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Xu P, Chen AY, Ganaie SS, Cheng F, Shen W, Wang X, Kleiboeker S, Li Y, Qiu J. The 11-Kilodalton Nonstructural Protein of Human Parvovirus B19 Facilitates Viral DNA Replication by Interacting with Grb2 through Its Proline-Rich Motifs. J Virol 2019; 93:e01464-18. [PMID: 30282717 PMCID: PMC6288338 DOI: 10.1128/jvi.01464-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/01/2018] [Indexed: 12/27/2022] Open
Abstract
Lytic infection of human parvovirus B19 (B19V) takes place exclusively in human erythroid progenitor cells of bone marrow and fetal liver, which disrupts erythropoiesis. During infection, B19V expresses three nonstructural proteins (NS1, 11-kDa, and 7.5-kDa) and two structural proteins (VP1 and VP2). While NS1 is essential for B19V DNA replication, 11-kDa enhances viral DNA replication significantly. In this study, we confirmed the enhancement role of 11-kDa in viral DNA replication and elucidated the underlying mechanism. We found that 11-kDa specially interacts with cellular growth factor receptor-bound protein 2 (Grb2) during virus infection and in vitro We determined a high affinity interaction between 11-kDa and Grb2 that has an equilibrium dissociation constant (KD ) value of 18.13 nM. In vitro, one proline-rich motif was sufficient for 11-kDa to sustain a strong interaction with Grb2. In consistence, in vivo during infection, one proline-rich motif was enough for 11-kDa to significantly reduce phosphorylation of extracellular signal-regulated kinase (ERK). Mutations of all three proline-rich motifs of 11-kDa abolished its capability to reduce ERK activity and, accordingly, decreased viral DNA replication. Transduction of a lentiviral vector encoding a short hairpin RNA (shRNA) targeting Grb2 decreased the expression of Grb2 as well as the level of ERK phosphorylation, which resulted in an increase of B19V replication. These results, in concert, indicate that the B19V 11-kDa protein interacts with cellular Grb2 to downregulate ERK activity, which upregulates viral DNA replication.IMPORTANCE Human parvovirus B19 (B19V) infection causes hematological disorders and is the leading cause of nonimmunological fetal hydrops during pregnancy. During infection, B19V expresses two structural proteins, VP1 and VP2, and three nonstructural proteins, NS1, 11-kDa, and 7.5-kDa. While NS1 is essential, 11-kDa plays an enhancing role in viral DNA replication. Here, we elucidated a mechanism underlying 11-kDa protein-regulated B19V DNA replication. 11-kDa is tightly associated with cellular growth factor receptor-bound protein 2 (Grb2) during infection. In vitro, 11-kDa interacts with Grb2 with high affinity through three proline-rich motifs, of which at least one is indispensable for the regulation of viral DNA replication. 11-kDa and Grb2 interaction disrupts extracellular signal-regulated kinase (ERK) signaling, which mediates upregulation of B19V replication. Thus, our study reveals a novel mechanism of how a parvoviral small nonstructural protein regulates viral DNA replication by interacting with a host protein that is predominately expressed in the cytoplasm.
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Affiliation(s)
- Peng Xu
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Aaron Yun Chen
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Safder S Ganaie
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Fang Cheng
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Weiran Shen
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Xiaomei Wang
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
- Department of Biological Science and Technology, Wuhan University of Bioengineering, Wuhan, China
| | - Steve Kleiboeker
- Department of Research and Development, Viracor Eurofins Laboratories, Lee's Summit, Missouri, USA
| | - Yi Li
- Department of Biological Science and Technology, Wuhan University of Bioengineering, Wuhan, China
| | - Jianming Qiu
- Department of Microbiology, Molecular Genetics and Immunology, University of Kansas Medical Center, Kansas City, Kansas, USA
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Zhang G, Scarborough H, Kim J, Rozhok AI, Chen YA, Zhang X, Song L, Bai Y, Fang B, Liu RZ, Koomen J, Tan AC, Degregori J, Haura EB. Coupling an EML4-ALK-centric interactome with RNA interference identifies sensitizers to ALK inhibitors. Sci Signal 2016; 9:rs12. [PMID: 27811184 DOI: 10.1126/scisignal.aaf5011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Patients with lung cancers harboring anaplastic lymphoma kinase (ALK) gene fusions benefit from treatment with ALK inhibitors, but acquired resistance inevitably arises. A better understanding of proximal ALK signaling mechanisms may identify sensitizers to ALK inhibitors that disrupt the balance between prosurvival and proapoptotic effector signals. Using affinity purification coupled with mass spectrometry in an ALK fusion lung cancer cell line (H3122), we generated an ALK signaling network and investigated signaling activity using tyrosine phosphoproteomics. We identified a network of 464 proteins composed of subnetworks with differential response to ALK inhibitors. A small hairpin RNA screen targeting 407 proteins in this network revealed 64 and 9 proteins that when knocked down sensitized cells to crizotinib and alectinib, respectively. Among these, knocking down fibroblast growth factor receptor substrate 2 (FRS2) or coiled-coil and C2 domain-containing protein 1A (CC2D1A), both scaffolding proteins, sensitized multiple ALK fusion cell lines to the ALK inhibitors crizotinib and alectinib. Collectively, our data set provides a resource that enhances our understanding of signaling and drug resistance networks consequent to ALK fusions and identifies potential targets to improve the efficacy of ALK inhibitors in patients.
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Affiliation(s)
- Guolin Zhang
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Hannah Scarborough
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Jihye Kim
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Andrii I Rozhok
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Yian Ann Chen
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Xiaohui Zhang
- Department of Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Lanxi Song
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Yun Bai
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Bin Fang
- Proteomics Core Facility, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Richard Z Liu
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - John Koomen
- Department of Molecular Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Aik Choon Tan
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - James Degregori
- Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Eric B Haura
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
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Ahmed Z, Timsah Z, Suen KM, Cook NP, Lee GR, Lin CC, Gagea M, Marti AA, Ladbury JE. Grb2 monomer-dimer equilibrium determines normal versus oncogenic function. Nat Commun 2015; 6:7354. [PMID: 26103942 PMCID: PMC4491180 DOI: 10.1038/ncomms8354] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 04/29/2015] [Indexed: 01/09/2023] Open
Abstract
The adaptor protein growth factor receptor-bound protein 2 (Grb2) is ubiquitously expressed in eukaryotic cells and involved in a multitude of intracellular protein interactions. Grb2 plays a pivotal role in tyrosine kinase-mediated signal transduction including linking receptor tyrosine kinases to the Ras/mitogen-activated protein (MAP) kinase pathway, which is implicated in oncogenic outcome. Grb2 exists in a constitutive equilibrium between monomeric and dimeric states. Here we show that only monomeric Grb2 is capable of binding to SOS and upregulating MAP kinase signalling and that the dimeric state is inhibitory to this process. Phosphorylation of tyrosine 160 (Y160) on Grb2, or binding of a tyrosylphosphate-containing ligand to the SH2 domain of Grb2, results in dimer dissociation. Phosphorylation of Y160 on Grb2 is readily detectable in the malignant forms of human prostate, colon and breast cancers. The self-association/dissociation of Grb2 represents a switch that regulates MAP kinase activity and hence controls cancer progression.
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Affiliation(s)
- Zamal Ahmed
- 1] Department of Biochemistry and Molecular Biology, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA [2] Center for Biomolecular Structure and Function, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Zahra Timsah
- 1] Department of Biochemistry and Molecular Biology, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA [2] School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK
| | - Kin M Suen
- 1] Department of Biochemistry and Molecular Biology, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA [2] School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK
| | - Nathan P Cook
- Department of Chemistry, Rice University, Houston, Texas 77005, USA
| | - Gilbert R Lee
- Center for Biomolecular Structure and Function, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Chi-Chuan Lin
- 1] Department of Biochemistry and Molecular Biology, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA [2] School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK
| | - Mihai Gagea
- Department of Veterinary Medicine and Surgery, University of Texas, M.D. Anderson Cancer Center, Unit 63, 1515 Holcombe Boulevard, Houston, Texas 77030, USA
| | - Angel A Marti
- Department of Chemistry, Rice University, Houston, Texas 77005, USA
| | - John E Ladbury
- 1] Department of Biochemistry and Molecular Biology, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA [2] Center for Biomolecular Structure and Function, University of Texas, M.D. Anderson Cancer Center, Unit 1000, 1515 Holcombe Boulevard, Houston, Texas 77030, USA [3] School of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK
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Rolfo C, Passiglia F, Castiglia M, Raez LE, Germonpre P, Gil-Bazo I, Zwaenepoel K, De Wilde A, Bronte G, Russo A, Van Meerbeeck JP, Van Schil P, Pauwels P. ALK and crizotinib: after the honeymoon…what else? Resistance mechanisms and new therapies to overcome it. Transl Lung Cancer Res 2015; 3:250-61. [PMID: 25806308 DOI: 10.3978/j.issn.2218-6751.2014.03.01] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/06/2014] [Indexed: 12/16/2022]
Abstract
The last few decades have witnessed a silent revolution in the war against NSCLC, thanks to the discovery of "oncogenic drivers" and the subsequent development of targeted therapies. The discovery of the EML4-ALK fusion gene in a subgroup of patients with NSCLC and the subsequent clinical development of crizotinib has been an amazing success story in lung cancer translational-research, and its accelerated approval [only 4 years from the discovery of ALK rearrangement in NSCLC to the approval by the Food and Drug Administration (FDA)] marked the beginning of the new decade of targeted therapy. However, common to all targeted therapies, despite an initial benefit, patients inevitably experience tumor progression, due to the development of resistance. Several molecular mechanisms are responsible for acquired resistance, such as secondary mutations of ALK kinase domain or amplification of ALK fusion gene, or the activation of other oncogenic drivers, which may cause resistance independently of ALK genetic alterations. Pre-clinical data and early clinical trials showed the promising efficacy of a new class of ALK-inhibitors in overcoming acquired resistance. The inhibition of the molecular chaperone, HSP90, represents another promising strategy to overcome crizotinib resistance in ALK-rearranged NSCLC. Several molecules are currently under investigation in order to establish their specific role in the treatment of ALK-rearranged NSCLC.
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Affiliation(s)
- Christian Rolfo
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Francesco Passiglia
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Marta Castiglia
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Luis E Raez
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Paul Germonpre
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Ignacio Gil-Bazo
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Karen Zwaenepoel
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Annemieke De Wilde
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Giuseppe Bronte
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Antonio Russo
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Jan P Van Meerbeeck
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van Schil
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
| | - Patrick Pauwels
- 1 Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 2 Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy ; 3 Molecular Pathology Unit, Pathology Department, Antwerp University Hospital, Edegem, Belgium ; 4 Memorial Cancer Institute, Memorial Health Care System, Florida International University, Miami, FL, USA ; 5 Thoracic Oncology Unit, Integrated Cancer Centre, AZ Maria Middelares, Gent, Belgium ; 6 Lung Cancer Unit, Department of Oncology, Clinica Universidad de Navarra, Pamplona, Spain ; 7 Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA), Antwerp University Hospital, Edegem, Belgium ; 8 Thoracic Surgery Department, Antwerp University Hospital, Edegem, Belgium
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