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Vikkula J, Uusi-Rauva K, Ranki T, Toppila I, Aalto-Setälä M, Pousar K, Vassilev L, Porkka K, Silvennoinen R, Brück O. Real-world evidence of multiple myeloma treated from 2013 to 2019 in the Hospital District of Helsinki and Uusimaa, Finland. Future Oncol 2023; 19:2029-2043. [PMID: 37828901 DOI: 10.2217/fon-2023-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Background: The rapid development of multiple myeloma (MM) management underscores the value of real-world data. In our study we examined 509 adult MM patients treated with immunochemotherapy (ICT) with/without stem cell transplantation (SCT) from 2013 to 2019 in the Hospital District of Helsinki and Uusimaa, Finland. Materials & methods: Our study was based on computational analyses of data integrated into the hospital data lake. Results: After 2017, treatment pattern diversity increased with improved access to novel treatments. 5-year survivals were 74.4% (95% CI: 65.5-84.5) in SCT-eligible and 44.0% (95% CI: 37.6-51.4) in non-SCT subgroups. In the SCT-eligible subgroup, high first-year hospitalization costs were followed by stable resource requirements. Conclusion: Hospital data lakes can be adapted to carry out complex analysis of large MM cohorts.
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Affiliation(s)
| | | | | | | | | | | | | | - Kimmo Porkka
- Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center, & University of Helsinki, Helsinki, Finland
| | - Raija Silvennoinen
- Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center, & University of Helsinki, Helsinki, Finland
| | - Oscar Brück
- Hematoscope Lab, Comprehensive Cancer Center & Center of Diagnostics, Helsinki University Hospital & University of Helsinki, Haartmaninkatu 8, PO Box 700, Helsinki, 00290, Finland
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Haque R, Chen LH, Oestreicher N, Lalla D, Chlebowski RT. Risk of Subsequent Breast Cancer in Women with Early Stage HER2-Positive Breast Cancer in a Large Community Health Plan. BREAST CANCER (DOVE MEDICAL PRESS) 2023; 15:637-645. [PMID: 37605715 PMCID: PMC10440088 DOI: 10.2147/bctt.s420061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023]
Abstract
Purpose Clinical outcomes have improved for women with early stage, HER2-positive breast cancer following the FDA approval of adjuvant trastuzumab use in 2006. However, only limited information exists on such patients' outcomes in real-world settings outside of clinical trials. We examined the risk of subsequent breast cancer in women with HER-2 positive disease, and the impact of trastuzumab use, in a large California community-based health plan. Patients and Methods A cohort of 3550 women with HER2-positive breast cancer (stages I-III) from 2009-2017 were followed through December 2018. We calculated subsequent breast cancer (SBC) rates overall and by trastuzumab use. Multivariable Cox proportional hazards modeling was used to compute hazard ratios (HR) and 95% confidence intervals (CI) for SBC by trastuzumab use. Results Within the cohort diagnosed with HER2-positive disease, 81% received adjuvant trastuzumab. After 4.1 mean years follow-up (maximum 10 years), the risk of SBC was 22% lower with adjuvant trastuzumab use (hazard ratio [HR] = 0.78, 95% confidence interval [CI]: 0.66-0.92) compared with non-use. The cumulative incidence of SBC precipitously rose two years after diagnosis and by the 10th year, the cumulative incidence was 31% among those who had trastuzumab therapy versus 34% without this therapy. Conclusion In community practice settings, the cumulative incidence of SBC in patients with early stage HER2-positive BC was 31% at 10 years in a cohort treated with adjuvant trastuzumab. Trastuzumab use was associated with a 22% reduced risk of developing SBC. This residual disease burden suggests breast cancer outcomes may be improved with further treatment given the advent of next-generation HER2-targeted therapies.
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Affiliation(s)
- Reina Haque
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, USA
- Kaiser Permanente School of Medicine, Department of Health Systems Science, Pasadena, CA, USA
| | - Lie Hong Chen
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, USA
| | | | | | - Rowan T Chlebowski
- Lundquist Research Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
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Heinolainen K, Saarinen S, Vertuani S, Ellonen A, Karlsson A, Utriainen M, Carlqvist P, Mandelin J, Holm B. Characterization of clinicopathological features, treatment practices, and outcomes among Finnish advanced breast cancer patients in real-life clinical practice. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04723-0. [PMID: 37178424 PMCID: PMC10374819 DOI: 10.1007/s00432-023-04723-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/22/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE In recent years, several new targeted therapies have emerged for advanced breast cancer (aBC). However, real-life data specific to aBC and different breast cancer subtypes are scarce. This retrospective cohort study was designed to describe the distribution of aBC subtypes, incidence, treatment patterns, survival, and PIK3CA hotspot mutation frequency. METHODS The study included all patients in the Hospital District of Southwest Finland diagnosed with aBC between 2004 and 2013 and with a sample available in Auria Biobank. In addition to registry-based data collection, 161 HR+/HER2- aBCs were screened for PIK3CA mutations. RESULTS Altogether, 54.7% of the 444 patients included in the study had luminal B subtype. The smallest representations were in HR-/HER2+ (4.5%) and triple-negative (5.6%) subgroups. The percentage of aBC among all diagnosed breast cancers increased until 2010, after which it remained stable. The triple-negative cancers were associated with shorter median overall survival (5.5 months) compared to other subgroups (16.5-24.6 months). Most (84%) triple-negative cancers also metastasized during the first two years, whereas this was more evenly distributed over time in other subgroups. Of the HR+/HER2- tumors, 32.3% harbored a PIK3CA hotspot mutation. These patients, however, did not have inferior survival compared to patients with PIK3CA wild-type cancers. CONCLUSION This study described real-world aBC subgroups and indicated that the clinical outcomes of subgroups vary. Although PIK3CA hotspot mutations did not lead to inferior survival, they are relevant as possible treatment targets. Overall, these data could be utilized to further evaluate the subgroup-specific medical needs in breast cancer.
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Affiliation(s)
| | | | | | - Antti Ellonen
- Department of Oncology, Turku University Central Hospital, Turku, Finland
| | | | - Meri Utriainen
- Comprehensive Cancer Center, Helsinki University Central Hospital, Helsinki, Finland
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The inhibition of centromere protein K causes anticancer effects in breast carcinoma via effects on the FAK/PI3K/AKT/mTOR pathway. Toxicol Appl Pharmacol 2022; 454:116232. [PMID: 36089000 DOI: 10.1016/j.taap.2022.116232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/25/2022] [Accepted: 09/04/2022] [Indexed: 11/21/2022]
Abstract
The overexpression of centromere protein K (CENPK) is a major contributor to the malignant progression of numerous cancers. To date, the detailed functions and mechanisms of CENPK in breast carcinoma are not fully elucidated. The goals of this project were to comprehensively address the relevance of CENPK in breast carcinoma. The initial investigation by TCGA analysis revealed a high expression level of CENPK in breast carcinoma. Subsequently, an immunoblotting assay confirmed that CENPK is highly expressed in the clinical samples of breast carcinoma. In vitro experiments elucidated that the inhibition of CENPK produced substantial anticancer effects, including a reduction of proliferation, the inhibition of epithelial-mesenchymal transition, the induction of cell cycle arrest and chemosensitivity. Mechanism research unveiled a role for CENPK in mediating the focal adhesion kinase (FAK1)/PI3K/AKT/mTOR pathway. Inhibiting the FAK/PI3K/AKT/mTOR pathway was able to reverse CENPK-elicited cancer-promoting effects. Additionally, CENPK-silenced breast carcinoma cells exhibited low tumorigenicity in vivo. In summary, our data demonstrated that CENPK inhibition provided an excellent anticancer effect for breast carcinoma by regulating FAK/PI3K/AKT/mTOR pathway. This work illustrates a novel molecular mechanism for CENPK in breast carcinoma and suggests CENPK inhibition as a promising targeted therapy for breast carcinoma.
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Tang M, O'Grady S, Crown J, Duffy MJ. MYC as a therapeutic target for the treatment of triple-negative breast cancer: preclinical investigations with the novel MYC inhibitor, MYCi975. Breast Cancer Res Treat 2022; 195:105-115. [PMID: 35908121 PMCID: PMC9374613 DOI: 10.1007/s10549-022-06673-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND MYC is one of the most frequently altered driver genes in triple-negative breast cancer (TNBC). The aim of this study was to evaluate targeting MYC for the treatment of TNBC. METHODS The anti-proliferative and apoptosis-inducing effects of the recently discovered MYC inhibitor, MYCi975 were investigated in a panel of 14 breast cancer cell lines representing the main molecular forms of breast cancer. RESULTS IC50 values for growth inhibition by MYCi975 varied from 2.49 to 7.73 µM. Response was inversely related to endogenous MYC levels as measured by western blotting (p = 0.047, r = - 0.5385) or ELISA (p = 0.001, r = - 0.767), i.e., response to MYCi975 decreased as endogenous MYC levels increased. MYCi975 also induced variable levels of apoptosis across the panel of cell lines, ranging from no detectable induction to 80% induction. Inhibition of proliferation and induction of apoptosis were greater in TNBC than in non-TNBC cell lines (p = 0.041 and p = 0.001, respectively). Finally, combined treatment with MYCi975 and either paclitaxel or doxorubicin resulted in enhanced cell growth inhibition. DISCUSSION Our findings open the possibility of targeting MYC for the treatment of TNBC. Based on our results, we suggest that trials use a combination of MYCi975 and either docetaxel or doxorubicin and include MYC as a putative therapy predictive biomarker.
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Affiliation(s)
- Minhong Tang
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Shane O'Grady
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - John Crown
- Department of Medical Oncology, St Vincent's University Hospital, Dublin, Ireland
| | - Michael J Duffy
- UCD School of Medicine, Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland.
- Clinical Research Centre, St Vincent's University Hospital, Elm Park, Dublin, D04 T6F4, Ireland.
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Tuominen S, Uusi-Rauva K, Blom T, Jyrkkiö S, Tuppurainen K, Alanne E. Real-world data on diffuse large B-cell lymphoma in 2010-2019: usability of large data sets of Finnish hospital data lakes. Future Oncol 2022; 18:1103-1114. [PMID: 35109670 DOI: 10.2217/fon-2021-0806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: Real-world data on diffuse large B-cell lymphoma (DLBCL) has remained incomplete. In Finland, health record data originally recorded in different hospital data record systems are collectively available via data lake technology, enabling efficient extraction and analysis of large data sets. The usability of Finnish data lake data in the assessment of DLBCL was evaluated. Methods: Adult DLBCL patients diagnosed between 2010 and 2019, home municipality in the Hospital District of Southwest Finland and data available in respective data lake were included. Results: The algorithmic determination of treatment lines and respective survival was successful. Patient characterization was feasible, albeit partly incomplete because of limited data content/availability and coverage. Stage, International Prognostic Index and cell of origin were available for 63.0, 68.3 and 28.4% of patients, respectively. Genetic aberrations were not structurally available or feasible to extract without a manual chart review. Conclusion: Finnish data lakes represent an efficient way to analyze large DLBCL data sets. The current study provides a tool for developing recording practices in routine care.
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Affiliation(s)
| | | | - Tea Blom
- Roche Oy, PO Box 112, 02101 Espoo, Finland
| | - Sirkku Jyrkkiö
- Department of Oncology and Radiotherapy, Turku University Central Hospital, Turku, 20521, Finland.,Western Finland Cancer Centre, Turku, 20521, Finland
| | | | - Erika Alanne
- Department of Oncology and Radiotherapy, Turku University Central Hospital, Turku, 20521, Finland.,Western Finland Cancer Centre, Turku, 20521, Finland
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