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Multi-Omics Approaches for the Prediction of Clinical Endpoints after Immunotherapy in Non-Small Cell Lung Cancer: A Comprehensive Review. Biomedicines 2022; 10:biomedicines10061237. [PMID: 35740259 PMCID: PMC9219996 DOI: 10.3390/biomedicines10061237] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023] Open
Abstract
Immune checkpoint inhibitors (ICI) have revolutionized the management of locally advanced and advanced non-small lung cancer (NSCLC). With an improvement in the overall survival (OS) as both first- and second-line treatments, ICIs, and especially programmed-death 1 (PD-1) and programmed-death ligands 1 (PD-L1), changed the landscape of thoracic oncology. The PD-L1 level of expression is commonly accepted as the most used biomarker, with both prognostic and predictive values. However, even in a low expression level of PD-L1, response rates remain significant while a significant number of patients will experience hyperprogression or adverse events. The dentification of such subtypes is thus of paramount importance. While several studies focused mainly on the prediction of the PD-L1 expression status, others aimed directly at the development of prediction/prognostic models. The response to ICIs depends on a complex physiopathological cascade, intricating multiple mechanisms from the molecular to the macroscopic level. With the high-throughput extraction of features, omics approaches aim for the most comprehensive assessment of each patient. In this article, we will review the place of the different biomarkers (clinical, biological, genomics, transcriptomics, proteomics and radiomics), their clinical implementation and discuss the most recent trends projecting on the future steps in prediction modeling in NSCLC patients treated with ICI.
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Janket SJ, Conte HA, Diamandis EP. Do Prevotella copri and Blastocystis promote euglycaemia? THE LANCET MICROBE 2021; 2:e565-e566. [DOI: 10.1016/s2666-5247(21)00215-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022] Open
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Janket SJ, Conte HA, Meurman JH, Diamandis EP. Commensals can become pathobionts. J Clin Periodontol 2021; 48:1491-1492. [PMID: 34409628 DOI: 10.1111/jcpe.13535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/16/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Sok-Ja Janket
- Translational Oral Medicine, Forsyth Institute, Cambridge, Massachusetts, USA
| | - Harry A Conte
- Department of Infectious Diseases, Saint Francis Hospital, Hartford, Connecticut, USA.,Department of Infectious Diseases, Johnson Memorial Hospital, Stafford Springs, Connecticut, USA
| | - Jukka H Meurman
- Department of Oral Maxillofacial Diseases, University of Helsinki Hospital, Helsinki, Finland
| | - Eleftherios P Diamandis
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
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Wu J, Wang S, Zheng B, Qiu X, Wang H, Chen L. Modulation of Gut Microbiota to Enhance Effect of Checkpoint Inhibitor Immunotherapy. Front Immunol 2021; 12:669150. [PMID: 34267748 PMCID: PMC8276067 DOI: 10.3389/fimmu.2021.669150] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/14/2021] [Indexed: 12/19/2022] Open
Abstract
Accumulating evidence demonstrated the crucial role of gut microbiota in many human diseases, including cancer. Checkpoint inhibitor therapy has emerged as a novel treatment and has been clinically accepted as a major therapeutic strategy for cancer. Gut microbiota is related to cancer and the effect of immune checkpoint inhibitors (ICIs), and supplement with specific bacterial species can restore or enhance the responses to the ICIs. Namely, specified bacteria can serve as the biomarkers for distinguishing the patient who will respond to ICIs and determine the effectiveness of ICIs, as well as predicting the efficacy of checkpoint inhibitor immunotherapy. Regardless of the significant findings, the relationship between gut microbiota and the effect of ICIs treatment needs a more thorough understanding to provide more effective therapeutic plans and reduce treatment complication. In this review, we summarized the role of gut microbiota played in immune system and cancer. We mainly focus on the relationship between gut microbiota and the checkpoint inhibitor immunotherapy.
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Affiliation(s)
- Jianmin Wu
- Institute of Metabolism & Integrative Biology (IMIB), Fudan University, Shanghai, China
| | - Shan Wang
- Department of Oncology, Shanghai Medical College, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Bo Zheng
- The International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Xinyao Qiu
- Department of Oncology, Shanghai Medical College, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Hongyang Wang
- Institute of Metabolism & Integrative Biology (IMIB), Fudan University, Shanghai, China.,The International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
| | - Lei Chen
- The International Cooperation Laboratory on Signal Transduction, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
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Janket SJ, Conte HA, Diamandis EP. Inappropriate extrapolations abound in fecal microbiota research. Clin Chem Lab Med 2021; 59:e307-e308. [PMID: 33567176 DOI: 10.1515/cclm-2020-1862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/29/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Sok-Ja Janket
- Translational Oral Medicine, Forsyth Institute, Cambridge, MA, USA
| | - Harry A Conte
- Department of Infectious Diseases, Saint Francis Hospital, Hartford, CT, USA.,Department of Emergency Medicine, Johnson Memorial Hospital, Stafford Springs, CT, USA
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Fiala C, Diamandis EP. The Outcomes of Scientific Debates Should Be Published: The Arivale Story. J Appl Lab Med 2020; 5:1070-1075. [PMID: 32830260 DOI: 10.1093/jalm/jfaa110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022]
Abstract
There is an ongoing scientific debate regarding the merits and shortcomings of P4 Medicine (predictive, preventive, personalized, and participatory) and O4 Medicine (overtesting, overdiagnosis, overtreatment, and overcharging). P4 Medicine promises to revolutionize scientific wellness through longitudinal big data collection, denoted as "dense phenotyping," which could uncover early, actionable signs of disease, thus allowing earlier interventions and possible disease reversal. On the other hand, O4 Medicine draws attention to the potential side effects of P4 Medicine: overtesting, overdiagnosis, overtreatment, and overcharging fees. Preliminary data from the P4 Medicine concept have been recently published. A novel biotechnology company, Arivale, provided customers with services based on P4 Medicine principles; however it could not sustain its operations and closed its doors in April 2019. In this report, we provide our own insights as to why Arivale failed. While we do not discount that in the future, improved testing strategies may provide a path to better health, we suggest that until the evidence is provided, selling of such products to the public, especially through the "direct to consumer" approach, should be discouraged. We hope that our analysis will provide useful information for the burgeoning fields of personalized medicine, preventive medicine, and direct to consumer health testing.
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Affiliation(s)
- Clare Fiala
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Eleftherios P Diamandis
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada
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Ren AH, Fiala CA, Diamandis EP, Kulasingam V. Pitfalls in Cancer Biomarker Discovery and Validation with Emphasis on Circulating Tumor DNA. Cancer Epidemiol Biomarkers Prev 2020; 29:2568-2574. [PMID: 32277003 DOI: 10.1158/1055-9965.epi-20-0074] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/19/2020] [Accepted: 04/03/2020] [Indexed: 11/16/2022] Open
Abstract
Despite significant investment of funds and resources, few new cancer biomarkers have been introduced to the clinic in the last few decades. Although many candidates produce promising results in the laboratory, deficiencies in sensitivity, specificity, and predictive value make them less than desirable in a patient setting. This review will analyze these challenges in detail as well as discuss false discovery, problems with reproducibility, and tumor heterogeneity. Circulating tumor DNA (ctDNA), an emerging cancer biomarker, is also analyzed, particularly in the contexts of assay specificity, sensitivity, fragmentation, lead time, mutant allele fraction, and clinical relevance. Emerging artificial intelligence technologies will likely be valuable tools in maximizing the clinical utility of ctDNA which is often found in very small quantities in patients with early-stage tumors. Finally, the implications of challenging false discoveries are examined and some insights about improving cancer biomarker discovery are provided.See all articles in this CEBP Focus section, "NCI Early Detection Research Network: Making Cancer Detection Possible."
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Affiliation(s)
- Annie H Ren
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Clare A Fiala
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Eleftherios P Diamandis
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Clinical Biochemistry, University Health Network, Toronto, Ontario, Canada
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada. .,Department of Clinical Biochemistry, University Health Network, Toronto, Ontario, Canada
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Janket SJ, Ackerson LK, Diamandis EP. Potential risks in fecal microbiota transplantation. Clin Chem Lab Med 2020; 58:e95. [PMID: 31811801 DOI: 10.1515/cclm-2019-1076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/13/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Sok-Ja Janket
- Section of Translational Oral Medicine, Forsyth Institute, Cambridge, MA, USA
| | - Leland K Ackerson
- Department of Public Health, University of Massachusetts at Lowell, Lowell, MA, USA
| | - Eleftherios P Diamandis
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Department of Clinical Biochemistry, University Health Network, Toronto, Ontario, Canada.,Head of Clinical Biochemistry, Mount Sinai Hospital and University Health Network, Toronto, Canada
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Janket SJ, Meurman J, Diamandis EP. Advocate cultivation of academic ethics: why is it necessary? F1000Res 2019; 8:1830. [PMID: 32148762 PMCID: PMC7043133 DOI: 10.12688/f1000research.20640.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2020] [Indexed: 11/20/2022] Open
Abstract
We teach and practice ethical behavior with all clinical and research activities. Notably, we are well educated to treat the subjects participating in research studies with high ethical standards. However, the ethics of interacting with colleagues, or with junior faculty members, are neither well defined nor taught. Dealing with junior faculty has parallels to dealing with vulnerable research subjects such as children, mentally or physically challenged groups, prison inmates or army recruits. Like any other vulnerable population, lower-ranking faculty members are often at the mercy of department chairs or other higher-ranked faculty members. Herein we present some potentially unethical or unfair examples related to academic research. Our goal is to educate the academic community of conceptual paths and to prevent similar untoward occurrences from happening in the future. Unethical behaviors related to sexual misconduct have already been described elsewhere and are not included in this manuscript.
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Affiliation(s)
- Sok-Ja Janket
- Section of Translational Oral Medicine, Forsyth Institute, Cambridge, MA, 02142, USA
| | - Jukka Meurman
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Eleftherios P Diamandis
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Toronto, Ontario, M5T 3L9, Canada
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