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Boutas I, Kontogeorgi A, Kalantaridou SN, Dimitrakakis C, Patsios P, Kalantzi M, Xanthos T. Reverse Onco-Cardiology: What Is the Evidence for Breast Cancer? A Systematic Review of the Literature. Int J Mol Sci 2023; 24:16500. [PMID: 38003690 PMCID: PMC10671526 DOI: 10.3390/ijms242216500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
Breast cancer and cardiovascular diseases (CVD) represent significant global health challenges, with CVD being the leading cause of mortality and breast cancer, showing a complex pattern of incidence and mortality. We explore the intricate interplay between these two seemingly distinct medical conditions, shedding light on their shared risk factors and potential pathophysiological connections. A specific connection between hypertension (HTN), atrial fibrillation (AF), myocardial infarction (MI), and breast cancer was evaluated. HTN is explored in detail, emphasizing the role of aging, menopause, insulin resistance, and obesity as common factors linking HTN and breast cancer. Moreover, an attempt is made to identify the potential impact of antihypertensive medications and highlight the increased risk of breast cancer among those women, with a focus on potential mechanisms. A summary of key findings underscores the need for a multisystem approach to understanding the relationship between CVD and breast cancer is also explored with a highlight for all the gaps in current research, such as the lack of clinical observational data on MI and breast cancer in humans and the need for studies specifically designed for breast cancer. This paper concludes that there should be a focus on potential clinical applications of further investigation in this field, including personalized prevention and screening strategies for women at risk. Overall, the authors attempt to provide a comprehensive overview of the intricate connections between breast cancer and cardiovascular diseases, emphasizing the importance of further research in this evolving field of cardio-oncology.
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Affiliation(s)
- Ioannis Boutas
- Breast Unit, Rea Maternity Hospital, 383 Andrea Siggrou Ave., Paleo Faliro, 175 64 Athens, Greece
| | - Adamantia Kontogeorgi
- Medical School, University of Crete, 13 Andrea Kalokairinoy Ave., 715 00 Giofirakia, Greece
| | - Sophia N. Kalantaridou
- Third Department of Obstetrics and Gynecology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, 1 Rimini Str., 124 62 Chaidari, Greece;
| | - Constantine Dimitrakakis
- First Department of Obstetrics and Gynecology, Alexandra University Hospital, Medical School, National and Kapodistrian University of Athens, 4-2 Lourou Str., 115 28 Athens, Greece;
| | - Panagiotis Patsios
- Cardiology Department, Elpis General Hospital, 7 Dimitsana Str., 115 22 Athens, Greece;
| | - Maria Kalantzi
- Post Graduate Study Program “Cardiopulmonary Resuscitation”, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 115 27 Athens, Greece;
| | - Theodoros Xanthos
- School of Health Sciences, University of West Attica, 28 Aghiou Spyridonos Str., 122 43 Aigaleo, Greece;
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2
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Deng S, Ramos-Castaneda M, Velasco WV, Clowers MJ, Gutierrez BA, Noble O, Dong Y, Zarghooni M, Alvarado L, Caetano MS, Yang S, Ostrin EJ, Behrens C, Wistuba II, Stabile LP, Kadara H, Watowich SS, Moghaddam SJ. Interplay between estrogen and Stat3/NF-κB-driven immunomodulation in lung cancer. Carcinogenesis 2020; 41:1529-1542. [PMID: 32603404 PMCID: PMC7896112 DOI: 10.1093/carcin/bgaa064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/30/2020] [Accepted: 06/19/2020] [Indexed: 12/17/2022] Open
Abstract
K-ras mutant lung adenocarcinoma (LUAD) is the most common type of lung cancer, displays abysmal prognosis and is tightly linked to tumor-promoting inflammation, which is increasingly recognized as a target for therapeutic intervention. We have recently shown a gender-specific role for epithelial Stat3 signaling in the pathogenesis of K-ras mutant LUAD. The absence of epithelial Stat3 in male K-ras mutant mice (LR/Stat3Δ/Δ mice) promoted tumorigenesis and induced a nuclear factor-kappaB (NF-κB)-driven pro-tumor immune response while reducing tumorigenesis and enhancing anti-tumor immunity in female counterparts. In the present study, we manipulated estrogen and NF-κB signaling to study the mechanisms underlying this intriguing gender-disparity. In LR/Stat3Δ/Δ females, estrogen deprivation by bilateral oophorectomy resulted in higher tumor burden, an induction of NF-κB-driven immunosuppressive response, and reduced anti-tumor cytotoxicity, whereas estrogen replacement reversed these changes. On the other hand, exogenous estrogen in males successfully inhibited tumorigenesis, attenuated NF-κB-driven immunosuppression and boosted anti-tumor immunity. Mechanistically, genetic targeting of epithelial NF-κB activity resulted in reduced tumorigenesis and enhanced the anti-tumor immune response in LR/Stat3Δ/Δ males, but not females. Our data suggest that estrogen exerts a context-specific anti-tumor effect through inhibiting NF-κB-driven tumor-promoting inflammation and provide insights into developing novel personalized therapeutic strategies for K-ras mutant LUAD.
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Affiliation(s)
- Shanshan Deng
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marco Ramos-Castaneda
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Walter V Velasco
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael J Clowers
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- The University of Texas M.D. Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Berenice A Gutierrez
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Oscar Noble
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yiping Dong
- Department of Oncology Radiotherapy, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Melody Zarghooni
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lucero Alvarado
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mauricio S Caetano
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shuanying Yang
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Edwin J Ostrin
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carmen Behrens
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ignacio I Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laura P Stabile
- Department of Pharmacology and Chemical Biology, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Humam Kadara
- The University of Texas M.D. Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephanie S Watowich
- The University of Texas M.D. Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Seyed Javad Moghaddam
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- The University of Texas M.D. Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
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3
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Differential Expression of KRAS and SIRT1 in Ovarian Cancers with and Without Endometriosis. Reprod Sci 2020; 27:145-151. [PMID: 32046380 DOI: 10.1007/s43032-019-00017-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/18/2019] [Indexed: 02/06/2023]
Abstract
Accumulating research shows that ovarian cancer progression can be influenced by both gene mutations and endometriosis. However, the exact mechanism at hand is poorly understood. In the current study, we explored the expression of KRAS and SIRT1, two genes previously identified as altered in endometriosis and ovarian cancer. Human endometrial samples were obtained from regularly cycling women with endometriosis, ovarian cancer, and endometriosis-associated ovarian cancer between 18 and 50 of age undergoing hysterectomy, and immunohistochemical analyses were performed. The cytoplasmic expression of KRAS was low in eutopic endometrium from women without endometriosis or ovarian cancer; however, it was elevated in those who have been diagnosed with endometriosis, as well as ovarian cancer with or without the presence of endometriosis. Nuclear and cytoplasmic SIRT1 expression was also low within endometrium without either disease. However, nuclear SIRT1 expression was increased in those with endometriosis and ovarian cancer associated with endometriosis. Nuclear but not the cytoplasmic expression of SIRT1 correlated with KRAS expression in ovarian cancers associated with endometriosis. These results suggest roles of KRAS and SIRT1 in endometriosis and endometriosis-associated ovarian cancer. Cytoplasmic KRAS expression proves to be a key biomarker in both diseases, while nuclear SIRT1 may be a new biomarker specific to those with endometriosis and those with both endometriosis and ovarian cancer. Further research of these genes could aid in determining the pathogenesis of both diseases and help in clarifying the development of endometriosis-associated ovarian cancer.
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4
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Jung SY, Malhotra P, Nguyen KC, Salzman D, Qi Y, Pak EH, King J, Vlashi E, Ann D, Weidhaas JB. The KRAS-variant and its impact on normal breast epithelial cell biology. Cell Death Differ 2019; 26:2568-2576. [PMID: 30932013 DOI: 10.1038/s41418-019-0320-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 01/17/2019] [Accepted: 02/18/2019] [Indexed: 12/12/2022] Open
Abstract
MicroRNA (miRNA)-binding site variants in 3' untranslated regions (3'UTRs) are a novel class of germ-line, functional mutations, which are now recognized as powerful biomarkers of human cancer risk and biology. The first mutation discovered in this class is the KRAS-variant, a let-7-binding site mutation in the 3'UTR of the KRAS oncogene. The KRAS-variant predicts increased cancer risk for certain populations, is a predictive biomarker of cancer treatment response across cancer types, leads to conserved tumor biology and elevated AKT signaling in KRAS-variant patient tumors, and was recently found to predict elevated TGF-β and immunosuppression in cancer patients. Based on the functional biology of the KRAS-variant in cancer patients, here we chose to investigate altered normal cellular biology in the presence of the KRAS-variant, through interrogation of an isogenic normal breast epithelial cell line model with and without the KRAS-variant. We find that KRAS-variant normal breast epithelial cells exhibit a mesenchymal phenotype, which appears to be due to numerous molecular changes, including miRNA dysregulation and autocrine pathway alterations, including elevated TGF-β, resulting in ZEB and SNAIL upregulation. Our findings support the hypothesis that the KRAS-variant has a fundamental biological impact on normal cellular biology, that is conserved in these patients when they develop cancer.
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Affiliation(s)
- Song-Yi Jung
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Poonam Malhotra
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Kiana C Nguyen
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - David Salzman
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Yue Qi
- Department of Diabetes Complications and Metabolism, City of Hope, Duarte, CA, 91010, USA
| | - Ethan H Pak
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Joshua King
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - Erina Vlashi
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA
| | - David Ann
- Department of Diabetes Complications and Metabolism, City of Hope, Duarte, CA, 91010, USA
| | - Joanne B Weidhaas
- Department of Radiation Oncology, University of California, Los Angeles, CA, USA.
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5
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Malhotra P, Read GH, Weidhaas JB. Breast Cancer and miR-SNPs: The Importance of miR Germ-Line Genetics. Noncoding RNA 2019; 5:ncrna5010027. [PMID: 30897768 PMCID: PMC6468861 DOI: 10.3390/ncrna5010027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/08/2019] [Accepted: 03/15/2019] [Indexed: 12/11/2022] Open
Abstract
Recent studies in cancer diagnostics have identified microRNAs (miRNAs) as promising cancer biomarkers. Single nucleotide polymorphisms (SNPs) in miRNA binding sites, seed regions, and coding sequences can help predict breast cancer risk, aggressiveness, response to stimuli, and prognosis. This review also documents significant known miR-SNPs in miRNA biogenesis genes and their effects on gene regulation in breast cancer, taking into account the genetic background and ethnicity of the sampled populations. When applicable, miR-SNPs are evaluated in the context of other patient factors, including mutations, hormonal status, and demographics. Given the power of miR-SNPs to predict patient cancer risk, prognosis, and outcomes, further study of miR-SNPs is warranted to improve efforts towards personalized medicine.
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Affiliation(s)
- Poonam Malhotra
- Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA 90001, USA.
| | - Graham H Read
- Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA 90001, USA.
| | - Joanne B Weidhaas
- Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA 90001, USA.
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6
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Gao S, Cao C, Dai Q, Chen J, Tu J. miR-202 acts as a potential tumor suppressor in breast cancer. Oncol Lett 2018; 16:1155-1162. [PMID: 29963190 DOI: 10.3892/ol.2018.8726] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/26/2018] [Indexed: 12/17/2022] Open
Abstract
Breast cancer affects ~10% of women worldwide and is responsible for ~12% of all cancer-associated mortalities. Breast cancer is more prone to metastasis compared with other types of cancer. Up to 5% of patients with breast cancer present with incurable metastasis and an additional 10-15% of patients develop metastases within 3 years of their initial diagnosis. MicroRNAs (miRNAs) are short RNAs, 21-25 nucleotides in length, that have been shown to significantly affect gene expression. In total >2,000 miRNAs have been identified and specific miRNAs have been revealed to be associated with cancer. In the present study, we observed that the majority of breast cancer specimens collected expressed low levels of miR-202 compared with adjacent tissues and normal cell lines. Mechanistic investigations identified KRAS as a potential target gene of miR-202 and it was demonstrated that miR-202 exerted its tumor-suppressive effects by regulating the expression of KRAS in breast cancer cells. Functional assays revealed that miR-202 significantly reduced cell proliferation, migration and invasion in vitro. In summary, these results indicate the function of miR-202 in breast cancer progression and suggest that its use within breast cancer therapy is promising.
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Affiliation(s)
- Shanshan Gao
- Department of Laboratory Medicine, Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China.,Central Laboratory, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian 364000, P.R. China
| | - Chunfang Cao
- Central Laboratory, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian 364000, P.R. China
| | - Qingfu Dai
- Central Laboratory, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian 364000, P.R. China
| | - Jian Chen
- Central Laboratory, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian 364000, P.R. China
| | - Jiancheng Tu
- Department of Laboratory Medicine, Clinical Laboratory Medicine and Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
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7
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Warkentin MT, Tammemägi MC, Freedman MT, Ragard LR, Hocking WG, Kvale PA, Brenner DR, Hu P, Riley TL, Commins J, Church TR, Berg CD. Factors Associated With Small Aggressive Non-Small Cell Lung Cancers in the National Lung Screening Trial: A Validation Study. JNCI Cancer Spectr 2018; 2:pkx010. [PMID: 31360836 PMCID: PMC6649725 DOI: 10.1093/jncics/pkx010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/17/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022] Open
Abstract
Background A small proportion of non-small cell lung cancers (NSCLCs) have been observed to spread to distant lymph nodes (N3) or metastasize (M1) or both, while the primary tumor is small (≤3 cm, T1). These small aggressive NSCLCs (SA-NSLSC) are important as they are clinically significant, may identify unique biologic pathways, and warrant aggressive follow-up and treatment. This study identifies factors associated with SA-NSCLC and attempts to validate a previous finding that women with a family history of lung cancer are at particularly elevated risk of SA-NSCLC. Methods This study used a case-case design within the National Cancer Institute's National Lung Screening Trial (NLST) cohort. Case patients and "control" patients were selected based on TNM staging parameters. Case patients (n = 64) had T1 NSCLCs that were N3 or M1 or both, while "control" patients (n = 206) had T2 or T3, N0 to N2, and M0 NSCLCs. Univariate and multivariable logistic regression were used to identify factors associated with SA-NSCLC. Results In bootstrap bias-corrected multivariable logistic regression models, small aggressive adenocarcinomas were associated with a positive history of emphysema (odds ratio [OR] = 5.15, 95% confidence interval [CI] = 1.63 to 23.00) and the interaction of female sex and a positive family history of lung cancer (OR = 6.55, 95% CI = 1.06 to 50.80). Conclusions Emphysema may play a role in early lung cancer progression. Females with a family history of lung cancer are at increased risk of having small aggressive lung adenocarcinomas. These results validate previous findings and encourage research on the role of female hormones interacting with family history and genetic factors in lung carcinogenesis and progression.
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Affiliation(s)
- Matthew T Warkentin
- Department of Health Sciences, Brock University, St. Catharine's, Ontario, Canada.,Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Martin C Tammemägi
- Department of Health Sciences, Brock University, St. Catharine's, Ontario, Canada
| | - Matthew T Freedman
- Cancer Prevention and Control, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | | | - William G Hocking
- Department of Clinical Oncology, Marshfield Clinic Health System, Marshfield, WI
| | - Paul A Kvale
- Division of Pulmonary and Critical Care Medicine, Henry Ford Health System, Detroit, MI
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Community Health Sciences and Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ping Hu
- Biometry Research Group, National Cancer Institute, Bethesda, MD
| | | | - John Commins
- Information Management Services, Inc., Rockville, MD
| | - Timothy R Church
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Christine D Berg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
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8
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Peng C, Lou HL, Liu F, Shen J, Lin X, Zeng CP, Long JR, Su KJ, Zhang L, Greenbaum J, Deng WF, Li YM, Deng HW. Enhanced Identification of Potential Pleiotropic Genetic Variants for Bone Mineral Density and Breast Cancer. Calcif Tissue Int 2017; 101:489-500. [PMID: 28761973 PMCID: PMC5796546 DOI: 10.1007/s00223-017-0308-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/22/2017] [Indexed: 10/19/2022]
Abstract
Epidemiological and clinical evidences have shown that bone mineral density (BMD) has a close relationship with breast cancer (BC). They might potentially have a shared genetic basis. By incorporating information about these pleiotropic effects, we may be able to explore more of the traits' total heritability. We applied a recently developed conditional false discovery rate (cFDR) method to the summary statistics from two independent GWASs to identify the potential pleiotropic genetic variants for BMD and BC. By jointly analyzing two large independent GWASs of BMD and BC, we found strong pleiotropic enrichment between them and identified 102 single-nucleotide polymorphisms (SNPs) in BMD and 192 SNPs in BC with cFDR < 0.05, including 230 SNPs that might have been overlooked by the standard GWAS analysis. cFDR-significant genes were enriched in GO terms and KEGG pathways which were crucial to bone metabolism and/or BC pathology (adjP < 0.05). Some cFDR-significant genes were partially validated in the gene expressional validation assay. Strong interactions were found between proteins produced by cFDR-significant genes in the context of biological mechanism of bone metabolism and/or BC etiology. Totally, we identified 7 pleiotropic SNPs that were associated with both BMD and BC (conjunction cFDR < 0.05); CCDC170, ESR1, RANKL, CPED1, and MEOX1 might play important roles in the pleiotropy of BMD and BC. Our study highlighted the significant pleiotropy between BMD and BC and shed novel insight into trait-specific as well as the potentially shared genetic architecture for both BMD and BC.
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Affiliation(s)
- Cheng Peng
- Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, People's Republic of China
| | - Hui-Ling Lou
- Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, People's Republic of China
| | - Feng Liu
- Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, 510180, People's Republic of China
| | - Jie Shen
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People's Republic of China
| | - Xu Lin
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People's Republic of China
| | - Chun-Ping Zeng
- Department of Endocrinology and Metabolism, Affiliated Nanhai Hospital of Southern Medical University, Guangzhou, People's Republic of China
| | - Ji-Rong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kuan-Jui Su
- Department of Global Statistics and Data Science, School of Public Health and Tropical Medicine, Center for Bioinformatics and Genomics, Tulane University, New Orleans, LA, 70112, USA
| | - Lan Zhang
- Department of Global Statistics and Data Science, School of Public Health and Tropical Medicine, Center for Bioinformatics and Genomics, Tulane University, New Orleans, LA, 70112, USA
| | - Jonathan Greenbaum
- Department of Global Statistics and Data Science, School of Public Health and Tropical Medicine, Center for Bioinformatics and Genomics, Tulane University, New Orleans, LA, 70112, USA
| | - Wei-Feng Deng
- Hunan University of Medicine, Huaihua, 418000, People's Republic of China
| | - Yu-Mei Li
- School of Mathematics and Computational Science, Huaihua University, Huaihua, 418008, Hunan, People's Republic of China
| | - Hong-Wen Deng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People's Republic of China.
- Department of Global Statistics and Data Science, School of Public Health and Tropical Medicine, Center for Bioinformatics and Genomics, Tulane University, New Orleans, LA, 70112, USA.
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9
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The impact of the Biomolecular Era on breast cancer surgery. Surgeon 2017; 15:169-181. [DOI: 10.1016/j.surge.2016.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/14/2016] [Accepted: 09/18/2016] [Indexed: 01/10/2023]
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10
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Weidhaas JB, Harris J, Schaue D, Chen AM, Chin R, Axelrod R, El-Naggar AK, Singh AK, Galloway TJ, Raben D, Wang D, Matthiesen C, Avizonis VN, Manon RR, Yumen O, Nguyen-Tan PF, Trotti A, Skinner H, Zhang Q, Ferris RL, Sidransky D, Chung CH. The KRAS-Variant and Cetuximab Response in Head and Neck Squamous Cell Cancer: A Secondary Analysis of a Randomized Clinical Trial. JAMA Oncol 2017; 3:483-491. [PMID: 28006059 DOI: 10.1001/jamaoncol.2016.5478] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Importance There is a significant need to find biomarkers of response to radiotherapy and cetuximab in locally advanced head and neck squamous cell carcinoma (HNSCC) and biomarkers that predict altered immunity, thereby enabling personalized treatment. Objectives To examine whether the Kirsten rat sarcoma viral oncogene homolog (KRAS)-variant, a germline mutation in a microRNA-binding site in KRAS, is a predictive biomarker of cetuximab response and altered immunity in the setting of radiotherapy and cisplatin treatment and to evaluate the interaction of the KRAS-variant with p16 status and blood-based transforming growth factor β1 (TGF-β1). Design, Setting, and Participants A total of 891 patients with advanced HNSCC from a phase 3 trial of cisplatin plus radiotherapy with or without cetuximab (NRG Oncology RTOG 0522) were included in this study, and 413 patients with available samples were genotyped for the KRAS-variant. Genomic DNA was tested for the KRAS-variant in a CLIA-certified laboratory. Correlation of the KRAS-variant, p16 positivity, outcome, and TGF-β1 levels was evaluated. Hazard ratios (HRs) were estimated with the Cox proportional hazards model. Main Outcomes and Measures The correlation of KRAS-variant status with cetuximab response and outcome, p16 status, and plasma TGF-β1 levels was tested. Results Of 891 patients eligible for protocol analyses (786 male [88.2%], 105 [11.2%] female, 810 white [90.9%], 81 nonwhite [9.1%]), 413 had biological samples for KRAS-variant testing, and 376 had plasma samples for TGF-β1 measurement. Seventy patients (16.9%) had the KRAS-variant. Overall, for patients with the KRAS-variant, cetuximab improved both progression-free survival (PFS) for the first year (HR, 0.31; 95% CI, 0.10-0.94; P = .04) and overall survival (OS) in years 1 to 2 (HR, 0.19; 95% CI, 0.04-0.86; P = .03). There was a significant interaction of the KRAS-variant with p16 status for PFS in patients treated without cetuximab. The p16-positive patients with the KRAS-variant treated without cetuximab had worse PFS than patients without the KRAS-variant (HR, 2.59; 95% CI, 0.91-7.33; P = .07). There was a significant 3-way interaction among the KRAS-variant, p16 status, and treatment for OS (HR, for KRAS-variant, cetuximab and p16 positive, 0.22; 95% CI, 0.03-1.66; HR for KRAS-variant, cetuximab and p16 negative, 1.43; 95% CI, 0.48-4.26; HR for KRAS-variant, no cetuximab and p16 positive, 2.48; 95% CI, 0.64-9.65; and HR for KRAS-variant, no cetuximab and p16 negative, 0.61; 95% CI, 0.23-1.59; P = .02). Patients with the KRAS-variant had significantly elevated TGF-β1 plasma levels (median, 23 376.49 vs 18 476.52 pg/mL; P = .03) and worse treatment-related toxic effects. Conclusions and Relevance Patients with the KRAS-variant with HNSCC significantly benefit from the addition of cetuximab to radiotherapy and cisplatin, and there is a significant interaction between the KRAS-variant and p16 status. Elevated TGF-β1 levels in patients with the KRAS-variant suggests that cetuximab may help these patients by overcoming TGF-β1-induced suppression of antitumor immunity. Trial Registration clinicaltrials.gov Identifier: NCT00265941.
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Affiliation(s)
- Joanne B Weidhaas
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles, California
| | - Jonathan Harris
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles, California
| | - Allen M Chen
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles, California
| | - Robert Chin
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles, California
| | - Rita Axelrod
- Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Adel K El-Naggar
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | | | | | - David Raben
- Department of Radiation Oncology, University of Colorado at Denver, Aurora
| | - Dian Wang
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee
| | - Chance Matthiesen
- Department of Radiation Oncology, Oklahoma University Health Sciences Center, Oklahoma City
| | - Vilija N Avizonis
- Department of Radiation Oncology, Intermountain Medical Center, Salt Lake City, Utah
| | - Rafael R Manon
- University of Florida Health Cancer Center, Orlando Health, Orlando
| | - Omar Yumen
- Department of Radiation Oncology, Geisinger Medical Center CCOP, Danville, Pennsylvania
| | - Phuc Felix Nguyen-Tan
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montreal, Montreal, Quebec, Canada
| | - Andy Trotti
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Heath Skinner
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Qiang Zhang
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania
| | - Robert L Ferris
- Cancer Immunology Program and Tumor Microvenvironment Center, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - David Sidransky
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Christine H Chung
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida
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11
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Bullock MD, Silva AM, Calin GA. Estrogen and breast cancer: can less mean more? Cell Cycle 2015; 14:2197-8. [PMID: 26090587 PMCID: PMC5242311 DOI: 10.1080/15384101.2015.1056617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Marc D Bullock
- Cancer Sciences Unit; University of Southampton School of Medicine; Southampton, UK
- Division of Surgery; University Hospital Southampton; Southampton, UK
- Department of Experimental Therapeutics; The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Andreia M Silva
- Department of Experimental Therapeutics; The University of Texas MD Anderson Cancer Center; Houston, TX USA
- Instituto de Investigação em Saúde; Universidade do Porto; Porto, Portugal
- Institute of Biomedical Engineering; Universidade do Porto; Porto, Portugal
| | - George A Calin
- Department of Experimental Therapeutics; The University of Texas MD Anderson Cancer Center; Houston, TX USA
- Center for RNA Interference and Non-Coding RNAs; The University of Texas MD Anderson Cancer Center; Houston, TX USA
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