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Mari R, Mamessier E, Lambaudie E, Provansal M, Birnbaum D, Bertucci F, Sabatier R. Liquid Biopsies for Ovarian Carcinoma: How Blood Tests May Improve the Clinical Management of a Deadly Disease. Cancers (Basel) 2019; 11:E774. [PMID: 31167492 PMCID: PMC6627130 DOI: 10.3390/cancers11060774] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 02/07/2023] Open
Abstract
Ovarian cancers (OvC) are frequent, with more than 22,000 new cases each year for 14,000 deaths in the United States. Except for patients with BRCA1 or BRCA2 mutations, diagnostic methods, prognostic tools, and therapeutic strategies have not much improved in the last two decades. High throughput tumor molecular analyses have identified important alterations involved in ovarian carcinoma growth and spreading. However, these data have not modified the clinical management of most of patients. Moreover, tumor sample collection requires invasive procedures not adapted to objectives, such as the screening, prediction, or assessment of treatment efficacy, monitoring of residual disease, and early diagnosis of relapse. In recent years, circulating tumor biomarkers (also known as "liquid biopsies") such as circulating tumor cells, circulating nucleotides (DNA or miRNA), or extracellular vesicles, have been massively explored through various indications, platforms, and goals, but their use has not yet been validated in routine practice. This review describes the methods of analysis and results related to liquid biopsies for ovarian epithelial cancer. The different settings that a patient can go through during her journey with OvC are explored: screening and early diagnosis, prognosis, prediction of response to systemic therapies for advanced stages, and monitoring of residual subclinical disease.
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Affiliation(s)
- Roxane Mari
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Emilie Mamessier
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Eric Lambaudie
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Magali Provansal
- Department of Medical Oncology, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Daniel Birnbaum
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - François Bertucci
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Renaud Sabatier
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
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Mari R, Mamessier E, Lambaudie E, Provansal M, Birnbaum D, Bertucci F, Sabatier R. Liquid Biopsies for Ovarian Carcinoma: How Blood Tests May Improve the Clinical Management of a Deadly Disease. Cancers (Basel) 2019. [PMID: 31167492 DOI: 10.3390/cancers11060774] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ovarian cancers (OvC) are frequent, with more than 22,000 new cases each year for 14,000 deaths in the United States. Except for patients with BRCA1 or BRCA2 mutations, diagnostic methods, prognostic tools, and therapeutic strategies have not much improved in the last two decades. High throughput tumor molecular analyses have identified important alterations involved in ovarian carcinoma growth and spreading. However, these data have not modified the clinical management of most of patients. Moreover, tumor sample collection requires invasive procedures not adapted to objectives, such as the screening, prediction, or assessment of treatment efficacy, monitoring of residual disease, and early diagnosis of relapse. In recent years, circulating tumor biomarkers (also known as "liquid biopsies") such as circulating tumor cells, circulating nucleotides (DNA or miRNA), or extracellular vesicles, have been massively explored through various indications, platforms, and goals, but their use has not yet been validated in routine practice. This review describes the methods of analysis and results related to liquid biopsies for ovarian epithelial cancer. The different settings that a patient can go through during her journey with OvC are explored: screening and early diagnosis, prognosis, prediction of response to systemic therapies for advanced stages, and monitoring of residual subclinical disease.
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Affiliation(s)
- Roxane Mari
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Emilie Mamessier
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Eric Lambaudie
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Magali Provansal
- Department of Medical Oncology, Institut Paoli-Calmettes, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Daniel Birnbaum
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - François Bertucci
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
| | - Renaud Sabatier
- CRCM-Predictive Oncology laboratory, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
- CRCM-Department of Medical Oncology, Institut Paoli-Calmettes, Inserm, CNRS, Aix-Marseille Univ, 232 Boulevard Sainte Marguerite, 13009 Marseille, France.
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53
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Oikkonen J, Zhang K, Salminen L, Schulman I, Lavikka K, Andersson N, Ojanperä E, Hietanen S, Grénman S, Lehtonen R, Huhtinen K, Carpén O, Hynninen J, Färkkilä A, Hautaniemi S. Prospective Longitudinal ctDNA Workflow Reveals Clinically Actionable Alterations in Ovarian Cancer. JCO Precis Oncol 2019; 3:1800343. [PMID: 32914024 PMCID: PMC7446450 DOI: 10.1200/po.18.00343] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2019] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Circulating tumor DNA (ctDNA) detection is a minimally invasive technique that offers dynamic molecular snapshots of genomic alterations in cancer. Although ctDNA markers can be used for early detection of cancers or for monitoring treatment efficacy, the value of ctDNA in guiding treatment decisions in solid cancers is controversial. Here, we monitored ctDNA to detect clinically actionable alterations during treatment of high-grade serous ovarian cancer, the most common and aggressive form of epithelial ovarian cancer with a 5-year survival rate of 43%. PATIENTS AND METHODS We implemented a clinical ctDNA workflow to detect clinically actionable alterations in more than 500 cancer-related genes. We applied the workflow to a prospective cohort consisting of 78 ctDNA samples from 12 patients with high-grade serous ovarian cancer before, during, and after treatment. These longitudinal data sets were analyzed using our open-access ctDNA-tailored bioinformatics analysis pipeline and in-house Translational Oncology Knowledgebase to detect clinically actionable genomic alterations. The alterations were ranked according to the European Society for Medical Oncology scale for clinical actionability of molecular targets. RESULTS Our results show good concordance of mutations and copy number alterations in ctDNA and tumor samples, and alterations associated with clinically available drugs were detected in seven patients (58%). Treatment of one chemoresistant patient was changed on the basis of detection of ERBB2 amplification, and this ctDNA-guided decision was followed by significant tumor shrinkage and complete normalization of the cancer antigen 125 tumor marker. CONCLUSION Our results demonstrate a proof of concept for using ctDNA to guide clinical decisions. Furthermore, our results show that longitudinal ctDNA samples can be used to identify poor-responding patients after first cycles of chemotherapy. We provide what we believe to be the first comprehensive, open-source ctDNA workflow for detecting clinically actionable alterations in solid cancers.
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Affiliation(s)
- Jaana Oikkonen
- Research Program in Systems Oncology, University of Helsinki, Finland
| | - Kaiyang Zhang
- Research Program in Systems Oncology, University of Helsinki, Finland
| | | | - Ingrid Schulman
- Research Program in Systems Oncology, University of Helsinki, Finland
| | - Kari Lavikka
- Research Program in Systems Oncology, University of Helsinki, Finland
| | - Noora Andersson
- Research Program in Systems Oncology, University of Helsinki, Finland
| | - Erika Ojanperä
- Research Program in Systems Oncology, University of Helsinki, Finland
| | | | | | - Rainer Lehtonen
- Research Program in Systems Oncology, University of Helsinki, Finland
| | - Kaisa Huhtinen
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Olli Carpén
- Research Program in Systems Oncology, University of Helsinki, Finland.,Institute of Biomedicine, University of Turku, Turku, Finland.,Helsinki University Hospital, Helsinki, Finland
| | | | - Anniina Färkkilä
- Research Program in Systems Oncology, University of Helsinki, Finland.,Helsinki University Hospital, Helsinki, Finland.,Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Sampsa Hautaniemi
- Research Program in Systems Oncology, University of Helsinki, Finland
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Colombo N, Sessa C, Bois AD, Ledermann J, McCluggage WG, McNeish I, Morice P, Pignata S, Ray-Coquard I, Vergote I, Baert T, Belaroussi I, Dashora A, Olbrecht S, Planchamp F, Querleu D. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Int J Gynecol Cancer 2019; 29:ijgc-2019-000308. [PMID: 31048403 DOI: 10.1136/ijgc-2019-000308] [Citation(s) in RCA: 133] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/25/2019] [Indexed: 12/29/2022] Open
Abstract
The development of guidelines is one of the core activities of the European Society for Medical Oncology (ESMO) and European Society of Gynaecologial Oncology (ESGO), as part of the mission of both societies to improve the quality of care for patients with cancer across Europe. ESMO and ESGO jointly developed clinically relevant and evidence-based recommendations in several selected areas in order to improve the quality of care for women with ovarian cancer. The ESMO-ESGO consensus conference on ovarian cancer was held on April 12-14, 2018 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of ovarian cancer. Before the conference, the expert panel worked on five clinically relevant questions regarding ovarian cancer relating to each of the following four areas: pathology and molecular biology, early-stage and borderline tumours, advanced stage disease and recurrent disease. Relevant scientific literature, as identified using a systematic search, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. The recommendations presented here are thus based on the best available evidence and expert agreement. This article presents the recommendations of this ESMO-ESGO consensus conference, together with a summary of evidence supporting each recommendation.
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Affiliation(s)
- N Colombo
- Division of Medical Gynecologic Oncology, European Institute of Oncology IRCCS, University of Milan-Bicocca, Milan, Italy
| | - C Sessa
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - A du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - J Ledermann
- Department of Oncology and Cancer Trials, UCL Cancer Institute, London, UK
| | - W G McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
| | - I McNeish
- Department of Surgery and Cancer, Imperial College, London, UK
| | - P Morice
- Department of Gynecologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Pignata
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy
| | - I Ray-Coquard
- Department of Medical and Surgical Oncology, Centre Léon Bérard, Lyon, France
| | - I Vergote
- Department of Gynaecological Oncology, Leuven Cancer Institute, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - T Baert
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - I Belaroussi
- Department of Gynecologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - A Dashora
- Department of Cellular Pathology, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
| | - S Olbrecht
- Department of Gynaecological Oncology, Leuven Cancer Institute, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - F Planchamp
- Clinical Research Unit, Institut Bergonié, Bordeaux, France
| | - D Querleu
- Department of Surgery, Institut Bergonié, Bordeaux, France
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55
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Colombo N, Sessa C, du Bois A, Ledermann J, McCluggage WG, McNeish I, Morice P, Pignata S, Ray-Coquard I, Vergote I, Baert T, Belaroussi I, Dashora A, Olbrecht S, Planchamp F, Querleu D. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease†. Ann Oncol 2019; 30:672-705. [PMID: 31046081 DOI: 10.1093/annonc/mdz062] [Citation(s) in RCA: 591] [Impact Index Per Article: 118.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
The development of guidelines recommendations is one of the core activities of the European Society for Medical Oncology (ESMO) and European Society of Gynaecologial Oncology (ESGO), as part of the mission of both societies to improve the quality of care for patients with cancer across Europe. ESMO and ESGO jointly developed clinically relevant and evidence-based recommendations in several selected areas in order to improve the quality of care for women with ovarian cancer. The ESMO-ESGO consensus conference on ovarian cancer was held on 12-14 April 2018 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of ovarian cancer. Before the conference, the expert panel worked on five clinically relevant questions regarding ovarian cancer relating to each of the following four areas: pathology and molecular biology, early-stage and borderline tumours, advanced stage disease and recurrent disease. Relevant scientific literature, as identified using a systematic search, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. The recommendations presented here are thus based on the best available evidence and expert agreement. This article presents the recommendations of this ESMO-ESGO consensus conference, together with a summary of evidence supporting each recommendation.
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Affiliation(s)
- N Colombo
- Division of Medical Gynecologic Oncology, European Institute of Oncology IRCCS, University of Milan-Bicocca, Milan, Italy.
| | - C Sessa
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - A du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - J Ledermann
- Department of Oncology and Cancer Trials, UCL Cancer Institute, London
| | - W G McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast
| | - I McNeish
- Department of Surgery and Cancer, Imperial College, London, UK
| | - P Morice
- Department of Gynecologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Pignata
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS 'Fondazione G. Pascale', Naples, Italy
| | - I Ray-Coquard
- Department of Medical and Surgical Oncology, Centre Léon Bérard, Lyon, France
| | - I Vergote
- Department of Gynaecological Oncology, Leuven Cancer Institute, Leuven; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - T Baert
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - I Belaroussi
- Department of Gynecologic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - A Dashora
- Department of Cellular Pathology, Maidstone and Tunbridge Wells NHS Trust, Kent, UK
| | - S Olbrecht
- Department of Gynaecological Oncology, Leuven Cancer Institute, Leuven; Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | | | - D Querleu
- Department of Surgery, Institut Bergonié, Bordeaux, France.
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Keserű JS, Soltész B, Lukács J, Márton É, Szilágyi-Bónizs M, Penyige A, Póka R, Nagy B. Detection of cell-free, exosomal and whole blood mitochondrial DNA copy number in plasma or whole blood of patients with serous epithelial ovarian cancer. J Biotechnol 2019; 298:76-81. [PMID: 31002856 DOI: 10.1016/j.jbiotec.2019.04.015] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/15/2019] [Accepted: 04/15/2019] [Indexed: 01/05/2023]
Abstract
Ovarian tumor is one of the leading causes of cancer among women. Patients are diagnosed at an advanced stage, usually. There is a need for new specific and sensitive biomarkers. Mitochondrial DNA copy number change was observed in various cancers. Our aim was to detect mitochondrial DNA copy number in whole blood (wb-mtDNA) and in plasma (cell-free and exosome encapsulated mtDNA) in patients with serous epithelial ovarian tumor. DNA was isolated from EDTA blood and plasma obtained from 24 patients and 24 healthy controls. Exosomes were isolated from cell-free plasma, and exosome encapsulated DNA (exoDNA) was extracted. Quantitative-real-time PCR was performed with Human Mitochondrial DNA (mtDNA) Monitoring Primer Set. Kruskall‑Wallis and Mann‑Whitney U test were used for data analysis. Wb-mtDNA copy number was significantly different among healthy controls and patients in multiple comparison (p = 0.0090 considering FIGO stage independently, and p = 0.0048 considering early- and late-stage cancers). There was a significant decrease among early-stage, all advanced stage and all cancer patients (FIGO I: 32.5 ± 8.3, p = 0.0061; FIGO III + IV: 37.2 ± 13.7 p = 0.0139; FIGO I + III + IV: 35.6 ± 12.2, p = 0.0017) or FIGO III patients alone (32.8 ± 5.6, p = 0.00089) compared to healthy controls. We found significant increase in copy number in exosomal mtDNA in cancer patients (236.0 ± 499.0, p = 0.0155), advanced-stage cancer patients (333.0 ± 575.0, p = 0.0095), of FIGO III (362.0 ± 609.2, p = 0.0494), and FIGO IV (304.0 ± 585.0, p = 0.0393) patients alone but not in samples of FIGO I patients (10.0 ± 3.5, p = 0.3907). In multiple comparison the increase was significant considering early- and late-stage cancers (p = 0.0253). Cell-free mtDNA copy numbers were not increased significantly. We found the highest copy number of mtDNA in exosomes, followed by plasma and peripheral blood in late-stage cancer patients. We observed significant difference in wb-mtDNA copy number between healthy controls and both early- and late-stage cancer patients.
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Affiliation(s)
- Judit Szilvia Keserű
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - Beáta Soltész
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - János Lukács
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Éva Márton
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Melinda Szilágyi-Bónizs
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - András Penyige
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Róbert Póka
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bálint Nagy
- Department of Human Genetics, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Schwich E, Rebmann V, Michita RT, Rohn H, Voncken JW, Horn PA, Kimmig R, Kasimir-Bauer S, Buderath P. HLA-G 3' untranslated region variants +3187G/G, +3196G/G and +3035T define diametrical clinical status and disease outcome in epithelial ovarian cancer. Sci Rep 2019; 9:5407. [PMID: 30932005 PMCID: PMC6443684 DOI: 10.1038/s41598-019-41900-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 03/01/2019] [Indexed: 12/19/2022] Open
Abstract
Expression of the non-classical human leukocyte antigen-G (HLA-G) promotes cancer progression in various malignancies including epithelial ovarian cancer (EOC). As single nucleotide polymorphisms (SNPs) in the HLA-G 3' untranslated region (UTR) regulate HLA-G expression, we investigated HLA-G 3'UTR haplotypes arranged by SNPs in healthy controls (n = 75) and primary EOC patients (n = 79) and determined soluble HLA-G (sHLA-G) levels. Results were related to the clinical status and outcome. Although haplotype frequencies were similar in patients and controls, (i) sHLA-G levels were increased in EOC independent of the haplotype, (ii) homozygosity for UTR-1 or UTR-2 genotypes were significantly associated with metastases formation and presence of circulating tumor cells before therapy, whereas (iii) the UTR-5 and UTR-7 haplotypes were significantly associated with a beneficial clinical outcome regarding negative nodal status, early FIGO staging, and improved overall survival. Lastly, (iv) the ambivalent impact on clinical EOC aspects could be deduced to specific SNPs in the HLA-G 3'UTR: +3187G, +3196G and +3035T alleles. Our results give evidence that even if the genetic background of the HLA-G 3'UTR is identical between patients and controls, certain SNPs have the potential to contribute to diametrical clinical status/outcome in EOC.
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Affiliation(s)
- Esther Schwich
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany
| | - Vera Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany.
| | - Rafael Tomoya Michita
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany
- Genetics Department, Post-Graduation Program in Genetics and Molecular Biology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Hana Rohn
- Department of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Jan Willem Voncken
- Molecular Genetics, Maastricht University, PO Box 6161, 6200 MD, Maastricht, Netherlands
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147, Essen, Germany
| | - Rainer Kimmig
- Department for Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Sabine Kasimir-Bauer
- Department for Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Paul Buderath
- Department for Gynecology and Obstetrics, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
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58
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Hallal S, Ebrahimkhani S, Shivalingam B, Graeber MB, Kaufman KL, Buckland ME. The emerging clinical potential of circulating extracellular vesicles for non-invasive glioma diagnosis and disease monitoring. Brain Tumor Pathol 2019; 36:29-39. [PMID: 30859343 DOI: 10.1007/s10014-019-00335-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 02/27/2019] [Indexed: 12/25/2022]
Abstract
Diffuse gliomas (grades II-IV) are amongst the most frequent and devastating primary brain tumours of adults. Currently, patients are monitored by clinical examination and radiographic imaging, which can be challenging to interpret and insensitive to early signs of treatment failure and tumour relapse. While brain biopsy and histologic analysis can evaluate disease progression, serial biopsies are invasive and impractical given the cumulative surgical risk, and may not capture the complete molecular landscape of an evolving tumour. The availability of a minimally invasive 'liquid biopsy' that could assess tumour activity and molecular phenotype in situ has the potential to greatly enhance patient care. Circulating extracellular vesicles (EVs) hold significant promise as robust disease-specific biomarkers accessible in the blood of patients with glioblastoma and other diffuse gliomas. EVs are membrane-bound nanoparticles shed from most if not all cells of the body, and carry DNA, RNA, protein, and lipids that reflect the identity and molecular state of their cell-of-origin. EVs can cross the blood-brain barrier and their release is upregulated in neoplasia. In this review, we describe the current knowledge of EV biology, the role of EVs in glioma biology and the current experience and challenges in profiling glioma-EVs from the circulation.
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Affiliation(s)
- Susannah Hallal
- Brainstorm Brain Cancer Research, Brain Tumour Research Laboratories, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,Discipline of Pathology, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Saeideh Ebrahimkhani
- Discipline of Pathology, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Department of Neuropathology, Royal Prince Alfred Hospital, Brain and Mind Centre, Camperdown, NSW, Australia
| | - Brindha Shivalingam
- Department of Neurosurgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Manuel B Graeber
- Brain Tumour Research Laboratories, Brain and Mind Centre, Charles Perkins Centre, Bosch Institute and School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Kimberley L Kaufman
- Brainstorm Brain Cancer Research, Brain Tumour Research Laboratories, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.,Discipline of Pathology, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,Department of Neurosurgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Michael E Buckland
- Brainstorm Brain Cancer Research, Brain Tumour Research Laboratories, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia. .,Discipline of Pathology, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia. .,Department of Neuropathology, Royal Prince Alfred Hospital, Brain and Mind Centre, Camperdown, NSW, Australia.
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Liquid biopsy in ovarian cancer: the potential of circulating miRNAs and exosomes. Transl Res 2019; 205:77-91. [PMID: 30391474 DOI: 10.1016/j.trsl.2018.10.003] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/08/2018] [Accepted: 10/08/2018] [Indexed: 02/06/2023]
Abstract
Ovarian cancer still remains the most lethal female cancer, since in most cases it is diagnosed at an advanced stage. Usually after completion of primary treatment chemoresistance occurs, and recurrent disease is finally observed. Liquid biopsy, based on minimally invasive and serial blood tests, has the advantage of following tumor evolution in real time, offering novel insights on precision medicine. Circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), circulating cell-free microRNAs (cfmiRNAs) and circulating exosomes represent the major components of liquid biopsy analysis. Liquid biopsy has been already implemented in ovarian cancer, and most studies so far are mainly focused on CTCs and ctDNA. This review is mainly focused on the clinical potential of circulating miRNAs and exosomes as a source of liquid biopsy biomarkers in ovarian cancer diagnosis, prognosis, and response to treatment.
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