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We predict that when applied to large cohorts of patients enrolled in clinical trials, this integrated epigenomics approach will provide more accurate disease classification and more powerful prognostic information, which could be then used to design improved risk adapted and targeted therapy clinical trials.
For example, nodal status is a more powerful prognostic predictor than HER2 status [ 2].
This might have enabled the calculation of a potentially more powerful prognostic algorithm.
Combined strong MMP-2 and weak TIMP-2 were more powerful prognostic factors than MMP-2 or TIMP-2 alone.
Multivariate analysis showed histological grade to be a more powerful prognostic factor than c-erbB-2 protein expression.
With new techniques like GEP and biomarker models [ 43], several putative markers can be linked together to obtain a more powerful prognostic or predictive tool.
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This is relevant given that our analysis exploring the relative prognostic power of models containing ASXL1 mutations identified no difference in prognostic power compared with other models, perhaps suggesting that combinations of mutations such as CBL and interrogation of RNA expression signatures may yield a more powerful molecular prognostic model.
Although in the multivariate analysis both the GPA score and the SIR were statistically significant in predicting survival, the GPA score may be the more powerful independent prognostic factor because it takes into account both the KPS and the presence of extracranial metastasis.
However, using more quantitative methods and many cell cycle regulated genes to assess proliferation can provide more powerful and objective prognostic information over grade or a mitotic index by Ki-67 [ 14].
In pre-treatment serum, methylated RASSF1A and APC may be independently associated with poor outcome and more powerful predictors than standard prognostic parameters [ 57].
Multivariate analysis demonstrates that PR expression is an independent prognostic variable more powerful than ER for predicting BCSS and DFS.
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