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Review
. 2017 Feb 21;8(8):13979-13985.
doi: 10.18632/oncotarget.14704.

Prognostic and predictive value of VHL gene alteration in renal cell carcinoma: a meta-analysis and review

Affiliations
Review

Prognostic and predictive value of VHL gene alteration in renal cell carcinoma: a meta-analysis and review

Bum Jun Kim et al. Oncotarget. .

Abstract

The von Hippel-Lindau (VHL) gene is often inactivated in sporadic renal cell carcinoma (RCC) by mutation or promoter hypermethylation. The prognostic or predictive value of VHL gene alteration is not well established. We conducted this meta-analysis to evaluate the association between the VHL alteration and clinical outcomes in patients with RCC. We searched PUBMED, MEDLINE and EMBASE for articles including following terms in their titles, abstracts, or keywords: 'kidney or renal', 'carcinoma or cancer or neoplasm or malignancy', 'von Hippel-Lindau or VHL', 'alteration or mutation or methylation', and 'prognostic or predictive'. There were six studies fulfilling inclusion criteria and a total of 633 patients with clear cell RCC were included in the study: 244 patients who received anti-vascular endothelial growth factor (VEGF) therapy in the predictive value analysis and 419 in the prognostic value analysis. Out of 663 patients, 410 (61.8%) had VHL alteration. The meta-analysis showed no association between the VHL gene alteration and overall response rate (relative risk = 1.47 [95% CI, 0.81-2.67], P = 0.20) or progression free survival (hazard ratio = 1.02 [95% CI, 0.72-1.44], P = 0.91) in patients with RCC who received VEGF-targeted therapy. There was also no correlation between the VHL alteration and overall survival (HR = 0.80 [95% CI, 0.56-1.14], P = 0.21). In conclusion, this meta-analysis indicates that VHL gene alteration has no prognostic or predictive value in patients with clear cell RCC.

Keywords: anti-VEGF therapy; meta-analysis; prognosis; renal cell carcinoma; von Hippel-Lindau.

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Conflict of interest statement

CONFLICTS OF INTEREST

Authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Flow diagram of searching process
Figure 2
Figure 2. Forest plots for the association between VHL gene alteration and outcomes of VEGF-targeted therapy
A. The relation between VHL gene alteration and overall response rate to VEGF-targeted therapy. B. The relation between VHL gene alteration and progression-free survival to VEGF-targeted therapy.
Figure 3
Figure 3. Forest plot for the association between VHL gene alteration and overall survival

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