens and post-treatment specimens. IHC for P16 was performed on diagnostic specimens.
Results: Median age was 32. Median progression free survival (PFS) was 11.5 months. Median overall survival (OS) was 38.0 months. Positive β-hCG staining on diagnostic specimens did not correlate with percent tumor necrosis, 2 year PFS or OS. Patients with a post-treatment β-hCG staining of ≥ 50% had a median PFS of 6.1 months vs 19.2 months in patients with β-hCG less than 50% (p = 0.03). Patients with a post-treatment β-hCG staining ≥ 50% also demonstrated a trend toward shorter median OS (17.1 months vs 19.2). There was no statistically significant relationship between P16 staining on diagnostic osteosarcoma specimens and post- treatment percent tumor necrosis. Patients with negative P16 staining on diagnostic specimens had a lower 2 year PFS compared to positive P16 staining (2 year PFS 0% vs 71%), p=0.022. There was a trend toward worse 2 year OS in patients with P16 negative diagnostic specimens compared to patients with P16 positive tumors, 22% vs 86%.
Discussion: We have demonstrated feasibility and utility in examining P16 and β-hCG in osteosarcoma. We found that post-treatment β-hCG expression correlated with poorer outcomes, specifically worsened PFS. In congruence with previous reports, negative P16 staining confers worse outcomes.

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Cite the Article:

Nye L, Yeldandi A, Peabody T, Attar S, Salamon MA, Gandhi M, et al. Ectopic Production of Β-hCG and Loss of P16 as a Predictor of Outcome in Patients with Newly Diagnosed Osteosarcoma. Clin Oncol. 2016; 1: 1061.