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Nannini DR, Cortese R, VonTungeln C, Hildebrandt GC. Chemotherapy-induced acceleration of DNA methylation-based biological age in breast cancer. Epigenetics 2024; 19:2360160. [PMID: 38820227 PMCID: PMC11146438 DOI: 10.1080/15592294.2024.2360160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/21/2024] [Indexed: 06/02/2024] Open
Abstract
Breast cancer is the most common cancer diagnosed in women and is often treated with chemotherapy. Although previous studies have demonstrated increasing biological age in patients who receive chemotherapy, evaluation of this association with DNA methylation-based markers of biological ageing may provide novel insight into the role of chemotherapy on the ageing process. We therefore sought to investigate the association between chemotherapy and markers of biological ageing as estimated from DNA methylation in women with breast cancer. DNA methylation profiling was performed on peripheral blood collected from 18 patients before and after the first cycle of chemotherapy using the Infinium HumanMethylation450 BeadChip. Six markers of biological age acceleration were estimated from DNA methylation levels. Multiple linear regression analyses were performed to evaluate the association between each metric of biological age acceleration and chemotherapy. After adjusting for chronological age and race, intrinsic epigenetic age acceleration (p = 0.041), extrinsic epigenetic age acceleration (p = 0.050), PhenoAge acceleration (p = 0.001), GrimAge acceleration (p < 0.001), and DunedinPACE (p = 0.006) were significantly higher and telomere length (p = 0.027) was significantly lower following the first cycle of chemotherapy compared to before treatment initiation. These results demonstrate greater biological ageing as estimated from DNA methylation following chemotherapy in women with breast cancer. Our findings illustrate that cytotoxic therapies may modulate the ageing process among breast cancer patients and may also have implications for age-related health conditions in cancer survivors.
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Affiliation(s)
- Drew R. Nannini
- Department of Internal Medicine, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
| | - Rene Cortese
- Department of Child Health and Department of Obstetrics, Gynecology, and Women’s Health, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, USA
| | - Christopher VonTungeln
- Department of Internal Medicine, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
| | - Gerhard C. Hildebrandt
- Ellis Fischel Cancer Center, University of Missouri at Columbia, Columbia, MO, USA
- Division of Hematology and Medical Oncology, School of Medicine, University of Missouri at Columbia, Columbia, MO, USA
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Shah C, Whitworth P, Vicini FA, Narod S, Gerber N, Jhawar SR, King TA, Mittendorf EA, Willey SC, Rabinovich R, Gold L, Brown E, Patel A, Vargo J, Barry PN, Rock D, Friedman N, Bedi G, Templeton S, Brown S, Gabordi R, Riley L, Lee L, Baron P, Majithia L, Mirabeau-Beale KL, Reid VJ, Hirsch A, Hwang C, Pellicane J, Maganini R, Khan S, MacDermed DM, Small W, Mittal K, Borgen P, Cox C, Shivers SC, Bremer T. The Clinical Utility of a 7-Gene Biosignature on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery: An Updated Analysis of the DCISionRT ® PREDICT Study. Ann Surg Oncol 2024:10.1245/s10434-024-15566-5. [PMID: 38916700 DOI: 10.1245/s10434-024-15566-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/13/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Breast-conserving surgery (BCS) followed by adjuvant radiotherapy (RT) is a standard treatment for ductal carcinoma in situ (DCIS). A low-risk patient subset that does not benefit from RT has not yet been clearly identified. The DCISionRT test provides a clinically validated decision score (DS), which is prognostic of 10-year in-breast recurrence rates (invasive and non-invasive) and is also predictive of RT benefit. This analysis presents final outcomes from the PREDICT prospective registry trial aiming to determine how often the DCISionRT test changes radiation treatment recommendations. METHODS Overall, 2496 patients were enrolled from February 2018 to January 2022 at 63 academic and community practice sites and received DCISionRT as part of their care plan. Treating physicians reported their treatment recommendations pre- and post-test as well as the patient's preference. The primary endpoint was to identify the percentage of patients where testing led to a change in RT recommendation. The impact of the test on RT treatment recommendation was physician specialty, treatment settings, individual clinical/pathological features and RTOG 9804 like criteria. Multivariate logisitc regression analysis was used to estimate the odds ratio (ORs) for factors associated with the post-test RT recommendations. RESULTS RT recommendation changed 38% of women, resulting in a 20% decrease in the overall recommendation of RT (p < 0.001). Of those women initially recommended no RT (n = 583), 31% were recommended RT post-test. The recommendation for RT post-test increased with increasing DS, from 29% to 66% to 91% for DS <2, DS 2-4, and DS >4, respectively. On multivariable analysis, DS had the strongest influence on final RT recommendation (odds ratio 22.2, 95% confidence interval 16.3-30.7), which was eightfold greater than clinicopathologic features. Furthermore, there was an overall change in the recommendation to receive RT in 42% of those patients meeting RTOG 9804-like low-risk criteria. CONCLUSIONS The test results provided information that changes treatment recommendations both for and against RT use in large population of women with DCIS treated in a variety of clinical settings. Overall, clinicians changed their recommendations to include or omit RT for 38% of women based on the test results. Based on published clinical validations and the results from current study, DCISionRT may aid in preventing the over- and undertreatment of clinicopathological 'low-risk' and 'high-risk' DCIS patients. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03448926 ( https://clinicaltrials.gov/study/NCT03448926 ).
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Affiliation(s)
- Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Pat Whitworth
- Nashville Breast Center, Nashville, TN, USA
- PreludeDX, Laguna Hills, CA, USA
| | - Frank A Vicini
- Michigan Healthcare Professionals, Farmington Hills, MI, USA
| | - Steven Narod
- Center for Global Health, University of Toronto, Toronto, ON, Canada
| | - Naamit Gerber
- Department of Radiation Oncology, Laura and Isaac Perlmutter Cancer Center, New York, NY, USA
| | - Sachin R Jhawar
- Department of Radiation Oncology, James Cancer Center, Ohio State University, Columbus, OH, USA
| | - Tari A King
- Department of Surgery, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | - Rachel Rabinovich
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Linsey Gold
- Comprehensive Breast Care, Michigan Healthcare Professionals, Troy, MI, USA
| | - Eric Brown
- Comprehensive Breast Care, Michigan Healthcare Professionals, Troy, MI, USA
| | | | - John Vargo
- Department of Radiation Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Parul N Barry
- Department of Radiation Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Gauri Bedi
- Mercy Medical Center, Baltimore, MD, USA
| | | | | | | | - Lee Riley
- St. Luke's Hospital, Allentown, PA, USA
| | - Lucy Lee
- Northwell Health, New Hyde Park, NY, USA
| | - Paul Baron
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | | | | | | | | | | | | | | | - William Small
- Department of Radiation Oncology, Loyola University, Chicago, IL, USA
| | | | | | - Charles Cox
- University of South Florida Morsani College of Medicine, Tampa, FL, USA
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Hariharan R, Hood L, Price ND. A data-driven approach to improve wellness and reduce recurrence in cancer survivors. Front Oncol 2024; 14:1397008. [PMID: 38665952 PMCID: PMC11044254 DOI: 10.3389/fonc.2024.1397008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
For many cancer survivors, toxic side effects of treatment, lingering effects of the aftermath of disease and cancer recurrence adversely affect quality of life (QoL) and reduce healthspan. Data-driven approaches for quantifying and improving wellness in healthy individuals hold great promise for improving the lives of cancer survivors. The data-driven strategy will also guide personalized nutrition and exercise recommendations that may help prevent cancer recurrence and secondary malignancies in survivors.
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Affiliation(s)
- Ramkumar Hariharan
- College of Engineering, Northeastern University, Seattle, WA, United States
- Institute for Experiential Artificial Intelligence, Northeastern University, Boston, MA, United States
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA, United States
- Buck Institute for Research on Aging, Novato, CA, United States
- Phenome Health, Seattle, WA, United States
| | - Nathan D. Price
- Institute for Systems Biology, Seattle, WA, United States
- Thorne HealthTech, New York, NY, United States
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Jeremian R, Lytvyn Y, Fotovati R, Georgakopoulos JR, Gooderham M, Yeung J, Sachdeva M, Lefrançois P, Litvinov IV. Distinct Signatures of Mitotic Age Acceleration in Cutaneous Melanoma and Acquired Melanocytic Nevi. J Invest Dermatol 2024:S0022-202X(24)00083-6. [PMID: 38290647 DOI: 10.1016/j.jid.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Affiliation(s)
- Richie Jeremian
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada; The Research Institute of the McGill University Health Centre, Montréal, Canada
| | - Yuliya Lytvyn
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Rayyan Fotovati
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Jorge R Georgakopoulos
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Jensen Yeung
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Muskaan Sachdeva
- Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Philippe Lefrançois
- The Research Institute of the McGill University Health Centre, Montréal, Canada; Division of Dermatology, McGill University, Montréal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada
| | - Ivan V Litvinov
- The Research Institute of the McGill University Health Centre, Montréal, Canada; Division of Dermatology, McGill University, Montréal, Canada.
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