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Manganaro L, Celli V, Viggiani V, Berardelli E, Granato T, Tartaglione S, Farina A, Catalano C, Angeloni A, Anastasi E. CT imaging phenotypes linked to CA125 and HE4 biomarkers are highly predictive in discriminating between hereditary and sporadic ovarian cancer patients. Tumour Biol 2022; 44:171-185. [DOI: 10.3233/tub-211557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Hereditary ovarian cancers (HOC) represent about 23% of ovarian cancer (OC) cases: they are most frequently related to germline mutations in the BRCA genes. OBJECTIVE: We aimed to compare CA125/HE4 serum levels and Computed Tomography (CT) features at time of ovarian cancer (OC) diagnosis in two populations: BRCA mutant and BRCA wild-type (WT) OC, and to investigate the relationship between this laboratory and radiological biomarker and BRCA mutation status. METHODS: This retrospective study included 60 newly diagnosed OC patients with FIGO stage IIIC-IV disease, tested for BRCA1/2 germline mutation status of which preoperative CT scan and serum tumor marker assay were available. RESULTS: The median level of CA125 (708 U/mL) was significantly higher (p < 0.002) in BRCA1/2 mutated patients than in WT patients (176 U/mL), whereas the median level of HE4 (492 pmol/L) was significantly higher (p < 0.002) in WT than in BRCA-mutated patients (252 pmol/L). BRCA mutation carriers showed a higher incidence of bilateral ovarian masses (p = 0.0303) characterized by solid structures (p < 0.00001), higher peritoneal tumor load, macronodular implants >2 cm (p = 0.000099), increased frequency of lymphadenopathies (p = 0.019), and metastasis (p = 0.052) compared to patients with BRCA WT. CONCLUSIONS: Tumor markers and CT patterns may help in identifying BRCA mutation status in OC directing patients towards a personalized treatment.
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Affiliation(s)
- Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Veronica Celli
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Valentina Viggiani
- Department of Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Elena Berardelli
- Department of Experimental Medicine “Sapienza” University of Rome, Rome, Italy
| | - Teresa Granato
- CNR-IBPM, National Research Council, Institute of Molecular Biology and Pathology, Rome, Italy
| | - Sara Tartaglione
- Department of Experimental Medicine “Sapienza” University of Rome, Rome, Italy
| | - Antonella Farina
- Department of Experimental Medicine “Sapienza” University of Rome, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Antonio Angeloni
- Department of Experimental Medicine “Sapienza” University of Rome, Rome, Italy
| | - Emanuela Anastasi
- Department of Experimental Medicine “Sapienza” University of Rome, Rome, Italy
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2
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Olaparib as first line in BRCA-mutated advanced ovarian carcinoma: Is it cost-effective in Spain? Gynecol Oncol 2021; 164:406-414. [PMID: 34844775 DOI: 10.1016/j.ygyno.2021.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/03/2021] [Accepted: 11/13/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To estimate the cost-effectiveness of olaparib after being funded by the Spanish National Health Service (SNHS) as first-line monotherapy maintenance treatment in patients with advanced high-grade serous ovarian carcinoma (HGSOC) and BRCA mutations in Spain. METHODS A semi-Markov model with one-month cycles was adapted to the Spanish healthcare setting, using the perspective of the SNHS, and a time horizon of 50 years. Two scenarios were compared: receiving olaparib vs. no maintenance treatment. The model comprised four health states and included the clinical results of the SOLO1 study, along with the direct healthcare costs associated with the use of first-line and subsequent treatment resources (2020 €). A discount rate of 3% was applied for future cost and quality-of-life outcomes. A probabilistic sensitivity analysis (PSA) was also carried out and a cost-effectiveness threshold of €25,000 per quality adjusted life year (QALY) was considered. RESULTS The introduction of olaparib as a first-line maintenance treatment for advanced HGSOC patients with BRCA mutations implied a cost of €131,614.98 compared to €102,369.54 without olaparib (difference: €29,245.44), with an improvement of 2.00 QALYs (5.56 and 3.57, respectively). Therefore, olaparib is cost-effective for advanced HGSOC patients with BRCA mutations, with an incremental cost-effectiveness ratio of €14,653.2/QALY. The results from the PSA showed that 92.1% of the simulations fell below the €25,000/QALY threshold. The model showed that olaparib could improve the overall survival by 2 years, vs. no maintenance treatment. CONCLUSIONS Olaparib as first-line maintenance treatment is cost-effective in advanced HGSOC patients with BRCA mutations in Spain.
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3
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Moya-Alarcón C, Piera G, Callejo Á, Gascó A. Real-world treatment patterns and outcomes in platinum-sensitive recurrent high-grade serous ovarian cancer patients. J Comp Eff Res 2021; 11:13-27. [PMID: 34697945 DOI: 10.2217/cer-2021-0135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: To describe the overall cancer-related healthcare utilization patterns, treatment patterns and outcomes in women diagnosed with platinum-sensitive recurrent high-grade serous ovarian cancer. Patients & methods: Subanalysis of the Spanish sample of a retrospective, noninterventional, multinational, observational study. Results: BRCA-mutated patients had better outcomes in terms of progression-free survival and overall survival than patients who were BRCA wild-type. It was observed that patients' treatment outcomes after the first recurrence progressively worsened as the patient underwent subsequent chemotherapy lines. Healthcare resource utilization when accounting for the follow-up time did not substantially differ between BRCA1/2-mutated and BRCA wild-type patients. Conclusion: BRCA1/2 mutation carriers have better treatment outcomes, including longer survival, without a negative impact on the use of healthcare resources.
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Affiliation(s)
| | | | | | - Amaya Gascó
- Global Clinical Program Lead, AstraZeneca, USA
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4
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Pujol P, Barberis M, Beer P, Friedman E, Piulats JM, Capoluongo ED, Garcia Foncillas J, Ray-Coquard I, Penault-Llorca F, Foulkes WD, Turnbull C, Hanson H, Narod S, Arun BK, Aapro MS, Mandel JL, Normanno N, Lambrechts D, Vergote I, Anahory M, Baertschi B, Baudry K, Bignon YJ, Bollet M, Corsini C, Cussenot O, De la Motte Rouge T, Duboys de Labarre M, Duchamp F, Duriez C, Fizazi K, Galibert V, Gladieff L, Gligorov J, Hammel P, Imbert-Bouteille M, Jacot W, Kogut-Kubiak T, Lamy PJ, Nambot S, Neuzillet Y, Olschwang S, Rebillard X, Rey JM, Rideau C, Spano JP, Thomas F, Treilleux I, Vandromme M, Vendrell J, Vintraud M, Zarca D, Hughes KS, Alés Martínez JE. Clinical practice guidelines for BRCA1 and BRCA2 genetic testing. Eur J Cancer 2021; 146:30-47. [PMID: 33578357 DOI: 10.1016/j.ejca.2020.12.023] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 12/24/2022]
Abstract
BRCA1 and BRCA2 gene pathogenic variants account for most hereditary breast cancer and are increasingly used to determine eligibility for PARP inhibitor (PARPi) therapy of BRCA-related cancer. Because issues of BRCA testing in clinical practice now overlap with both preventive and therapeutic management, updated and comprehensive practice guidelines for BRCA genotyping are needed. The integrative recommendations for BRCA testing presented here aim to (1) identify individuals who may benefit from genetic counselling and risk-reducing strategies; (2) update germline and tumour-testing indications for PARPi-approved therapies; (3) provide testing recommendations for personalised management of early and metastatic breast cancer; and (4) address the issues of rapid process and tumour analysis. An international group of experts, including geneticists, medical and surgical oncologists, pathologists, ethicists and patient representatives, was commissioned by the French Society of Predictive and Personalised Medicine (SFMPP). The group followed a methodology based on specific formal guidelines development, including (1) evaluating the likelihood of BRCAm from a combined systematic review of the literature, risk assessment models and expert quotations, and (2) therapeutic values of BRCAm status for PARPi therapy in BRCA-related cancer and for management of early and advanced breast cancer. These international guidelines may help clinicians comprehensively update and standardise BRCA testing practices.
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Affiliation(s)
- Pascal Pujol
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France; CREEC, UMR IRD 224-CNRS 5290 Université Montpellier, Montpellier, France.
| | | | - Philp Beer
- Wellcome Trust Sanger institute, Cambridge, United Kingdom; Glasgow Precision Oncology Laboratory, United Kingdom.
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
| | - Josep M Piulats
- Unidad Funcional de Cáncer de Próstata, Servicio de Oncología Médica, Hospital Universitari de Bellvitge-Institut Català d'Oncologia (ICO), Hospitalet de Llobregat, Spain; Servicio de Oncología Médica, Institut Català d'Oncologia (ICO), Hospitalet de Llobregat, Spain.
| | - Ettore D Capoluongo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche Università Federico II, CEINGE Biotecnologie Avanzate, Naples, 80145, Italy.
| | - Jesus Garcia Foncillas
- Translational Oncology Division, Oncohealth Institute, IIS-Fundación Jimenez Diaz-UAM, Madrid, Spain.
| | - Isabelle Ray-Coquard
- Oncologie Médicale, Centre Leon Bérard; Univ Lyon, Université Claude Bernard Lyon1, Hesper EA 7425, F - 69003, Lyon, France.
| | - Frédérique Penault-Llorca
- Department of Biology and Pathology, Centre Jean Perrin, Clermont Ferrand, France; UMR INSERM 1240, Université Clermont Auvergne, Clermont Ferrand, France.
| | - William D Foulkes
- McGill University, Division of Medical Genetics, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK; Genomics England, Queen Mary University of London, London, UK; Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, UK.
| | - Helen Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK.
| | - Steven Narod
- University of Toronto Dalla Lana School of Public Health, Toronto, ON, Canada; Canada Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
| | - Banu K Arun
- Anderson Cancer Center, The University of Texas, Department of Breast Medical Oncology, Division of Cancer Medicine, USA.
| | | | - Jean-Louis Mandel
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France; Université de Strasbourg, Illkirch, France.
| | - Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Naples, Italy.
| | - Diether Lambrechts
- Laboratory of Translational Genetics (VIB-KU Leuven), ON IV Herestraat 49 - box 912, 3000, Leuven Belgium.
| | - Ignace Vergote
- Department of Gynaecologic Oncology University Hospitals Leuven, Gasthuisberg Herestraat 49, 3000 Leuven, Belgium.
| | - Michèle Anahory
- Pech de Laclause, Bathmanabane & Associés Law Firm, Paris, France.
| | - Bernard Baertschi
- French National Institute for Health and Medical Research (INSERM) Ethics Committee, France University of Geneva, Geneva, Switzerland.
| | - Karen Baudry
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Yves-Jean Bignon
- Department of Oncogenetics, Centre Jean Perrin, CBRV, Clermont-Ferrand, France; INSERM-U1240-Molecular Imaging and Theranostic Strategies (IMOST), Clermont-Ferrand, France.
| | - Marc Bollet
- Institut Hartmann, 4, rue Kléber, et Institut Rafael, 3 bd Bineau, 92309 Levallois-Perret cedex, France.
| | - Carole Corsini
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Olivier Cussenot
- CeRePP, Hopital Tenon, Paris, France; Sorbonne Université, Institut Universitaire de Cancérologie, GRC n°5 ONCOTYPE-URO, Hopital Tenon, APHP, Paris, France; Department of Urology, Assistance Publique- Hôpitaux de Paris, Hopital Tenon, Paris, France.
| | - Thibault De la Motte Rouge
- Inserm, Oncogenesis, Stress and Signaling, 35000 Rennes, France; Service d'oncologie médicale, CRLCC Eugène-Marquis, 35000 Rennes, France; UMR 1242, Inserm, Univ Rennes, CLCC Eugène Marquis, Rue Bataille Flandres Dunkerque, 35042, Rennes, France.
| | | | - Florence Duchamp
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | | | - Karim Fizazi
- Institut Gustave Roussy and University of Paris Sud, Villejuif, France.
| | - Virginie Galibert
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Laurence Gladieff
- Department of Medical Oncology, Institut Claudius Regaud, IUCT-O, Toulouse, France.
| | | | - Pascal Hammel
- Department of Pancreatology, Hôpital Beaujon (AP-HP), Université Denis Diderot-Paris VII, Clichy, France.
| | | | - William Jacot
- Department of Medical Oncology, Institut du Cancer de Montpellier (ICM), Univ. Montpellier, 208 rue des Apothicaires, 34298, Montpellier Cedex 5, France; Translational Research Unit, Institut du Cancer de Montpellier (ICM), Univ. Montpellier, Montpellier, France.
| | - Tatiana Kogut-Kubiak
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Pierre-Jean Lamy
- Institut d'analyse génomique-Imagenome, Labosud, Montpellier, France.
| | - Sophie Nambot
- Centre de Génétique et Centre de Référence Maladies Rares (Anomalies du Développement de l'Interrégion Est), Hôpital d'Enfants, CHU Dijon Bourgogne, Dijon, France; Inserm UMR 1231 GAD (Génétique des Anomalies du Développement), Université de Bourgogne, Dijon, France; Fédération Hospitalo-Universitaire Médecine Translationnelle et Anomalies du Développement (FHU TRANSLAD), CHU Dijon Bourgogne et Université de Bourgogne-Franche Comté, Dijon, France.
| | - Yann Neuzillet
- Service d'urologie et de transplantation rénale, hôpital Foch, université de Versailles - Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
| | - Sylviane Olschwang
- Aix Marseille Université, INSERM GMGF UMR 1251, France; Département de Génétique Médicale, Hôpital Européen & Groupe Ramsay Générale de Santé, Hôpital Clairval, Aix Marseille Université, Marseille, France.
| | | | - Jean-Marc Rey
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Chloé Rideau
- Department of Cancer Genetics, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Jean-Philippe Spano
- Department of Medical Oncology, Hôpital Pitié Salpêtrière, APHP, Sorbonne Université, Paris, France; Inserm UMRS 1136, Sorbonne Université, Paris, France.
| | - Frédéric Thomas
- IRD, CREEC et MIVE911 avenue Agropolis, BP 64501, Montpellier 34 394, France.
| | - Isabelle Treilleux
- Department of Pathology, Centre Léon Bérard, 28 rue Laënnec, 69373, Lyon Cédex 08, France.
| | | | - Julie Vendrell
- IRCM, INSERM 1194, Department of Pathology and Oncobiology, Laboratoire de biologie des tumeurs solides, CHU Montpellier, Univ Montpellier, Montpellier, France.
| | - Michèle Vintraud
- Department of Radiotherapy, Hartmann Radiotherapy Center, Levallois-Perret, France.
| | - Daniel Zarca
- The Paris Breast Centre- L'Institut Français du Sein- 15 rue Jean Nicot, 75007, Paris, France.
| | - Kevin S Hughes
- Division of Surgical Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Jose E Alés Martínez
- Medical Oncology Department, Hospital Nuestra Señora de Sonsoles, Ávila, Ávila, Spain.
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5
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Callens C, Vaur D, Soubeyran I, Rouleau E, Just PA, Guillerm E, Golmard L, Goardon N, Sevenet N, Cabaret O, Harter P, Gonzalez-Martin A, Fujiwara K, Cecere SC, Colombo N, Marth C, Vergote I, Maenpaa J, Pujade-Lauraine E, Ray-Coquard I. Concordance Between Tumor and Germline BRCA Status in High-Grade Ovarian Carcinoma Patients in the Phase III PAOLA-1/ENGOT-ov25 Trial. J Natl Cancer Inst 2020; 113:917-923. [PMID: 33372675 DOI: 10.1093/jnci/djaa193] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/16/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND PAOLA1 is a phase III study assessing olaparib maintenance therapy in advanced high-grade ovarian carcinoma patients responding to first-line platinum-taxane-based chemotherapy plus bevacizumab as standard of care. Randomization was stratified by treatment outcome and tumor BRCA1/2 status (tBRCA) at screening. METHODS tBRCA was tested on formalin-fixed, paraffin-embedded tumor blocks on 5 French platforms using 2 next-generation sequencing methods based either on hybrid capture or amplicon technology. One of the exploratory objectives was to assess the concordance between germline (gBRCA) and tBRCA testing in French patients. gBRCA testing was performed on blood samples on the same platforms. RESULTS From May 2015 to July 2017, tBRCA tests were performed for 1176 screened patients. Only 52 (4.4%) tumor samples were noncontributive. The median interval between reception of the tumor sample and availability of the tBRCA status result was 37 days (range = 8-260). A pathogenic variant was reported in 27.1% tumor samples (319 of 1176 screened patients). tBRCA and gBRCA testing were performed for 451 French patients with negative results for both tests in 306 patients (67.8%) and positive results for both tests in 85 patients (18.8%). Only 1 large genomic rearrangement of BRCA1 was detected, exclusively in the blood sample. Interestingly, tBRCA testing revealed 6.4% of pathogenic variant (29 of 451) not detected by gBRCA testing. CONCLUSIONS tBRCA testing is an appropriate tool with an acceptable turnaround time for clinical practice and a low failure rate, ensuring reliable identification of patients likely to benefit from poly(ADP-ribose) polymerase inhibitor therapy.
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Affiliation(s)
- Céline Callens
- Genetics Department, Institut Curie and Paris Sciences Lettres University, Paris, France
| | - Dominique Vaur
- Laboratoire de Biologie Clinique et Oncologique, Centre François Baclesse, Caen, France
| | | | - Etienne Rouleau
- Biopathology Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Pierre-Alexandre Just
- Department of Pathological Anatomy and Cytology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France, Genetics Department, Hôpital Universitaire Pitié-Salpétrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Erell Guillerm
- Department of Pathological Anatomy and Cytology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France, Genetics Department, Hôpital Universitaire Pitié-Salpétrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Lisa Golmard
- Genetics Department, Institut Curie and Paris Sciences Lettres University, Paris, France
| | - Nicolas Goardon
- Laboratoire de Biologie Clinique et Oncologique, Centre François Baclesse, Caen, France
| | - Nicolas Sevenet
- Biopathology Department, Institut Bergonié, Bordeaux, France
| | - Odile Cabaret
- Biopathology Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Philipp Harter
- Obstetric and Gynecologic Department, Kliniken Essen Mitte, Essen, AGO De, Germany
| | - Antonio Gonzalez-Martin
- Oncology Department, Clínica Universidad de Navarra, Madrid, formerly MD Anderson Cancer Center, Madrid, GEICO, Spain
| | - Keiichi Fujiwara
- Gynecologic Oncologic Department, Saitama Medical University, Saitama, GOTIC, Japan
| | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Mito Italy
| | - Nicoletta Colombo
- Gynecology Oncology Division, European Institute of Oncology, Milan, Mango Italy
| | - Christian Marth
- Obstetric and Gynecologic Department, Medical University of Innsbruck, AGO Au, Austria
| | - Ignace Vergote
- Gynecologic Oncologic Department, University Hospital Leuven, Department of Gynecologic oncology, Leuven Cancer Institute, Leuven, BGOG, Belgium
| | - Johanna Maenpaa
- Gynecologic Oncologic Department, Tampere University and University Hospital Cancer Centre, Tampere, NSGO, Finland
| | | | - Isabelle Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard and University, Claude Bernard Lyon 1, Lyon, GINECO, France
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6
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De Paolis E, De Bonis M, Concolino P, Piermattei A, Fagotti A, Urbani A, Scambia G, Minucci A, Capoluongo E. Droplet digital PCR for large genomic rearrangements detection: A promising strategy in tissue BRCA1 testing. Clin Chim Acta 2020; 513:17-24. [PMID: 33301768 DOI: 10.1016/j.cca.2020.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS With the introduction of Olaparib as target therapy for High Grade Serous Ovarian Cancer (HGSOC) patients with germline and somatic BRCA1/2 mutations, the genetic test performed on tumor tissue has become important like the germline test. In somatic testing the evaluation of Large Genomic Rearrangements (LGRs) represents the main challenge. We describe a droplet digital PCR (ddPCR) assay for the evaluation of target BRCA1 LGRs on blood and formalin-fixed paraffin-embedded (FFPE)/Fresh Frozen Tissue (FFT) samples. MATERIALS AND METHODS We analyzed blood, FFPE and FFT samples in a validation setting of n = 78 HGSOC patients. We applied the ddPCR to BRCA1 exons 2, 20 and 21 as some of the most common BRCA1 exons involved in LGRs in our cohort of patients. RESULTS The ddPCR custom assays allowed the identification of LGRs in all sample types, including FFPE specimens. Moreover, we were able to clearly detect LGRs accounted as somatic event. CONCLUSION The introduction of ddPCR in a comprehensive workflow, encompassing both germline and somatic tests, represents an improvement in BRCA1/2 testing. ddPCR can overcome challenges related to BRCA testing, especially on FFPE analysis. Finally, ddPCR represents a promising alternative strategy to the established standard methods currently used in clinical setting.
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Affiliation(s)
- Elisa De Paolis
- Molecular Diagnostic and Genomic Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Maria De Bonis
- Molecular Diagnostic and Genomic Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Paola Concolino
- Molecular Diagnostic and Genomic Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Alessia Piermattei
- Division of Oncological Gynecology, Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Anna Fagotti
- Division of Oncological Gynecology, Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Andrea Urbani
- Molecular Diagnostic and Genomic Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; Catholic University of the Sacred Heart, 00168 Rome, Italy.
| | - Giovanni Scambia
- Division of Oncological Gynecology, Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Angelo Minucci
- Molecular Diagnostic and Genomic Laboratory, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
| | - Ettore Capoluongo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, 80131 Naples, Italy; Federico II University, CEINGE, Advanced Biotechnology, 80131 Naples, Italy.
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7
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Marchetti C, Minucci A, Pietragalla A, Scambia G, Fagotti A. BRCA status assessment in epithelial ovarian cancer and the challenge of tumor testing. Int J Gynecol Cancer 2020; 30:1465-1466. [PMID: 32753564 DOI: 10.1136/ijgc-2020-001670] [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: 05/27/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Claudia Marchetti
- Department of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Angelo Minucci
- Molecular and Genomics Diagnostics Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | | | - Giovanni Scambia
- Department of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Fagotti
- Department of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy .,Catholic University of the Sacred Heart, Rome, Italy
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8
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Vu HA, Phu ND, Khuong LT, Hoa PH, Nhu BTH, Nhan VT, Thanh LQ, Sinh ND, Chi HT, Quan ND, Binh NT. Recurrent BRCA1 Mutation, but no BRCA2 Mutation, in Vietnamese Patients with Ovarian Carcinoma Detected with Next Generation Sequencing. Asian Pac J Cancer Prev 2020; 21:2331-2335. [PMID: 32856862 PMCID: PMC7771942 DOI: 10.31557/apjcp.2020.21.8.2331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Identification of germline and somatic BRCA1/2 mutations in ovarian cancer is important for genetic counseling and treatment decision making with poly ADP ribose polymerase inhibitors. Unfortunately, data on the frequency of BRCA1/2 mutations in Vietnamese patients are scare. Methods: We aim to explore the occurrence of BRCA1/2 mutations in 101 Vietnamese patients with ovarian cancer including serous (n = 58), endometrioid (n = 14), mucinous (n = 24), and clear cell (n = 5) carcinomas. BRCA1/2 mutations were detected from formalin-fixed parafin-embedded tumor samples using the OncomineTM BRCA Research Assay on Personal Genome Machine Platform with Ion Reporter Software for sequencing data analysis. The presence of pathogenic mutations was confirmed by Sanger sequencing. Results: We found no BRCA2 mutation in the entire cohort. Four types of pathogenic mutations in BRCA1 (Ser454Ter, Gln541Ter, Arg1751Ter, and Gln1779AsnfsTer14) were detected in 8 unrelated patients (7.9%) belonging to serous and endometrioid carcinoma groups. Except for the c.1360_1361delAG (Ser454Ter) mutation in BRCA1 exon 11 that was somatic, the other mutations in exons 11, 20, and 22 were germline. Interestingly, the recurrent Arg1751Ter mutation in BRCA1 exon 20 appeared in 4 patients, suggesting that this is a founder mutation in Vietnamese patients. Conclusion: Mutational analysis of tumor tissue using next generation sequencing allowed the detection of both germline and somatic BRCA1/2 mutations.
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Affiliation(s)
- Hoang Anh Vu
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ngo Dai Phu
- University of Science - Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Thai Khuong
- Center for Molecular Biomedicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | | | | | | | - Nguyen Duy Sinh
- Vinmec Central Park International Hospital, Ho Chi Minh City, Vietnam
| | - Hoang Thanh Chi
- Mekophar Chemical Pharmaceutical Joint Stock Company, Ho Chi Minh City, Vietnam
| | - Nguyen Dang Quan
- Biotechnology Center of Ho Chi Minh City, Ho Chi Minh City, Vietnam
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9
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Valle BL, Rodriguez-Torres S, Kuhn E, Díaz-Montes T, Parrilla-Castellar E, Lawson FP, Folawiyo O, Ili-Gangas C, Brebi-Mieville P, Eshleman JR, Herman J, Shih IM, Sidransky D, Guerrero-Preston R. HIST1H2BB and MAGI2 Methylation and Somatic Mutations as Precision Medicine Biomarkers for Diagnosis and Prognosis of High-grade Serous Ovarian Cancer. Cancer Prev Res (Phila) 2020; 13:783-794. [PMID: 32581010 DOI: 10.1158/1940-6207.capr-19-0412] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 04/15/2020] [Accepted: 06/11/2020] [Indexed: 12/23/2022]
Abstract
Molecular alterations that contribute to long-term (LT) and short-term (ST) survival in ovarian high-grade serous carcinoma (HGSC) may be used as precision medicine biomarkers. DNA promoter methylation is an early event in tumorigenesis, which can be detected in blood and urine, making it a feasible companion biomarker to somatic mutations for early detection and targeted treatment workflows. We compared the methylation profile in 12 HGSC tissue samples to 30 fallopian tube epithelium samples, using the Infinium Human Methylation 450K Array. We also used 450K methylation arrays to compare methylation among HGSCs long-term survivors (more than 5 years) and short-term survivors (less than 3 years). We verified the array results using bisulfite sequencing and methylation-specific PCR (qMSP). in another cohort of HGSC patient samples (n = 35). Immunoblot and clonogenic assays after pharmacologic unmasking show that HIST1H2BB and MAGI2 promoter methylation downregulates mRNA expression levels in ovarian cancer cells. We then used qMSP in paired tissue, ascites, plasma/serum, vaginal swabs, and urine from a third cohort of patients with HGSC cancer (n = 85) to test the clinical potential of HIST1H2BB and MAGI2 in precision medicine workflows. We also performed next-generation exome sequencing of 50 frequently mutated in human cancer genes, using the Ion AmpliSeqCancer Hotspot Panel, to show that the somatic mutation profile found in tissue and plasma can be quantified in paired urine samples from patients with HGSC. Our results suggest that HIST1H2BB and MAGI2 have growth-suppressing roles and can be used as HGSC precision medicine biomarkers.
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Affiliation(s)
- Blanca L Valle
- Otolaryngology Department, Head and Neck Cancer Research Division, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Sebastian Rodriguez-Torres
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania
| | - Elisabetta Kuhn
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Italy.,Departments of Pathology, Gynecology and Obstetrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Teresa Díaz-Montes
- The Lya Segall Ovarian Cancer Institute, Mercy Medical Center, Baltimore, Maryland
| | | | - Fahcina P Lawson
- Otolaryngology Department, Head and Neck Cancer Research Division, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Oluwasina Folawiyo
- Otolaryngology Department, Head and Neck Cancer Research Division, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Carmen Ili-Gangas
- Laboratory Integrative Biology (LIBi), Center for Excellence in Translational Medicine-Scientific and Technological Bioresources Nucleus (CEMT-BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Priscilla Brebi-Mieville
- Laboratory Integrative Biology (LIBi), Center for Excellence in Translational Medicine-Scientific and Technological Bioresources Nucleus (CEMT-BIOREN), Universidad de La Frontera, Temuco, Chile
| | - James R Eshleman
- Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - James Herman
- Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania
| | - Ie-Ming Shih
- Division of Pathology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico; Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Italy
| | - David Sidransky
- Otolaryngology Department, Head and Neck Cancer Research Division, The Johns Hopkins University, School of Medicine, Baltimore, Maryland
| | - Rafael Guerrero-Preston
- Otolaryngology Department, Head and Neck Cancer Research Division, The Johns Hopkins University, School of Medicine, Baltimore, Maryland. .,University of Puerto Rico School of Medicine, Department of Obstetrics and Gynecology, San Juan, Puerto Rico.,LifeGene Biomarks Inc., San Juan, Puerto Rico
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10
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Muscarella LA, Fabrizio FP, De Bonis M, Mancini MT, Balsamo T, Graziano P, Centra F, Sparaneo A, Trombetta D, Bonfitto A, Scagliusi V, Larizza P, Capoluongo ED, Fazio VM. Automated Workflow for Somatic and Germline Next Generation Sequencing Analysis in Routine Clinical Cancer Diagnostics. Cancers (Basel) 2019; 11:cancers11111691. [PMID: 31671666 PMCID: PMC6896097 DOI: 10.3390/cancers11111691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/27/2019] [Accepted: 10/25/2019] [Indexed: 12/22/2022] Open
Abstract
Thanks to personalized medicine trends and collaborations between industry, clinical research groups and regulatory agencies, next generation sequencing (NGS) is turning into a common practice faster than one could have originally expected. When considering clinical applications of NGS in oncology, a rapid workflow for DNA extraction from formalin-fixed paraffin-embedded (FFPE) tissue samples, as well as producing high quality library preparation, can be real challenges. Here we consider these targets and how applying effective automation technology to NGS workflows may help improve yield, timing and quality-control. We firstly evaluated DNA recovery from archived FFPE blocks from three different manual extraction methods and two automated extraction workstations. The workflow was then implemented to somatic (lung/colon panel) and germline (BRCA1/2) library preparation for NGS analysis exploiting two automated workstations. All commercial kits gave good results in terms of DNA yield and quality. On the other hand, the automated workstation workflow has been proven to be a valid automatic extraction system to obtain high quality DNA suitable for NGS analysis (lung/colon Ampli-seq panel). Moreover, it can be efficiently integrated with an open liquid handling platform to provide high-quality libraries from germline DNA with more reproducibility and high coverage for targeted sequences in less time (BRCA1/2). The introduction of automation in routine workflow leads to an improvement of NGS standardization and increased scale up of sample preparations, reducing labor and timing, with optimization of reagents and management.
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Affiliation(s)
- Lucia Anna Muscarella
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Federico Pio Fabrizio
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Maria De Bonis
- Department of Laboratory Medicine of the 'Agostino Gemelli' Foundation in Rome, 00168 Rome, Italy.
| | | | - Teresa Balsamo
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Paolo Graziano
- Unit of Pathology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Flavia Centra
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Angelo Sparaneo
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Domenico Trombetta
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | - Antonio Bonfitto
- Unit of Pathology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
| | | | | | - Ettore Domenico Capoluongo
- Department of Molecular Medicine and Medical Biotechnologies, University Federico II-CEINGE, 80145 Naples, Italy.
| | - Vito Michele Fazio
- Laboratory of Oncology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, (FG), Italy.
- Department of Medicine, R.U. in Molecular Medicine and Biotechnology, University Campus Bio-Medico of Rome, Rome, Italy.
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11
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BRCA1/2 Molecular Assay for Ovarian Cancer Patients: A Survey through Italian Departments of Oncology and Molecular and Genomic Diagnostic Laboratories. Diagnostics (Basel) 2019; 9:diagnostics9040146. [PMID: 31600986 PMCID: PMC6963957 DOI: 10.3390/diagnostics9040146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/04/2019] [Accepted: 10/04/2019] [Indexed: 12/15/2022] Open
Abstract
In Italy, 5200 new ovarian cancers were diagnosed in 2018, highlighting an increasing need to test women for BRCA1/2. The number of labs offering this test is continuously increasing. The aim of this study was to show the results coming from the intersociety survey coordinated by four different Clinical and Laboratory Italian Scientific Societies (AIOM, SIAPEC-IAP, SIBIOC, and SIGU). A multidisciplinary team belonging to the four scientific societies drew up two different questionnaires: One was targeted toward all Italian Departments of Medical Oncology, and the second toward laboratories of clinical molecular biology. This survey was implemented from September 2017 to March 2018. Seventy-seven out of 305 (25%) Departments of Medical Oncology filled our survey form. Indeed, 59 molecular laboratories were invited. A total of 41 laboratories (70%) filled in the questionnaire. From 2014 to 2017, 16 new molecular laboratories were activated. A total of 12,559 tests were performed in the year 2016, with a mean of 339 tests and a median of 254 tests per laboratory, showing a glimpse of an extreme low number of tests performed per year by some laboratories. In terms of the type and number of professionals involved in the pre- and post-test counseling, results among the onco-genetic team were heterogeneous. Our data show that the number of laboratories providing BRCA1/2 germline assays is significantly increased with further implementation of the somatic test coming soon. The harmonization of the complete laboratory diagnostic path should be encouraged, particularly in order to reduce the gap between laboratories with high and low throughput.
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12
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Capillary electrophoresis as alternative method to detect tumor genetic mutations: the model built on the founder BRCA1 c.4964_4982del19 variant. Fam Cancer 2018; 18:29-35. [DOI: 10.1007/s10689-018-0094-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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