What is the clinical evidence from this study?

Study design: Observational. Population: Ovarian cancer (n=578). Intervention: High CACNA1C expression vs. Low CACNA1C expression. Primary outcome: Overall survival (HR 1.615, 95% CI 1.261-2.067, p=<0.001).

July 1, 2021Open Access

CACNA1C is a prognostic predictor for patients with ovarian cancer

Q: What are the key findings of this study?

High CACNA1C expression was identified as an independent risk factor for worse overall survival in patients with ovarian cancer (HR 1.615).

Key Result

High CACNA1C expression was identified as an independent risk factor for worse overall survival in patients with ovarian cancer (HR 1.615).

Study Design

Type

Observational (n=578)

Structured PICO

Does CACNA1C expression predict overall survival in patients with ovarian cancer?

Population

Patients with ovarian cancer (data from TCGA and ICGC datasets)

Intervention

CACNA1C expression and genetic alteration

Comparator

Normal tissues or unaltered CACNA1C groups

Outcome

Overall survival (OS)hard clinical

CACNA1C expression is lower in ovarian cancer tissues and serves as an independent prognostic predictor for overall survival.

Main Result

Effect estimate: HR 1.615 (95% CI 1.261-2.067)

p-value: p=<0.001

Limitations

Absence of normal ovarian cancer samples in TCGA required combining TCGA and GTEx datasets, which may lead to biases.
Retrospective study based on public databases without extensive experimental verification from the authors' own samples.
A larger sample size is required to verify the prognostic roles of CACNA1C in ovarian cancer and confirm its associations with immunity.

Abstract

BACKGROUND: CACNA1C, as a type of voltage-dependent calcium ion transmembrane channel, played regulatory roles in the development and progress of multiple tumors. This study was aimed to analyze the roles of CACNA1C in ovarian cancer (OC) of overall survival (OS) and to explore its relationships with immunity. METHODS: Single gene mRNA sequencing data and corresponding clinical information were obtained from The Cancer Genome Atlas Database (TCGA) and the International Cancer Genome Consortium (ICGC) datasets. Gene set enrichment analysis (GSEA) was used to identify CACNA1C-related signal pathways. Univariate and multivariate Cox regression analyses were applied to evaluate independent prognostic factors. Besides, associations between CACNA1C and immunity were also explored. RESULTS: CACNA1C had a lower expression in OC tumor tissues than in normal tissues (P < 0.001), with significant OS (P = 0.013) and a low diagnostic efficiency. We further validated the expression levels of CACNA1C in OC by means of the ICGC dataset (P = 0.01), qRT-PCR results (P < 0.001) and the HPA database. Univariate and multivariate Cox hazard regression analyses indicated that CACNA1C could be an independent risk factor of OS for OC patients (both P < 0.001). Five significant CACNA1C-related signaling pathways were identified by means of GSEA. As for genetic alteration analysis, altered CACNA1C groups were significantly associated with OS (P = 0.0169), progression-free survival (P = 0.0404), disease-free survival (P = 0.0417) and disease-specific survival (P = 9.280e-3), compared with unaltered groups in OC. Besides, CACNA1C was dramatically associated with microsatellite instability (MSI) and immunity. CONCLUSIONS: Our results shed light on that CACNA1C could be a prognostic predictor of OS in OC and it was closely related to immunity.

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