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Tan ES, Knepper TC, Wang X, Permuth JB, Wang L, Fleming JB, Xie H. Copy Number Alterations as Novel Biomarkers and Therapeutic Targets in Colorectal Cancer. Cancers (Basel) 2022; 14:2223. [PMID: 35565354 PMCID: PMC9101426 DOI: 10.3390/cancers14092223] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 12/10/2022] Open
Abstract
In colorectal cancer, somatic mutations have played an important role as prognostic and predictive biomarkers, with some also functioning as therapeutic targets. Another genetic aberration that has shown significance in colorectal cancer is copy number alterations (CNAs). CNAs occur when a change to the DNA structure propagates gain/amplification or loss/deletion in sections of DNA, which can often lead to changes in protein expression. Multiple techniques have been developed to detect CNAs, including comparative genomic hybridization with microarray, low pass whole genome sequencing, and digital droplet PCR. In this review, we summarize key findings in the literature regarding the role of CNAs in the pathogenesis of colorectal cancer, from adenoma to carcinoma to distant metastasis, and discuss the roles of CNAs as prognostic and predictive biomarkers in colorectal cancer.
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Affiliation(s)
- Elaine S. Tan
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive Tampa, Tampa, FL 33612, USA; (E.S.T.); (J.B.P.); (J.B.F.)
| | - Todd C. Knepper
- Department of Individualized Cancer Management, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive Tampa, Tampa, FL 33612, USA;
| | - Xuefeng Wang
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive Tampa, Tampa, FL 33612, USA;
| | - Jennifer B. Permuth
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive Tampa, Tampa, FL 33612, USA; (E.S.T.); (J.B.P.); (J.B.F.)
| | - Liang Wang
- Department of Tumor Biology, H. Lee Moffitt Cancer Center and Research Institute, 12901 USF Magnolia Drive Tampa, Tampa, FL 33612, USA;
| | - Jason B. Fleming
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive Tampa, Tampa, FL 33612, USA; (E.S.T.); (J.B.P.); (J.B.F.)
| | - Hao Xie
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive Tampa, Tampa, FL 33612, USA; (E.S.T.); (J.B.P.); (J.B.F.)
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2
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Yu Z, Wang H, Song Q, Huang J, Xu J, Su J, Wang H, Tan L, Wang X, Jiang Z, Chen W, Jiang D, Hou Y. Prognostic value and characterization of NTRK1 variation by fluorescence in situ hybridization in esophageal squamous cell carcinoma. J Cancer Res Clin Oncol 2021; 147:3113-3121. [PMID: 33963905 DOI: 10.1007/s00432-021-03578-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/20/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Rearrangement of the neurotrophic tyrosine kinase receptor (NTRK) 1 gene is a target of tropomyosin receptor kinase A (TRKA) inhibitors, and its targeted drug (larotrectinib) has been approved by the US Food and Drug Administration. We investigated the existence and prognostic importance of NTRK1 variation in esophageal squamous cell carcinoma (ESCC). METHODS Fluorescence in situ hybridization of a NTRK1 rearrangement was conducted on 523 ESCC samples through tissue microarrays. Kaplan-Meier curves with log-rank tests were used to evaluate survival. RESULTS We identified 8 (1.5%), 35(6.7%) and 109 (20.8%) cases with a NTRK1 rearrangement using 15%, 10% and 5% as cut-off values, respectively. We observed copy number (CN) variation of NTRK1 in some cases: 79 (15.1%) cases had a gain in NTRK1 CN ≥ 3, and 24 (4.6%) cases had NTRK1 CN ≥ 4. A NTRK1 rearrangement at the above-mentioned thresholds was not related to disease-free survival (DFS, P = 0.45, 0.47, 0.87) and overall survival (OS, P = 0.80, 0.74, 0.57), respectively. Gain in NTRK1 CN was associated with a poor prognosis irrespective of whether NTRK1 CN ≥ 4 (DFS, P = 0.015; OS, P = 0.035) or NTRK1 CN ≥ 3 (DFS, P = 0.039; OS, P = 0.025). CONCLUSION A NTRK1 rearrangement occurred rarely in ESCC. The increased CN of NTRK1 might be a prognostic indicator for DFS and OS in patients with ESCC.
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Affiliation(s)
- Zixiang Yu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Haixing Wang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Qi Song
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jie Huang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Jianfang Xu
- Department of Pathology, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, Fujian, 361015, People's Republic of China
| | - Jieakesu Su
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Hao Wang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Lijie Tan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Xin Wang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Zhengzeng Jiang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Weijie Chen
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China
| | - Dongxian Jiang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China.
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. .,Department of Pathology, School of Basic Medical Sciences and Zhongshan Hospital, Fudan University, Shanghai, 200032, People's Republic of China. .,Department of Pathology, Xiamen Branch of Zhongshan Hospital, Fudan University, Xiamen, Fujian, 361015, People's Republic of China.
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3
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EGFR gene copy number decreases during anti-EGFR antibody therapy in colorectal cancer. Hum Pathol 2018; 82:163-171. [PMID: 30096327 DOI: 10.1016/j.humpath.2018.07.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/18/2018] [Accepted: 07/23/2018] [Indexed: 12/18/2022]
Abstract
Epidermal growth factor receptor (EGFR) gene copy number (GCN) increase is associated with a favorable anti-EGFR antibody treatment response in RAS wild-type metastatic colorectal cancer. However, there are limited and comparative data regarding the EGFR GCN in primary colorectal cancer tumors and corresponding metastases or the effect of anti-EGFR antibody treatment on EGFR GCN in recurrent disease. In addition, little is known about the potential EGFR GCN changes during anti-EGFR therapy in comparison with other treatment regimens. EGFR GCN was analyzed by EGFR immunohistochemistry-guided silver in situ hybridization in primary and corresponding recurrent local or metastatic tumors from 80 colorectal cancer patients. GCN levels were compared between KRAS wild-type patients having received anti-EGFR therapy and patients having received other forms of treatment after primary surgery. The EGFR GCN decrease between primary and recurrent tumors was more pronounced among the anti-EGFR-treated patients than among patients not treated with anti-EGFR therapy (P = .047). None of the patients experiencing an EGFR GCN increase of at least 1.0 between the primary and recurrent tumors were treated with anti-EGFR antibodies. When including only patients with distant metastases, an EGFR GCN decrease of at least 1.0 was more common among the anti-EGFR-treated patients than among patients not treated with anti-EGFR therapy (P = .028). Our results suggest that anti-EGFR antibody treatment is associated with EGFR GCN decrease between the primary and recurrent colorectal adenocarcinomas, whereas no GCN change is observed among patients receiving other forms of treatment after primary surgery.
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Tang C, Lin MB, Xu JL, Zhang LH, Zuo XM, Zhang ZS, Liu MX, Xu JM. Are ADC values of readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) correlated with pathological prognostic factors in rectal adenocarcinoma? World J Surg Oncol 2018; 16:138. [PMID: 30001205 PMCID: PMC6043992 DOI: 10.1186/s12957-018-1445-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
Background Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values as imaging biomarkers of rectal cancer are currently a hot research spot. The use of ADC values for preoperative judgment of pathological features in rectal cancer has been generally accepted. The image quality evaluation of conventional diffusion is severe deformation, and the measurement of ADC values can easily lead to bias. Readout-segmented echo-planar diffusion-weighted imaging (RESOLVE) provides high signal-to-noise ratio images and significantly reduces distortions caused by magnetosensitive effects. The purpose of this study was to explore the correlations between ADC values of RESOLVE and pathological prognostic factors in rectal adenocarcinoma. Methods We collected pathological data of 89 patients with pathologically confirmed rectal adenocarcinoma who directly underwent surgical resection without receiving adjuvant therapy. The patients were grouped according to the pathologic type, gross classification, degree of differentiation, TN stage, and immunohistochemical expression of epidermal growth factor receptor (EGFR). Results RESOLVE ADC values of rectal cancer were measured at b = 800, and correlations between the RESOLVE ADC values obtained in different groups were analysed. We found that RESOLVE ADC values in the ulcer-type group were significantly higher than those in the eminence-type group. Conclusion RESOLVE ADC values in different pathologic types of rectal cancer were significantly different. RESOLVE ADC values in the EGFR-positive group were significantly lower than those in the EGFR-negative group. There was no significant difference in RESOLVE ADC values between different degrees of pathologic differentiation, TN stages, and positive or negative lymph nodes. The quantitative description of RESOLVE ADC values could be used to assess the biological behaviour of rectal adenocarcinoma.
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Affiliation(s)
- Cui Tang
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Mou-Bin Lin
- Department of General Surgery, Tongji University Affiliated Yangpu Hospital, Shanghai, 200090, China
| | - Jin-Lei Xu
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Lan-Hua Zhang
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China
| | - Xiao-Ming Zuo
- Department of Pathology, Tongji University Affiliated Yangpu Hospital, Shanghai, 200090, China
| | | | | | - Jin-Ming Xu
- Department of Radiology, Tongji University Affiliated Yangpu Hospital, No. 450 Tengyue Road, Shanghai, 200090, China.
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5
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Birkman EM, Mansuri N, Kurki S, Ålgars A, Lintunen M, Ristamäki R, Sundström J, Carpén O. Gastric cancer: immunohistochemical classification of molecular subtypes and their association with clinicopathological characteristics. Virchows Arch 2017; 472:369-382. [PMID: 29046940 PMCID: PMC5886993 DOI: 10.1007/s00428-017-2240-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/05/2017] [Accepted: 09/25/2017] [Indexed: 12/13/2022]
Abstract
Gastric cancer is traditionally divided into intestinal and diffuse histological subtypes, but recent molecular analyses have led to novel classification proposals based on genomic alterations. While the intestinal- and diffuse-type tumours are distinguishable from each other at the molecular level, intestinal-type tumours have more diverse molecular profile. The technology required for comprehensive molecular analysis is expensive and not applicable for routine clinical diagnostics. In this study, we have used immunohistochemistry and in situ hybridisation in molecular classification of gastric adenocarcinomas with an emphasis on the intestinal subtype. A tissue microarray consisting of 244 gastric adenocarcinomas was constructed, and the tumours were divided into four subgroups based on the presence of Epstein-Barr virus, TP53 aberrations and microsatellite instability. The intestinal- and diffuse-type tumours were separately examined. The distribution of EGFR and HER2 gene amplifications was studied in the intestinal-type tumours. Epstein-Barr virus positive intestinal-type tumours were more common in male patients (p = 0.035) and most often found in the gastric corpus (p = 0.011). The majority of the intestinal-type tumours with TP53 aberrations were proximally located (p = 0.010). All tumours with microsatellite instability showed intestinal-type histology (p = 0.017) and were associated with increased overall survival both in the univariate (p = 0.040) and multivariate analysis (p = 0.015). In conclusion, this study shows that gastric adenocarcinomas can be classified into biologically and clinically different subgroups by using a simple method also applicable for clinical diagnostics.
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Affiliation(s)
- Eva-Maria Birkman
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland.
- Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland.
| | - Naziha Mansuri
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Samu Kurki
- Auria Biobank, University of Turku and Turku University Hospital, Kiinamyllynkatu 8, 20520, Turku, Finland
| | - Annika Ålgars
- Department of Oncology, Turku University Hospital, Hämeentie 11, 20520, Turku, Finland
- MediCity Research Laboratory, University of Turku, Tykistökatu 6, 20520, Turku, Finland
| | - Minnamaija Lintunen
- Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Raija Ristamäki
- Department of Oncology, Turku University Hospital, Hämeentie 11, 20520, Turku, Finland
| | - Jari Sundström
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
- Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Olli Carpén
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland
- Auria Biobank, University of Turku and Turku University Hospital, Kiinamyllynkatu 8, 20520, Turku, Finland
- Pathology, Research Programs Unit and HUSLAB, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 3, 00014, Helsinki, Finland
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Ålgars A, Sundström J, Lintunen M, Jokilehto T, Kytölä S, Kaare M, Vainionpää R, Orpana A, Österlund P, Ristimäki A, Carpen O, Ristamäki R. EGFR gene copy number predicts response to anti-EGFR treatment in RAS wild type and RAS/BRAF/PIK3CA wild type metastatic colorectal cancer. Int J Cancer 2016; 140:922-929. [PMID: 27879995 DOI: 10.1002/ijc.30507] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 09/15/2016] [Accepted: 10/05/2016] [Indexed: 12/17/2022]
Abstract
Anti-EGFR antibodies are used for the treatment of RAS wild type metastatic colorectal cancer. We previously showed that EGFR gene copy number (GCN) predicts response to anti-EGFR therapy in KRAS exon 2 wild type metastatic colorectal cancer. The aim of our study was to analyse the predictive role of EGFR GCN in RAS/BRAF/PIK3CA wild type metastatic colorectal cancer. The material included 102 patients with KRAS exon 2 wild type metastatic colorectal cancer treated with anti-EGFR ± cytotoxic therapy. Next generation sequencing was used for KRAS, NRAS, BRAF and PIK3CA gene mutation analyses. EGFR GCN was analysed by EGFR immunohistochemistry guided automated silver in situ hybridisation. Increased EGFR GCN (≥4.0) predicted a better response and prolonged progression free survival in anti-EGFR treated RAS/BRAF/PIK3CA wild type patients (Log-rank test, p = 0.0004). In contrast, survival of RAS/BRAF/PIK3CA wild type, EGFR GCN below 4.0 patients did not differ from patients with mutant RAS, BRAF or PIK3CA. Our study indicates that EGFR GCN predicts anti-EGFR treatment efficacy in patients with RAS/BRAF/PIK3CA wt metastatic CRC. Tumours with EGFR GCN below 4.0 appear to be as refractory to anti-EGFR treatment as tumours with mutation in any of the RAS/RAF/PIK3CA pathway genes.
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Affiliation(s)
- Annika Ålgars
- Department of Oncology, Turku University Hospital, Hämeentie 11, Turku, 20521, Finland.,MediCity Research Laboratory, University of Turku, Tykistökatu 6 A, Turku, 20520, Finland
| | - Jari Sundström
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, Turku, 20520, Finland.,Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, Turku, 20520, Finland
| | - Minnamaija Lintunen
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, Turku, 20520, Finland.,Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, Turku, 20520, Finland
| | - Terhi Jokilehto
- MediCity Research Laboratory, University of Turku, Tykistökatu 6 A, Turku, 20520, Finland.,Department of Pathology, University of Turku, Kiinamyllynkatu 10, Turku, 20520, Finland.,Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, Turku, 20520, Finland
| | - Soili Kytölä
- HUSLAB, Division of Pathology and Genetics, Helsinki University Hospital, Topeliuksenkatu 32, Helsinki, 00029 HUS, Finland
| | - Milja Kaare
- HUSLAB, Division of Pathology and Genetics, Helsinki University Hospital, Topeliuksenkatu 32, Helsinki, 00029 HUS, Finland
| | - Reetta Vainionpää
- HUSLAB, Division of Pathology and Genetics, Helsinki University Hospital, Topeliuksenkatu 32, Helsinki, 00029 HUS, Finland
| | - Arto Orpana
- HUSLAB, Division of Pathology and Genetics, Helsinki University Hospital, Topeliuksenkatu 32, Helsinki, 00029 HUS, Finland
| | - Pia Österlund
- Department of Oncology, Helsinki University Hospital, Haartmaninkatu 4, P.O. Box 180, Helsinki, 00290, Finland.,Clinicum/Oncology, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, Helsinki, 00014, Finland
| | - Ari Ristimäki
- Pathology, Research Programs Unit and HUSLAB, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 3, P.O. Box 21, Helsinki, 00014, Finland
| | - Olli Carpen
- Department of Pathology, University of Turku, Kiinamyllynkatu 10, Turku, 20520, Finland.,Department of Pathology, Turku University Hospital, Kiinamyllynkatu 10, Turku, 20520, Finland.,Pathology, Research Programs Unit and HUSLAB, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 3, P.O. Box 21, Helsinki, 00014, Finland.,Auria Biobank, University of Turku and Turku University Hospital, Kiinamyllynkatu 8, Turku, 20521, Finland
| | - Raija Ristamäki
- Department of Oncology, Turku University Hospital, Hämeentie 11, Turku, 20521, Finland
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Yang J, Li S, Wang B, Wu Y, Chen Z, Lv M, Lin Y, Yang J. Potential biomarkers for anti-EGFR therapy in metastatic colorectal cancer. Tumour Biol 2016; 37:11645-11655. [PMID: 27422777 DOI: 10.1007/s13277-016-5140-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/11/2016] [Indexed: 12/14/2022] Open
Abstract
Anti-epidermal growth factor receptor (EGFR) therapy has established efficacy in metastatic colorectal cancer, but a significant number of patients do not respond to such treatment. Recently, various biomarkers were reported to be useful in predicting resistance to anti-EGFR. All the potential biomarkers predicting resistance to anti-EGFR are reviewed herein from five aspects. First, upstream molecules, including epiregulin (EREG) and amphiregulin (AREG), might play different roles according to their abnormal levels in tumor tissue and serum. Second, the EGFR amplification and distinct polymorphisms may have roles in identifying patients for initial anti-EGFR mAbs therapy, while rare EGFR mutations have limited predictive values. Third, among the downstream molecularly related factors, rat sarcoma viral oncogene (Ras) has been identified as a successful predictor, while B-Raf proto-oncogene (BRAF) is considered as a prognostic factor rather than a predictor. Fourth, among the molecular bypass pathway components, phosphatidylinositol 3-kinase (PI3K) and phosphatase and tensin homolog (PTEN) may be potential biomarkers in the future, while activation of hepatocyte growth factor (HGF)/c-Met signaling confers resistance to anti-EGFR therapy. Fifth, many microRNAs and additional molecular biomarkers are promising in predicting the efficacy of anti-EGFR therapy. Applications of multiple biomarkers are more effective than the use of a single biomarker in selecting patients who might benefit from cetuximab- or panitumumab-based treatments. Comprehensive molecular analyses of the EGFR signaling pathways should be considered in the future. Subsequent prospective trials will be required to further confirm the clinical utility of these biomarkers.
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Affiliation(s)
- Jiao Yang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Shuting Li
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Biyuan Wang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Yinying Wu
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Zheling Chen
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Meng Lv
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Yayun Lin
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China
| | - Jin Yang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 Yanta West Road, Xi'an, 710061, Shaanxi Province, China.
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8
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Birkman EM, Ålgars A, Lintunen M, Ristamäki R, Sundström J, Carpén O. EGFR gene amplification is relatively common and associates with outcome in intestinal adenocarcinoma of the stomach, gastro-oesophageal junction and distal oesophagus. BMC Cancer 2016; 16:406. [PMID: 27387915 PMCID: PMC4936304 DOI: 10.1186/s12885-016-2456-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 06/23/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Approximately 50 % of gastric adenocarcinomas belong to a molecular subgroup characterised by chromosomal instability and a strong association with the intestinal histological subtype. This subgroup typically contains alterations in the receptor tyrosine kinase-RAS pathway, for example EGFR or HER2 gene amplifications leading to protein overexpression. In clinical practice, HER2 overexpressing metastatic gastric cancer is known to respond to treatment with anti-HER2 antibodies. By contrast, anti-EGFR antibodies have not been able to provide survival benefit in clinical trials, which, however, have not included patient selection based on the histological subtype or EGFR gene copy number analysis of the tumours. To examine the role of EGFR as a potential biomarker, we studied the prevalence, clinicopathological associations as well as prognostic role of EGFR and HER2 expression and gene amplification in intestinal adenocarcinomas of the stomach, gastro-oesophageal junction and distal oesophagus. METHODS Tissue samples from 220 patients were analysed with EGFR and HER2 immunohistochemistry. Those samples with moderate/strong staining intensity were further analysed with silver in situ hybridization to quantify gene copy numbers. The results were associated with clinical patient characteristics and survival. RESULTS Moderate/strong EGFR protein expression was found in 72/220 (32.7 %) and EGFR gene amplification in 31/220 (14.1 %) of the tumours, while moderate/strong HER2 protein expression was detected in 31/220 (14.1 %) and HER2 gene amplification in 29/220 (13.2 %) of the tumours. EGFR and HER2 genes were co-amplified in eight tumours (3.6 %). EGFR gene amplification was more common in tumours of distal oesophagus/gastro-oesophageal junction/cardia than in those of gastric corpus (p = 0.013). It was associated with shortened time to cancer recurrence (p = 0.026) and cancer specific survival (p = 0.033). CONCLUSIONS EGFR gene amplification is relatively common in intestinal adenocarcinomas and associates with decreased survival. It is rarely concurrent with HER2 gene amplification, suggesting that anti-EGFR therapies might be applicable to some patients not eligible for anti-HER2 treatment. Analogous to HER2 testing, determination of EGFR gene amplification status in concert with immunohistochemistry could improve the specificity of patient selection when investigating the possible benefits of anti-EGFR therapies in the treatment of gastric adenocarcinomas.
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Affiliation(s)
- Eva-Maria Birkman
- Department of Pathology, University of Turku and Turku University Hospital, TYKS-SAPA, Turku, Finland.
| | - Annika Ålgars
- Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland.,MediCity Research Laboratory, University of Turku, Turku, Finland
| | - Minnamaija Lintunen
- Department of Pathology, University of Turku and Turku University Hospital, TYKS-SAPA, Turku, Finland
| | - Raija Ristamäki
- Department of Oncology, University of Turku and Turku University Hospital, Turku, Finland
| | - Jari Sundström
- Department of Pathology, University of Turku and Turku University Hospital, TYKS-SAPA, Turku, Finland
| | - Olli Carpén
- Department of Pathology, University of Turku and Turku University Hospital, TYKS-SAPA, Turku, Finland.,Auria Biobank, Turku, Finland
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9
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Collazo-Lorduy A, Castillo-Martin M, Wang L, Patel V, Iyer G, Jordan E, Al-Ahmadie H, Leonard I, Oh WK, Zhu J, McBride RB, Cordon-Cardo C, Solit DB, Sfakianos JP, Galsky MD. Urachal Carcinoma Shares Genomic Alterations with Colorectal Carcinoma and May Respond to Epidermal Growth Factor Inhibition. Eur Urol 2016; 70:771-775. [PMID: 27178450 DOI: 10.1016/j.eururo.2016.04.037] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/27/2016] [Indexed: 02/02/2023]
Abstract
Metastatic urachal carcinoma is a rare, understudied, and aggressive malignancy with limited treatment options. Histologically, urachal carcinomas resemble enteric adenocarcinomas and anecdotally respond to systemic therapies utilized in colorectal cancer. Targeted exome sequencing of archival primary tumor tissue from a patient with metastatic urachal cancer revealed EGFR amplification and wild-type KRAS. The patient was treated with cetuximab, a monoclonal antibody directed against EGFR, as a single agent, and achieved a response lasting more than 8 mo. Subsequent whole-exome sequencing revealed no additional alterations likely to be associated with cetuximab sensitivity. Formalin-fixed, paraffin-embedded tumor specimens from nine additional urachal cancers were subjected to targeted exome sequencing. Mitogen-activated protein kinase (MAPK) pathway mutations were found in four of the nine samples, but no EGFR amplification was detected. Importantly, APC mutations were detected in two of the nine patients. To our knowledge, this is the first report of a response to single-agent cetuximab in a patient with metastatic urachal cancer and of molecular analysis to probe the basis for sensitivity. On the basis of these findings and the histologic, and now genomic, similarities with colorectal cancer, monoclonal antibodies directed at EGFR could be used in the treatment of metastatic urachal cancer. PATIENT SUMMARY Urachal cancers are morphologically and genomically similar to colon adenocarcinomas and may respond to drugs targeting the epidermal growth factor receptor.
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Affiliation(s)
- Ana Collazo-Lorduy
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Spanish Society of Medical Oncology, Madrid, Spain
| | | | - Li Wang
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Vaibhav Patel
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gopa Iyer
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emmet Jordan
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hikmat Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Issa Leonard
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - William K Oh
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jun Zhu
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Russell B McBride
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carlos Cordon-Cardo
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David B Solit
- Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John P Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew D Galsky
- Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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10
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Holst F. Estrogen receptor alpha gene amplification in breast cancer: 25 years of debate. World J Clin Oncol 2016; 7:160-173. [PMID: 27081639 PMCID: PMC4826962 DOI: 10.5306/wjco.v7.i2.160] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 01/05/2016] [Accepted: 02/16/2016] [Indexed: 02/06/2023] Open
Abstract
Twenty-five years ago, Nembrot and colleagues reported amplification of the estrogen receptor alpha gene (ESR1) in breast cancer, initiating a broad and still ongoing scientific debate on the prevalence and clinical significance of this genetic aberration, which affects one of the most important genes in breast cancer. Since then, a multitude of studies on this topic has been published, covering a wide range of divergent results and arguments. The reported prevalence of this alteration in breast cancer ranges from 0% to 75%, suggesting that ESR1 copy number analysis is hampered by technical and interpreter issues. To date, two major issues related to ESR1 amplification remain to be conclusively addressed: (1) The extent to which abundant amounts of messenger RNA can mimic amplification in standard fluorescence in situ hybridization assays in the analysis of strongly expressed genes like ESR1, and (2) the clinical relevance of ESR1 amplification: Such relevance is strongly disputed, with data showing predictive value for response as well as for resistance of the cancer to anti-estrogen therapies, or for subsequent development of cancers in the case of precursor lesions that display amplification of ESR1. This review provides a comprehensive summary of the various views on ESR1 amplification, and highlights explanations for the contradictions and conflicting data that could inform future ESR1 research.
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11
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Allard D, Allard B, Gaudreau PO, Chrobak P, Stagg J. CD73-adenosine: a next-generation target in immuno-oncology. Immunotherapy 2016; 8:145-63. [PMID: 26808918 DOI: 10.2217/imt.15.106] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Cancer immunotherapy has entered in a new era with the development of first-generation immune checkpoint inhibitors targeting the PD1/PD-L1 and CTLA-4 pathways. In this context, considerable research effort is being deployed to find the next generation of cancer immunotherapeutics. The CD73-adenosine axis constitutes one of the most promising pathways in immuno-oncology. We and others have demonstrated the immunosuppressive role of CD73-adenosine in cancer and established proof-of-concept that the targeted blockade of CD73 or adenosine receptors could effectively promote anti-tumor immunity and enhance the activity of first-generation immune checkpoint blockers. With Phase I clinical trials now underway evaluating anti-CD73 or anti-A2A therapies in cancer patients, we here discuss the fundamental, preclinical and clinical findings related to the role of the CD73-adenosinergic pathway in tumor immunity.
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Affiliation(s)
- David Allard
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Québec, Canada.,Faculté de Pharmacie, Université de Montréal, Québec, Canada
| | - Bertrand Allard
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Québec, Canada.,Faculté de Pharmacie, Université de Montréal, Québec, Canada
| | - Pierre-Olivier Gaudreau
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Québec, Canada.,Faculté de Pharmacie, Université de Montréal, Québec, Canada
| | - Pavel Chrobak
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Québec, Canada.,Faculté de Pharmacie, Université de Montréal, Québec, Canada
| | - John Stagg
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal et Institut du Cancer de Montréal, Québec, Canada.,Faculté de Pharmacie, Université de Montréal, Québec, Canada
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12
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Higaki E, Kuwata T, Nagatsuma AK, Nishida Y, Kinoshita T, Aizawa M, Nitta H, Nagino M, Ochiai A. Gene copy number gain of EGFR is a poor prognostic biomarker in gastric cancer: evaluation of 855 patients with bright-field dual in situ hybridization (DISH) method. Gastric Cancer 2016; 19:63-73. [PMID: 25487305 DOI: 10.1007/s10120-014-0449-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/17/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND EGFR overexpression is a prognostic biomarker and is expected to be a predictive biomarker for anti-EGFR therapies in gastric cancer. However, few studies have reported the clinical impact of EGFR gene copy number (GCN) and its correlation with EGFR overexpression. METHODS We used dual in situ hybridization (DISH) to detect EGFR GCN and chromosome 7 centromere (CEN7) in a set of tissue microarrays representing 855 patients with gastric cancer. These data were compared with those of immunohistochemical (IHC) analysis of EGFR expression to evaluate prognostic value. RESULTS EGFR GCN gain (≥ 2.5 EGFR signals per cell) was detected in 194 patients (22.7%) and indicated poor prognosis. Among 194 patients, EGFR amplification (EGFR/CEN7 ≥ 2.0) was observed in 29 patients (14.9%), which was almost identical to the IHC 3+ subgroup and worst prognostic subgroup. Patients with EGFR GCN gain but not amplification, including those exhibiting polysomy, also exhibited poorer prognosis than GCN non-gain patients and were distributed between IHC 0/1+ and 2+ subgroups. GCN gain was frequently observed in patients with more advanced disease, but served as an independent prognostic factor regardless of the pathological stage. CONCLUSIONS EGFR GCN gain is a more accurate prognostic biomarker than EGFR overexpression in patients with gastric cancer.
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Affiliation(s)
- Eiji Higaki
- Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Gastric Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Takeshi Kuwata
- Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Pathology and Clinical Laboratory, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Akiko Kawano Nagatsuma
- Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yasunori Nishida
- Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Gastric Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takahiro Kinoshita
- Department of Gastric Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Masaki Aizawa
- Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishi-cho, Chuo-ku, Niigata, 951-8566, Japan
| | - Hiroaki Nitta
- Technology and Applied Research, Ventana Medical Systems, Inc., 1910 E Innovation Park Drive, Tucson, AZ, 85755, USA
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Atsushi Ochiai
- Division of Pathology, Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
- Department of Pathology and Clinical Laboratory, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
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13
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Nakayama N, Yamashita K, Tanaka T, Kawamata H, Ooki A, Sato T, Nakamura T, Watanabe M. Genomic gain of the PRL-3 gene may represent poor prognosis of primary colorectal cancer, and associate with liver metastasis. Clin Exp Metastasis 2015; 33:3-13. [PMID: 26563151 DOI: 10.1007/s10585-015-9749-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/18/2015] [Indexed: 12/30/2022]
Abstract
PRL-3 genomic copy number is increased in colorectal cancer (CRC), and PRL-3 expression is closely associated with lymph node and liver metastasis of CRC. However, the clinical significance of PRL-3 genomic gain for CRC remains obscure. Here, PRL-3 genomic status in 109 primary CRC tumors and in 44 CRC tumors that had metastasized to the liver, was quantified using real time PCR. Association of PRL-3 genomic status with clinicopathological factors and prognosis was assessed in detail. PRL-3 genomic gain was identified in 31 primary CRC (27.4 %) and was more frequently seen in stage III than in stage II (p = 0.025). Among the clinicopathological factors assessed, PRL-3 genomic gain was significantly associated with poorly differentiated histology (p = 0.0039). Moreover, CRC patients with PRL-3 genomic gain exhibited poorer prognosis than those with no gain in stage II-IV CRC (p = 0.017). PRL-3 genomic gain was identified in 18 (41 %) of the liver metastasis tumors, and this frequency of gain was significantly increased as compared to that of the corresponding primary CRCs (11 %) (p = 0.001). Our findings suggested that PRL-3 genomic gain may represent an aggressive phenotype of primary CRC, and may associate with liver metastasis.
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Affiliation(s)
- N Nakayama
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
| | - K Yamashita
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan.
| | - T Tanaka
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
| | - H Kawamata
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
| | - A Ooki
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
| | - T Sato
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
| | - T Nakamura
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
| | - M Watanabe
- Department of Surgery, Kitasato University School of Medicine, Asamizodai 2-1-1, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan
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14
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Routila J, Bilgen T, Saramäki O, Grénman R, Visakorpi T, Westermarck J, Ventelä S. Copy number increase of oncoprotein CIP2A is associated with poor patient survival in human head and neck squamous cell carcinoma. J Oral Pathol Med 2015; 45:329-37. [PMID: 26436875 DOI: 10.1111/jop.12372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND CIP2A, an inhibitor of PP2A tumour suppressor function, is a widely overexpressed biomarker of aggressive disease and poor therapy response in multiple human cancer types. METHODS CIP2A and DPPA4 copy number alterations and expression were analysed by fluorescence in situ hybridisation (FISH) and immunohistochemistry (IHC) in different cell lines and a tissue microarray of 52 HNSCC patients. Results were correlated with patient survival and other clinicopathological data. RESULTS CIP2A and DPPA4 copy number increase occurred at a relatively high frequency in human HNSCC patient samples. CIP2A but not DPPA4 FISH status was significantly associated with patient survival. CIP2A detection by combining IHC with FISH yielded superior resolution in the prognostication of HNSCC. CONCLUSIONS CIP2A copy number increase is associated with poor patient survival in human HNSCC. We suggest that the reliability and prognostic value of CIP2A detection can be improved by performing FISH analysis to CIP2A IHC positive tumours.
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Affiliation(s)
- Johannes Routila
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
| | - Türker Bilgen
- Prostate Cancer Research Center, Institute of Biosciences and Medical Technology-BioMediTech, University of Tampere, Tampere, Finland.,Research and Application Centre for Scientific and Technological Investigations (NABILTEM), Namik Kemal University, Tekirdag, Turkey
| | - Outi Saramäki
- Prostate Cancer Research Center, Institute of Biosciences and Medical Technology-BioMediTech, University of Tampere, Tampere, Finland.,Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Reidar Grénman
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Tapio Visakorpi
- Prostate Cancer Research Center, Institute of Biosciences and Medical Technology-BioMediTech, University of Tampere, Tampere, Finland.,Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Jukka Westermarck
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department of Pathology, University of Turku, Turku, Finland
| | - Sami Ventelä
- Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland.,Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
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15
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Chen Y, Shi Y, Lin J, Ye YB, Wang XJ, Chen G, Guo ZQ. Combined Analysis of EGFR and PTEN Status in Patients With KRAS Wild-Type Metastatic Colorectal Cancer. Medicine (Baltimore) 2015; 94:e1698. [PMID: 26448020 PMCID: PMC4616741 DOI: 10.1097/md.0000000000001698] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
To determine the relationship between the expression of phosphatase and tensin homologue (PTEN) and epidermal growth factor receptor (EGFR) in metastatic colorectal cancer (mCRC) and the clinical outcome of cetuximab-containing chemotherapy. A total of 158 consecutive mCRC patients with wild-type KRAS status who received chemotherapy with or without cetuximab, and for whom tumor tissue was available, were enrolled. The EGFR and PTEN expression was determined by immunohistochemistry (IHC). A total of 158 mCRC patients with wild-type KRAS status were enrolled in the study; 51 patients received chemotherapy combined with cetuximab, 107 patients received chemotherapy alone. Patients who received chemotherapy combined with cetuximab had longer overall survival (OS) compared with patients who received chemotherapy alone. High EGFR expression was detected in 60 patients (38.0%), while normal PTEN expression was detected in 60 patients (59.5%). The PTEN status was significantly related with the histological grade. For patients who received chemotherapy combined with cetuximab the median OS of patients with high-expression of EGFR was longer than the OS of patients with low EGRF expression; 25.0 versus 19.0 months, P = 0.002. For patient with normal PTEN the median OS were longer than the median OS for patients with loss of PTEN; 24.0 versus 19.0 months, P = 0.026. The overall response rate (ORR) had a borderline association with EGFR and PTEN expression (P = 0.055 and 0.048, respectively). In a multivariate analysis, ECOG PS, EGFR status, chemotherapy ± cetuximab, and the interaction of EGFR or PTEN and chemotherapy ± cetuximab were independent prognostic factors for OS. Our findings show that chemotherapy combined with cetuximab demonstrated encouraging antitumor activity for mCRC patients with wild-type KRAS status. Especially, those who have high EGFR expression or normal PTEN expression were more likely to benefit from such a treatment strategy. Subsequent studies in clinical trial cohorts will be required to confirm the clinical utility of these markers.
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Affiliation(s)
- Yu Chen
- From the Department of Medical Oncology, Fujian Provincial Cancer Hospital, Fujian Medical University Teaching Hospital (YC, JL, X-JW, Z-QG); The Union Clinical Medical College of Fujian Medical University (YC); Department of Molecular Pathology, Fujian Provincial Cancer Hospital, Fujian Medical University Teaching Hospital (YS, GC); Laboratory of Immuno-Oncology, Fujian Provincial Cancer Hospital, Fujian Medical University Teaching Hospital (YBY); and Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian Province, People's Republic of China (YBY, GC)
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16
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Bertotti A, Papp E, Jones S, Adleff V, Anagnostou V, Lupo B, Sausen M, Phallen J, Hruban CA, Tokheim C, Niknafs N, Nesselbush M, Lytle K, Sassi F, Cottino F, Migliardi G, Zanella ER, Ribero D, Russolillo N, Mellano A, Muratore A, Paraluppi G, Salizzoni M, Marsoni S, Kragh M, Lantto J, Cassingena A, Li QK, Karchin R, Scharpf R, Sartore-Bianchi A, Siena S, Diaz LA, Trusolino L, Velculescu VE. The genomic landscape of response to EGFR blockade in colorectal cancer. Nature 2015; 526:263-7. [PMID: 26416732 PMCID: PMC4878148 DOI: 10.1038/nature14969] [Citation(s) in RCA: 346] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 07/22/2015] [Indexed: 11/09/2022]
Abstract
Colorectal cancer is the third most common cancer worldwide, with 1.2 million patients diagnosed annually. In late-stage colorectal cancer, the most commonly used targeted therapies are the monoclonal antibodies cetuximab and panitumumab, which prevent epidermal growth factor receptor (EGFR) activation. Recent studies have identified alterations in KRAS and other genes as likely mechanisms of primary and secondary resistance to anti-EGFR antibody therapy. Despite these efforts, additional mechanisms of resistance to EGFR blockade are thought to be present in colorectal cancer and little is known about determinants of sensitivity to this therapy. To examine the effect of somatic genetic changes in colorectal cancer on response to anti-EGFR antibody therapy, here we perform complete exome sequence and copy number analyses of 129 patient-derived tumour grafts and targeted genomic analyses of 55 patient tumours, all of which were KRAS wild-type. We analysed the response of tumours to anti-EGFR antibody blockade in tumour graft models and in clinical settings and functionally linked therapeutic responses to mutational data. In addition to previously identified genes, we detected mutations in ERBB2, EGFR, FGFR1, PDGFRA, and MAP2K1 as potential mechanisms of primary resistance to this therapy. Novel alterations in the ectodomain of EGFR were identified in patients with acquired resistance to EGFR blockade. Amplifications and sequence changes in the tyrosine kinase receptor adaptor gene IRS2 were identified in tumours with increased sensitivity to anti-EGFR therapy. Therapeutic resistance to EGFR blockade could be overcome in tumour graft models through combinatorial therapies targeting actionable genes. These analyses provide a systematic approach to evaluating response to targeted therapies in human cancer, highlight new mechanisms of responsiveness to anti-EGFR therapies, and delineate new avenues for intervention in managing colorectal cancer.
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Affiliation(s)
- Andrea Bertotti
- Department of Oncology, University of Turin Medical School, 10060 Candiolo, Turin, Italy.,Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy.,National Institute of Biostructures and Biosystems (INBB), 00136 Rome, Italy
| | - Eniko Papp
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | - Siân Jones
- Personal Genome Diagnostics, Baltimore, Maryland 21224, USA
| | - Vilmos Adleff
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | - Valsamo Anagnostou
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | - Barbara Lupo
- Department of Oncology, University of Turin Medical School, 10060 Candiolo, Turin, Italy.,Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Mark Sausen
- Personal Genome Diagnostics, Baltimore, Maryland 21224, USA
| | - Jillian Phallen
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | - Carolyn A Hruban
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | - Collin Tokheim
- Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland 21204, USA
| | - Noushin Niknafs
- Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland 21204, USA
| | | | - Karli Lytle
- Personal Genome Diagnostics, Baltimore, Maryland 21224, USA
| | - Francesco Sassi
- Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Francesca Cottino
- Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Giorgia Migliardi
- Department of Oncology, University of Turin Medical School, 10060 Candiolo, Turin, Italy.,Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Eugenia R Zanella
- Department of Oncology, University of Turin Medical School, 10060 Candiolo, Turin, Italy.,Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Dario Ribero
- Department of Surgery, Mauriziano Umberto I Hospital, 10128 Turin, Italy
| | - Nadia Russolillo
- Department of Surgery, Mauriziano Umberto I Hospital, 10128 Turin, Italy
| | - Alfredo Mellano
- Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Andrea Muratore
- Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Gianluca Paraluppi
- Liver Transplantation Center, San Giovanni Battista Hospital, 10126 Turin, Italy
| | - Mauro Salizzoni
- Liver Transplantation Center, San Giovanni Battista Hospital, 10126 Turin, Italy.,Department of Surgical Sciences, University of Turin Medical School, 10126 Turin, Italy
| | - Silvia Marsoni
- Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | | | | | - Andrea Cassingena
- Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, 20162 Milan, Italy
| | - Qing Kay Li
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | - Rachel Karchin
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.,Department of Biomedical Engineering, Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland 21204, USA
| | - Robert Scharpf
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
| | | | - Salvatore Siena
- Niguarda Cancer Center, Ospedale Niguarda Ca' Granda, 20162 Milan, Italy.,University of Milan Medical School, 20162 Milan, Italy
| | - Luis A Diaz
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.,Swim Across America Laboratory, The Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins, Baltimore, Maryland 21287, USA
| | - Livio Trusolino
- Department of Oncology, University of Turin Medical School, 10060 Candiolo, Turin, Italy.,Translational Cancer Medicine, Surgical Oncology, and Clinical Trials Coordination, Candiolo Cancer Institute - Fondazione del Piemonte per l'Oncologia IRCCS, 10060 Candiolo, Turin, Italy
| | - Victor E Velculescu
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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17
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Acquired resistance to anti-EGFR mAb ICR62 in cancer cells is accompanied by an increased EGFR expression, HER-2/HER-3 signalling and sensitivity to pan HER blockers. Br J Cancer 2015; 113:1010-9. [PMID: 26372697 PMCID: PMC4651123 DOI: 10.1038/bjc.2015.319] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/15/2015] [Accepted: 08/12/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The human epidermal growth factor receptor (EGFR) is an important target for cancer treatment. Currently, only the EGFR antibodies cetuximab and panitumumab are approved for the treatment of patients with colorectal cancer. However, a major clinical challenge is a short-term response owing to development of acquired resistance during the course of the treatment. METHODS In this study, we investigated the molecular mechanisms underlying development of acquired resistance in DiFi colorectal cancer cells to the anti-EGFR mAb ICR62 (termed DiFi62) and to the small molecule tyrosine kinase inhibitor (TKI) gefitinib (termed DiFiG) using a range of techniques. RESULTS Compared with the findings from parental DiFi and DiFiG cells, development of acquired resistance to anti-EGFR mAb ICR62 in DiFi62 cells was accompanied by an increase in cell surface EGFR and increased phosphorylation of HER-2 and HER-3. Interestingly, DiFi62 cells also acquired resistance to treatment with anti-EGFR mAbs cetuximab and ICR61, which bind to other distinct epitopes on the extracellular domain of EGFR, but these cells remained equally sensitive as the parental cells to treatment with pan-HER inhibitors such as afatinib. CONCLUSIONS Our results provide a novel mechanistic insight into the development of acquired resistance to EGFR antibody-based therapy in colorectal cancer cells and justify further investigations on the therapeutic benefits of pan-HER family inhibitors in the treatment of colorectal cancer patients once acquired resistance to EGFR antibody-based therapy is developed.
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18
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Hutchinson RA, Adams RA, McArt DG, Salto-Tellez M, Jasani B, Hamilton PW. Epidermal growth factor receptor immunohistochemistry: new opportunities in metastatic colorectal cancer. J Transl Med 2015; 13:217. [PMID: 26149458 PMCID: PMC4492076 DOI: 10.1186/s12967-015-0531-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Accepted: 05/12/2015] [Indexed: 02/06/2023] Open
Abstract
The treatment of cancer is becoming more precise, targeting specific oncogenic drivers with targeted molecular therapies. The epidermal growth factor receptor has been found to be over-expressed in a multitude of solid tumours. Immunohistochemistry is widely used in the fields of diagnostic and personalised medicine to localise and visualise disease specific proteins. To date the clinical utility of epidermal growth factor receptor immunohistochemistry in determining monoclonal antibody efficacy has remained somewhat inconclusive. The lack of an agreed reproducible scoring criteria for epidermal growth factor receptor immunohistochemistry has, in various clinical trials yielded conflicting results as to the use of epidermal growth factor receptor immunohistochemistry assay as a companion diagnostic. This has resulted in this test being removed from the licence for the drug panitumumab and not performed in clinical practice for cetuximab. In this review we explore the reasons behind this with a particular emphasis on colorectal cancer, and to suggest a way of resolving the situation through improving the precision of epidermal growth factor receptor immunohistochemistry with quantitative image analysis of digitised images complemented with companion molecular morphological techniques such as in situ hybridisation and section based gene mutation analysis.
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Affiliation(s)
- Ryan A Hutchinson
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
- Waring Laboratory, Department of Pathology, Centre for Translational Pathology, University of Melbourne, Parkville, 3010, VIC, Australia.
| | - Richard A Adams
- Institute of Cancer and Genetics, Cardiff University School of Medicine, Institute of Medical Genetics Building, Heath Park, Cardiff, CF14 4XN, UK.
| | - Darragh G McArt
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
| | - Manuel Salto-Tellez
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
| | - Bharat Jasani
- Department of Biomedical Sciences, Nazarbayev University School of Medicine, Astana, 010000, Kazakhstan.
| | - Peter W Hamilton
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
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Kiviniemi A, Gardberg M, Frantzén J, Parkkola R, Vuorinen V, Pesola M, Minn H. Serum levels of GFAP and EGFR in primary and recurrent high-grade gliomas: correlation to tumor volume, molecular markers, and progression-free survival. J Neurooncol 2015; 124:237-45. [PMID: 26033547 DOI: 10.1007/s11060-015-1829-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/25/2015] [Indexed: 11/28/2022]
Abstract
Our aim was to study the association of two potential serum biomarkers glial fibrillary acidic protein (GFAP) and epidermal growth factor receptor (EGFR) with prognostic markers such as IDH1 mutation, tumor burden, and survival in patients with high-grade gliomas (HGG). Additionally, our objective was to evaluate the potential of serum EGFR as a surrogate marker for EGFR status in the tumor. Pre-operative serum samples were prospectively collected from patients with primary (n = 17) or recurrent (n = 10) HGG. Serum GFAP and EGFR levels were determined by ELISA and studied for correlation with molecular markers including EGFR amplification, tumor volume in contrast-enhanced T1-weighted MRI, and progression-free survival (PFS). Pre-operative serum GFAP level of ≥0.014 ng/ml was 86 % sensitive and 85 % specific for the diagnosis of glioblastoma. High GFAP was related to the lack of IDH1 mutation (P = 0.016), high Ki67 proliferation index (P < 0.001), and poor PFS (HR 5.9, CI 1.2-29.9, P = 0.032). Serum GFAP correlated with enhancing tumor volume in primary (r = 0.64 P = 0.005), but also in recurrent HGGs (r = 0.76 P = 0.011). In contrast, serum EGFR levels did not differ between HGG patients and 13 healthy controls, and were not related to EGFR status in the tumor. We conclude that high serum GFAP associates with IDH1 mutation-negative HGG, and poor PFS. Correlation with tumor burden in recurrent HGG implicates the potential of serum GFAP for detection of tumor recurrence. Our results suggest that circulating EGFR is not derived from glioma cells and cannot be used as a marker for EGFR status in the tumor.
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Affiliation(s)
- Aida Kiviniemi
- Department of Radiology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland.
| | - Maria Gardberg
- Department of Pathology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Janek Frantzén
- Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Ville Vuorinen
- Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland
| | - Marko Pesola
- Department of Radiology, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521, Turku, Finland
| | - Heikki Minn
- Department of Oncology and Radiotherapy, Turku University Hospital, Hämeentie 11, 20521, Turku, Finland
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Kiviniemi A, Gardberg M, Frantzén J, Pesola M, Vuorinen V, Parkkola R, Tolvanen T, Suilamo S, Johansson J, Luoto P, Kemppainen J, Roivainen A, Minn H. Somatostatin receptor subtype 2 in high-grade gliomas: PET/CT with (68)Ga-DOTA-peptides, correlation to prognostic markers, and implications for targeted radiotherapy. EJNMMI Res 2015; 5:25. [PMID: 25977882 PMCID: PMC4420768 DOI: 10.1186/s13550-015-0106-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 04/14/2015] [Indexed: 01/20/2023] Open
Abstract
Background High-grade gliomas (HGGs) express somatostatin receptors (SSTR), rendering them candidates for peptide receptor radionuclide therapy (PRRT). Our purpose was to evaluate the potential of 68Ga-DOTA-1-Nal3-octreotide (68Ga-DOTANOC) or 68Ga-DOTA-Tyr3-octreotide (68Ga-DOTATOC) to target SSTR subtype 2 (SSTR2) in HGGs, and to study the association between SSTR2 expression and established biomarkers. Methods Twenty-seven patients (mean age 52 years) with primary or recurrent HGG prospectively underwent 68Ga-DOTA-peptide positron emission tomography/computed tomography (PET/CT) before resection. Maximum standardized uptake values (SUVmax) and receptor binding potential (BP) were calculated on PET/CT and disruption of blood–brain barrier (BBB) from contrast-enhanced T1-weighted magnetic resonance imaging (MRI-T1-Gad). Tumor volume concordance between PET and MRI-T1-Gad was assessed by Dice similarity coefficient (DC) and correlation by Spearman’s rank. Immunohistochemically determined SSTR2 status was compared to receptor imaging findings, prognostic biomarkers, and survival with Kruskal-Wallis, Pearson chi-square, and multivariate Cox regression, respectively. Results All 19 HGGs with disrupted BBB demonstrated tracer uptake. Tumor SUVmax (2.25 ± 1.33) correlated with MRI-T1-Gad (r = 0.713, P = 0.001) although DC 0.41 ± 0.19 suggested limited concordance. SSTR2 immunohistochemistry was regarded as positive in nine HGGs (32%) but no correlation with SUVmax or BP was found. By contrast, SSTR2 expression was associated with IDH1 mutation (P = 0.007), oligodendroglioma component (P = 0.010), lower grade (P = 0.005), absence of EGFR amplification (P = 0.021), and longer progression-free survival (HR 0.161, CI 0.037 to 0.704, P = 0.015). Conclusions In HGGs, uptake of 68Ga-DOTA-peptides is associated with disrupted BBB and cannot be predicted by SSTR2 immunohistochemistry. Thus, PET/CT shows limited value to detect HGGs suitable for PRRT. However, high SSTR2 expression portends favorable outcome along with established biomarkers such as IDH1 mutation. Trial registration ClinicalTrials.gov NCT01460706
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Affiliation(s)
- Aida Kiviniemi
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland ; Department of Radiology, Medical Imaging Centre of Southwest Finland, Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Maria Gardberg
- Department of Pathology, Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Janek Frantzén
- Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521 Turku, Finland
| | - Marko Pesola
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Ville Vuorinen
- Department of Neurosurgery, Turku University Hospital, Hämeentie 11, 20521 Turku, Finland
| | - Riitta Parkkola
- Department of Radiology, Medical Imaging Centre of Southwest Finland, Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Tuula Tolvanen
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Sami Suilamo
- Department of Oncology and Radiotherapy, Turku University Hospital, Hämeentie 11, 20521 Turku, Finland
| | - Jarkko Johansson
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Pauliina Luoto
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Jukka Kemppainen
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland
| | - Anne Roivainen
- Turku PET Centre, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, 20521 Turku, Finland ; Turku Center for Disease Modeling, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Heikki Minn
- Department of Oncology and Radiotherapy, Turku University Hospital, Hämeentie 11, 20521 Turku, Finland
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Perkins G, Pilati C, Blons H, Laurent-Puig P. Beyond KRAS status and response to anti-EGFR therapy in metastatic colorectal cancer. Pharmacogenomics 2015; 15:1043-52. [PMID: 24956256 DOI: 10.2217/pgs.14.66] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In patients with metastatic colorectal cancer, overall survival has improved over the last decade mainly due to the use of effective targeted therapies such as anti-EGFR. However, survival improvement is linked to proper selection of patients expected to benefit from these treatments. KRAS codons 12 and 13 mutation status was the first validated molecular biomarker for anti-EGFR antibodies. Today, rare KRAS alterations and NRAS mutations were implemented, defining the 'RAS' status as the new validated marker of response to anti-EGFR antibodies. Moreover, other biomarkers are under investigation to screen for other targets and help with patients selection. Here, we reviewed these promising biomarkers: mutations in the RAS-MAPK and PI3K-AKT pathways genes, MET activation, HER/ErbB receptors activation (EGFR, HER2 and HER3), EGFR ligands, antibody-dependent cell-mediated cytotoxicity) and miRNAs. Further data are needed to define their impact for the treatment of patients with metastatic colorectal cancer.
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Affiliation(s)
- Geraldine Perkins
- Institut National de la Santé et de la Recherche Médicale (INSERM), Unité Mixte de Recherche (UMR)-S1147, Personalized Medicine, Pharmacogenomics, Therapeutic Optimization, University Paris Descartes, 45 rue des Saints Pères, Paris 75006, France
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Silencing the wild-type and mutant K-ras increases the resistance to 5-flurouracil in HCT-116 as a colorectal cancer cell line. Anticancer Drugs 2015; 26:187-96. [DOI: 10.1097/cad.0000000000000175] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ålgars A, Avoranta T, Österlund P, Lintunen M, Sundström J, Jokilehto T, Ristimäki A, Ristamäki R, Carpén O. Heterogeneous EGFR gene copy number increase is common in colorectal cancer and defines response to anti-EGFR therapy. PLoS One 2014; 9:e99590. [PMID: 24940619 PMCID: PMC4062406 DOI: 10.1371/journal.pone.0099590] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/15/2014] [Indexed: 12/21/2022] Open
Abstract
Anti-EGFR therapy is commonly used to treat colorectal cancer (CRC), although only a subset of patients benefit from the treatment. While KRAS mutation predicts non-responsiveness, positive predictive markers are not in clinical practice. We previously showed that immunohistochemistry (IHC)-guided EGFR gene copy number (GCN) analysis may identify CRC patients benefiting from anti-EGFR treatment. Here we tested the predictive value of such analysis in chemorefractory metastatic CRC, elucidated EGFR GCN heterogeneity within the tumors, and evaluated the association between EGFR GCN, KRAS status, and anti-EGFR antibody response in CRC cell lines. The chemorefractory patient cohort consisted of 54 KRAS wild-type (WT) metastatic CRC patients. EGFR GCN status was analyzed by silver in situ hybridization using a cut-off value of 4.0 EGFR gene copies/cell. KRAS-WT and KRAS mutant CRC cell lines with different EGFR GCN were used in in vitro studies. The chemorefractory CRC tumors with EGFR GCN increase (≥4.0) responded better to anti-EGFR therapy than EGFR GCN (<4.0) tumors (clinical benefit, P = 0.0004; PFS, HR = 0.23, 95% CI 0.12–0.46). EGFR GCN counted using EGFR IHC guidance was significantly higher than the value from randomly selected areas verifying intratumoral EGFR GCN heterogeneity. In CRC cell lines, EGFR GCN correlated with EGFR expression. Best anti-EGFR response was seen with KRAS-WT, EGFR GCN = 4 cells and poorest response with KRAS-WT, EGFR GCN = 2 cells. Anti-EGFR response was associated with AKT and ERK1/2 phosphorylation, which was effectively inhibited only in cells with KRAS-WT and increased EGFR GCN. In conclusion, IHC-guided EGFR GCN is a promising predictor of anti-EGFR treatment efficacy in chemorefractory CRC.
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Affiliation(s)
- Annika Ålgars
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Tuulia Avoranta
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Pia Österlund
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology, University of Helsinki, Helsinki, Finland
| | - Minnamaija Lintunen
- Department of Pathology, University of Turku, Turku, Finland
- Department of Pathology, Turku University Hospital –Tyks-Sapa, Turku, Finland
| | - Jari Sundström
- Department of Pathology, University of Turku, Turku, Finland
- Department of Pathology, Turku University Hospital –Tyks-Sapa, Turku, Finland
| | - Terhi Jokilehto
- Department of Pathology, University of Turku, Turku, Finland
- Department of Pathology, Turku University Hospital –Tyks-Sapa, Turku, Finland
| | - Ari Ristimäki
- Division of Pathology and Genetics, Helsinki University Central Hospital - HUSLAB, Helsinki, Finland
- Department of Pathology, Haartman Institute and Genome-Scale Biology, Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Raija Ristamäki
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - Olli Carpén
- Department of Pathology, University of Turku, Turku, Finland
- Department of Pathology, Turku University Hospital –Tyks-Sapa, Turku, Finland
- * E-mail:
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24
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Combined assessment of epidermal [corrected] growth factor receptor dual color in situ hybridization and immunohistochemistry with downstream gene mutations in prediction of response to the anti-EGFR therapy for patients with metastatic colorectal cancer. Arch Med Res 2014; 45:366-74. [PMID: 24830936 DOI: 10.1016/j.arcmed.2014.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 04/28/2014] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Biomarkers associated with anti-EGFR antibodies therapy have been investigated in metastatic colorectal cancer (CRC). We conducted this study to evaluate the clinical utility of a combined assessment of EGFR status and genomic mutations of the EGFR downstream signal pathway in predicting the efficacy of anti-EGFR antibody treatment. METHODS We collected formalin-fixed paraffin-embedded tumor tissues and evaluated the EGFR status by immunohistochemistry (IHC), dual color in situ hybridization (DISH) and genomic analyses of KRAS, BRAF, PIK3CA and NRAS by direct sequencing. RESULTS A total of 129 patients were evaluated in our study. Among KRAS wild-type patients, EGFR DISH positivity was associated with a higher response rate than DISH negativity (56.3 vs. 21.1%, p = 0.011). A subgroup with EGFR DISH positivity plus IHC3+ and wild-type of EGFR downstream gene mutations achieved higher response rate and disease control rate. EGFR DISH positivity, KRAS codon 146 mutation and NRAS codon 61 mutation were prognostic factors in both progression-free survival and overall survival by multivariate analyses. CONCLUSIONS Combined assessment of DISH plus IHC and EGFR downstream gene mutations was useful to predict the response to anti-EGFR antibodies treatment in metastatic colorectal cancer patients in our study.
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25
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Muharram G, Sahgal P, Korpela T, De Franceschi N, Kaukonen R, Clark K, Tulasne D, Carpén O, Ivaska J. Tensin-4-dependent MET stabilization is essential for survival and proliferation in carcinoma cells. Dev Cell 2014; 29:421-36. [PMID: 24814316 PMCID: PMC4118019 DOI: 10.1016/j.devcel.2014.03.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 02/05/2014] [Accepted: 03/31/2014] [Indexed: 12/25/2022]
Abstract
Inappropriate MET tyrosine kinase receptor signaling is detected in almost all types of human cancer and contributes to malignant growth and MET dependency via proliferative and antiapoptotic activities. Independently, Tensin-4 (TNS4) is emerging as a putative oncogene in many cancer types, but the mechanisms of TNS4 oncogenic activity are not well established. Here, we demonstrate that TNS4 directly interacts with phosphorylated MET via the TNS4 SH2-domain to positively regulate cell survival, proliferation, and migration, through increased MET protein stability. In addition, TNS4 interaction with β1-integrin cytoplasmic tail positively regulates β1-integrin stability. Loss of TNS4 or disruption of MET-TNS4 interaction triggers MET trafficking toward the lysosomal compartment that is associated with excessive degradation of MET and triggers MET-addicted carcinoma cell death in vitro and in vivo. Significant correlation between MET and TNS4 expression in human colon carcinoma and ovarian carcinoma suggests TNS4 plays a critical role in MET stability in cancer. A direct interaction is identified between MET and Tensin-4 TNS4 protects MET from degradation, thus promoting its oncogenic activity TNS4 and MET are significantly coexpressed in human carcinomas Loss of TNS4 inhibits survival of MET-dependent tumors
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Affiliation(s)
- Ghaffar Muharram
- Turku Centre for Biotechnology, University of Turku, Turku, 20520, Finland; VTT Technical Research Centre of Finland, Turku, 20521, Finland
| | - Pranshu Sahgal
- Turku Centre for Biotechnology, University of Turku, Turku, 20520, Finland; VTT Technical Research Centre of Finland, Turku, 20521, Finland
| | - Taina Korpela
- Department of Pathology, University of Turku, Turku, 20520, Finland; Department of Pathology, Turku University Hospital, Turku, 20520, Finland
| | - Nicola De Franceschi
- Turku Centre for Biotechnology, University of Turku, Turku, 20520, Finland; VTT Technical Research Centre of Finland, Turku, 20521, Finland
| | - Riina Kaukonen
- Turku Centre for Biotechnology, University of Turku, Turku, 20520, Finland; VTT Technical Research Centre of Finland, Turku, 20521, Finland
| | - Katherine Clark
- Department of Biochemistry, University of Leicester, Leicester LE1 9HN, UK
| | - David Tulasne
- Institut de Biologie de Lille-UMR8161, CNRS, 59021 Lille, France
| | - Olli Carpén
- Department of Pathology, University of Turku, Turku, 20520, Finland; Department of Pathology, Turku University Hospital, Turku, 20520, Finland
| | - Johanna Ivaska
- Turku Centre for Biotechnology, University of Turku, Turku, 20520, Finland; VTT Technical Research Centre of Finland, Turku, 20521, Finland; Department of Biochemistry and Food Chemistry, University of Turku, 20520, Finland.
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Andersson N, Anttonen M, Färkkilä A, Pihlajoki M, Bützow R, Unkila-Kallio L, Heikinheimo M. Sensitivity of human granulosa cell tumor cells to epidermal growth factor receptor inhibition. J Mol Endocrinol 2014; 52:223-34. [PMID: 24463098 DOI: 10.1530/jme-13-0286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Epidermal growth factor receptor (EGFR) is implicated in the progression of many human cancers, but its significance in ovarian granulosa cell tumor (GCT) pathobiology remains poorly understood. We assessed the EGFR gene copy number, surveyed the mRNA and protein expression patterns of EGFR in 90 adult GCTs, and assessed the in vitro sensitivity of GCT cells to EGFR inhibition. Low-level amplification of EGFR gene was observed in five GCTs and high-level amplification in one sample. EGFR mRNA was robustly expressed in GCTs. Most tumors expressed both unphosphorylated and phosphorylated EGFR protein, but the protein expression did not correlate with clinical parameters, including the risk of recurrence. Small-molecule EGFR inhibitors reduced the EGF-induced activation of EGFR and its downstream signaling molecules at nanomolar doses, but cell viability was reduced, and caspase-3/7 was activated in GCT cells only at micromolar doses. Based on the present results, EGFR is active and abundantly expressed in the majority of GCTs, but probably has only minor contribution to GCT cell growth. Given the high doses of EGFR inhibitors required to reduce GCT cell viability in vitro, they are not likely to be effective for GCT treatment as single agents; they should rather be tested as part of combination therapies for these malignancies.
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Affiliation(s)
- Noora Andersson
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, PO Box 20, 00014 University of Helsinki, Finland Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, PO Box 140, 00290 Helsinki, Finland Department of Pathology, Helsinki University Central Hospital, University of Helsinki and HUSlab, Haartmaninkatu 3, 00290 Helsinki, Finland Department of Pediatrics, Washington University School of Medicine, St Louis Children's Hospital, St Louis, Missouri 63110, USA
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Shen WD, Chen HL, Liu PF. EGFR gene copy number as a predictive biomarker for resistance to anti-EGFR monoclonal antibodies in metastatic colorectal cancer treatment: a meta-analysis. Chin J Cancer Res 2014; 26:59-71. [PMID: 24653627 DOI: 10.3978/j.issn.1000-9604.2014.01.10] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 07/22/2013] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The epidermal growth factor receptor (EGFR) inhibitors monoclonal antibodies (MoAbs) have already shown the therapeutic effectiveness in patients with metastatic colorectal cancer (mCRC). But many patients resist to the treatment. The aim of this meta-analysis was to assess EGFR gene copy number (GCN) as a candidate predictive biomarker for resistance to anti-EGFR MoAbs in mCRC treatment. METHODS Systematic computerized searches of the PubMed, EMBase and Cochrane Library were performed. The primary endpoint was objective response rate (ORR). The second endpoints included progression-free survival (PFS), and overall survival (OS). The pooled odd ratio (OR) and pooled sensitivity, specificity, and summary receiver operator characteristic (SROC) for ORR were estimated. The pooled hazard ratios (HR) for PFS and OS were also calculated. RESULTS Fourteen studies with 1,021 patients were included. Increased EGFR GCN was associated with increased ORR (OR=6.905; 95% CI: 4.489-10.620). It was also found in wild-type KRAS mCRC patients, with the pooled OR of 8.133 (95% CI: 4.316-15.326). GCN has medium value for predicting ORR, with the pooled sensitivity of 0.79 (95% CI: 0.73-0.84), the pooled specificity of 0.59 (95% CI: 0.55-0.62). In wild-type KRAS mCRC patients, the sensitivity and the specificity were 0.80 (95% CI: 0.70-0.87) and 0.60 (95% CI: 0.53-0.66), respectively. Increased EGFR GCN was associated with increased PFS (HR=0.557; 95% CI: 0.382-0.732) and OS (HR=0.579; 95% CI: 0.422-0.737). CONCLUSIONS This meta-analysis suggests that EGFR GCN represents a predictive biomarker for tumor response in mCRC patients treated with MoAbs regardless of KRAS mutation. mCRC patients with increased EGFR GCN are more likely to have a better response, PFS, and OS when treated with cetuximab or panitumumab.
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Affiliation(s)
- Wei-Dong Shen
- 1 Department of Gastroenterology, the Affiliated Jiangyin Hospital of Nantong University, Shoushan Road 163#, Jiangyin 214400, China ; 2 Nantong University, Qixiu Road 19#, Nantong 226019, China
| | - Hong-Lin Chen
- 1 Department of Gastroenterology, the Affiliated Jiangyin Hospital of Nantong University, Shoushan Road 163#, Jiangyin 214400, China ; 2 Nantong University, Qixiu Road 19#, Nantong 226019, China
| | - Peng-Fei Liu
- 1 Department of Gastroenterology, the Affiliated Jiangyin Hospital of Nantong University, Shoushan Road 163#, Jiangyin 214400, China ; 2 Nantong University, Qixiu Road 19#, Nantong 226019, China
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Yeo DM, Oh SN, Jung CK, Lee MA, Oh ST, Rha SE, Jung SE, Byun JY, Gall P, Son Y. Correlation of dynamic contrast-enhanced MRI perfusion parameters with angiogenesis and biologic aggressiveness of rectal cancer: Preliminary results. J Magn Reson Imaging 2013; 41:474-80. [PMID: 24375840 DOI: 10.1002/jmri.24541] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 11/19/2013] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To investigate whether quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) are correlated with angiogenesis and biologic aggressiveness of rectal cancer. MATERIALS AND METHODS A total of 46 patients with rectal cancer underwent DCE-MRI. Using a two-compartmental model, quantitative parameters (K(trans) , kep , ve , and iAUC) were calculated from the whole-transverse region of interest (ROI) and high K(trans) area ROI of entire tumors. Histological specimens were analyzed for tumor size; T/N stage; lymphatic, vascular, perineural invasion; expression of epidermal growth factor receptor (EGFR); and KRAS gene mutations. Tumor angiogenesis was evaluated based on the microvessel density (MVD) and the expression level of the vascular endothelial growth factor. Correlations of the DCE-MRI parameters with histological markers and angiogenesis were determined using Student's t-test and analysis of variance (ANOVA). RESULTS The mean kep from high K(trans) area ROIs showed a significantly positive correlation with MVD (P = 0.030, r = 0.514, R(2) = 0.264). The mean kep from the whole-transverse ROIs showed a significant inverse correlation with T stage (T1 vs. T2-4, P = 0.021). EGFR-positive cancer displayed higher mean K(trans) (P = 0.045) and kep (P = 0.038) than EGFR-negative cancer in whole-transverse ROIs. CONCLUSION These preliminary results suggest that the determination of kep of high K(trans) area permits the noninvasive estimation of tumor angiogenesis in rectal cancer and that DCE-MRI parameters can be used as imaging biomarkers to predict the biologic aggressiveness of the tumor and patient prognosis.
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Affiliation(s)
- Dong-Myung Yeo
- Department of Radiology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea
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Moelans CB, Holst F, Hellwinkel O, Simon R, van Diest PJ. ESR1 amplification in breast cancer by optimized RNase FISH: frequent but low-level and heterogeneous. PLoS One 2013; 8:e84189. [PMID: 24367641 PMCID: PMC3867473 DOI: 10.1371/journal.pone.0084189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 11/13/2013] [Indexed: 01/09/2023] Open
Abstract
Prevalence of ESR1 amplification in breast cancer is highly disputed and discrepancies have been related to different technical protocols and different scoring approaches. In addition, pre-mRNA artifacts have been proposed to influence outcome of ESR1 FISH analysis. We analyzed ESR1 gene copy number status combining an improved RNase FISH protocol with multiplex ligation-dependent probe amplification (MLPA) after laser microdissection. FISH showed a high prevalence of ESR1 gains and amplifications despite RNase treatment but MLPA did not confirm ESR1 copy number increases detected by FISH in more than half of cases. We suggest that the combination of the ESR1-specific intra-tumor heterogeneity and low-level copy number increase accounts for these discrepancies.
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Affiliation(s)
- Cathy B. Moelans
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frederik Holst
- Section of Gynecology and Obstetrics, Department of Clinical Science, Haukeland University Hospital, Bergen, Norway
- Department of Pathology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Olaf Hellwinkel
- Department of Legal Medicine, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Ronald Simon
- Department of Pathology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Paul J. van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
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Burandt E, Schreiber M, Stein A, Minner S, Clauditz TS, Bokemeyer C, Jänicke F, Fisch M, Izbicki JR, Knecht R, Sauter G, Stahl PR. Continuous tissue microarray based identification of cancers with homogeneous target expression for successful targeted therapy in clinical routine practice. Genes Chromosomes Cancer 2013; 53:228-39. [PMID: 24311521 DOI: 10.1002/gcc.22130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/23/2013] [Indexed: 01/22/2023] Open
Abstract
In cancer therapy, the number of drugs targeting cells with characteristic molecular aberrations is continuously rising. However, application of these new drugs still is limited to a few tumor entities. The aim of this study was to test the concept of routinely identifying all possible cancer patients who might eventually benefit from targeted therapy. Therefore, all malignant tumors routinely submitted to our Institute of Pathology over a period of 4 months were brought into a tissue microarray format. Using "in situ" methods, tumors were analyzed for HER2, EGFR, and KIT status as examples for potential therapeutic target genes. In positive cases, target heterogeneity was excluded by analyzing all available large sections. Outside of tumor entities for which targeted drugs are already approved, the study revealed six tumors with homogeneously distributed HER2 overexpression/amplification (bladder, esophageal and colorectal) and seven tumors with homogeneous EGFR amplification (vulvar, ovarian, breast, esophageal and laryngeal, and adenocarcinoma of unknown primary). A total of 151 tumors showed KIT overexpression but none of seven sequenced cases showed KIT mutations. We furthermore report on a 69-year-old patient with homogeneously HER2-amplified metastatic colorectal cancer who is successfully treated by trastuzumab monotherapy. This study demonstrates that tissue microarray based screening for therapeutic target genes in tumors outside established indications represents a feasible approach suitable for routine application. The successful treatment of one patient with homogeneously HER2 positive metastatic colorectal cancer argues for the clinical utility of this approach at least in carefully selected, homogeneous cancers.
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Affiliation(s)
- Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Genetic and immune factors underlying the efficacy of cetuximab and panitumumab in the treatment of patients with metastatic colorectal cancer. Contemp Oncol (Pozn) 2013; 18:7-16. [PMID: 24876815 PMCID: PMC4037996 DOI: 10.5114/wo.2013.38566] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/25/2013] [Accepted: 10/21/2013] [Indexed: 01/26/2023] Open
Abstract
Efficacy of monoclonal anti-EGFR antibodies (cetuximab, panitumumab) used in combination with chemotherapy or alone has been demonstrated in clinical trials of patients with mCRC. Both drugs block signaling EGFR pathway in malignant cells (blocking ligand binding and EGFR dimerization). Obtaining treatment responses with anti-EGFR agents is possible only in a selected subgroup of patients with mCRC. Successful treatment with cetuximab and panitumab is possible almost exclusively in patients without RAS mutations. Research on predictive value of EGFR gene copy number, PI3KCA gene mutations, P53 and PTEN, and EGFR their ligands concentrations is ongoing. Cetuximab, as IgG1 class antibody, can cause antibody dependent cellular cytotoxicity against neoplasm cells, while panitumumab, as IgG2 class antibody, does not induce such effect. Therefore a potential predictor cetuximab therapy may be the presence of different polymorphic forms of the genes for receptor immunoglobulin Fc fragments: FcγRIIa and FcγRIII subclasses.
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Koskensalo S, Louhimo J, Hagström J, Lundin M, Stenman UH, Haglund C. Concomitant tumor expression of EGFR and TATI/SPINK1 associates with better prognosis in colorectal cancer. PLoS One 2013; 8:e76906. [PMID: 24204699 PMCID: PMC3808372 DOI: 10.1371/journal.pone.0076906] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 08/29/2013] [Indexed: 02/06/2023] Open
Abstract
Background Epidermal growth factor receptor (EGFR) activation plays a role in colorectal cancer (CRC) carcinogenesis, and anti-EGFR drugs are used in treatment of advanced CRC. One of the EGFR ligands is tumor-associated trypsinogen inhibitor TATI, also called serine protease inhibitor Kazal type1 (SPINK 1), which we recently showed to be an independent prognostic marker in CRC. Methods We studied the prognostic value of immunohistochemical expression of EGFR and concomitant expression of EGFR and TATI/SPINK1 in a series of 619 colorectal cancer patients. Results Of the samples, 92% were positive for EGFR. EGFR+/TATI+ was seen in 62.8%, EGFR+/TATI− in 29.5%, EGFR−/TATI+ in 4.9%, and EGFR−/TATI− in 2.7% of patients. EGFR expression correlated with WHO grade (p = 0.040). In univariate analysis, EGFR expression correlated with favourable survival (p = 0.006). EGFR+/TATI+ patients showed better survival than did those with other combinations (p<0.001). In multivariate analysis, EGFR+/TATI+ was an independent prognostic factor of favourable prognosis (p<0.001). Conclusion Concomitant positivity of EGFR and TATI/SPINK1 predicts favourable prognosis in CRC.
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Affiliation(s)
- Selja Koskensalo
- Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Johanna Louhimo
- Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Jaana Hagström
- Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Mikael Lundin
- Finnish Institution of Molecular Medicine Helsinki, University of Helsinki, Helsinki, Finland
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
| | - Caj Haglund
- Department of Surgery, Helsinki University Central Hospital, Helsinki, Finland
- Department of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland
- Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
- * E-mail:
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Fabi A, Merola R, Ferretti G, Di Benedetto A, Antoniani B, Ercolani C, Nisticò C, Papaldo P, Ciccarese M, Sperduti I, Vici P, Marino M, Gori S, Botti C, Malaguti P, Cognetti F, Mottolese M. Epidermal growth factor receptor gene copy number may predict lapatinib sensitivity in HER2-positive metastatic breast cancer. Expert Opin Pharmacother 2013; 14:699-706. [PMID: 23472669 DOI: 10.1517/14656566.2013.779672] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Lapatinib, a dual HER2/EGFR tyrosine kinase inhibitor (TKI), associated to capecitabine represents the treatment of choice in HER2-positive metastatic breast cancer (BC) patients in progression after trastuzumab-based therapy. Though lapatinib-based therapy prolongs the time to progression, its efficacy is often limited by the development of drug resistance. It is aimed to evaluate novel biomarkers predictive of lapatinib response, we analyzed EGFR protein and gene status in a series of 50 metastatic HER2-positive BC patients. METHODS Lapatinib was given at 1250 mg/day continuously and capecitabine at 2000 mg/m(2)/day every 3 weeks. EGFR protein expression and gene copy number (GCN) were assessed by immunohistochemistry and FISH, respectively. Receiver operating curve (ROC) analysis identified the value of > 3.36 EGFR copies/nucleus as the cut-off point able to discriminate responders versus non-responders. RESULTS A statistical significant correlation between EGFR GCN value > 3.36 and response to lapatinib (p = 0.01) was found. Cox regression analysis further supported these findings evidencing that HER2 score 3+ and EGFR GCN increase are positive predictor factors of lapatinib response. CONCLUSIONS Though further investigations are needed to confirm these findings, EGFR GCN could be a suitable screening to identify the subset of BC patients particularly responsive to the dual TKI lapatinib.
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Affiliation(s)
- Alessandra Fabi
- Regina Elena National Cancer Institute, Department of Oncology A, Via Elio Chianesi, 53, 00144 Rome, Italy.
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Jiang Z, Li C, Li F, Wang X. EGFR gene copy number as a prognostic marker in colorectal cancer patients treated with cetuximab or panitumumab: a systematic review and meta analysis. PLoS One 2013; 8:e56205. [PMID: 23441167 PMCID: PMC3575344 DOI: 10.1371/journal.pone.0056205] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 01/07/2013] [Indexed: 12/18/2022] Open
Abstract
Background The epidermal growth factor receptor (EGFR) gene copy number (GCN) has been previously demonstrated to correlate with the clinical outcome of colorectal cancer (CRC) treated with anti-EGFR monoclonal antibodies (mAbs), although it remains controversial. We conducted a systematic review and meta-analysis to assess EGFR GCN as a potential biomarker of survival for patients with advanced CRC receiving treatment with anti-EGFR mAbs. Methods We systematically identified articles investigating EGFR GCN by fluorescent or chromogenic in situ hybridization or other detection techniques in patients with metastatic CRC treated with panitumumab or cetuximab, (last search: 10 August 2012). Eligible studies had to report on overall survival (OS), progression-free survival (PFS) or time-toprogression (TTP), stratified by EGFR GCN. Summary hazard ratios (HRs) were calculated using random-effects models. Results Among 13 identified studies, 10 (776 patients, 302 with increased GCN), 8 (893 patients, 282 with increased GCN) and 3 (149 patients, 66 with increased GCN) were eligible for the OS, PFS and TTP meta-analyses, respectively. Increased EGFR GCN was associated with increased OS (HR = 0.62; 95% CI 0.50–0.77; P<0.001), PFS (HR = 0.65; 95% CI 0.47–0.89; P = 0.008) but not TTP (HR = 0.71; 95% CI 0.44–1.14; P = 0.157). It was also shown that EGFR GCN is independent of other factors such as KRAS status. Among those populations received second-line or higher treatment, increased EGFR GCN was strongly associated with improved survival (for OS, HR = 0.60; 95% CI 0.47–0.75; P<0.001; for PFS, HR = 0.59; 95% CI 0.47–0.75; P<0.001), whereas it did not influence survival in patients that received first-line therapy. Conclusion Among the anti-EGFR-treated patients, increased EGFR GCN appears to be associated with improved survival outcomes. The effect on survival appears to be related to patients receiving the line of treatment.
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Affiliation(s)
- Zheng Jiang
- Department of Colorectal Cancer Surgery, The 2nd Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
- Colorectal Cancer Institute of the Heilongjiang Academy of Medical Sciences, Harbin, Heilongjiang, China
| | - Chunxiang Li
- Laboratory of Medical Genetics, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fuyuan Li
- Department of Biochemistry and Molecular Biology, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xishan Wang
- Department of Colorectal Cancer Surgery, The 2nd Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
- Colorectal Cancer Institute of the Heilongjiang Academy of Medical Sciences, Harbin, Heilongjiang, China
- * E-mail:
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Hagan S, Orr MCM, Doyle B. Targeted therapies in colorectal cancer-an integrative view by PPPM. EPMA J 2013; 4:3. [PMID: 23356214 PMCID: PMC3584939 DOI: 10.1186/1878-5085-4-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 12/26/2012] [Indexed: 12/12/2022]
Abstract
In developed countries, colorectal cancer (CRC) is the third most common malignancy, but it is the second most frequent cause of cancer-related death. Clinicians are still faced with numerous challenges in the treatment of this disease, and future approaches which target the molecular features of the disorder will be critical for success in this disease setting. Genetic analyses of many solid tumours have shown that up to 100 protein-encoding genes are mutated. Within CRC, numerous genetic alterations have been identified in a number of pathways. Therefore, understanding the molecular pathology of CRC may present information on potential routes for treatment and may also provide valuable prognostic information. This will be particularly pertinent for molecularly targeted treatments, such as anti-vascular endothelial growth factor therapies and anti-epidermal growth factor receptor (EGFR) monoclonal antibody therapy. KRAS and BRAF mutations have been shown to predict response to anti-EGFR therapy. As EGFR can also signal via the phosphatidylinositol 3-kinase (PI3K) kinase pathway, there is considerable interest in the potential roles of members of this pathway (such as PI3K and PTEN) in predicting treatment response. Therefore, a combined approach of new techniques that allow identification of these biomarkers alongside interdisciplinary approaches to the treatment of advanced CRC will aid in the treatment decision-making process and may also serve to guide future therapeutic approaches.
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Affiliation(s)
- Suzanne Hagan
- Department of Life Sciences Glasgow, Caledonian University, Glasgow, G4 0BA, UK
| | - Maria C M Orr
- Personalised Healthcare and Biomarkers, AstraZeneca, Alderley Park, Macclesfield, Cheshire, SK10 4TG, UK
| | - Brendan Doyle
- Department of Histopathology, Trinity College, St. James's Hospital, Dublin, 8, Ireland
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Reply: EGFR alterations and response to anti-EGFR therapy: is it a matter of gene amplification or gene copy number gain? Br J Cancer 2011. [PMCID: PMC3261665 DOI: 10.1038/bjc.2011.571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Sesboüé R, Le Pessot F, Di Fiore F, Frebourg T. EGFR alterations and response to anti-EGFR therapy: is it a matter of gene amplification or gene copy number gain? Br J Cancer 2011; 106:426-7; author reply 428. [PMID: 22187031 PMCID: PMC3261662 DOI: 10.1038/bjc.2011.570] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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