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Kerr K, Thunnissen E, Dafni U, Soltermann A, Finn S, Bubendorf L, Verbeken E, Biernat W, Warth A, Marchetti A, Speel EJ, Pokharel S, Quinn A, Monkhorst K, Navarro A, Polydoropoulou V, Kammler R, Peters S, Stahel R, Lungscape Consortium O. Association of programmed cell death 1 ligand (PD-L1) expression with molecular alterations in non-small cell lung cancer (NSCLC) patients (pts): Results from the European Thoracic Oncology Platform (ETOP) Lungscape cohort. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx390.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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van der Wekken AJ, Kuiper JL, Saber A, Terpstra MM, Wei J, Hiltermann TJN, Thunnissen E, Heideman DAM, Timens W, Schuuring E, Kok K, Smit EF, van den Berg A, Groen HJM. Overall survival in EGFR mutated non-small-cell lung cancer patients treated with afatinib after EGFR TKI and resistant mechanisms upon disease progression. PLoS One 2017; 12:e0182885. [PMID: 28854272 PMCID: PMC5576694 DOI: 10.1371/journal.pone.0182885] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/26/2017] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine survival in afatinib-treated patients after treatment with first-generation EGFR tyrosine kinase inhibitors (TKIs) and to study resistance mechanisms in afatinib-resistant tumors. METHODS Characteristics and survival of patients treated with afatinib after resistance to erlotinib or gefitinib in two large Dutch centers were collected. Whole exome sequencing (WES) and pathway analysis was performed on available pre- and post-afatinib tumor biopsies and normal tissue. RESULTS A total of 38 patients were treated with afatinib. T790M mutations were identified in 22/29 (76%) pre-afatinib treatment tumor samples. No difference in median progression-free-survival (2.8 months (95% CI 2.3-3.3) and 2.7 months (95% CI 0.9-4.6), p = 0.55) and median overall-survival (8.8 months (95% CI 4.2-13.4) and 3.6 months (95% CI 2.3-5.0), p = 0.14) were observed in T790M+ patients compared to T790M- mutations. Somatic mutations in TP53, ADAMTS2, CNN2 and multiple genes in the Wnt and PI3K-AKT pathway were observed in post-afatinib tumors of six afatinib-responding and in one non-responding patient. No new EGFR mutations were found in the post-afatinib samples of the six responding patients. Further analyses of post-afatinib progressive tumors revealed 28 resistant specific mutations in six genes (HLA-DRB1, AQP7, FAM198A, SEC31A, CNTLN, and ESX1) in three afatinib responding patients. No known EGFR-TKI resistant-associated copy number gains were acquired in the post-afatinib samples. CONCLUSION No differences in survival were observed in patients with EGFR-T790M treated with afatinib compared to those without T790M. Tumors from patients who had progressive disease during afatinib treatment were enriched for mutations in genes involved in Wnt and PI3K-AKT pathways.
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Kuiper JL, Hashemi SMS, Thunnissen E, Snijders PJF, Grünberg K, Bloemena E, Sie D, Postmus PE, Heideman DAM, Smit EF. Non-classic EGFR mutations in a cohort of Dutch EGFR-mutated NSCLC patients and outcomes following EGFR-TKI treatment. Br J Cancer 2016; 115:1504-1512. [PMID: 27875527 PMCID: PMC5155366 DOI: 10.1038/bjc.2016.372] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/24/2016] [Accepted: 10/15/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Data on non-small-cell lung cancer (NSCLC) patients with non-classic epidermal growth factor receptor (EGFR) mutations are scarce, especially in non-Asian populations. The purpose of this study was to evaluate prevalence, clinical characteristics and outcome on EGFR-TKI treatment according to type of EGFR mutation in a Dutch cohort of NSCLC patients. METHODS We retrospectively evaluated a cohort of 240 EGFR-mutated NSCLC patients. Data on demographics, clinical and tumour-related features, EGFR-TKI treatment and clinical outcome were collected and compared between patients with classic EGFR mutations, EGFR exon 20 insertions and other uncommon EGFR mutations. RESULTS Classic EGFR mutations were detected in 186 patients (77.5%) and non-classic EGFR mutations in 54 patients (22.5%); 23 patients with an exon 20 insertion (9.6%) and 31 patients with an uncommon EGFR mutation (12.9%). Median progression-free survival (PFS) and overall survival (OS) on EGFR-TKI treatment were 2.9 and 9.7 months, respectively, for patients with an EGFR exon 20 insertion, and 6.4 and 20.2 months, respectively, for patients with an uncommon EGFR mutation. Patients with a double uncommon EGFR mutation that included G719X/L861Q/S768I had longer PFS and OS on EGFR-TKI treatment compared with patients with a single G719X/L861Q/S768I EGFR mutation (both P=0.02). CONCLUSIONS In our Dutch cohort, prevalence and genotype distribution of non-classic EGFR mutations were in accordance with previously reported data. The PFS and OS on EGFR-TKI treatment in patients with an uncommon EGFR mutation were shorter compared with patients with classic EGFR mutations, but varied among different uncommon EGFR mutations.
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Derks J, van Suylen R, Thunnissen E, Den Bakker M, Groen H, Smit E, Damhuis R, Speel EJ, Dingemans AM. A population based analysis of outcome of chemotherapy for metastatic pulmonary large cell neuroendocrine carcinomas: does the regimen matter? Ann Oncol 2016. [DOI: 10.1093/annonc/mdw369.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rosoux A, Pauwels P, Duplaquet F, D'Haene N, Weynand B, Delos M, Menon R, Heukamp LC, Thunnissen E, Ocak S. Effectiveness of crizotinib in a patient with ALK IHC-positive/FISH-negative metastatic lung adenocarcinoma. Lung Cancer 2016; 98:118-121. [PMID: 27393517 DOI: 10.1016/j.lungcan.2016.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 11/30/2022]
Abstract
We report a case of crizotinib effectiveness in a heavily pretreated patient with a metastatic NSCLC initially considered IHC-positive and FISH-negative for ALK rearrangement. After repeated analyses of tumor samples, borderline ALK FISH-positivity (18.5% positive cells) was demonstrated.
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Kerr K, Dafni U, Schulze K, Thunnissen E, Bubendorf L, Hager H, Gately K, Biernat W, Vliegen L, Hernandez Losa J, Marchetti A, Cheney R, Warth A, Speel E, Blackhall F, Molina M, Shames D, Peters S, Stahel R. 3001 Prevalence and clinical association of gene mutations through Multiplex Mutation Testing in patients with NSCLC: Results from the ETOP Lungscape Project. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31647-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hubers AJ, Heideman DAM, Burgers SA, Herder GJM, Sterk PJ, Rhodius RJ, Smit HJ, Krouwels F, Welling A, Witte BI, Duin S, Koning R, Comans EFI, Steenbergen RDM, Postmus PE, Meijer GA, Snijders PJF, Smit EF, Thunnissen E. DNA hypermethylation analysis in sputum for the diagnosis of lung cancer: training validation set approach. Br J Cancer 2015; 112:1105-13. [PMID: 25719833 PMCID: PMC4366885 DOI: 10.1038/bjc.2014.636] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/06/2014] [Accepted: 12/01/2014] [Indexed: 01/22/2023] Open
Abstract
Background: Lung cancer has the highest mortality of all cancers. The aim of this study was to examine DNA hypermethylation in sputum and validate its diagnostic accuracy for lung cancer. Methods: DNA hypermethylation of RASSF1A, APC, cytoglobin, 3OST2, PRDM14, FAM19A4 and PHACTR3 was analysed in sputum samples from symptomatic lung cancer patients and controls (learning set: 73 cases, 86 controls; validation set: 159 cases, 154 controls) by quantitative methylation-specific PCR. Three statistical models were used: (i) cutoff based on Youden's J index, (ii) cutoff based on fixed specificity per marker of 96% and (iii) risk classification of post-test probabilities. Results: In the learning set, approach (i) showed that RASSF1A was best able to distinguish cases from controls (sensitivity 42.5%, specificity 96.5%). RASSF1A, 3OST2 and PRDM14 combined demonstrated a sensitivity of 82.2% with a specificity of 66.3%. Approach (ii) yielded a combination rule of RASSF1A, 3OST2 and PHACTR3 (sensitivity 67.1%, specificity 89.5%). The risk model (approach iii) distributed the cases over all risk categories. All methods displayed similar and consistent results in the validation set. Conclusions: Our findings underscore the impact of DNA methylation markers in symptomatic lung cancer diagnosis. RASSF1A is validated as diagnostic marker in lung cancer.
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Johannesma P, Houweling A, Reinhard R, Thunnissen E, Menko F, van Waesberghe J, Paul M, Horenblas S, Postmus P, van Moorselaar R. Early Detection of Hereditary Renal Cell Cancer By Improved Evaluation of Spontaneous Pneumothorax Patients. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu335.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bubendorf L, Dafni O, Tischler V, Finn S, Biernat W, Verbeken E, Hager H, Murtra N, Thunnissen E, Nonaka D, Warth A, Speel E, Savic S, Martorell M, Tsourti Z, Schulze K, Das-Gupta A, Kerr K, Peters S, Stahel R. Prevalence and Clinical Outcomes for Patients with Met Protein Expression in Patients with Non-Small Cell Lung Cancer in Europe: Results from the European Thoracic Oncology Platform Lungscape Project. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kuiper J, Hendriks L, Buijs E, De Langen J, Bahce I, Thunnissen E, Heideman D, Speel E, Dingemans A, Smit E. Leptomeningeal Metastases in Non-Small Cell Lung Cancer Patients with an Epidermal Growth Factor Receptor Mutation. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dequeker E, Tembuyser L, Tack V, Zwaenepoel K, Pauwels P, Thunnissen E. Importance of External Quality Assessement in Immuno-Oncology. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu321.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bahce I, Vos C, Dickhoff C, Hartemink K, Dahele M, Smit E, Boellaard R, Hoekstra O, Thunnissen E. Metabolic activity measured by FDG PET predicts pathological response in locally advanced superior sulcus NSCLC. Lung Cancer 2014; 85:205-12. [DOI: 10.1016/j.lungcan.2014.04.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/11/2014] [Accepted: 04/15/2014] [Indexed: 10/25/2022]
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Patton S, Normanno N, Blackhall F, Murray S, Kerr KM, Dietel M, Filipits M, Benlloch S, Popat S, Stahel R, Thunnissen E. Assessing standardization of molecular testing for non-small-cell lung cancer: results of a worldwide external quality assessment (EQA) scheme for EGFR mutation testing. Br J Cancer 2014; 111:413-20. [PMID: 24983368 PMCID: PMC4102953 DOI: 10.1038/bjc.2014.353] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 05/19/2014] [Accepted: 05/20/2014] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The external quality assurance (EQA) process aims at establishing laboratory performance levels. Leading European groups in the fields of EQA, Pathology, and Medical and Thoracic Oncology collaborated in a pilot EQA scheme for somatic epidermal growth factor receptor (EGFR) gene mutational analysis in non-small-cell lung cancer (NSCLC). METHODS EQA samples generated from cell lines mimicking clinical samples were provided to participating laboratories, each with a mock clinical case. Participating laboratories performed the analysis using their usual method(s). Anonymous results were assessed and made available to all participants. Two subsequent EQA rounds followed the pilot scheme. RESULTS One hundred and seventeen labs from 30 countries registered and 91 returned results. Sanger sequencing and a commercial kit were the main methodologies used. The standard of genotyping was suboptimal, with a significant number of genotyping errors made. Only 72 out of 91 (72%) participants passed the EQA. False-negative and -positive results were the main sources of error. The quality of reports submitted was acceptable; most were clear, concise and easy to read. However, some participants reported the genotyping result in the absence of any interpretation and many obscured the interpretation required for clinical care. CONCLUSIONS Even in clinical laboratories, the technical performance of genotyping in EGFR mutation testing for NSCLC can be improved, evident from a high level of diagnostic errors. Robust EQA can contribute to global optimisation of EGFR testing for NSCLC patients.
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Kuiper J, Heideman D, Thunnissen E, Paul M, van Wijk A, Postmus P, Smit E. Incidence of T790M mutation in (sequential) rebiopsies in EGFR-mutated NSCLC-patients. Lung Cancer 2014; 85:19-24. [DOI: 10.1016/j.lungcan.2014.03.016] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/11/2014] [Accepted: 03/14/2014] [Indexed: 01/17/2023]
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Kuiper JL, Heideman DAM, Thunnissen E, van Wijk AW, Postmus PE, Smit EF. High-dose, weekly erlotinib is not an effective treatment in EGFR-mutated non-small cell lung cancer-patients with acquired extracranial progressive disease on standard dose erlotinib. Eur J Cancer 2014; 50:1399-401. [PMID: 24582911 DOI: 10.1016/j.ejca.2014.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 02/01/2014] [Indexed: 10/25/2022]
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Vos C, Dahele M, van Sörnsen de Koste J, Senan S, Bahce I, Paul M, Thunnissen E, Smit E, Hartemink K. Semiautomated volumetric response evaluation as an imaging biomarker in superior sulcus tumors. Strahlenther Onkol 2013; 190:204-9. [DOI: 10.1007/s00066-013-0482-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 09/26/2013] [Indexed: 01/24/2023]
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Johannesma PC, Thunnissen E, Postmus PE. Lung cysts as indicator for Birt-Hogg-Dubé syndrome. Lung 2013; 192:215-6. [PMID: 24146214 DOI: 10.1007/s00408-013-9522-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 10/02/2013] [Indexed: 01/30/2023]
Abstract
In this case, we describe a patient with a history of recurrent pneumothorax. Based on CT-thorax and histopathology of the lung tissue, the Birt-Hogg-Dubé syndrome was suspected and confirmed after genetic testing. Recognizing this syndrome by pulmonologists and radiologists is very important, because the risk on developing of renal cell cancer is high.
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Hubers AJ, Prinsen CFM, Sozzi G, Witte BI, Thunnissen E. Molecular sputum analysis for the diagnosis of lung cancer. Br J Cancer 2013; 109:530-7. [PMID: 23868001 PMCID: PMC3738145 DOI: 10.1038/bjc.2013.393] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 05/08/2013] [Accepted: 06/21/2013] [Indexed: 12/20/2022] Open
Abstract
Lung cancer is the leading cause of cancer mortality rate worldwide, mainly because of the presence of metastatic disease at the time of diagnosis. Early detection of lung cancer improves prognosis, and towards this end, large screening trials in high-risk individuals have been conducted since the past century. Despite all efforts, the need for novel (complementary) lung cancer diagnostic and screening methods still exists. In this review, we focus on the assessment of lung cancer-related biomarkers in sputum in the past decennium. Besides cytology, mutation and microRNA analysis, special attention has been paid to DNA promoter hypermethylation, of which all available literature is summarised without time restriction. A model is proposed to aid in the distinction between diagnostic and risk markers. Research on the use of sputum for non-invasive detection of early-stage lung cancer has brought new insights and advanced molecular techniques. The sputum shows a promising potential for routine diagnostic and possibly screening purposes.
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Vos C, Hartemink K, Blaauwgeers J, Oosterhuis J, Senan S, Smit E, Thunnissen E, Paul M. Trimodality therapy for superior sulcus tumours: Evolution and evaluation of a treatment protocol. Eur J Surg Oncol 2013; 39:197-203. [DOI: 10.1016/j.ejso.2012.09.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/03/2012] [Accepted: 09/26/2012] [Indexed: 11/27/2022] Open
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van Riel S, Thunnissen E, Heideman D, Smit EF, Biesma B. A patient with simultaneously appearing adenocarcinoma and small-cell lung carcinoma harbouring an identical EGFR exon 19 mutation. Ann Oncol 2012; 23:3188-3189. [PMID: 23079729 DOI: 10.1093/annonc/mds525] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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46
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Normanno N, Patton S, Blackhall F, Murray S, Kerr K, Dietel M, Filipits M, Benlloch S, Stahel R, Thunnissen E. Results of the Second Pilot External Quality Assurance Scheme for Somatic Egfr Mutation Testing in Non-Small-Cell Lung Cancer (NSCLC). Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32779-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Blackhall F, Peters S, Kerr K, O'Byrne K, Hager H, Sejda A, Soltermann A, Dooms C, Felip E, Marchetti A, Speel EJ, Price N, Savic S, de Jong J, Martorell M, Thunnissen E, Bubendorf L, Dafni O, Rosell R, Stahel R. Prevalence and Clinical Outcomes for Patients With ALK Gene Rearrangement in Europe: Preliminary Results from the European Thoracic Oncology Platform Lungscape Project. Ann Oncol 2012. [DOI: 10.1093/annonc/mds391] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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48
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Normanno N, Patton S, Murray S, Blackhall F, Kerr K, Dietel M, Filipits M, Taron M, Stahel R, Thunnissen E. Results of a Pilot External Quality Assurance Scheme for Somatic EGFR Mutation Testing in Non-Small Cell Lung Cancer Managed by EMQN, ESMO, ESP, and ETOP. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70125-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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49
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van Klaveren RV, Oudkerk M, Mali W, Scholten E, Nackaerts K, Thunnissen E, de Koning HJ. Baseline and second round results from the population based Dutch-Belgian randomized lung cancer screening trial (NELSON). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Pelosi G, Fabbri A, Leon M, Masullo M, Sozzi G, Thunnissen E, Prinsen C, Sonzogni A, Viale G, Pastorino U. P-669 Pathological, immunohistochemical and molecular features ofscreening spiral computed tomography (SCT)-detected lung cancers. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81162-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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