Plasma methoxytyramine: A novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Graeme Eisenhofer - , Institute of Clinical Chemistry and Laboratory Medicine, Department of Internal Medicine III (Author)
  • Jacques W.M. Lenders - , Radboud University Nijmegen, Department of Internal Medicine 3 (Author)
  • Gabriele Siegert - , Institute for Clinical Chemistry and Laboratory Medicine (Author)
  • Stefan R. Bornstein - , Department of Internal Medicine III (Author)
  • Peter Friberg - , Sahlgrenska University Hospital (Author)
  • Dragana Milosevic - , Mayo Clinic Rochester, MN (Author)
  • Massimo Mannelli - , University of Florence (Author)
  • W. Marston Linehan - , National Cancer Institute (NCI) (Author)
  • Karen Adams - , Eunice Kennedy Shriver National Institute of Child Health and Human Development (Author)
  • Henri J. Timmers - , Radboud University Nijmegen, Eunice Kennedy Shriver National Institute of Child Health and Human Development (Author)
  • Karel Pacak - , Eunice Kennedy Shriver National Institute of Child Health and Human Development (Author)

Abstract

Background: There are currently no reliable biomarkers for malignant pheochromocytomas and paragangliomas (PPGLs). This study examined whether measurements of catecholamines and their metabolites might offer utility for this purpose. Methods: Subjects included 365 patients with PPGLs, including 105 with metastases, and a reference population of 846 without the tumour. Eighteen catecholamine-related analytes were examined in relation to tumour location, size and mutations of succinate dehydrogenase subunit B (SDHB). Results: Receiver-operating characteristic curves indicated that plasma methoxytyramine, the O-methylated metabolite of dopamine, provided the most accurate biomarker for discriminating patients with and without metastases. Plasma methoxytyramine was 4.7-fold higher in patients with than without metastases, a difference independent of tumour burden and the associated 1.6- to 1.8-fold higher concentrations of norepinephrine and normetanephrine. Increased plasma methoxytyramine was associated with SDHB mutations and extra-adrenal disease, but was also present in patients with metastases without SDHB mutations or those with metastases secondary to adrenal tumours. High risk of malignancy associated with SDHB mutations reflected large size and extra-adrenal locations of tumours, both independent predictors of metastatic disease. A plasma methoxytyramine above 0.2 nmol/L or a tumour diameter above 5 cm indicated increased likelihood of metastatic spread, particularly when associated with an extra-adrenal location. Conclusion: Plasma methoxytyramine is a novel biomarker for metastatic PPGLs that together with SDHB mutation status, tumour size and location provide useful information to assess the likelihood of malignancy and manage affected patients.

Details

Original languageEnglish
Pages (from-to)1739-1749
Number of pages11
JournalEuropean journal of cancer
Volume48
Issue number11
Publication statusPublished - Jul 2012
Peer-reviewedYes

External IDs

PubMed 22036874

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • Catecholamines, Dopamine, Metanephrines, Metastases, Methoxytyramine, Paraganglioma, Pheochromocytoma, Succinate dehydrogenase type B