Background
Myc transcriptional activity is frequently deregulated in human cancers, but a Myc activity signature with predictive ability and clinical utility in multiple tumour types remains to be developed.
Methods
18 Myc-regulated genes were selected from published studies of Myc family targets based on analysis of gene expression and correlation with clinical outcome in epithelial ovarian cancer (EOC) and neuroblastoma. A Myc family activity score, derived from the expression of 18 genes using qPCR assays arrayed in Taqman low density format, was first correlated to MYC/MYCN/MYCL1 expression in a panel of 35 cancer cell lines. The prognostic utility of this signature was evaluated in neuroblastoma (n=649), medulloblastoma (n=130), diffuse large B-cell lymphoma (DLBCL; n=122) and EOC (n=540) microarray gene expression datasets using Kaplan-Meier and multivariate Cox regression analyses, and was further validated in 42 primary neuroblastomas using qPCR.
Results
Cell lines with high MYC, MYCN and/or MYCL1 gene expression exhibited elevated expression of the signature genes. Survival analysis showed that high signature score was significantly associated with poor outcome in the overall cohort (p<0.001) and a subset of tumours lacking MYCN amplification (p<0.001) in neuroblastoma. Moreover, high signature score was associated with poor prognosis independently of well-defined prognostic factors in neuroblastoma, breast cancer, DLBCL and medulloblastoma. In EOC, the 18-gene Myc activity signature was capable of identifying a group of patients with poor prognosis in a “high-MYCN” molecular subtype but not in the overall cohort. The predictive ability of this signature was reproduced using qPCR analysis of an independent cohort of neuroblastomas, including a subset of tumours without MYCN amplification.
Conclusion
An 18-gene Myc activity signature is highly predictive of clinical outcome in diverse Myc-associated malignancies, independent of Myc amplification. This suggests its potential clinical application in the identification of Myc-mediated tumours that might be treated with Myc-targeted therapies.