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VEGF and progression in bladder cancer

VEGF and relapse-free/stage progression-free survival¹

Kaplan-Meier survival curves demonstrating relapse free (A) and stage progression free (B) survival in 55 T₁G₁ and T₁G₂ bladder cancers expressing low VEGF mRNA (below the median, n=27), high VEGF mRNA (above the median) and p53 negative (n=15), and high VEGF mRNA and p53 positive (n=13). All but 1 p53-positive tumor expressed high levels of VEGF mRNA.

Crew et al investigated the relationship between vascular endothelial growth factor (VEGF) mRNA levels and relapse and progression status in 55 patients (37 male and 18 female with a median age of 73 years) with primary transitional cell carcinomas of the bladder. High median levels of VEGF expression (>10 units) directly correlated with lower rates of relapse-free and progression-free survival (hazard ratios 1.11 and 1.14, respectively).¹

Adapted with permission from Crew JP, O'Brien T, Bradburn M, et al. Cancer Res. 1997;57:5281-5285. Figure 2.

Significance of VEGF in risk of relapse and progression

The same study by Crew et al showed VEGF as a predictor of relapse (P<0.001) and progression (P=0.02) in superficial bladder cancer. Increased risk was significantly associated with high levels of VEGF expression (>10 units), which were found in tumors that had recurred within 6 months or underwent stage progression. Crew et al also determined that presence of VEGF mRNA was associated with shortened time to recurrence and shortened progression-free survival.¹

A clinical study by Bernardini et al involving 58 patients with superficial or invasive tumors reported similar findings. In this study, the authors described a significant association of VEGF levels with tumor stage (P<0.0001), grade (P<0.002), vascular invasion (P<0.001), and carcinoma in situ (P<0.01). Levels of VEGF were also significantly higher in patients with metastases (582 pg/mL) compared with localized disease (194 pg/mL).²

References:

1.

Crew JP, O'Brien T, Bradburn M, et al. Cancer Res. 1997;57:5281-5285.

2.

Bernardini S, Fauconnet S, Chabannes E, et al. J Urol. 2001;166:1275-1279.