NBN gain is predictive for adverse outcome following imageguided radiotherapy for localized prostate cancer

Alejandro Berlin, Emilie Lalonde, Jenna Sykes, Gaetano Zafarana, Kenneth C. Chu, Varune R. Ramnarine, Adrian Ishkanian, Dorota H.S. Sendorek, Ivan Pasic, Wan L. Lam, Igor Jurisica, Theo van der Kwast, Michael Milosevic, Paul C. Boutros, Robert G. Bristow

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Despite the use of clinical prognostic factors (PSA, T-category and Gleason score), 20-60% of localized prostate cancers (PCa) fail primary local treatment. Herein, we determined the prognostic importance of main sensors of the DNA damage response (DDR): MRE11A, RAD50, NBN, ATM, ATR and PRKDC. We studied copy number alterations in DDR genes in localized PCa treated with image-guided radiotherapy (IGRT; n=139) versus radical prostatectomy (RadP; n=154). In both cohorts, NBN gains were the most frequent genomic alteration (14.4 and 11% of cases, respectively), and were associated with overall tumour genomic instability (p<0.0001). NBN gains were the only significant predictor of 5yrs biochemical relapsefree rate (bRFR) following IGRT (46% versus 77%; p=0.00067). On multivariate analysis, NBN gain remained a significant independent predictor of bRFR after adjusting for known clinical prognostic variables (HR=3.28, 95% CI 1.56-6.89, Wald p-value=0.0017). No DDR-sensing gene was prognostic in the RadP cohort. In vitro studies correlated NBN gene overexpression with PCa cells radioresistance. In conclusion, NBN gain predicts for decreased bRFR in IGRT, but not in RadP patients. If validated independently, Nibrin gains may be the first PCa predictive biomarker to facilitate local treatment decisions using precision medicine approaches with surgery or radiotherapy.

Original languageEnglish (US)
Pages (from-to)11081-11090
Number of pages10
Issue number22
StatePublished - 2014


  • Biomarker
  • MRN complex
  • NBN
  • Prostate cancer
  • Radiotherapy
  • aCGH

ASJC Scopus subject areas

  • Oncology


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