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Gong J, Hu S, Shan Q, Qin J, Han N, Xie F, Lu H. Bone metastasis in non-small-cell lung cancer: genomic characterization and exploration of potential targets. Ther Adv Med Oncol 2024; 16:17588359241239293. [PMID: 38510678 PMCID: PMC10953105 DOI: 10.1177/17588359241239293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
Background Bone metastasis (BM) seriously affects the quality of life and reduces the survival time of patients with non-small-cell lung cancer (NSCLC). The genomic characteristics and potential targets of BMs are yet to be fully explored. Objective To explore the genetic characteristics and potential targets of BM in NSCLC. Design In all, 83 patients with NSCLC were retrospectively selected in this study. Genomic characterization of BMs was explored with the analysis of NGS results from primary tumors and BMs in 6 patients, then combined with NGS results of lung tumors in 16 patients with initial recurrence in bone to analyze mutations potentially associated with BMs, and finally, the correlation was further validated in 61 postoperative patients. Methods The next generation sequencing (NGS) was performed to identify genomic differences between pulmonary primary tumors and BM. Fluorescence in situ hybridization and immunohistochemistry were performed in postoperative tumor tissues from patients who had undergone radical surgery to validate the predictive role of molecular targets for BM. The correlation between cyclin-dependent kinase 4 (CDK4) and BM was evaluated by Pearson's chi-square test. The university of alabama at birminghan cancer data analysis portal (UALCAN) was carried out for the detection of CDK4 expression in lung cancer and the relationship between CDK4 and clinicopathological parameters. The relationship between prognosis and CDK4 expression was analyzed by the Kaplan-Meier plotter. Results The rate of gene amplification was increased (24% versus 36%) while gene substitution/indel was decreased (64% versus 52%) in BMs. The BM-specific mutations were analyzed in 16 recurrent patients which revealed the highest incidence of CDK4 amplification (18.8%). According to the Kaplan-Meier plotter database, the NSCLC patients with high CDK4 gene expression showed poor overall survival (OS) and recurrence-free survival (RFS) (p < 0.05). The incidence of CDK4 amplification tended to be higher in recurrent patients compared to the patients without BM (18.8% versus 4.7%, p = 0.118). Conclusion Compared to the primary tumors of NSCLC, the genome of BMs showed an increased proportion of amplification and a decreased proportion of gene substitution/indel. Furthermore, the CDK4 amplification ratio seemed to be elevated in NSCLC patients with BM which may be associated with poor OS and RFS.
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Affiliation(s)
- Jiali Gong
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Hematology and Oncology, Ningbo No. 2 Hospital, Ningbo, Zhejiang, P.R. China
| | - Shumin Hu
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Qianyun Shan
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Jing Qin
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Na Han
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Fajun Xie
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Hongyang Lu
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, No. 1 East Banshan Road, Gongshu, Hangzhou 310022, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou 310022, P.R. China
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Dodin Y. Identification of LGR4 as a prognostic biomarker in KRAS-mutant lung adenocarcinoma: Evidence from integrated bioinformatics analysis. Medicine (Baltimore) 2023; 102:e36084. [PMID: 37986325 PMCID: PMC10659610 DOI: 10.1097/md.0000000000036084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/15/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023] Open
Abstract
Globally, lung cancer is the leading cause of cancer-related deaths, primarily non-small cell lung cancer. Kirsten Rat Sarcoma Oncogene Homolog (KRAS) mutations are common in non-small cell lung cancer and linked to a poor prognosis. Covalent inhibitors targeting KRAS-G12C mutation have improved treatment for some patients, but most KRAS-mutant lung adenocarcinoma (KRAS-MT LUAD) cases lack targeted therapies. This gap in treatment options underscores a significant challenge in the field. Our study aimed to identify hub/key genes specifically associated with KRAS-MT LUAD. These hub genes hold the potential to serve as therapeutic targets or biomarkers, providing insights into the pathogenesis and prognosis of lung cancer. We performed a comprehensive analysis on KRAS-MT LUAD samples using diverse data sources. This included TCGA project data for RNA-seq, clinical information, and somatic mutations, along with RNA-seq data for adjacent normal tissues. DESeq2 identified differentially expressed genes (DEGs), while weighted gene co-expression network analysis revealed co-expression modules. Overlapping genes between DEGs and co-expression module with the highest significance were analyzed using gene set enrichment analysis and protein-protein interaction network analysis. Hub genes were identified with the Maximal Clique Centrality algorithm in Cytoscape. Prognostic significance was assessed through survival analysis and validated using the GSE72094 dataset from Gene Expression Omnibus (GEO) database. In KRAS-MT LUAD, 3122 DEGs were found (2131 up-regulated, 985 down-regulated). The blue module, among 25 co-expression modules from weighted gene co-expression network analysis, had the strongest correlation. 804 genes overlapped between DEGs and the blue module. Among 20 hub genes in the blue module, leucine-rich repeats containing G protein-coupled receptor 4 (LGR4) overexpression correlated with worse overall survival. The prognostic significance of LGR4 was confirmed using GSE72094, but surprisingly, the direction of the association was opposite to what was expected. LGR4 stands as a promising biomarker in KRAS-MT LUAD prognosis. Contrasting associations in TCGA and GSE72094 datasets reveal the intricate nature of KRAS-MT LUAD. Additional explorations are imperative to grasp the precise involvement of LGR4 in lung adenocarcinoma prognosis, particularly concerning KRAS mutations. These insights could potentially pave the way for targeted therapeutic interventions, addressing the existing unmet demands in this specific subgroup.
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Affiliation(s)
- Yasmeen Dodin
- Cancer Control Office-King Hussein Cancer Center, Amman, Jordan
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Kumar S, Ali I, Abbas F, Rana A, Pandey S, Garg M, Kumar D. In-silico design, pharmacophore-based screening, and molecular docking studies reveal that benzimidazole-1,2,3-triazole hybrids as novel EGFR inhibitors targeting lung cancer. J Biomol Struct Dyn 2023:1-23. [PMID: 37646177 DOI: 10.1080/07391102.2023.2252496] [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: 05/02/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
Lung cancer is a complex and heterogeneous disease, which has been associated with various molecular alterations, including the overexpression and mutations of the epidermal growth factor receptor (EGFR). In this study, designed a library of 1843 benzimidazole-1,2,3-triazole hybrids and carried out pharmacophore-based screening to identify potential EGFR inhibitors. The 164 compounds were further evaluated using molecular docking and molecular dynamics simulations to understand the binding interactions between the compounds and the receptor. In-si-lico ADME and toxicity studies were also conducted to assess the drug-likeness and safety of the identified compounds. The results of this study indicate that benzimidazole-1,2,3-triazole hybrids BENZI-0660, BENZI-0125, BENZI-0279, BENZI-0415, BENZI-0437, and BENZI-1110 exhibit dock scores of -9.7, -9.6, -9.6, -9.6, -9.6, -9.6 while referencing molecule -7.9 kcal/mol for EGFR (PDB ID: 4HJO), respectively. The molecular docking and molecular dynamics simulations revealed that the identified compounds formed stable interactions with the active site of EGFR, indicating their potential as inhibitors. The in-silico ADME and toxicity studies showed that the compounds had favorable drug-likeness properties and low toxicity, further supporting their potential as therapeutic agents. Finally, performed DFT studies on the best-selected ligands to gain further insights into their electronic properties. The findings of this study provide important insights into the potential of benzimidazole-1,2,3-triazole hybrids as promising EGFR inhibitors for the treatment of lung cancer. This research opens up a new avenue for the discovery and development of potent and selective EGFR inhibitors for the treatment of lung cancer.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Sunil Kumar
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Shoolini University, Solan, India
| | - Iqra Ali
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Faheem Abbas
- Key Lab of Organic Optoelectronics and Molecular Engineering of Ministry of Education, Department of Chemistry, Tsinghua University, Beijing, P. R. China
| | - Anurag Rana
- Yogananda School of Artificial Intelligence, Computers, and Data Sciences, Shoolini University, Solan, India
| | - Sadanand Pandey
- Department of Chemistry, College of Natural Science, Yeungnam University, Gyeongsan, Korea
| | - Manoj Garg
- Amity Institute of Molecular Medicine and Stem Cell Research, Amity University, Noida, India
| | - Deepak Kumar
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Shoolini University, Solan, India
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Machado-Rugolo J, Baldavira C, Prieto T, Olivieri E, Fabro A, Rainho C, Castelli E, Ribolla P, Ab'Saber A, Takagaki T, Nagai M, Capelozzi V. Clinical outcome of Brazilian patients with non-small cell lung cancer in early stage harboring rare mutations in epidermal growth factor receptor. Braz J Med Biol Res 2023; 55:e12409. [PMID: 36629526 PMCID: PMC9828871 DOI: 10.1590/1414-431x2022e12409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/09/2022] [Indexed: 01/11/2023] Open
Abstract
The common epidermal growth factor receptor (EGFR) mutations, such as the L858R point mutation in exon 21 and the in-frame deletional mutation in exon 19, have been definitively associated with response to EGFR-tyrosine kinase inhibitors (EGFR-TKI). However, the clinical outcome and response to treatment for many other rarer mutations are still unclear. In this study, we report the results of Brazilian patients in stage IB-IIIA non-small cell lung cancer (NSCLC) following complete resection with minimal residual disease and EGFR mutations treated with adjuvant chemotherapy and/or EGFR-TKIs. The frequency of EGFR mutations was investigated in 70 cases of early stage NSCLC. Mutations in exons 18 and 20, uncommon mutations in exons 19 and 21, as well as in exons 3, 7, 14, 16, 22, 27, and 28, and/or the presence of different mutations in a single tumor (complex mutations) are considered rare. EGFR mutations were detected in 23 tumors (32.9%). Fourteen cases carried rare mutations and were treated with platinum-based chemotherapy and two cases were treated with erlotinib. The clinical outcome is described case by case with references to the literature. Notably, we found two rare EGFR mutations and one of them with an unknown response to chemotherapy and/or EGFR-TKIs. We have provided complementary information concerning the clinical outcome and treatment of patients with early stage NSCLC for several rare EGFR mutations not previously or only rarely reported. Description of cases harboring rare mutations can support the decision-making process in this subset of patients.
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Affiliation(s)
- J. Machado-Rugolo
- Laboratório de Histomorfometria e Genômica Pulmonar, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,Centro de Avaliação de Tecnologias em Saúde, Hospital das Clínicas de Botucatu, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - C.M. Baldavira
- Laboratório de Histomorfometria e Genômica Pulmonar, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - T.G. Prieto
- Laboratório de Histomorfometria e Genômica Pulmonar, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - E.H.R. Olivieri
- Centro Internacional de Pesquisa/CIPE, AC Camargo Cancer Center, São Paulo, SP, Brasil
| | - A.T. Fabro
- Laboratório de Histomorfometria e Genômica Pulmonar, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,Departamento de Patologia e Medicina Legal, Laboratório de Medicina Respiratória, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - C.A. Rainho
- Instituto de Biociências, Departamento de Ciências Químicas e Biológicas, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - E.C. Castelli
- Laboratório de Genética Molecular e Bioinformática, Unidade de Pesquisa Experimental, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil,Departamento de Patologia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - P.E.M. Ribolla
- Instituto de Biotecnologia, Universidade Estadual Paulista, Botucatu, SP, Brasil,Instituto de Biociências, Departamento de Bioestatística, Biologia Vegetal, Parasitologia e Zoologia, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - A.M. Ab'Saber
- Laboratório de Histomorfometria e Genômica Pulmonar, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - T. Takagaki
- Divisão de Pneumologia, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - M.A. Nagai
- Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil,Laboratório de Genética Molecular, Centro de Pesquisa Translacional em Oncologia, Instituto do Câncer de São Paulo, São Paulo, SP, Brasil
| | - V.L. Capelozzi
- Laboratório de Histomorfometria e Genômica Pulmonar, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Garcia BNC, van Kempen LC, Kuijpers CC, Schuuring E, Willems SM, van der Wekken AJ. Prevalence of KRAS p.(G12C) in stage IV NSCLC patients in the Netherlands; a nation-wide retrospective cohort study. Lung Cancer 2022; 167:1-7. [DOI: 10.1016/j.lungcan.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 01/02/2023]
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ten Berge DM, Aarts MJ, Groen HJ, Aerts JG, Kloover JS. A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands. Eur J Cancer 2022; 165:195-204. [DOI: 10.1016/j.ejca.2022.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/19/2022] [Accepted: 01/28/2022] [Indexed: 12/29/2022]
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Niu Y, Zhou Q. Th17 cells and their related cytokines: vital players in progression of malignant pleural effusion. Cell Mol Life Sci 2022; 79:194. [PMID: 35298721 PMCID: PMC11072909 DOI: 10.1007/s00018-022-04227-z] [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] [Received: 12/21/2021] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
Malignant pleural effusion (MPE) is an exudative effusion caused by primary or metastatic pleural carcinosis. Th17 cells and their cytokines are critical components in various disease including MPE. In this review, we summarize current published articles regarding the multifunctional roles of Th17 cells and their related cytokines in MPE. Th17 cells are accumulated in MPE compared with paired serum via certain manners. The upregulation of Th17 cells and the interactions between Th17 cells and other immune cells, such as Th1 cells, Th9 cells, regulatory T cells and B cells, are reported to be involved in the formation and development of MPE. In addition, cytokines, which are elaborated by Th17 cells, including IL-17A, IL-17F, IL-21, IL-22, IL-26, GM-CSF, or associated with Th17 cells differentiation, including IL-1β, IL-6, IL-23, TGF-β, are linked to the pathogenesis of MPE through exerting pro- or anti-tumorigenic functions on their own as well as regulating the generation and differentiation of Th17 cells in MPE. Based on these findings, we proposed that Th17 cells and their cytokines might be diagnostic or prognostic tools and potential therapeutic targets for MPE.
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Affiliation(s)
- Yiran Niu
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, Hubei, China
| | - Qiong Zhou
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277, Wuhan, Hubei, China.
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Worldwide Prevalence of Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancer: A Meta-Analysis. Mol Diagn Ther 2021; 26:7-18. [PMID: 34813053 PMCID: PMC8766385 DOI: 10.1007/s40291-021-00563-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2021] [Indexed: 01/22/2023]
Abstract
Background Identification of variable epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer (NSCLC) is important for the selection of appropriate targeted therapies. This meta-analysis was conducted to provide a worldwide overview of EGFR mutation and submutation (specifically exon 19 deletions, exon 21 L858R substitutions, and others) prevalence, and identify important covariates that influence EGFR mutation status in patients with advanced NSCLC to address this clinical data gap. Methods Embase® and MEDLINE® in Ovid were searched for studies published between 2004 and 2019 with cohorts of ≥ 50 adults with EGFR mutations, focusing on stage III/IV NSCLC (≤ 20% of patients with stage I/II NSCLC). Linear mixed-effects models were fitted to EGFR mutation endpoints using logistic transformation (logit), assuming a binomial distribution. The model included terms for an intercept reflecting European studies and further additive terms for other continents. EGFR submutations examined were exon 19 deletions, exon 21 L858R substitutions, and others. Results Of 3969 abstracts screened, 57 studies were included in the overall EGFR mutation analysis and 74 were included in the submutation analysis relative to the overall EGFR mutation population (Europe, n = 12; Asia, n = 51; North America, n = 5; Central America, n = 1; South America, n = 1; Oceania, n = 1; Global, n = 3). The final overall EGFR mutations model estimated Asian and European prevalence of 49.1% and 12.8%, respectively, and included an additive covariate for the proportion of male patients in a study. There were no significant covariates in the submutation analyses. Most submutations were actionable: exon 19 deletions (49.2% [Asia]; 48.4% [Europe]); exon 21 L858R substitutions (41.1% [Asia]; 29.9% [Europe]). Conclusions Although EGFR mutation prevalence was higher in Asian than Western countries, data support worldwide testing for EGFR overall and submutations to inform appropriate targeted treatment decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s40291-021-00563-1.
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Global, regional, and national burden of respiratory tract cancers and associated risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. THE LANCET RESPIRATORY MEDICINE 2021; 9:1030-1049. [PMID: 34411511 PMCID: PMC8410610 DOI: 10.1016/s2213-2600(21)00164-8] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 03/14/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prevention, control, and treatment of respiratory tract cancers are important steps towards achieving target 3.4 of the UN Sustainable Development Goals (SDGs)-a one-third reduction in premature mortality due to non-communicable diseases by 2030. We aimed to provide global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019. METHODS Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 methodology, we evaluated the incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) of respiratory tract cancers (ie, tracheal, bronchus, and lung cancer and larynx cancer). Deaths from tracheal, bronchus, and lung cancer and larynx cancer attributable to each risk factor were estimated on the basis of risk exposure, relative risks, and the theoretical minimum risk exposure level input from 204 countries and territories, stratified by sex and Socio-demographic Index (SDI). Trends were estimated from 1990 to 2019, with an emphasis on the 2010-19 period. FINDINGS Globally, there were 2·26 million (95% uncertainty interval 2·07 to 2·45) new cases of tracheal, bronchus, and lung cancer, and 2·04 million (1·88 to 2·19) deaths and 45·9 million (42·3 to 49·3) DALYs due to tracheal, bronchus, and lung cancer in 2019. There were 209 000 (194 000 to 225 000) new cases of larynx cancer, and 123 000 (115 000 to 133 000) deaths and 3·26 million (3·03 to 3·51) DALYs due to larynx cancer globally in 2019. From 2010 to 2019, the number of new tracheal, bronchus, and lung cancer cases increased by 23·3% (12·9 to 33·6) globally and the number of larynx cancer cases increased by 24·7% (16·0 to 34·1) globally. Global age-standardised incidence rates of tracheal, bronchus, and lung cancer decreased by 7·4% (-16·8 to 1·6) and age-standardised incidence rates of larynx cancer decreased by 3·0% (-10·5 to 5·0) in males over the past decade; however, during the same period, age-standardised incidence rates in females increased by 0·9% (-8·2 to 10·2) for tracheal, bronchus, and lung cancer and decreased by 0·5% (-8·4 to 8·1) for larynx cancer. Furthermore, although age-standardised incidence and death rates declined in both sexes combined from 2010 to 2019 at the global level for tracheal, bronchus, lung and larynx cancers, some locations had rising rates, particularly those on the lower end of the SDI range. Smoking contributed to an estimated 64·2% (61·9-66·4) of all deaths from tracheal, bronchus, and lung cancer and 63·4% (56·3-69·3) of all deaths from larynx cancer in 2019. For males and for both sexes combined, smoking was the leading specific risk factor for age-standardised deaths from tracheal, bronchus, and lung cancer per 100 000 in all SDI quintiles and GBD regions in 2019. However, among females, household air pollution from solid fuels was the leading specific risk factor in the low SDI quintile and in three GBD regions (central, eastern, and western sub-Saharan Africa) in 2019. INTERPRETATION The numbers of incident cases and deaths from tracheal, bronchus, and lung cancer and larynx cancer increased globally during the past decade. Even more concerning, age-standardised incidence and death rates due to tracheal, bronchus, lung cancer and larynx cancer increased in some populations-namely, in the lower SDI quintiles and among females. Preventive measures such as smoking control interventions, air quality management programmes focused on major air pollution sources, and widespread access to clean energy should be prioritised in these settings. FUNDING Bill & Melinda Gates Foundation.
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Koopman B, Cajiao Garcia BN, Kuijpers CCHJ, Damhuis RAM, van der Wekken AJ, Groen HJM, Schuuring E, Willems SM, van Kempen LC. A Nationwide Study on the Impact of Routine Testing for EGFR Mutations in Advanced NSCLC Reveals Distinct Survival Patterns Based on EGFR Mutation Subclasses. Cancers (Basel) 2021; 13:3641. [PMID: 34298851 PMCID: PMC8307492 DOI: 10.3390/cancers13143641] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022] Open
Abstract
EGFR mutation analysis in non-small-cell lung cancer (NSCLC) patients is currently standard-of-care. We determined the uptake of EGFR testing, test results and survival of EGFR-mutant NSCLC patients in the Netherlands, with the overall objective to characterize the landscape of clinically actionable EGFR mutations and determine the role and clinical relevance of uncommon and composite EGFR mutations. Non-squamous NSCLC patients diagnosed in 2013, 2015 and 2017 were identified in the Netherlands Cancer Registry (NCR) and matched to the Dutch Pathology Registry (PALGA). Overall, 10,254 patients were included. Between 2013-2017, the uptake of EGFR testing gradually increased from 72.7% to 80.9% (p < 0.001). Multi-gene testing via next-generation sequencing (increased from 7.8% to 78.7% (p < 0.001), but did not affect the number of detected EGFR mutations (n = 925; 11.7%; 95% confidence interval (CI), 11.0-12.4) nor the distribution of variants. For patients treated with first-line EGFR inhibitors (n = 651), exon 19 deletions were associated with longer OS than L858R (HR 1.58; 95% CI, 1.30-1.92; p < 0.001) or uncommon, actionable variants (HR 2.13; 95% CI, 1.60-2.84; p < 0.001). Interestingly, OS for patients with L858R was similar to those with uncommon, actionable variants (HR 1.31; 95% CI, 0.98-1.75; p = 0.069). Our analysis indicates that grouping exon 19 deletions and L858R into one class of 'common' EGFR mutations in a clinical trial may mask the true activity of an EGFR inhibitor towards specific mutations.
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Affiliation(s)
- Bart Koopman
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (B.K.); (B.N.C.G.); (E.S.); (S.M.W.)
| | - Betzabel N. Cajiao Garcia
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (B.K.); (B.N.C.G.); (E.S.); (S.M.W.)
| | | | - Ronald A. M. Damhuis
- Netherlands Comprehensive Cancer Organisation (IKNL), P.O. Box 19079, 3501 DB Utrecht, The Netherlands;
| | - Anthonie J. van der Wekken
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (A.J.v.d.W.); (H.J.M.G.)
| | - Harry J. M. Groen
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (A.J.v.d.W.); (H.J.M.G.)
| | - Ed Schuuring
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (B.K.); (B.N.C.G.); (E.S.); (S.M.W.)
| | - Stefan M. Willems
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (B.K.); (B.N.C.G.); (E.S.); (S.M.W.)
| | - Léon C. van Kempen
- Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (B.K.); (B.N.C.G.); (E.S.); (S.M.W.)
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11
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Pasmans CTB, Tops BBJ, Steeghs EMP, Coupé VMH, Grünberg K, de Jong EK, Schuuring EMD, Willems SM, Ligtenberg MJL, Retèl VP, van Snellenberg H, de Bruijn E, Cuppen E, Frederix GWJ. Micro-costing diagnostics in oncology: from single-gene testing to whole- genome sequencing. Expert Rev Pharmacoecon Outcomes Res 2021; 21:413-414. [PMID: 33852815 DOI: 10.1080/14737167.2021.1917385] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose: Predictive diagnostics play an increasingly important role in personalized medicine for cancer treatment. Whole-genome sequencing (WGS)-based treatment selection is expected to rapidly increase worldwide. This study aimed to calculate and compare the total cost of currently used diagnostic techniques and of WGS in treatment of non-small cell lung carcinoma (NSCLC), melanoma, colorectal cancer (CRC), and gastrointestinal stromal tumor (GIST) in the Netherlands.Methods: The activity-based costing (ABC) method was conducted to calculate total cost of included diagnostic techniques based on data provided by Dutch pathology laboratories and the Dutch-centralized cancer WGS facility. Costs were allocated to four categories: capital costs, maintenance costs, software costs, and operational costs.Results: The total cost per cancer patient per technique varied from € 58 (Sanger sequencing, three amplicons) to € 2925 (paired tumor-normal WGS). The operational costs accounted for the vast majority (over 90%) of the total per cancer patient technique costs.Conclusion: This study outlined in detail all costing aspects and cost prices of current and new diagnostic modalities used in treatment of NSCLC, melanoma, CRC, and GIST in the Netherlands. Detailed cost differences and value comparisons between these diagnostic techniques enable future economic evaluations to support decision-making.
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Affiliation(s)
- Clémence T B Pasmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Bastiaan B J Tops
- Princess Máxima Center for Pediatric Oncology, Bilthoven, The Netherlands
| | - Elisabeth M P Steeghs
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU Amsterdam, Amsterdam, The Netherlands
| | - Katrien Grünberg
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eiko K de Jong
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ed M D Schuuring
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stefan M Willems
- Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,PALGA Foundation, Houten, The Netherlands
| | - Marjolijn J L Ligtenberg
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Human Genetics, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Valesca P Retèl
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | | | | | - Edwin Cuppen
- Hartwig Medical Foundation, Amsterdam, The Netherlands.,Center for Molecular Medicine and Cancer Genomics Netherlands, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Geert W J Frederix
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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12
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Li C, Wang Y, Su K, Liu Y, Wang L, Zheng B, Yan N, Yuan D, Zhang Y, Xue L, Gao S, He J. Presentation of EGFR mutations in 162 family probands with multiple primary lung cancer. Transl Lung Cancer Res 2021; 10:1734-1746. [PMID: 34012789 PMCID: PMC8107753 DOI: 10.21037/tlcr-20-1001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background The number of multiple primary lung cancer (MPLC) patients has rapidly increased in recent years. However, information regarding the etiology of MPLC and responsiveness to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) is rare. The present study aims to describe the mutation signatures of EGFR in MPLC. Methods Polymerase chain reaction (PCR) and Sanger sequencing were used to screen EGFR mutations in 162 family probands comprising 366 tumor lesions and 162 paired noncancerous adjacent tissues (NATs). Sequencing data from 3,243 sporadic lung adenocarcinoma (LUAD) samples were analyzed as a control. Results Candidate germline mutations were observed in exons 19 (3, 1.85%), 20 (8, 4.94%) and 21 (5, 3.10%), with a total frequency of 9.88% in NATs (16/162). There were 63 probands harboring somatic mutations (63/162, 38.89%), 9 patients harbored the consistency mutations among lesions, and 8 patients carried 2 or more mutations. The overall rate of EGFR somatic mutations was lower in the MPLC probands, but those of exon 19 p.747-752del, 20 p.V769indelsVASV and 20 p.D770indelsDSVD were significantly higher in MPLC probands than in patients with sporadic LUAD. Conclusions There exists unique EGFR mutation signatures in a large cohort of MPLC probands, which might provide objective evidence of the etiology and effectiveness of clinical TKI treatment of high-risk MPLC patients.
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Affiliation(s)
- Chunxiang Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yalong Wang
- Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Su
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liyu Wang
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Zheng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Yan
- Geneis (Beijing) Co., Ltd., Beijing, China
| | - Dawei Yuan
- Geneis (Beijing) Co., Ltd., Beijing, China
| | | | - Liyan Xue
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Fois SS, Paliogiannis P, Zinellu A, Fois AG, Cossu A, Palmieri G. Molecular Epidemiology of the Main Druggable Genetic Alterations in Non-Small Cell Lung Cancer. Int J Mol Sci 2021; 22:E612. [PMID: 33435440 PMCID: PMC7827915 DOI: 10.3390/ijms22020612] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/30/2020] [Accepted: 01/06/2021] [Indexed: 12/13/2022] Open
Abstract
Lung cancer is the leading cause of death for malignancy worldwide. Its molecular profiling has enriched our understanding of cancer initiation and progression and has become fundamental to provide guidance on treatment with targeted therapies. Testing the presence of driver mutations in specific genes in lung tumors has thus radically changed the clinical management and outcomes of the disease. Numerous studies performed with traditional sequencing methods have investigated the occurrence of such mutations in lung cancer, and new insights regarding their frequency and clinical significance are continuously provided with the use of last generation sequencing technologies. In this review, we discuss the molecular epidemiology of the main druggable genetic alterations in non-small cell lung cancer, namely EGFR, KRAS, BRAF, MET, and HER2 mutations or amplification, as well as ALK and ROS1 fusions. Furthermore, we investigated the predictive impact of these alterations on the outcomes of modern targeted therapies, their global prognostic significance, and their mutual interaction in cases of co-occurrence.
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Affiliation(s)
- Sara S. Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy; (S.S.F.); (A.G.F.); (A.C.)
| | - Panagiotis Paliogiannis
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy; (S.S.F.); (A.G.F.); (A.C.)
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43b, 07100 Sassari, Italy;
| | - Alessandro G. Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy; (S.S.F.); (A.G.F.); (A.C.)
| | - Antonio Cossu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy; (S.S.F.); (A.G.F.); (A.C.)
| | - Giuseppe Palmieri
- Unit of Cancer Genetics, Institute of Genetic and Biomedical Research (IRGB), National Research Council (CNR), Traversa La Crucca 3, 07100 Sassari, Italy;
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14
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Lemine Sow M, El Yacoubi H, Moukafih B, Balde S, Akimana G, Najem S, El Khoyaali S, Abahssain H, Chaibi A, Zeb Khan S, Trapani D, Benzekri A, Ghaouti M, Gamra L, Mestari A, Kettani F, Rahali Y, Mrabti H, Elghissassi I, Errihani H. Frequency and types of EGFR mutations in Moroccan patients with non-small cell lung cancer. TUMORI JOURNAL 2020; 107:335-340. [PMID: 33079008 DOI: 10.1177/0300891620964571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mutations in the epidermal growth factor receptor (EGFR) gene are commonly observed in non-small cell lung cancer (NSCLC), particularly in adenocarcinoma histology. The frequency of EGFR mutations is ethnicity-dependent, with a higher proportion reported in Asian populations than Caucasian populations. There is a lack of data on these mutations in north Africa. METHODS Tumor specimens from Moroccan patients with NSCLC were collected from five pathology laboratories between November 2010 and December 2017 to determine frequency and types of EGFR mutations. Tumors were tested in a reference center for EGFR by polymerase chain reaction and sequencing of exons 18, 19, 20, and 21. RESULTS A total of 334 patients were enrolled: 242 (72.5%) males and 92 females (27.5%). A total of 56.9% had a history of smoking. EGFR testing of the 334 lung adenocarcinoma samples demonstrated a wild-type EGFR in 261 (78.1%) and mutated EGFR in 73 (21.9%). Mutations were mainly detected in the exon 19 deletion (65.8%), followed by exon 21 L858 (17.8%) and other exon 21 codon mutations (5.5%) and exon 18 (6.8%), whereas primary mutations of exon 20 were less frequent (4.1%). In patients with advanced NSCLC, the detection of EGFR mutation was independently associated with sex (41.3% female vs 14.5% male; p < 0.001) and smoking status (34.8% nonsmokers vs 12.9% active smokers; p < 0.001). The mean age was significantly different between the two groups (p = 0.041). CONCLUSION Our findings confirm the genetic heterogeneity of NSCLC worldwide, reporting frequency of EGFR mutations in Moroccan patients with NSCLC between those of Asian and Caucasian populations.
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Affiliation(s)
- Mohamed Lemine Sow
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Hind El Yacoubi
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Badreddine Moukafih
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Salif Balde
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Gloria Akimana
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Salma Najem
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Siham El Khoyaali
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Halima Abahssain
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Aicha Chaibi
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Shah Zeb Khan
- Department of Clinical Oncology, BINOR Cancer Hospital, Bannu, Pakistan
| | - Dario Trapani
- Department of Oncology and Hematology, University of Milan.,Division of New Drug Development, European Institute of Oncology, Milan, Italy
| | - Asmae Benzekri
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Merieme Ghaouti
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Lamia Gamra
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Amina Mestari
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Fouad Kettani
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Younes Rahali
- Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Hind Mrabti
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Ibrahim Elghissassi
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
| | - Hassan Errihani
- Department of Medical Oncology, National Institute of Oncology, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco
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15
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Jang J, To C, De Clercq DJH, Park E, Ponthier CM, Shin BH, Mushajiang M, Nowak RP, Fischer ES, Eck MJ, Jänne PA, Gray NS. Mutant-Selective Allosteric EGFR Degraders are Effective Against a Broad Range of Drug-Resistant Mutations. Angew Chem Int Ed Engl 2020; 59:14481-14489. [PMID: 32510788 PMCID: PMC7686272 DOI: 10.1002/anie.202003500] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/11/2020] [Indexed: 12/13/2022]
Abstract
Targeting epidermal growth factor receptor (EGFR) through an allosteric mechanism provides a potential therapeutic strategy to overcome drug-resistant EGFR mutations that emerge within the ATP binding site. Here, we develop an allosteric EGFR degrader, DDC-01-163, which can selectively inhibit the proliferation of L858R/T790M (L/T) mutant Ba/F3 cells while leaving wildtype EGFR Ba/F3 cells unaffected. DDC-01-163 is also effective against osimertinib-resistant cells with L/T/C797S and L/T/L718Q EGFR mutations. When combined with an ATP-site EGFR inhibitor, osimertinib, the anti-proliferative activity of DDC-01-163 against L858R/T790M EGFR-Ba/F3 cells is enhanced. Collectively, DDC-01-163 is a promising allosteric EGFR degrader with selective activity against various clinically relevant EGFR mutants as a single agent and when combined with an ATP-site inhibitor. Our data suggests that targeted protein degradation is a promising drug development approach for mutant EGFR.
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Affiliation(s)
- Jaebong Jang
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Ciric To
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute
- Department of Medical Oncology, Dana-Farber Cancer Institute
- Department of Medicine, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston Massachusetts 02215 USA
| | - Dries J. H. De Clercq
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Eunyoung Park
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Charles M. Ponthier
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Bo Hee Shin
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute
- Department of Medical Oncology, Dana-Farber Cancer Institute
- Department of Medicine, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston Massachusetts 02215 USA
| | - Mierzhati Mushajiang
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute
- Department of Medical Oncology, Dana-Farber Cancer Institute
- Department of Medicine, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston Massachusetts 02215 USA
| | - Radosław P. Nowak
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Eric S. Fischer
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Michael J. Eck
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
| | - Pasi A. Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute
- Department of Medical Oncology, Dana-Farber Cancer Institute
- Department of Medicine, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston Massachusetts 02215 USA
- Belfer Center for Applied Cancer Science
- Longwood Center, 360 Longwood Avenue, Boston Massachusetts 02215 USA
| | - Nathanael S. Gray
- Department of Cancer Biology, Dana-Farber Cancer Institute
- Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School
- Longwood Center, 360 Longwood Avenue, Boston, Massachusetts 02215 USA
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16
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Jang J, To C, De Clercq DJH, Park E, Ponthier CM, Shin BH, Mushajiang M, Nowak RP, Fischer ES, Eck MJ, Jänne PA, Gray NS. Mutant‐Selective Allosteric EGFR Degraders are Effective Against a Broad Range of Drug‐Resistant Mutations. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202003500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Jaebong Jang
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
- Current address: College of Pharmacy Korea University 2511 Sejong-ro Sejong 30019 Republic of Korea
| | - Ciric To
- Lowe Center for Thoracic Oncology Dana-Farber Cancer Institute Department of Medical Oncology Dana-Farber Cancer Institute Department of Medicine Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Dries J. H. De Clercq
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Eunyoung Park
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Charles M. Ponthier
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Bo Hee Shin
- Lowe Center for Thoracic Oncology Dana-Farber Cancer Institute Department of Medical Oncology Dana-Farber Cancer Institute Department of Medicine Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Mierzhati Mushajiang
- Lowe Center for Thoracic Oncology Dana-Farber Cancer Institute Department of Medical Oncology Dana-Farber Cancer Institute Department of Medicine Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Radosław P. Nowak
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Eric S. Fischer
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Michael J. Eck
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Pasi A. Jänne
- Lowe Center for Thoracic Oncology Dana-Farber Cancer Institute Department of Medical Oncology Dana-Farber Cancer Institute Department of Medicine Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
- Belfer Center for Applied Cancer Science Longwood Center 360 Longwood Avenue Boston MA 02215 USA
| | - Nathanael S. Gray
- Department of Cancer Biology Dana-Farber Cancer Institute Department of Biological Chemistry and Molecular Pharmacology Harvard Medical School Longwood Center 360 Longwood Avenue Boston MA 02215 USA
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17
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Zhang Q, Cui Y, Zhang J, Kenjiabieke J, Aerxiding P. Comparison of the characteristics of uncommon epidermal growth factor receptor (EGFR) mutations and EGFR-tyrosine kinase inhibitor treatment in patients with non-small cell lung cancer from different ethnic groups. Exp Ther Med 2020; 19:3513-3520. [PMID: 32346412 PMCID: PMC7185161 DOI: 10.3892/etm.2020.8612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 01/10/2020] [Indexed: 01/16/2023] Open
Abstract
Patients with epidermal growth factor receptor (EGFR)-sensitive mutations generally have a significantly higher objective response rate (ORR) and longer progression-free survival (PFS) after EGFR-tyrosine kinase inhibitor (TKI) treatment. However, the efficacy of EGFR-TKIs in the case of uncommon EGFR mutations has remained elusive. In the present study, the characteristics of uncommon EGFR mutations and EGFR-TKI treatments were compared in patients with non-small cell lung cancer (NSCLC) from different ethnic groups. A total of 2,984 patients with pathologically confirmed NSCLC encountered between February 2012 to February 2017 at the Affiliated Tumor Hospital of Xinjiang Medical University (Urumqi, China) were enrolled in the present study. The Amplification Refractory Mutation System was adopted to determine EGFR gene expression, compare the ethnic differences in EGFR mutations between Xinjiang Uygur and Han people, analyze the distribution of uncommon mutation types and evaluate the link between clinicopathological features associated with uncommon mutations and the efficacy of EGFR-TKI treatment. There were significant differences in EGFR mutations in lung adenocarcinoma and lung squamous cell carcinoma between patients from the Xinjiang Uygur group and the Han group (P<0.001). The differences in the uncommon EGFR mutations were significant in patients with lung adenocarcinoma (P<0.05). The most common site of lymph node metastasis in patients with uncommon mutations was the hilar lymph node, supraclavicular/subclavian lymph node, cervical lymph node and mediastinal lymph node; the most common distant metastatic organs were the lung, bone, brain, liver and adrenal gland. Of the uncommon mutations, the most common single mutations were L861Q, G719X and 20ins mutations; the most common double mutation was the S768I and 20ins mutation. The incidence rate of EGFR gene mutations was significantly higher in Han people from Xinjiang than in Uygur people. There were marked differences between individuals regarding the efficacy of EGFR-TKI treatment and the survival time of patients with uncommon EGFR mutations, second-line EGFR-TKIs had a lower ORR and DCR while had a longer mPFS. All of these could provide a basis for the exploration of different regimens for patients with different types of uncommon mutations.
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Affiliation(s)
- Qiao Zhang
- Department of Thoracic Oncology, The Third Clinical Medical College of Xinjiang Medical University, The Affiliated Tumor Hospital Xinjiang Medical University, Urumqi, Xinjiang 830011, P.R. China
| | - Yanyan Cui
- Department of Geriatric, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang 832000, P.R. China
| | - Jian Zhang
- Outpatient Department, People's Liberation Army 69260 Troops of Medical Team, Urumqi, Xinjiang 830002, P.R. China
| | - Jiayideng Kenjiabieke
- Department of Thoracic Oncology, The Third Clinical Medical College of Xinjiang Medical University, The Affiliated Tumor Hospital Xinjiang Medical University, Urumqi, Xinjiang 830011, P.R. China
| | - Patiguli Aerxiding
- Department of Thoracic Oncology, The Third Clinical Medical College of Xinjiang Medical University, The Affiliated Tumor Hospital Xinjiang Medical University, Urumqi, Xinjiang 830011, P.R. China
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18
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Dormieux A, Mezquita L, Cournede PH, Remon J, Tazdait M, Lacroix L, Rouleau E, Adam J, Bluthgen MV, Facchinetti F, Tselikas L, Aboubakar F, Naltet C, Lavaud P, Gazzah A, Le Pechoux C, Lassau N, Balleyguier C, Planchard D, Besse B, Caramella C. Association of metastatic pattern and molecular status in stage IV non-small cell lung cancer adenocarcinoma. Eur Radiol 2020; 30:5021-5028. [PMID: 32323012 DOI: 10.1007/s00330-020-06784-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/02/2020] [Accepted: 02/28/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The aim of our study was to investigate the association between driver oncogene alterations and metastatic patterns on imaging assessment, in a large cohort of metastatic lung adenocarcinoma patients. METHODS From January 2010 to May 2017, 550 patients with stage IV lung adenocarcinoma with molecular analysis were studied retrospectively including 135 EGFR-mutated, 81 ALK-rearrangement, 47 BRAF-mutated, 141 KRAS-mutated, and 146 negative tumors for these 4 mutations (4N). After review of the complete imaging report by two radiologists (junior and senior) to identify metastatic sites, univariate correlation analyzes were performed. RESULTS We found differences in metastatic tropism depending on the molecular alteration type when compared with the non-mutated 4N group: in the EGFR group, pleural metastases were more frequent (32% versus 20%; p = 0.021), and adrenal and node metastases less common (6% versus 23%; p < 0.001 and 11% versus 23%; p = 0.011). In the ALK group, there were more brain and lung metastases (respectively 42% versus 29%; p = 0.043 and 37% versus 24%; p = 0.037). In the BRAF group, pleural and pericardial metastases were more common (respectively 47% versus 20%; p < 0.001 and 11% versus 3%; p = 0.04) and bone metastases were rarer (21% versus 42%; p = 0.011). Lymphangitis was more frequent in EGFR, ALK, and BRAF groups (respectively 6%, 7%, and 15% versus 1%); p = 0.016; p = 0.009; and p < 0.001. CONCLUSION The application of these correlations between molecular status and metastatic tropism in clinical practice may lead to earlier and more accurate identification of patients for targeted therapy. KEY POINTS • Bone and brain metastasis are the most common organs involved in lung adenocarcinoma but the relative incidence of each metastatic site depends on the molecular alteration. • EGFR-mutated tumors preferentially spread to the pleura and less commonly to adrenals, ALK-rearrangement tumors usually spread to the brain and the lungs, whereas BRAF-mutated tumors are unlikely to spread to bones and have a serous (pericardial ad pleural) tropism. • These correlations could help in the clinical management of patients with metastatic lung adenocarcinoma.
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Affiliation(s)
- Alison Dormieux
- Imaging Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Laura Mezquita
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Paul Henry Cournede
- MICS laboratory, CentraleSupélec, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Jordi Remon
- Medical Oncology Department, Centro Integral Oncología Clara Campal Bacelona, HM-Delfos, Barcelona, Spain
| | - Melodie Tazdait
- Imaging Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Ludovic Lacroix
- Molecular Biology Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Etienne Rouleau
- Molecular Biology Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Julien Adam
- Pathology Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Maria-Virginia Bluthgen
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Francesco Facchinetti
- Research Department (U981), Gustave Roussy Cancer Campus, Université Paris-Saclay, F-94805, Villejuif, France
| | - Lambros Tselikas
- Imaging Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Frank Aboubakar
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Charles Naltet
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Pernelle Lavaud
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Anas Gazzah
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Cécile Le Pechoux
- Radiation Therapy Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Nathalie Lassau
- Imaging Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
- IR4M, UMR 8081, CNRS, Université Paris-Saclay, F-91400, Orsay, France
| | - Corinne Balleyguier
- Imaging Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
- IR4M, UMR 8081, CNRS, Université Paris-Saclay, F-91400, Orsay, France
| | - David Planchard
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Benjamin Besse
- Cancer Medicine Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France
| | - Caroline Caramella
- Imaging Department, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France.
- IR4M, UMR 8081, CNRS, Université Paris-Saclay, F-91400, Orsay, France.
- Radiology Department, Gustave Roussy, 114 Rue Édouard-Vaillant, 94805, Villejuif Cedex, France.
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19
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Andreis TF, Correa BS, Vianna FS, De-Paris F, Siebert M, Leistner-Segal S, Hahn EC, Ulbrich JM, Rivero LFR, De Oliveira FH, Lorandi V, Ashton-Prolla P, Macedo GS. Analysis of Predictive Biomarkers in Patients With Lung Adenocarcinoma From Southern Brazil Reveals a Distinct Profile From Other Regions of the Country. J Glob Oncol 2020; 5:1-9. [PMID: 31532708 PMCID: PMC6872182 DOI: 10.1200/jgo.19.00174] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE Adenocarcinoma is the most common histologic subtype of non–small-cell lung cancer, representing 40% of all diagnoses. Several biomarkers are currently used to determine patient eligibility for targeted treatments, including analysis of molecular alterations in EGFR and ALK, as well as programmed death-ligand 1 (PD-L1) protein expression. Epidemiologic data reporting the frequency of these biomarkers in Brazilian patients with lung adenocarcinoma (LUAD) are limited, and existing studies predominantly included patients from the southeast region of the country. MATERIALS AND METHODS The goal of this study was to investigate the frequency of somatic mutations in the EGFR, KRAS, NRAS, and BRAF genes, ALK, and PD-L1 expression in a series of Brazilian patients diagnosed with LUAD predominantly recruited from centers in southern Brazil. Molecular analysis of the EGFR, KRAS, NRAS, and BRAF genes was performed by next-generation sequencing using DNA extracted from tumor tissue. Immunohistochemistry was used to detect ALK and PD-L1 expression. RESULTS Analysis of 619 tumors identified KRAS mutations in 189 (30.2%), EGFR mutations in 120 (19.16%), and BRAF mutations in 19 (3%). Immunohistochemistry demonstrated ALK and PD-L1 expression in 4% and 35.1% of patients, respectively. CONCLUSION To our knowledge, this is the first study investigating the molecular epidemiology of patients with LUAD from southern Brazil and the largest assessing the frequency of multiple predictive biomarkers for this tumor in the country. The study also reveals a distinct mutation profile compared with data originating from other regions of Brazil.
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Affiliation(s)
- Tiago F Andreis
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Bruno S Correa
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Fernanda S Vianna
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Marina Siebert
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | - Eriza C Hahn
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jane M Ulbrich
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | | | - Patricia Ashton-Prolla
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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20
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Zhou B, Xiong J. [Research Progress in Consistency of Driver Gene Status between Primary and Corresponding Metastatic Lesions in Non-small Cell Lung Cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 23:196-203. [PMID: 32102137 PMCID: PMC7118335 DOI: 10.3779/j.issn.1009-3419.2020.03.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
非小细胞肺癌(non-small cell lung cancer, NSCLC)作为肺癌最常见的病理类型,具有恶性程度高和侵袭性强的特点,晚期极易发生淋巴结和不同脏器转移。近年来,随着精准医学应用的深入,不断出现NSCLC转移部位的耐药和治疗失效为分子靶向治疗带来困扰,研究证实这些可能与肿瘤转移后发生的分子学改变有关。本文旨在阐述NSCLC原发灶与转移部位驱动基因状态,系统性综述两者间驱动基因状态一致性的研究进展,为探讨转移性NSCLC的分子靶向治疗提供新的思路。
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Affiliation(s)
- Bing Zhou
- Department of Pathology, The Affiliated Jiujiang Hospital of Nanchang University, Jiujiang 332000, China
| | - Jianping Xiong
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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21
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Meng H, Guo X, Sun D, Liang Y, Lang J, Han Y, Lu Q, Zhang Y, An Y, Tian G, Yuan D, Xu S, Geng J. Genomic Profiling of Driver Gene Mutations in Chinese Patients With Non-Small Cell Lung Cancer. Front Genet 2019; 10:1008. [PMID: 31749831 PMCID: PMC6842958 DOI: 10.3389/fgene.2019.01008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 09/23/2019] [Indexed: 01/15/2023] Open
Abstract
Worldwide, especially in China, lung cancer accounts to a major cause of mortality related to cancer. Treatment decisions mainly depend on oncogenic driver mutations, which offer novel therapeutic targets for anticancer therapy. However, studies of genomic profiling of driver gene mutations in mainland China are rare. Hence, this is an extensive study of these mutations in Non-small-cell lung cancer (NSCLC) Chinese patients. Comparison of driver gene mutations of lung adenocarcinoma with other races showed that the mutational frequencies were similar within the different East Asian populations, while there were differences between East Asian and non-Asian populations. Further, four promising candidates for druggable mutations of epidermal growth factor receptor (EGFR) were revealed that open up avenues to develop and design personal therapeutic approaches for patients harboring mutations. These results will help to develop personalized therapy targeting NSCLC.
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Affiliation(s)
- Hongxue Meng
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xuejie Guo
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Dawei Sun
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yuebin Liang
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Jidong Lang
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Yingmin Han
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Qingqing Lu
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Yanxiang Zhang
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Yanxin An
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Geng Tian
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Dawei Yuan
- Department of Medicine, Geneis (Beijing) Co., Ltd., Beijing, China
| | - Shidong Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jingshu Geng
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, China
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22
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Zhou B, Li L, Shi D, Jiang T, Xue G, Xiong J. Morphological characterization and molecular profiling of malignant pericardial effusion in patients with pulmonary adenocarcinoma. INDIAN J PATHOL MICR 2019; 62:566-571. [PMID: 31611441 DOI: 10.4103/ijpm.ijpm_69_19] [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: 11/04/2022] Open
Abstract
Context Malignant pericardial effusions (MPCEs) is a common complication observed in advanced pulmonary adenocarcinoma. In such cases, investigating molecular alterations can have significant therapeutic implication in determining anticancer drugs. Aim The objective was to evaluate the significance of cell block technique in the diagnosis of MPCE and further investigate the morphological and molecular profiles of MPCE in patients with pulmonary adenocarcinoma. Setting and Design Cytopathological and molecular profiles of 19 MPCE cases in patients with pulmonary adenocarcinoma were retrospectively analyzed. The control group consisted of 14 malignant pleural effusion (MPE) cases in patients with pulmonary adenocarcinoma. Materials and Methods Anaplastic lymphoma kinase (ALK) and tyrosine-protein kinase Met (C-MET) expression was evaluated by fluorescence in situ hybridization (FISH). Epithelial growth factor receptor (EGFR) and K-Ras (KRAS) mutations were detected by ARMS real-time polymerase chain reaction (RT-PCR). Statistical Analysis Used Associations between MPCE and MPE were analyzed using Fisher's exact test. Results MPCE was found to have micropapillary and solid pattern predominant with mucin secretion compared to acinar patterns, as seen in MPE. Seventeen MPCE cases (89.5%) and all MPE cases (100%) underwent molecular analysis. Mutations in EGFR and KRAS, ALK rearrangement, and C-MET amplification were observed in MPCE and MPE with statistical differences. Additionally, two MPCE cases demonstrated EGFR T790M mutation and multiple insertions at L858. Conclusions MPCE shows micropapillary and solid cytological patterns predominant with mucin secretion. MPCE are suitable to analyze oncogenic mutations and to develop targeted therapy for patients with pulmonary adenocarcinoma. Further molecular investigations may reveal novel molecular alterations.
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Affiliation(s)
- Bing Zhou
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang; Department of Pathology, The Affiliated Jiujiang Hospital of Nanchang University, Jiujiang, Jiangxi, P.R. China
| | - Lin Li
- Department of Gerontology, Wuhan No. 1 Hospital, Wuhan, Hubei, P.R. China
| | - Dayou Shi
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Tao Jiang
- Department of Pathology, The Affiliated Jiujiang Hospital of Nanchang University, Jiujiang, Jiangxi, P.R. China
| | - Guohui Xue
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
| | - Jianping Xiong
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, P.R. China
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23
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Wang Z, Li J, Wu Y, Wang H. Combined identification of LncRNA CCAT1 and SOX2OT in serum as an effective screening for non-small cell lung cancer. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:3975-3981. [PMID: 31933793 PMCID: PMC6949749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Long non-coding RNAs (lncRNAs) CCAT1 and SOX2OT have been shown to play important regulatory roles in cancer biology. Tumor biomarkers need to be detectable in easily accessible body fluids, should be characterized by high specificity, sufficient sensitivity, and robustness against influencing factors. The aim of this study is to evaluate the clinical significance of serum CCAT1 and SOX2OT as a biomarker in the screening of NSCLC. RESULTS CCAT1 and SOX2OT were shown to be detectable in the cellular fraction of peripheral human blood, showing serum levels of CCAT1 and SOX2OT were significantly increased of cancer patients as compared to cancer-free controls. The ROC curves illustrated strong separation between the NSCLC patients and control group, with an AUC of 0.846 (95% CI 0.766-0.926; P < 0.001) for CCAT1 and 0.787 (95% CI: 0.691-0.883; P < 0.001) for SOX2OT. However, the combination of SOX2OT and CCAT1 yielded an AUC of 0.894 (95% CI: 0.825-0.963; P < 0.001), which was significantly improved as compared to CCAT1 or SOX2OT alone. Moreover, the interaction between lncRNAs and some functional proteins, such as TTF1, p63, Ck7, K-ras, EGFR, may contribute to the tumorigenesis. CONCLUSION Our results demonstrated that increased serum CCAT1 and SOX2OT could be used as a predictive biomarker for NSCLC screening, and that combination of CCAT1 and SOX2OT had a higher positive diagnostic efficiency of NSCLC than CCAT1 or SOX2OT alone.
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Affiliation(s)
- Zhipeng Wang
- School of Medicine, Jiangsu UniversityJiangsu, China
- Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu UniversityJiangsu, China
| | - Jian Li
- School of Medicine, Jiangsu UniversityJiangsu, China
- Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu UniversityJiangsu, China
| | - Yan Wu
- College of Marine Life and Fisheries, Jiangsu Ocean UniversityJiangsu, China
| | - Hongbin Wang
- College of Marine Life and Fisheries, Jiangsu Ocean UniversityJiangsu, China
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Comparison of Epidermal Growth Factor Receptor Gene Mutations Identified Using Pleural Effusion and Primary Tumor Tissue Samples in Non-Small Cell Lung Cancer. Appl Immunohistochem Mol Morphol 2019; 26:e44-e51. [PMID: 28800007 DOI: 10.1097/pai.0000000000000543] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although the use of pleural effusion samples for epidermal growth factor receptor (EGFR) testing in lung cancer is increasing, the accuracy rate and effectiveness of identifying EGFR mutations using these samples, rather than primary tumor tissue samples, is not established. MATERIALS AND METHODS One hundred ninety-two advanced, non-small cell lung cancer patients were enrolled into this study. All patients had primary tumor tissue and corresponding pleural effusion samples, and we employed the Amplification Refractory Mutation System to detect EGFR gene mutations in these samples. RESULT The number of EGFR mutations detected in primary tumor tissue and pleural effusion samples was 119 (61.98%) and 113 (58.85%), respectively. The EGFR-mutation rate was significantly higher in female than in male patients, and in adenocarcinoma than in nonadenocarcinoma patients (P=0.000). Single mutations in exons 19 and 21 were the predominant observed mutation type, and the overall concordance rate of EGFR-mutation status between the 192 matched pleural effusion and primary tumor tissue samples was 86.98%. CONCLUSIONS We observed a high concordance rate between EGFR mutations identified using primary tumor tissue and corresponding pleural effusion samples by Amplification Refractory Mutation System. Thus, it is likely that pleural effusion sampling from advanced non-small cell lung cancer patients, especially those with adenocarcinoma, may be effective in EGFR-mutation screening.
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25
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KRAS Exon 3 and PTEN Exon 7 Mutations in Small-cell Lung Cancer. Curr Med Sci 2019; 39:379-384. [PMID: 31209806 DOI: 10.1007/s11596-019-2046-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/26/2019] [Indexed: 12/21/2022]
Abstract
Small cell lung cancer (SCLC) is recognized as one of the most aggressive and fatal malignant tumors. No significant improvement has been made to prolong the survival of SCLC patients. This study aimed to examine the mutation status of K-Ras (KRAS) and phosphatase and tensin homolog (PTEN) in SCLC patients in order to identify potential therapeutic targets for SCLC. Nineteen primary SCLC tumor specimens were enrolled in the study. Direct sequencing was performed to detect the mutations of KRAS exon 3 and PTEN exon 7 in the specimens. Kaplan- Meier and Cox regression analysis was performed to determine the overall survival (OS) of these SCLC patients. KRAS exon 3 mutation was found in 4 (21%) SCLC patients, and PTEN exon 7 mutation in only 1 (5%) SCLC patient. Kaplan Meier analysis showed that clinical stage and brain metastasis were significantly associated with OS (both P<0.05), but neither KRAS exon 3 mutation nor PTEN exon 7 mutation was significantly associated with OS (P>0.05). Cox proportional hazards regression model indicated that extensive stage of disease was the only independent negative prognostic factor for OS in SCLC patients. In conclusion, KRAS exon 3 and PTEN exon 7 mutations had no significant impact on OS of SCLC patients. Further study is still necessary to validate the molecular profiles of SCLC.
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26
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Pang C, Ma H, Qin J, Wang S, Wan C, Yang T, Shen Y, Wang D. Pleural effusion as a substitute for tumor tissue in detecting EGFR/ALK mutations in non-small cell lung cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15450. [PMID: 31045816 PMCID: PMC6504331 DOI: 10.1097/md.0000000000015450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Pleural effusion (PE) has been reported useful in many studies for testing epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) with variable results. This systematic review and meta-analysis was performed to elucidate whether PE could be used as a surrogate for tumor tissue to detect EGFR mutations. METHODS We extracted 2 × 2 diagnostic table from each included study and calculated data on specificity, sensitivity, negative likelihood ratio (NLR), positive likelihood ratio (PLR) ,and diagnostic odds ratio (DOR). We used the area under curve (AUC) and summary receiver operating characteristic curve (SROC) to summarize the overall diagnostic performance and assessed publication bias by Deeks' funnel plot. RESULTS Our meta-analysis included 15 eligible publications. The following summary estimates for diagnostic parameters of the EGFR mutations detection in PE were made: sensitivity, 0.86 (95%CI 0.83-0.89); specificity, 0.93 (95%CI 0.91-0.95); PLR, 8.53 (95%CI 5,94-12.25); NLR, 0.18 (95%CI 0.13-0.25); DOR, 63.40 (95%CI 38.83-103.51); and AUC, 0.94. Funnel plot indicated publication bias insignificant. CONCLUSIONS The meta-analysis suggests that EGFR mutation detecting in PE, especially supernatants, is a promising surrogate for tumor tissue in EGFR mutations testing of patients with NSCLC.
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Affiliation(s)
- Caishuang Pang
- Chongqing University Cancer Hospital& Chongqing Cancer Institute & Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing
| | - Huiwen Ma
- Chongqing University Cancer Hospital& Chongqing Cancer Institute & Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing
| | - Jiangyue Qin
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
| | - Sixiong Wang
- Chongqing University Cancer Hospital& Chongqing Cancer Institute & Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing
| | - Chun Wan
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
| | - Ting Yang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
| | - Yongchun Shen
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University and Division of Pulmonary Diseases, State Key Laboratory of Biotherapy of China, Chengdu, China
| | - Donglin Wang
- Chongqing University Cancer Hospital& Chongqing Cancer Institute & Chongqing Cancer Hospital and Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing
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27
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Choi SY, Kim HW, Jeon SH, Kim BN, Kang N, Yeo CD, Park CK, Kim YK, Lee YH, Lee KY, Lee SH, Park JY, Park MS, Yim HW, Kim SJ. Comparison of PANAMutyper and PNAClamp for Detecting KRAS Mutations from Patients With Malignant Pleural Effusion. In Vivo 2019; 33:945-954. [PMID: 31028221 PMCID: PMC6559923 DOI: 10.21873/invivo.11563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 02/27/2019] [Accepted: 03/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND/AIM KRAS is one of the frequently mutated genes in human cancers and often relates with drug resistance and poor prognosis. PANAMutyper™ is a novel technology that integrates PNAClamp™ and PANA S-Melting™. In the present study, PANAMutyper™ and PNAClamp™ were compared for the detection of KRAS mutations using different samples of patients with malignant pleural effusion. PATIENTS AND METHODS A total of 103 patients (including 56 lung adenocarcinoma, 10 lung squamous carcinoma, 17 small cell lung cancer, 3 large cell lung cancer, 3 stomach cancer, 2 ovarian cancer, and others) with malignant pleural effusion were investigated using matched tumor tissue, cell block, and pleural effusion samples. The diagnostic performance of these two methods was compared. RESULTS KRAS mutations were detected in 18 (17.5%) of 103 patients using tissue, cell block, and pleural effusion samples. All 18 patients with KRAS mutations were detected by PANAMutyper™ using any sample type, however, only 7 cases were detected by PNAClamp™. Among the subtypes of KRAS mutations, substitution in codon 12, 35G>T was the most frequent, followed by substitution in codon 12, 35G>A and codon 12, 34G>A. In pleural effusion specimens, PANAMutyper™ showed a better diagnostic performance compared to PNAClamp™. CONCLUSION PANAMutyper™ had a diagnostic superiority for the detection of KRAS mutations in patients with malignant pleural effusion compared to PNAClamp™, although there was a concordance between PANAMutyper™ and PNAClamp™ results. Therefore, PANAMutyper™ can be used for a more sensitive and accurate detection of KRAS mutations.
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Affiliation(s)
- Su Yeon Choi
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Hoon Jeon
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bit Na Kim
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Nahyeon Kang
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang Dong Yeo
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kwon Park
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Kyoon Kim
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon Ho Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyo Young Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sug Hyung Lee
- Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, U.S.A
| | - Mi Sun Park
- Department of Biostatistics, Clinical Research Coordinating Center, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeon Woo Yim
- Department of Biostatistics, Clinical Research Coordinating Center, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Nie Y, Liu H, Tan X, Wang H, Li F, Li C, Han P, Lyv X, Xu X, Guo M. Correlation between high-resolution computed tomography lung nodule characteristics and EGFR mutation in lung adenocarcinomas. Onco Targets Ther 2019; 12:519-526. [PMID: 30666130 PMCID: PMC6330973 DOI: 10.2147/ott.s184217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The aim of this study was to investigate the correlation of EGFR mutation on the high-resolution computed tomography (HRCT) features in lung adenocarcinoma. Patients and methods A total of 121 patients were diagnosed with lung adenocarcinoma from January 2014 to December 2016. The correlation of indexes (gender, age, tumor diameter, and EGFR mutation) was analyzed based on the HRCT characteristics of lung adenocarcinoma. Results There were 73 cases of EGFR mutation and 48 cases of wild-type EGFR. One hundred and three cases had pleural indentation that was significant in patients with EGFR mutation than those with wild-type EGFR (P=0.038). Forty-two out of 121 cases exhibited the bronchus cutoff sign. Patients with EGFR mutation were likely to develop the bronchus cutoff sign (P=0.017). Sixty-one out of 121 cases exhibited the lobulation sign, which was significant in patients with EGFR mutation than those with wild-type EGFR (P<0.001). A significant correlation was found between lobulation sign and tumor diameter (P=0.024). Forty-eight out of 121 and 23 out of 121 cases showed the vessel and vacuole signs, respectively. However, patients with EGFR mutation did not exert a significant correlation on either of these signs (P=0.555 and P=0.372, respectively). A statistical significance was not observed in indexes such as age, gender, and tumor diameter on pleural indentation, bronchus cutoff sign, vessel sign, and vacuole sign (P>0.05). Age and gender did not vary significantly in the lobulation sign (P>0.05). Conclusion HRCT characteristics such as pleural indentation, bronchus cutoff sign, and lobulation sign in lung adenocarcinoma with EGFR mutation were significantly greater than those with wild-type EGFR; however, further study is essential in determining the predictive ability of computed tomography (CT) for EGFR mutations in lung adenocarcinoma.
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Affiliation(s)
- Yunqiang Nie
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi 276000, China
| | - Hongjun Liu
- Department of Internal Medicine, 120 Emergency Command Center of Linyi City, Linyi 276002, China
| | - Xiao Tan
- Department of Pathology, Linyi People's Hospital, Linyi 276000, China
| | - Hui Wang
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi 276000, China
| | - Fuzhou Li
- Department of Radiology, Linyi People's Hospital, Linyi 276000, China
| | - Cuiyun Li
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi 276000, China
| | - Ping Han
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi 276000, China
| | - Xin Lyv
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi 276000, China
| | - Xinyi Xu
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi 276000, China
| | - Miao Guo
- Department of Geriatrics, Linyi People's Hospital, Linyi 276000, China,
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Oh DK, Ji WJ, Kim WS, Choi CM, Yoon SK, Rho JK, Lee JC. Efficacy, safety, and resistance profile of osimertinib in T790M mutation-positive non-small cell lung cancer in real-world practice. PLoS One 2019; 14:e0210225. [PMID: 30625213 PMCID: PMC6326493 DOI: 10.1371/journal.pone.0210225] [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: 09/12/2018] [Accepted: 12/18/2018] [Indexed: 12/26/2022] Open
Abstract
The efficacy and safety of osimertinib were demonstrated in clinical trials; however, real-world clinical data, particularly the resistance profile, are limited. Here, we investigated the efficacy, safety, and resistance profile of osimertinib in real-world practice. We reviewed medical records of T790M mutation-positive lung cancer patients who started osimertinib between February 2016 and June 2017. Molecular pathologic data of biopsy samples obtained after acquisition of resistance to osimertinib were also analyzed. The study included 23 patients with a median age of 59 years. The median follow-up duration was 11.9 months (IQR, 4.7–15.8). Objective response was achieved in 17 (73.9%) patients, and the disease was controlled in 22 (95.7%) patients. Median progression-free survival (PFS) was 7.4 months (95% CI, 3.6–11.0). Adverse events were minimal except for one case of pneumonitis. Of 14 patients experiencing disease progression, 10 underwent re-biopsy. The T790M mutation disappeared in seven patients (70%), and one showed wild-type conversion. PFS was shorter in the T790M-loss group than in the T790M-persistent group (4.4 vs. 7.7 months). Two patients with small cell transformation responded well to subsequent chemotherapy. One patient developed a C797S mutation that became undetectable after two cycles of gemcitabine and cisplatin followed by six cycles of pembrolizumab, after which the patient responded well to osimertinib. In conclusion, osimertinib showed favorable efficacy and safety in real-world practice comparable to those observed in clinical trials. Repeat biopsy after the acquisition of resistance to osimertinib is helpful to direct further treatment strategies.
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Affiliation(s)
- Dong Kyu Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Jun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Sung Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Shin-Kyo Yoon
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Kyung Rho
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail:
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The Frequency of EGFR and KRAS Mutations in the Turkish Population with Non-small Cell Lung Cancer and their Response to Erlotinib Therapy. Balkan J Med Genet 2018; 21:21-26. [PMID: 30984520 PMCID: PMC6454234 DOI: 10.2478/bjmg-2018-0022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In this study, profiles of epidermal growth factor receptor (EGFR) and Kirsten ras sarcoma (KRAS) mutations and response to erlotinib therapy have been investigated in patients with non-small cell lung cancer (NSCLC). DNA from 300 patients with NSCLC was extracted from paraf-fin-embedded tissues. After the extracted DNA was sequenced by pyrosequencing method, a total of 97 (32.0%) patients out of 300 were detected to carry an EGFR mutation and 75 (25.0%) patients out of 300 carried a KRAS mutation; 20 (6.6%) patients were detected to carry both of EGFR and KRAS mutations. The EGFR mutations were found to be statistically significant in female patients (48.0 women vs. 28.0% men, non smokers (49.0 vs. 26.0%) and adenocarcinoma (37.8 vs. squamous 26.8%). The overall rate of survival in patients receiving erlotinib therapy than in patients who did not. In patients without the KRAS mutation, the median overall survival rate was 161 ± 30 weeks with erlotinib therapy and 90 ± 13 weeks in patients without erlotinib therapy. In patients having KRAS mutation, the median overall survival was 98 ± 16 weeks with erlotinib therapy and 34 ± 16 weeks with no erlotinib therapy. In our study, we once again demonstrated that the presence of these mutations affected response to erlotinib therapy. The KRAS mutations negatively affected survival rate with and without erlotinib therapy.
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Thompson JC, Fan R, Black T, Yu GH, Savitch SL, Chien A, Yee SS, Sen M, Hwang WT, Katz SI, Feldman M, Vachani A, Carpenter EL. Measurement and immunophenotyping of pleural fluid EpCAM-positive cells and clusters for the management of non-small cell lung cancer patients. Lung Cancer 2018; 127:25-33. [PMID: 30642547 DOI: 10.1016/j.lungcan.2018.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES A malignant pleural effusion (MPE) is a common complication in non-small cell lung cancer (NSCLC) with important staging and prognostic information. Patients with MPEs are often candidates for advanced therapies, however, the current gold standard, cytological analysis of pleural fluid samples, has limited sensitivity. We aimed to demonstrate the feasibility of non-invasive enumeration and immunophenotyping of EpCAM-positive cells in pleural fluid samples for the diagnosis of a MPE in NSCLC patients. MATERIALS AND METHODS Pleural fluid specimens were prospectively collected from patients with NSCLC and the CellSearch® technology was utilized for the enumeration of pleural EpCAM-positive cells (PECs) and determination of PD-L1 expression on PECs from pleural fluid samples. The diagnostic performance of the enumeration of single PECs and PEC clusters was assessed using receiver operating characteristic (ROC) curves. The Kaplan-Meier method and Cox proportional hazards model was used to assess the impact of PECs and PEC clusters on overall survival (OS). RESULTS 101 NSCLC patients were enrolled. The median number of PECs was significantly greater in the malignant (n = 84) versus non-malignant group (n = 17) (730 PECs/mL vs 1.0 PEC/mL, p < 0.001). The area under the ROC curve was 0.91. A cutoff value of 105 PECs/mL had a sensitivity and specificity of 73% and 100% for the diagnosis of a MPE, respectively. Among 69 patients with a pathology-confirmed MPE and tissue immunohistochemistry (IHC) results, 15 (22%) had greater than 50% PD-L1+ PECs. Overall concordance between tissue and PEC PD-L1 expression was 76%. Higher numbers of pleural effusion single PECs were associated with inferior overall survival (Cox adjusted HR 1.8, 95% CI: 1.02-3.05 p = 0.043). CONCLUSION Non-invasive measurement of PECs in NSCLC patients, using an automated, clinically available approach, may improve the diagnostic accuracy of a MPE, allow for immunophenotyping of PECs, and provide prognostic information.
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Affiliation(s)
- Jeffrey C Thompson
- Division of Pulmonary, Allergy and Critical Care Medicine, Thoracic Oncology Group, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
| | - Ryan Fan
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Taylor Black
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Gordon H Yu
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, United States
| | - Samantha L Savitch
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Austin Chien
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Stephanie S Yee
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Moen Sen
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Wei-Ting Hwang
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States; Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Sharyn I Katz
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Michael Feldman
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, United States; Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Anil Vachani
- Division of Pulmonary, Allergy and Critical Care Medicine, Thoracic Oncology Group, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Erica L Carpenter
- Division of Hematology-Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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Kordiak J, Szemraj J, Grabska-Kobylecka I, Bialasiewicz P, Braun M, Kordek R, Nowak D. Intratumor heterogeneity and tissue distribution of KRAS mutation in non-small cell lung cancer: implications for detection of mutated KRAS oncogene in exhaled breath condensate. J Cancer Res Clin Oncol 2018; 145:241-251. [PMID: 30368666 PMCID: PMC6325989 DOI: 10.1007/s00432-018-2779-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022]
Abstract
Purpose Mutated KRAS oncogene in exhaled breath condensate (EBC) can be a genetic marker of non-small cell lung cancer (NSCLC). However, a possibility of inhomogeneous distribution in cancer tissue and intratumor heterogeneity of KRAS mutation may decrease its significance. We investigated a status of KRAS point mutation and its sequence at codon 12 in 51 NSCLC patients after tumor resection. The comparison of KRAS mutation status between EBC–DNA and cancer tissue was performed in 19 cases. Methods Five cancer tissue samples from disparate tumor regions and one from normal lung were harvested at surgery. EBC was collected for DNA analysis the previous day. KRAS point mutations at codon 12 were detected using mutant-enriched PCR technique and pyrosequenced. Results Forty-six cancers revealed concordance of KRAS mutation status: 27 contained mutated KRAS and 19 had only wild KRAS. Five NSCLCs revealed inhomogeneous distribution of KRAS mutation. Two different mutations were found in 14 NSCLCs and the most frequent one was G12D and G12V (n = 8). No mutated KRAS was found in normal lung. The concordance ratios of KRAS sequence in codon 12 between EBC–DNA and cancer were 18/19 for NSCLC patients and 11/12 for KRAS mutation positive NSCLC. Conclusions Intratumor heterogeneity and inhomogeneous distribution of KRAS point mutation in codon 12 in cancer tissue can occur in NSCLCs. There was a high accordance between KRAS mutation status in EBC–DNA and cancer tissue in NSCLC patients what suggests usefulness of monitoring KRAS mutation in EBC–DNA as a biomarker of NSCLC.
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Affiliation(s)
- Jacek Kordiak
- Department of Chest Surgery, Oncologic and General Surgery, Medical University of Lodz, University Hospital No. 2, Zeromskiego St. 113, 91-647, Lodz, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Mazowiecka St. 6/8, 92-215, Lodz, Poland
| | - Izabela Grabska-Kobylecka
- Department of Clinical Physiology, Medical University of Lodz, Mazowiecka St. 6/8, 92-215, Lodz, Poland
| | - Piotr Bialasiewicz
- Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Mazowiecka St. 6/8, 92-215, Lodz, Poland
| | - Marcin Braun
- Department of Pathology, Medical University of Lodz, Pomorska St. 251, 92-215, Lodz, Poland
| | - Radzisław Kordek
- Department of Pathology, Medical University of Lodz, Pomorska St. 251, 92-215, Lodz, Poland
| | - Dariusz Nowak
- Department of Clinical Physiology, Medical University of Lodz, Mazowiecka St. 6/8, 92-215, Lodz, Poland.
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Roepman P, ten Heuvel A, Scheidel KC, Sprong T, Heideman DA, Seldenrijk KA, Herder GJ, Kummer JA. Added Value of 50-Gene Panel Sequencing to Distinguish Multiple Primary Lung Cancers from Pulmonary Metastases. J Mol Diagn 2018; 20:436-445. [DOI: 10.1016/j.jmoldx.2018.02.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 01/30/2018] [Accepted: 02/22/2018] [Indexed: 12/14/2022] Open
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Arfaoui Toumi A, Blel A, Aloui R, Zaibi H, Ksentinini M, Boudaya MS, Znaidi N, Zidi Y, Aouina H, Rammeh Rommani S. Assessment of EGFR mutation status in Tunisian patients with pulmonary adenocarcinoma. Curr Res Transl Med 2018. [PMID: 29540329 DOI: 10.1016/j.retram.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Despite recent advances, non-small cell lung cancer carries a grim prognosis. For appropriate treatment selection, the updated guidelines recommend broad molecular profiling for all patients with pulmonary adenocarcinoma. Precise histological subtyping and targeted epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) testing are mandatory. METHODS Herein, we assessed the EGFR mutation status of 26 formalin fixed-paraffin embedded (FFPE) samples of lung adenocarcinoma. Mutational analysis concerned exons 18-21 of EGFR by real-time polymerase chain reaction (Real time-PCR) using the Therascreen EGFR RGQ PCR mutation kit. ALK status was established on 22 among 26 patients using D5F3 antibody with a fully automated Ventana CDx technique. RESULTS Activating EGFR mutations were found in 3 men among 26 patients (11.5%). Positive ALK expression was found in 2 cases among 22 patients (9.09%). CONCLUSION Frequency of EGFR mutations in pulmonary adenocarcinomas of our series is similar to that found in the European ones with some particularities. The mutations detected are uncommon. Whereas, we found a high frequency of positive ALK expression in our series compared to frequency reported in literature. Further studies with larger Tunisian series are required to obtain more conclusive results.
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Affiliation(s)
- A Arfaoui Toumi
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia.
| | - A Blel
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - R Aloui
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - H Zaibi
- Department of Pneumology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - M Ksentinini
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - M S Boudaya
- Department of Surgery, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - N Znaidi
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - Y Zidi
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - H Aouina
- Department of Pneumology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - S Rammeh Rommani
- Department of Pathology, Charles Nicolle Hospital Tunis, Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
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Chiang CL, Wang LC, Ho HL, Tsai CM, Yeh YC, Hsu WH, Chou TY, Chiu CH, Wu YC. Effect of postoperative systemic therapy on pulmonary adenocarcinoma with unexpected pleural spread detected during thoracotomy or thoracoscopy. Oncotarget 2017; 9:5435-5444. [PMID: 29435191 PMCID: PMC5797062 DOI: 10.18632/oncotarget.23686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/18/2017] [Indexed: 02/04/2023] Open
Abstract
Background Occasionally, malignant pleural disease is only detected unexpectedly during surgery in patients with pulmonary adenocarcinoma. Previous studies mostly focused on the role of main tumor resection on patient's outcome, barely addressing the position of postoperative systemic therapy. Methods The medical records of 5321 non-small cell lung cancer patients who underwent thoracic surgery between January 1990 and December 2012 were reviewed. Pulmonary adenocarcinoma patients with unexpected pleural spread noted during surgery were included. The clinical and postoperative treatment variables were assessed for correlation with overall survival. Results In 134 patients identified, main tumor resection was performed in 87 (64.9%) patients, while 89 (66.4%) and 57 (42.5%) patients received postoperative chemotherapy and epidermal growth factor receptor- tyrosine kinase inhibitor (EGFR -TKI) therapy, respectively. Overall, the 5-year survival rate was 30.2% and median survival time was 29.3 months. Multivariate analysis showed main tumor resection and EGFR-TKI therapy were associated with better survival. Mutational status of EGFR was available in 57 patients and 43 (75.4%) had activating mutations. Resection of the main tumor conferred a better outcome in patients without EGFR mutation or with unknown EGFR mutation status and had not been treated with EGFR-TKI therapy (P = 0.003), but not in those with activating EGFR mutation and had been treated with EGFR-TKI (P = 0.857). Conclusions In pulmonary adenocarcinoma patients with unexpected pleural spread detected during surgery, main tumor resection and EGFR-TKI therapy correlated with better survival. Identifying EGFR mutation status before surgery can provide useful information for clinical decision during surgery.
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Affiliation(s)
- Chi-Lu Chiang
- Division of Thoracic Oncology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Lei-Chi Wang
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiang-Ling Ho
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chun-Ming Tsai
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Chen Yeh
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wen-Hu Hsu
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Teh-Ying Chou
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chao-Hua Chiu
- Division of Thoracic Oncology, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chung Wu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
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Yang SR, Lin CY, Stehr H, Long SR, Kong CS, Berry GJ, Zehnder JL, Kunder CA. Comprehensive Genomic Profiling of Malignant Effusions in Patients with Metastatic Lung Adenocarcinoma. J Mol Diagn 2017; 20:184-194. [PMID: 29269277 DOI: 10.1016/j.jmoldx.2017.10.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/17/2017] [Accepted: 10/25/2017] [Indexed: 12/20/2022] Open
Abstract
Cytology samples are increasingly used for comprehensive molecular testing. Although fine-needle aspirates are adequate substrates for high-throughput sequencing, the suitability of malignant body fluids remains largely unexplored. We investigated the adequacy and utility of performing targeted next-generation sequencing (NGS) on malignant effusions from patients with metastatic lung adenocarcinoma. Thirty-two effusion samples submitted for hybrid capture-based NGS using a clinically validated solid tumor genotyping panel were examined. All cases showed ≥5% tumor cellularity; however, 28 (88%) provided sufficient DNA for NGS (≥1 ng/μL). The sequencing reads showed satisfactory quality control statistics, and the variant allele frequencies were correlated with tumor cellularity. Furthermore, pathogenic or likely pathogenic genomic alterations were identified in 26 of 28 samples (93%), whereas clinically actionable alterations were present in 18 (64%). Notably, nine patients had additional molecular testing performed on preceding or subsequent biopsy specimens, and the results across multiple samples were compared. In two patients, the NGS-based fluid analysis identified clinically actionable alterations that were not detected by other hotspot testing. In four patients treated with tyrosine kinase inhibitors, malignant fluid sequencing confirmed driver alterations from prior testing and revealed new resistance mechanisms. Hence, given adequate DNA input and tumor cellularity, comprehensive genomic profiling of malignant effusions may be used to establish mutational status at diagnosis and inform treatment resistance during targeted therapy.
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Affiliation(s)
- Soo-Ryum Yang
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Chieh-Yu Lin
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Henning Stehr
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Steven R Long
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Christina S Kong
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Gerald J Berry
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - James L Zehnder
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Christian A Kunder
- Department of Pathology, Stanford University School of Medicine, Stanford, California.
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Doval DC, Sinha R, Batra U, Choudhury KD, Azam S, Mehta A. Clinical profile of nonsmall cell lung carcinoma patients treated in a single unit at a tertiary cancer care center. Indian J Cancer 2017; 54:193-196. [PMID: 29199689 DOI: 10.4103/0019-509x.219591] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent advances and understanding in the field of lung cancer and advent of newer treatments have shown a significant improvement in survival in the patients. The present study was conducted to analyze the clinical profile of nonsmall cell lung cancer (NSCLC) patients treated in a single unit at a tertiary cancer care center. MATERIALS AND METHODS In this retrospective analysis, 322 consecutive NSCLC patients from the year 2011 to 2012 treated in a single unit were included in the study. Patients with proven NSCLC were included in the study. The details of the patients included the demographic profile, pathological diagnosis as well as imaging data, tumor profile, details of treatment, and follow-up information. RESULTS The majority of the patients (95.6%) were in the age group >40 years. A large group of the patients (57.1%) were present/reformed smokers. The major histological type was adenocarcinoma (60.9%), of which 22.8% patients were found to be epidermal growth factor receptor positive. Anaplastic lymphoma kinase rearrangement positivity rate was 4.8%. Furthermore, 68% patients had Stage 4 disease. Upfront palliative chemotherapy (CT) was offered in 61.8% patients and pemetrexed with platinum compounds was the main CT regimen (46.6%). Partial response was achieved in 45.7% patients, whereas stable disease was observed in 10.9% cases. Median progression-free survival was 5 months and overall survival was 55% at 36 months. CONCLUSION NSCLC forms the largest subgroup of lung cancer with the patients presenting with advanced stages of disease. This area needs to be explored for the early detection and subsequently the radical treatment of the patients. Personalized approach may be considered for the management of lung cancer by identifying new predictive and prognostic biomarkers of this disease.
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Affiliation(s)
- D C Doval
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi; Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - R Sinha
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - U Batra
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - K D Choudhury
- Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - S Azam
- Department of Research, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - A Mehta
- Department of Laboratory Services, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
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Inoue T, Matsumura Y, Araki O, Karube Y, Maeda S, Kobayashi S, Chida M. Epidermal Growth Factor Receptor Gene Mutation in Pleural Lavage Cytology Findings of Primary Lung Adenocarcinoma Cases. Ann Thorac Cardiovasc Surg 2017; 24:1-5. [PMID: 29093430 DOI: 10.5761/atcs.oa.17-00088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE In the present study, we examined the relationship between intraoperative pleural lavage cytology findings and presence of epidermal growth factor receptor (EGFR) gene mutations. METHODS We investigated 160 patients who underwent surgical treatment for primary lung adenocarcinoma at our hospital from January 2011 to December 2013 to determine the presence of EGFR gene mutations and pleural lavage cytology. RESULTS In all, 52 subjects (31.5%) were positive EGFR gene mutations, of whom 38 were found to possess the Exon 21 L858R mutation. Intraoperative pleural lavage cytology examinations were performed in 160 subjects and 12 had positive results, of whom 6 were positive for EGFR gene mutations, which was the Exon 21 L858R mutation in all. In a comparison between subjects possessing the Exon 21 L858R mutation and those negative for EGFR gene mutations, lavage cytology-positive (p = 0.02) and vascular infiltration-negative (p = 0.01) were characteristics of the Exon 21 L868R mutation-positive group. CONCLUSION Subjects positive for the EGFR Exon 21 L858R mutation had a higher positive rate of intraoperative pleural lavage cytology than those not possessing EGFR mutations.
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Affiliation(s)
- Takashi Inoue
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Yuji Matsumura
- Department of Cardiothoracic Surgery, Dokkyo Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Osamu Araki
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Yoko Karube
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Sumiko Maeda
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Satoru Kobayashi
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Masayuki Chida
- Department of General Thoracic Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan
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Zhao J, Dinkel J, Warth A, Penzel R, Reinmuth N, Schnabel P, Muley T, Meister M, Zabeck H, Steins M, Yang JY, Zhou Q, Schlemmer HP, Herth FJF, Kauczor HU, Heussel CP. CT characteristics in pulmonary adenocarcinoma with epidermal growth factor receptor mutation. PLoS One 2017; 12:e0182741. [PMID: 28949965 PMCID: PMC5614426 DOI: 10.1371/journal.pone.0182741] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 07/24/2017] [Indexed: 12/12/2022] Open
Abstract
Comprehensively investigate the association of CT morphology and clinical findings of adenocarcinoma with EGFR mutation status. Retrospectively included 282 patients who was pathologically proved as lung adenocarcinoma with known EGFR mutation status (mutations: 138 patients, female: 86, median age: 66 years; wildtype: 144 patients, female: 67, median age: 62 years) and their pre-treatment CT scans were analyzed. CT findings and clinical information were collected. Univariate and multivariable logistic regression analysis were performed. Adjusted for age, gender and smoking history of two groups, significantly more patients with pleural tags, pleural and liver metastases were found in the EGFR mutated group (P = 0.007, 0.004, and 0.043, respectively). Multivariable logistic regression analysis found that the model included age, gender, smoking history, air bronchogram, pleural tags, pleural and liver metastasis had a moderate predictive value for EGFR mutation status (AUC = 0.741, P < .0001). Exon-19 deletion was associated with air bronchogram which adjusted for age, gender and smoking history (P = 0.007, OR: 2.91, 95%CI: 1.25–7.79). The evidence of pleural tags, pleural and liver metastases go along with a higher probability of EGFR mutation in adenocarcinoma patients and air bronchogram is positively associated with Exon-19 deletion mutation.
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Affiliation(s)
- Jing Zhao
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Department of Diagnostic and Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- * E-mail: (Zhao J); (Yang J.Y)
| | - Julien Dinkel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
| | - Arne Warth
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Roland Penzel
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Niels Reinmuth
- Airway Center North (ARCN), LungenClinic Grosshansdorf GmbH, Großhansdorf, Germany
| | - Philipp Schnabel
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Muley
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Translational Research Unit, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Michael Meister
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Translational Research Unit, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Heike Zabeck
- Department of Thoracic Surgery, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Martin Steins
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Department of Thoracic Oncology, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Jian-yong Yang
- Department of Diagnostic and Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
- * E-mail: (Zhao J); (Yang J.Y)
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Heinz-Peter Schlemmer
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Felix J. F. Herth
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Department of Pneumology and Respiratory Critical Care Medicine, Thoraxklinik at University of Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
| | - Claus Peter Heussel
- Department of Diagnostic and Interventional Radiology, University Hospital of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), Heidelberg, Germany
- Department of Radiology, German Cancer Research Center (dkfz), Heidelberg, Germany
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Ding X, Zhang Y, Yang H, Mao W, Chen B, Yang S, Ding X, Zou D, Mo W, He X, Zhang X. Long non-coding RNAs may serve as biomarkers in breast cancer combined with primary lung cancer. Oncotarget 2017; 8:58210-58221. [PMID: 28938549 PMCID: PMC5601645 DOI: 10.18632/oncotarget.17356] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/07/2017] [Indexed: 12/25/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) have been shown to play important regulatory role in certain type of cancers biology, including breast and lung cancers. However, the lncRNA expression in breast cancer combined with primary lung cancer remains unknown. In this study, databases of the Cancer Genome Atlas (TCGA) and the lncRNA profiler of contained candidate 192 lncRNAs were utilized. 11 lncRNAs were differentially expressed in breast cancer, 9 candidate lncRNAs were differentially expressed in lung cancer. In order to find the aberrant expression of lncRNAs in breast cancer combined with primary lung cancer, seven samples of primary breast cancer and lung cancer were studied for the expression of selected lncRNAs. The results showed that SNHG6 and NEAT1 were reversely expressed in breast cancer combined with primary lung cancer compared with primary breast or lung cancer. In addition, a significant correlation of lncRNAs was found in the patients whose age was above 56 in breast cancer. What's more, PVT1 expression was negatively correlated with the pathological stage, and the level of ER, PR, HER2, p53 in breast cancer. Furthermore, lncRNA expression did not have significant relationship with the 5-year survival of patients with breast cancer combined with primary lung cancer. The findings revealed that PVT1, SNHG6, NEAT1 may serve as a prognostic marker for breast cancer combined with primary lung cancer. Therefore, these lncRNAs are potential molecular indicators in the diagnosis and prognosis of cancer in the future.
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Affiliation(s)
- Xianfeng Ding
- College of Life Science, Zhejiang Sci-Tech University, Hangzhou 310008, Zhejiang Province, China
| | - Yuhan Zhang
- College of Life Science, Zhejiang Sci-Tech University, Hangzhou 310008, Zhejiang Province, China
| | - Hongjian Yang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Weimin Mao
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Bo Chen
- Department of Pathology, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Shifeng Yang
- Department of Pathology, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Xiaowen Ding
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Dehong Zou
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Wenju Mo
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Xiangming He
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
| | - Xiping Zhang
- Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China
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Jian H, Li W, Ma Z, Huang J, Feng J, Song Y, Gao B, Zhu H, Tao M, Bai C, Ma S, Pan H, Qin S, Hua D, Yu Y, Lu S. Intercalating and maintenance gefitinib plus chemotherapy versus chemotherapy alone in selected advanced non-small cell lung cancer with unknown EGFR status. Sci Rep 2017; 7:8483. [PMID: 28814805 PMCID: PMC5559626 DOI: 10.1038/s41598-017-08399-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/07/2017] [Indexed: 12/18/2022] Open
Abstract
Epidermal growth factor receptor tyrosine-kinase inhibitors (EGFR-TKIs) are standard treatment for advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation. However, EGFR mutation testing is not attainable in approximately 20% of patients. The current study examined intercalating and maintaining gefitinib treatment in stage IIIB/IV non-squamous NSCLC, never or former light smoking patients with unknown EGFR mutation status. Briefly, 219 patients who achieved stable disease (SD) with gemcitabine (1250 mg/m2) plus carboplatin (5 AUC) were randomized at 1:1 ratio to continue chemotherapy (n = 110) or intercalating gefitinib (250 mg/day on days 15–25 of each cycle until disease progress (n = 109). Progression-free survival (PFS) was 9.7 vs. 4.2 month in the gefitinib vs. control arm (HR: 0.41, 95% CI: 0.31–0.56; P < 0.001). Overall survival (OS) was also longer in the gefitinib arm (20.1 vs. 15.4 months; HR: 0.68; 95% CI 0.48–0.97; P = 0.0323). Adverse events, including diarrhea, dermal reaction and thrombocytopenia, were more common in the gefitinib arm. In conclusion, intercalating and maintenance gefitinib treatment is a viable option for advanced NSCLC patients with unknown EGFR mutation status in subpopulations with high EFGR mutation rate.
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Affiliation(s)
- Hong Jian
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Cancer Center, the First Hospital of Jilin University, Changchun, China
| | - Zhiyong Ma
- Department of Internal Medicine, Henan Cancer Hospital, Zhengzhou, China
| | - Jianjin Huang
- Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Jifeng Feng
- Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing, China
| | - Yong Song
- Department of Respiratory Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing, China
| | - Beili Gao
- Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huili Zhu
- Department of Respiratory Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Min Tao
- Department of Oncology, The First Affiliated Hospital of Soochow University, Soochow, China
| | - Chong Bai
- Department of Respiratory Medicine, Changhai Hospital Affiliated to Shanghai Second Military Medical University, Shanghai, China
| | - Shenglin Ma
- Department of Radiotherapy, Hangzhou First People's Hospital, Hangzhou, China
| | - Hongming Pan
- Department of Medical Oncology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shukui Qin
- Department of Medical Oncology, PLA 81 Hospital, Nanjing, China
| | - Dong Hua
- Department of Medical Oncology, Wuxi Fourth People's Hospital, Wuxi, China
| | - Yongfeng Yu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Shun Lu
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
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Zheng Z, Xie D, Su H, Lin B, Zhao L, Deng X, Chen H, Fei S, Jin X, Xie C. Treatment outcome comparisons between exons 19 and 21 EGFR mutations for non-small-cell lung cancer patients with malignant pleural effusion after first-line and second-line tyrosine kinase inhibitors. Tumour Biol 2017; 39:1010428317706211. [PMID: 28618947 DOI: 10.1177/1010428317706211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Recent studies demonstrated a significantly increased frequency of epidermal growth factor receptor (EGFR) gene mutations in non-small cell lung cancer (NSCLC) patients with malignant pleural effusions (MPEs). The purpose of this study is to investigate the effect of first-line and second-line EGFR-tyrosine kinase inhibitors (TKIs) in the treatment of NSCLC with MPEs harboring exon 19 deletion and L858R mutation. From 2010 to 2015, 203 NSCLC patients with MPEs harboring EGFR mutation treated with EGFR-TKIs were reviewed. The efficacy were evaluated with Pearson chi-square or Fisher's exact tests, Log-rank test and Cox proportional hazards model. The objective response rate (ORR) and disease control rate (DCR) for patients treated with first-line and second-line EGFR-TKIs were 21.9%, 91.4% and 14.7%, 85.3%, respectively. The overall median PFS and OS of enrolled NSCLC patients with MPE were 9.3 months (95% CI, 8.4-10.2 months), 20.9 months (95% CI, 18.9-22.9 months) after first-line TKIs, and 7.6 months (95% CI, 6.6-8.6 months), 15.3 months (95% CI, 13.6-15.9 months) after second-line TKIs. The exon 19 deletion arm had a longer median PFS (9.4 vs 7.1 months, p=0.003) and OS (16.8 vs 13.8 months, p=0.003) compared with the L858R mutation arm after second-line TKIs. In a conclusion, EGFR genotype was an independent predictor of PFS and OS. No significant side effects differences between the two mutation groups was observed for first or second-line EGFR-TKIs. This study demonstrated that EGFR mutations are significant predictors for advanced NSCLC patients with MPE receiving second-line EGFR-TKIs treatment.
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Affiliation(s)
- Zhen Zheng
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Deyao Xie
- 2 Department of Thoracic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huafang Su
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Baochai Lin
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lihao Zhao
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xia Deng
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hanbin Chen
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shaoran Fei
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiance Jin
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Congying Xie
- 1 Department of Radiotherapy and Chemotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Lindquist KE, Karlsson A, Levéen P, Brunnström H, Reuterswärd C, Holm K, Jönsson M, Annersten K, Rosengren F, Jirström K, Kosieradzki J, Ek L, Borg Å, Planck M, Jönsson G, Staaf J. Clinical framework for next generation sequencing based analysis of treatment predictive mutations and multiplexed gene fusion detection in non-small cell lung cancer. Oncotarget 2017; 8:34796-34810. [PMID: 28415793 PMCID: PMC5471012 DOI: 10.18632/oncotarget.16276] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/01/2017] [Indexed: 12/26/2022] Open
Abstract
Precision medicine requires accurate multi-gene clinical diagnostics. We describe the implementation of an Illumina TruSight Tumor (TST) clinical NGS diagnostic framework and parallel validation of a NanoString RNA-based ALK, RET, and ROS1 gene fusion assay for combined analysis of treatment predictive alterations in non-small cell lung cancer (NSCLC) in a regional healthcare region of Sweden (Scandinavia). The TST panel was clinically validated in 81 tumors (99% hotspot mutation concordance), after which 533 consecutive NSCLCs were collected during one-year of routine clinical analysis in the healthcare region (~90% advanced stage patients). The NanoString assay was evaluated in 169 of 533 cases. In the 533-sample cohort 79% had 1-2 variants, 12% >2 variants and 9% no detected variants. Ten gene fusions (five ALK, three RET, two ROS1) were detected in 135 successfully analyzed cases (80% analysis success rate). No ALK or ROS1 FISH fusion positive case was missed by the NanoString assay. Stratification of the 533-sample cohort based on actionable alterations in 11 oncogenes revealed that 66% of adenocarcinomas, 13% of squamous carcinoma (SqCC) and 56% of NSCLC not otherwise specified harbored ≥1 alteration. In adenocarcinoma, 10.6% of patients (50.3% if including KRAS) could potentially be eligible for emerging therapeutics, in addition to the 15.3% of patients eligible for standard EGFR or ALK inhibitors. For squamous carcinoma corresponding proportions were 4.4% (11.1% with KRAS) vs 2.2%. In conclusion, multiplexed NGS and gene fusion analyses are feasible in NSCLC for clinical diagnostics, identifying notable proportions of patients potentially eligible for emerging molecular therapeutics.
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Affiliation(s)
| | - Anna Karlsson
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Per Levéen
- Department of Pathology, Regional Laboratories Region Skåne, Lund SE 22185, Sweden
| | - Hans Brunnström
- Department of Pathology, Regional Laboratories Region Skåne, Lund SE 22185, Sweden
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund SE 22185, Sweden
| | - Christel Reuterswärd
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Karolina Holm
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Mats Jönsson
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Karin Annersten
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Frida Rosengren
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Karin Jirström
- Department of Pathology, Regional Laboratories Region Skåne, Lund SE 22185, Sweden
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund SE 22185, Sweden
| | - Jaroslaw Kosieradzki
- Department of Respiratory Medicine and Allergology, Skane University Hospital, Lund SE22185, Sweden
| | - Lars Ek
- Department of Respiratory Medicine and Allergology, Skane University Hospital, Lund SE22185, Sweden
| | - Åke Borg
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
- CREATE Health Strategic Center for Translational Cancer Research, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Maria Planck
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
- Department of Oncology, Skåne University Hospital, Lund SE 22381, Sweden
| | - Göran Jönsson
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
- CREATE Health Strategic Center for Translational Cancer Research, Lund University, Medicon Village, Lund SE 22381, Sweden
| | - Johan Staaf
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Medicon Village, Lund SE 22381, Sweden
- CREATE Health Strategic Center for Translational Cancer Research, Lund University, Medicon Village, Lund SE 22381, Sweden
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Mutant KRAS promotes malignant pleural effusion formation. Nat Commun 2017; 8:15205. [PMID: 28508873 PMCID: PMC5440809 DOI: 10.1038/ncomms15205] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 03/08/2017] [Indexed: 12/19/2022] Open
Abstract
Malignant pleural effusion (MPE) is the lethal consequence of various human cancers metastatic to the pleural cavity. However, the mechanisms responsible for the development of MPE are still obscure. Here we show that mutant KRAS is important for MPE induction in mice. Pleural disseminated, mutant KRAS bearing tumour cells upregulate and systemically release chemokine ligand 2 (CCL2) into the bloodstream to mobilize myeloid cells from the host bone marrow to the pleural space via the spleen. These cells promote MPE formation, as indicated by splenectomy and splenocyte restoration experiments. In addition, KRAS mutations are frequently detected in human MPE and cell lines isolated thereof, but are often lost during automated analyses, as indicated by manual versus automated examination of Sanger sequencing traces. Finally, the novel KRAS inhibitor deltarasin and a monoclonal antibody directed against CCL2 are equally effective against an experimental mouse model of MPE, a result that holds promise for future efficient therapies against the human condition.
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Porcel JM, Lui MMS, Lerner AD, Davies HE, Feller-Kopman D, Lee YCG. Comparing approaches to the management of malignant pleural effusions. Expert Rev Respir Med 2017; 11:273-284. [PMID: 28271728 DOI: 10.1080/17476348.2017.1300532] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Management of symptomatic malignant pleural effusions is becoming more complex due to the range of treatment options, which include therapeutic thoracenteses, thoracoscopic talc pleurodesis, bedside pleurodesis with talc or other sclerosing agents via small-bore chest catheters, indwelling pleural catheters, surgery, or a combination of some of these procedures. Areas covered: Recent advances for the expanding range of treatment options in malignant pleural effusions are summarized, according to the best available evidence. Expert commentary: Selection of a treatment approach in malignant pleural effusions should take into account patient preferences and performance status, tumor type, predicted prognosis, presence of a non-expandable lung, and local experience or availability. The role of pleurodesis has decreased with the advent of indwelling pleural catheters, which provide a high degree of symptomatic relief on an outpatient basis and, therefore, are being positioned as a first choice therapy in many centers. Talc poudrage pleurodesis should probably be reserved for those situations in which pleural tumor invasion is discovered during diagnostic thoracoscopy. Ongoing randomized controlled trials will offer solid evidence on which of the available palliative approaches should be selected for each particular patient.
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Affiliation(s)
- José M Porcel
- a Pleural Medicine Unit, Department of Internal Medicine , Arnau de Vilanova University Hospital , Lleida , Spain.,b Institute for Biomedical Research Dr Pifarre Foundation, IRBLLEIDA , Lleida , Spain
| | - Macy Mei-Sze Lui
- c Division of Respiratory and Critical Care Medicine, Department of Medicine , Queen Mary Hospital, University of Hong Kong , Hong Kong , China
| | - Andrew D Lerner
- d Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Helen E Davies
- e Department of Respiratory Medicine , Cardiff and Vale University Health Board , Cardiff , Wales , UK
| | - David Feller-Kopman
- d Section of Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Y C Gary Lee
- f Respiratory Department , Sir Charles Gairdner Hospital , Western Australia , Perth , Australia.,g Respiratory Medicine , Sir Charles Gairdner Hospital , Perth , Western Australia , Australia.,h Pleural Medicine Unit , Institute of Respiratory Health , Western Australia , Perth , Australia.,i Centre for Respiratory Health, School of Medicine , University of Western Australia , Perth , Australia
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Nie Y, Gao W, Li N, Chen W, Wang H, Li C, Zhang H, Han P, Zhang Y, Lv X, Xu X, Liu H. Relationship between EGFR gene mutation and local metastasis of resectable lung adenocarcinoma. World J Surg Oncol 2017; 15:55. [PMID: 28253871 PMCID: PMC5335737 DOI: 10.1186/s12957-017-1103-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 01/13/2017] [Indexed: 12/12/2022] Open
Abstract
Background Resectable lung adenocarcinoma is dominated by peripheral distribution, and surgical resection is the main treatment protocol. However, high recurrence rate remains after surgery. Lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutation has strong invasion ability, but the effects of this mutation on local invasion in early lung adenocarcinoma have been rarely studied. This study aimed to assess the effects of EGFR mutation on local invasion in resectable lung adenocarcinoma. Methods A retrospective analysis of 103 patients clinically diagnosed with peripheral lung adenocarcinoma was included. They underwent preoperative bronchoscopy, which indicated grades 2 or 3 bronchial involvement (lumen of the lobe or segment). The associations of EGFR mutation with pleural invasion, endobronchial metastasis, and lymph node metastasis were analyzed according to pathologies of pleural invasion and lymph node metastasis, as well as EGFR gene mutation detected by postoperative pathological specimens. Statistical analyses were performed by unpaired Chi-square test using the SPSS16.0 software. Results In patients with EGFR mutation, pleural invasion, endobronchial metastasis, and lymph node metastasis rates were 62.5, 39.1, and 34.4%, respectively, indicating statistically significant differences (p = 0.003). Meanwhile, the pleural invasion rate in patients with wild-type EGFR was 43.6%, significantly reduced compared with patients with mutated EGFR (62.5%; p = 0.018). In addition, the endobronchial metastasis rate in patients with wild-type EGFR was 17.9%, significantly lower than in patients with EGFR mutation (39.1%; p = 0.005). However, lymph node metastasis rates were similar between EGFR mutated and wild-type patients (34.4 vs 25.6%, respectively, p > 0.05). Conclusions Early resectable lung adenocarcinoma patients with EGFR mutation showed a higher rate of local invasion compared with those harboring wild-type EGFR. This finding provides a basis for improved therapy. Trial registration This study was supported by Project of Medical and Health Science Technology in Shandong Province (2015WS0376)
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Affiliation(s)
- Yunqiang Nie
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Wei Gao
- Department of Blood Screening Test, Linyi People's Hospital, Linyi, 276000, China
| | - Na Li
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Wenjun Chen
- Department of Oncology, Linyi People's Hospital, Linyi, 276000, China
| | - Hui Wang
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Cuiyun Li
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Haiyan Zhang
- Department of Pathology, Linyi People's Hospital, Linyi, 276000, China
| | - Ping Han
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Yingmei Zhang
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Xin Lv
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Xinyi Xu
- Department of Respiratory Medicine, Linyi People's Hospital, Linyi, 276000, China
| | - Hongyan Liu
- Department of Medicine, Linyi People's Hospital, Linyi, 276000, China.
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Saffroy R, Morère JF, Bosselut N, Innominato PF, Hamelin J, Trédaniel J, Masse S, Dussaule-Duchatelle V, Balaton A, Validire P, Guettier C, Bouchahda M, Lemoine A. Impact of country of birth on genetic testing of metastatic lung adenocarcinomas in France: African women exhibit a mutational spectrum more similar to Asians than to Caucasians. Oncotarget 2017; 8:50792-50803. [PMID: 28881604 PMCID: PMC5584205 DOI: 10.18632/oncotarget.15132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/09/2017] [Indexed: 01/15/2023] Open
Abstract
Background Limited data are available on the prevalence of oncogenic driver mutations in Caucasian populations, and especially in Europeans. Aim To evaluate the targetable mutational spectra in unselected patients with lung adenocarcinoma in routine clinical practice from several French hospitals, using the same molecular platform. Patients and Methods Samples from 2,219 consecutive patients with histologically-proven advanced lung adenocarcinoma were centrally analysed at a referenced and certified diagnostic platform in order to test for activating and resistance mutations in EGFR, KRAS, BRAF, ERBB2 and PI3KCA. Demographic and clinical features were retrieved from the medical charts. Multivariate binary logistic regression was used to determine the independent predictive factors for the occurrence of specific mutations, in the whole study population or in selected subgroups. Findings The overall respective incidence of EGFR, KRAS, BRAF, ERBB2 and PI3KCA mutations was 10.5%, 0.9%, 25%, 1.5%, 2.1% and 1.4%, in our study sample including 87.4% white Caucasians, 10.8% Africans and 1.8% Asians; 60.6% men, 30.7% never smoker (median age: 68.3 years). Ethnicity was an independent predictor for EGFR, KRAS and ERBB2 gene abnormalities. In all cases, a significantly higher prevalence of targetable EGFR and ERBB2, and a lower prevalence of resistance KRAS mutations were observed in African women as compared to African men or Caucasians. Conclusions In real life conditions of routine genetic testing, we have identified subsets of patients with specific targetable activating somatic mutations according to ethnicity, who could preferentially benefit from anti-EGFR and anti-ERBB2 targeted therapies.
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Affiliation(s)
- Raphael Saffroy
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Jean-François Morère
- INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France.,AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France
| | - Nelly Bosselut
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Pasquale F Innominato
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France.,INSERM UMR-935, Université Paris-Sud, Hôpital Paul Brousse, Villejuif, France.,Cancer Chronotherapy Unit, Cancer Research Centre, Warwick Medical School, University of Warwick, Coventry, United Kingdom.,Department of Oncology, Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Jocelyne Hamelin
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Jean Trédaniel
- Hôpital Saint Joseph, Department of Respiratory Medicine, Université Paris 5, Paris, France
| | - Sophie Masse
- Groupe Hospitalier Nord Essonne, Department of Pathology, Longjumeau, France
| | | | - André Balaton
- Hôpital Saint Joseph, Department of Pathology, Paris, France.,ACP Bievres-les Ulis, Department of Pathology, Les Ulis, France
| | - Pierre Validire
- Institut Mutualiste Montsouris, Department of Pathology, Paris, France
| | - Catherine Guettier
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Pathology, Platform Oncomolpath/INCa, Villejuif, France
| | - Mohamed Bouchahda
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Medical Oncology, Villejuif, France.,Ramsay-GDS Clinique du Mousseau, Department of Medical Oncology, Evry, France
| | - Antoinette Lemoine
- AP-HP, GH Paris-Sud, Hôpital Paul Brousse, Department of Biochiemistry and Oncogenetics, Platform Oncomolpath/INCa, Villejuif, France.,INSERM UMR-S 1193, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
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49
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Lung cancer mutation profile of EGFR, ALK, and KRAS: Meta-analysis and comparison of never and ever smokers. Lung Cancer 2016; 102:122-134. [DOI: 10.1016/j.lungcan.2016.10.010] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/15/2016] [Accepted: 10/24/2016] [Indexed: 02/07/2023]
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50
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Ardakani NM, Giardina T, Grieu-Iacopetta F, Tesfai Y, Carrello A, Taylor J, Robinson C, Spagnolo D, Amanuel B. Detection of Epidermal Growth Factor Receptor Mutations in Lung Adenocarcinoma: Comparing Cobas 4800 EGFR Assay With Sanger Bidirectional Sequencing. Clin Lung Cancer 2016; 17:e113-e119. [DOI: 10.1016/j.cllc.2016.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 02/03/2016] [Accepted: 02/08/2016] [Indexed: 11/28/2022]
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