MRE11 as a Predictive Biomarker of Outcome After Radiation Therapy in Bladder Cancer

Alexandra K Walker, Katalin Karaszi, Helen Valentine, Victoria Y Strauss, Ananya Choudhury, Shaun McGill, Kaisheng Wen, Michael D Brown, Vijay Ramani, Selina Bhattarai, Mark Tw Teo, Lingjian Yang, Kevin A Myers, Nayneeta Deshmukh, Helen Denley, Lisa Browning, Sharon B Love, Gopa Iyer, Noel W Clarke, Emma HallRobert Huddart, Nicholas D James, Peter J Hoskin, Catharine Ml West, Anne E Kiltie

Research output: Contribution to journalArticlepeer-review


PURPOSE: Organ-confined muscle-invasive bladder cancer (MIBC) is treated with cystectomy or bladder preservation techniques, including radiotherapy. There are currently no biomarkers to inform management decisions and aid patient choice. Previously we showed high levels of MRE11 protein, assessed by immunohistochemistry (IHC), predicted outcome following radiotherapy but not cystectomy. Therefore, we sought to develop the MRE11 IHC assay for clinical use and define its relationship to clinical outcome in samples from two major clinical trials.

METHODS AND MATERIALS: Samples from the BCON and BC2001 randomised controlled trials and a cystectomy cohort were stained using automated IHC methods and scored for MRE11 in three UK centres.

RESULTS: Despite step-wise creation of scoring cards and standard operating procedures for staining and interpretation, there was poor inter-centre scoring agreement (Kappa 0.32, 95% CI 0.17-0.47). There were no significant associations between MRE11 scores and cause-specific survival (CSS) identified in BCON (n=132) and BC2001 (n=221) samples. Re-optimised staining improved agreement between scores from BCON tissue microarrays (n=116), but MRE11 expression was not prognostic for CSS.

CONCLUSIONS: Manual IHC scoring of MRE11 was not validated as a reproducible biomarker of radiation-based bladder preservation success. There is a need for automated quantitative methods and/or a reassessment of how DNA-damage response relates to clinical outcomes.

Original languageEnglish
Pages (from-to)809-818
JournalInternational journal of radiation oncology, biology, physics
Issue number4
Early online date15 Mar 2019
Publication statusPublished - 15 Mar 2019

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre


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