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Yoon HJ, Sohn I, Cho JH, Lee HY, Kim JH, Choi YL, Kim H, Lee G, Lee KS, Kim J. Decoding Tumor Phenotypes for ALK, ROS1, and RET Fusions in Lung Adenocarcinoma Using a Radiomics Approach. Medicine (Baltimore) 2015; 94:e1753. [PMID: 26469915 PMCID: PMC4616787 DOI: 10.1097/md.0000000000001753] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Quantitative imaging using radiomics can capture distinct phenotypic differences between tumors and may have predictive power for certain phenotypes according to specific genetic mutations. We aimed to identify the clinicoradiologic predictors of tumors with ALK (anaplastic lymphoma kinase), ROS1 (c-ros oncogene 1), or RET (rearranged during transfection) fusions in patients with lung adenocarcinoma.A total of 539 pathologically confirmed lung adenocarcinomas were included in this retrospective study. The baseline clinicopathologic characteristics were retrieved from the patients' medical records and the ALK/ROS1/RET fusion status was reviewed. Quantitative computed tomography (CT) and positron emission tomography imaging characteristics were evaluated using a radiomics approach. Significant features for the fusion-positive tumor prediction model were extracted from all of the clinicoradiologic features, and were used to calculate diagnostic performance for predicting 3 fusions' positivity. The clinicoradiologic features were compared between ALK versus ROS1/RET fusion-positive tumors to identify the clinicoradiologic similarity between the 2 groups.The fusion-positive tumor prediction model was a combination of younger age, advanced tumor stage, solid tumor on CT, higher values for SUV(max) and tumor mass, lower values for kurtosis and inverse variance on 3-voxel distance than those of fusion-negative tumors (sensitivity and specificity, 0.73 and 0.70, respectively). ALK fusion-positive tumors were significantly different in tumor stage, central location, SUV(max), homogeneity on 1-, 2-, and 3-voxel distances, and sum mean on 2-voxel distance compared with ROS1/RET fusion-positive tumors.ALK/ROS1/RET fusion-positive lung adenocarcinomas possess certain clinical and imaging features that enable good discrimination of fusion-positive from fusion-negative lung adenocarcinomas.
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Affiliation(s)
- Hyun Jung Yoon
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (HJY, HYL, J-HK, KSL); Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea (IS, HK); Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (JHC, JK); Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (Y-LC); Department of Nursing, Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center, Samsumg Medical Center, Seoul, Korea (GL); and Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea (HJY)
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Gilardi L, de Marinis F, Grana CM. PET/CT characterization of non-small-cell lung cancer heterogeneity. Nucl Med Commun 2015; 36:411-3. [PMID: 25816217 DOI: 10.1097/mnm.0000000000000270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Laura Gilardi
- aDivision of Nuclear Medicine bThoracic Oncology Division, European Institute of Oncology, Milan, Italy
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Role of Imaging Biomarkers in Predicting Anaplastic Lymphoma Kinase–Positive Lung Adenocarcinoma. Clin Nucl Med 2015; 40:e34-9. [DOI: 10.1097/rlu.0000000000000581] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Ha S, Choi H, Cheon GJ, Kang KW, Chung JK, Kim EE, Lee DS. Autoclustering of Non-small Cell Lung Carcinoma Subtypes on (18)F-FDG PET Using Texture Analysis: A Preliminary Result. Nucl Med Mol Imaging 2014; 48:278-86. [PMID: 26396632 DOI: 10.1007/s13139-014-0283-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/20/2014] [Accepted: 05/22/2014] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Texture analysis on (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) scan is a relatively new imaging analysis tool to evaluate metabolic heterogeneity. We analyzed the difference in textural characteristics between non-small cell lung carcinoma (NSCLC) subtypes, namely adenocarcinoma (ADC) and squamous cell carcinoma (SqCC). METHODS Diagnostic (18)F-FDG PET/computed tomography (CT) scans of 30y patients (median age, 67; range, 42-88) with NSCLC (17 ADC and 13 SqCC) were retrospectively analyzed. Regions of interest were manually determined on selected transverse image containing the highest SUV value in tumors. Texture parameters were extracted by histogram-based algorithms, absolute gradient-based algorithms, run-length matrix-based algorithms, co-occurrence matrix-based algorithms, and autoregressive model-based algorithms. Twenty-four out of hundreds of texture features were selected by three algorithms: Fisher coefficient, minimization of both classification error probability and average correlation, and mutual information. Automated clustering of tumors was based on the most discriminating feature calculated by linear discriminant analysis (LDA). Each tumor subtype was determined by histopathologic examination after biopsy and surgery. RESULTS Fifteen texture features had significant different values between ADC and SqCC. LDA with 24 automate-selected texture features accurately clustered between ADC and SqCC with 0.90 linear separability. There was no high correlation between SUVmax and texture parameters (|r| ≤ 0.62). CONCLUSION Each subtype of NSCLC tumor has different metabolic heterogeneity. The results of this study support the potential of textural parameters on FDG PET as an imaging biomarker.
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Affiliation(s)
- Seunggyun Ha
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea
| | - Hongyoon Choi
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea ; Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu Seoul, 110-744 Korea
| | - Keon Wook Kang
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Euishin Edmund Kim
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea ; Department of Radiological Science, University of California at Irvine, Irvine, CA USA
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea ; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, and College of Medicine or College of Pharmacy, Seoul National University, Seoul, Korea
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Ko SJ, Lee YJ, Park JS, Cho YJ, Yoon HI, Chung JH, Kim TJ, Lee KW, Kim K, Jheon S, Kim H, Lee JH, Lee CT. Epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangements in lung cancer with nodular ground-glass opacity. BMC Cancer 2014; 14:312. [PMID: 24885886 PMCID: PMC4022408 DOI: 10.1186/1471-2407-14-312] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 04/24/2014] [Indexed: 12/21/2022] Open
Abstract
Background Nodular ground-glass opacities (nGGO) are a specific type of lung adenocarcinoma. ALK rearrangements and driver mutations such as EGFR and K-ras are frequently found in all types of lung adenocarcinoma. EGFR mutations play a role in the early carcinogenesis of nGGOs, but the role of ALK rearrangement remains unknown. Methods We studied 217 nGGOs resected from 215 lung cancer patients. Pathology, tumor size, tumor disappearance rate, and the EGFR and ALK markers were analyzed. Results All but one of the resected nGGOs were adenocarcinomas. ALK rearrangements and EGFR mutations were found in 6 (2.8%) and 119 (54.8%) cases. The frequency of ALK rearrangement in nGGO was significantly lower than previously reported in adenocarcinoma. Advanced disease stage (p = 0.018) and larger tumor size (p = 0.037) were more frequent in the ALK rearrangement-positive group than in ALK rearrangement-negative patients. nGGOs with ALK rearrangements were associated with significantly higher pathologic stage and larger maximal and solid diameter in comparison to EGFR-mutated lesions. Conclusion ALK rearrangement is rare in lung cancer with nGGOs, but is associated with advanced stage and larger tumor size, suggesting its association with aggressive progression of lung adenocarcinoma. ALK rearrangement may not be important in early pathogenesis of nGGO.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Choon-Taek Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
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Lennon FE, Salgia R. Mitochondrial dynamics: biology and therapy in lung cancer. Expert Opin Investig Drugs 2014; 23:675-92. [PMID: 24654596 DOI: 10.1517/13543784.2014.899350] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Lung cancer mortality rates remain at unacceptably high levels. Although mitochondrial dysfunction is a characteristic of most tumor types, mitochondrial dynamics are often overlooked. Altered rates of mitochondrial fission and fusion are observed in lung cancer and can influence metabolic function, proliferation and cell survival. AREAS COVERED In this review, the authors outline the mechanisms of mitochondrial fission and fusion. They also identify key regulatory proteins and highlight the roles of fission and fusion in metabolism and other cellular functions (e.g., proliferation, apoptosis) with an emphasis on lung cancer and the interaction with known cancer biomarkers. They also examine the current therapeutic strategies reported as altering mitochondrial dynamics and review emerging mitochondria-targeted therapies. EXPERT OPINION Mitochondrial dynamics are an attractive target for therapeutic intervention in lung cancer. Mitochondrial dysfunction, despite its molecular heterogeneity, is a common abnormality of lung cancer. Targeting mitochondrial dynamics can alter mitochondrial metabolism, and many current therapies already non-specifically affect mitochondrial dynamics. A better understanding of mitochondrial dynamics and their interaction with currently identified cancer 'drivers' such as Kirsten-Rat Sarcoma Viral Oncogene homolog will lead to the development of novel therapeutics.
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Affiliation(s)
- Frances E Lennon
- University of Chicago, Department of Medicine, Section of Hematology/Oncology , 5841 S. Maryland Avenue, MC 2115 Chicago, IL 60637 , USA +1 773 702 4399 ; +1 773 834 1798 ;
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Fallet V, Cadranel J, Doubre H, Toper C, Monnet I, Chinet T, Oliviero G, Foulon G, De Cremoux H, Vieira T, Antoine M, Wislez M. Prospective screening for ALK: clinical features and outcome according to ALK status. Eur J Cancer 2014; 50:1239-46. [PMID: 24589437 DOI: 10.1016/j.ejca.2014.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/09/2014] [Accepted: 02/03/2014] [Indexed: 01/30/2023]
Abstract
The aim of this study was to analyse the clinico-pathological characteristics and outcomes of a cohort of French patients who were prospectively screened for Anaplastic Lymphoma Kinase (ALK) rearrangement. One hundred and sixteen consecutive patients screened for ALK rearrangement to be recruited into a crizotinib registration trial were included from eight French centres. ALK rearrangement was detected by fluorescence in situ hybridization. Seventeen patients (14.6%) were positive for ALK. ALK+ patients were younger (p = 0.049) and more likely to be males (p=0.032), non- or light-smokers (p = 0.048) and without underlying respiratory disease (p=0.025) compared to ALK- patients. Thyroid-transcription factor-1 expression was present in all ALK+ tumours. ALK+ tumours tended to have lymph node and brain metastases. In multivariate analyses, gender, smoking history and N stage were independently associated with ALK status. Median overall survival (OS) was not reached for ALK+ patients and was significantly longer than for ALK- patients (hazard ratio for death for ALK- patients 2.98; 95% CI [1.29-6.90], p=0.01). French ALK+ patients present a specific phenotype. ALK rearrangement should be determined to improve OS with an effective targeted therapy.
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Affiliation(s)
- Vincent Fallet
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service de Pneumologie, Hôpital Tenon APHP, Paris, France
| | - Jacques Cadranel
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service de Pneumologie, Hôpital Tenon APHP, Paris, France
| | - Hélène Doubre
- Service de Pneumologie, Hôpital Foch, Suresnes, France
| | - Cécile Toper
- Service de Pneumologie, Hôpital Tenon APHP, Paris, France
| | - Isabelle Monnet
- Service de Pneumologie et Pathologie Professionnelle, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Thierry Chinet
- Service de Pneumologie, Hôpital Ambroise Paré APHP, Boulogne-Billancourt, France
| | - Gérard Oliviero
- Service de Pneumologie, Centre Hospitalier de Longjumeau, Longjumeau, France
| | - Guillaume Foulon
- Service de Pneumologie, Hôpital Max Fourestier, Nanterre, France
| | - Hubert De Cremoux
- Service de Pneumologie, Centre Hospitalier d'Argenteuil, Argenteuil, France
| | - Thibault Vieira
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France
| | - Martine Antoine
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service d'Anatomo-Pathologie, Hôpital Tenon APHP, Paris, France
| | - Marie Wislez
- GRC-04-Theranoscan, Université Pierre et Marie Curie, Paris, France; Service de Pneumologie, Hôpital Tenon APHP, Paris, France.
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Kim MH, Shim HS, Kang DR, Jung JY, Lee CY, Kim DJ, Lee JG, Bae MK, Kim HR, Lim SM, Kim EY, Park JS, Chung KY, Kim HJ, Kim JH, Cho BC. Clinical and prognostic implications of ALK and ROS1 rearrangements in never-smokers with surgically resected lung adenocarcinoma. Lung Cancer 2014; 83:389-95. [PMID: 24462463 DOI: 10.1016/j.lungcan.2014.01.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 12/30/2013] [Accepted: 01/03/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The aim of this study is to evaluate the prevalence and prognostic significance of anaplastic lymphoma kinase (ALK) and c-ros oncogene 1 (ROS1) rearrangement in never-smokers with surgically resected lung adenocarcinoma. METHODS We retrospectively analyzed 162 consecutive never-smokers who underwent curative resection for stage IB to IIIA lung adenocarcinoma at a single institution. We concurrently analyzed mutations in the epidermal growth factor receptor (EGFR) and v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) genes, and investigated ALK rearrangements by fluorescence in situ hybridization assay. ROS1 rearrangement was also determined in all triple (EGFR/KRAS/ALK)-negative tumors. RESULTS Of 162 never smokers with lung adenocarcinoma, 14 (8.6%) and 5 (3.1%) had ALK and ROS1 rearrangements, respectively. Nineteen of the 74 (25.7%) EGFR and KRAS mutation-negative patients were fusion-positive (ALK or ROS1 fusion). Fusion-positive patients tended to have shorter median disease-free survival (DFS) than fusion-negative patients (28.0 vs. 33.9 months; p=0.128). In multivariate analysis, fusion-positive patients had significantly poorer DFS than fusion-negative patients after adjustment for age, sex, T stage, N stage, and adjuvant chemotherapy use (p=0.022; hazard ratio, 2.11; 95% confidence interval, 1.19-4.30). The first recurrence sites were not significantly different between fusion-positive and fusion-negative patients in this study. CONCLUSION This study shows significantly poorer DFS of ALK or ROS1 fusion-positive lung adenocarcinoma in never-smokers after curative surgery.
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Affiliation(s)
- Min Hwan Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyo Sup Shim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae Ryong Kang
- Biostatistics Collaboration Unit, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Ye Jung
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Young Lee
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae Joon Kim
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Gu Lee
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Mi Kyung Bae
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Ryun Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Min Lim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Young Kim
- Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Soo Park
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyung Young Chung
- Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jung Kim
- JEUK Institute for Cancer Research, JEUK Co., Ltd., Gumi-City, Kyungbuk, Republic of Korea
| | - Joo Hang Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoung Chul Cho
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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