1
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Blechter B, Wong JYY, Chien LH, Shiraishi K, Shu XO, Cai Q, Zheng W, Ji BT, Hu W, Rahman ML, Jiang HF, Tsai FY, Huang WY, Gao YT, Han X, Steinwandel MD, Yang G, Daida YG, Liang SY, Gomez SL, DeRouen MC, Diver WR, Reddy AG, Patel AV, Le Marchand L, Haiman C, Kohno T, Cheng I, Chang IS, Hsiung CA, Rothman N, Lan Q. Age at lung cancer diagnosis in females versus males who never smoke by race and ethnicity. Br J Cancer 2024; 130:1286-1294. [PMID: 38388856 PMCID: PMC11014844 DOI: 10.1038/s41416-024-02592-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND We characterized age at diagnosis and estimated sex differences for lung cancer and its histological subtypes among individuals who never smoke. METHODS We analyzed the distribution of age at lung cancer diagnosis in 33,793 individuals across 8 cohort studies and two national registries from East Asia, the United States (US) and the United Kingdom (UK). Student's t-tests were used to assess the study population differences (Δ years) in age at diagnosis comparing females and males who never smoke across subgroups defined by race/ethnicity, geographic location, and histological subtypes. RESULTS We found that among Chinese individuals diagnosed with lung cancer who never smoke, females were diagnosed with lung cancer younger than males in the Taiwan Cancer Registry (n = 29,832) (Δ years = -2.2 (95% confidence interval (CI):-2.5, -1.9), in Shanghai (n = 1049) (Δ years = -1.6 (95% CI:-2.9, -0.3), and in Sutter Health and Kaiser Permanente Hawai'i in the US (n = 82) (Δ years = -11.3 (95% CI: -17.7, -4.9). While there was a suggestion of similar patterns in African American and non-Hispanic White individuals. the estimated differences were not consistent across studies and were not statistically significant. CONCLUSIONS We found evidence of sex differences for age at lung cancer diagnosis among individuals who never smoke.
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Affiliation(s)
- Batel Blechter
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - Jason Y Y Wong
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Li-Hsin Chien
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Department of Applied Mathematics, Chung-Yuan Christian University, Chung-Li, Taiwan
| | - Kouya Shiraishi
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan
- Department of Clinical Genomics, National Cancer Center Research Institute, Tokyo, Japan
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Bu-Tian Ji
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Wei Hu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Mohammad L Rahman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Hsin-Fang Jiang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Fang-Yu Tsai
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, Taiwan
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Xijing Han
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mark D Steinwandel
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Yihe G Daida
- Center for Integrated Health Care Research, Kaiser Permanente Hawai'i, Honolulu, HI, USA
| | - Su-Ying Liang
- Palo Alto Medical Foundation Research Institute, Sutter Health, Palo Alto, CA, USA
| | - Scarlett L Gomez
- Greater Bay Area Cancer Registry, University of California, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Mindy C DeRouen
- Greater Bay Area Cancer Registry, University of California, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - W Ryan Diver
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
| | - Ananya G Reddy
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
| | - Alpa V Patel
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
| | | | - Christopher Haiman
- Greater Bay Area Cancer Registry, University of California, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Takashi Kohno
- Division of Genome Biology, National Cancer Center Research Institute, Tokyo, Japan
| | - Iona Cheng
- Greater Bay Area Cancer Registry, University of California, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - I-Shou Chang
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, Taiwan
| | - Chao Agnes Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Barreira JV, Mendes JL, Parmanande A. Personalized medicine: paradigm shift in ALK positive non-small cell lung cancer: a case report. J Med Case Rep 2023; 17:374. [PMID: 37658466 PMCID: PMC10474633 DOI: 10.1186/s13256-023-04107-5] [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: 02/28/2023] [Accepted: 07/31/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Since the identification of multiple therapeutic targets, as is the case of anaplastic lymphoma kinase (ALK) translocation, the paradigm of treating patients with non-small cell lung cancer (NSCLC) has improved. In order to guarantee the possibility of longer survival outcomes with a better quality of life we must invest in the determination, in suitable time, of the consensual biomarkers and in the availability of the best treatments to our patients. CASE PRESENTATION We present a case of a caucasian male in his fifth decade of life, non-smoker, who highlights the complex journey of ALK-positive patients. This particular case, demonstrates the efficacy and tolerability of the new ALK target therapies, allowing our patients to maintain their routines without compromising the effectiveness of the therapy. CONCLUSION Focusing on the reality of ALK positive patients and the impact that this therapy has on the daily lives of our patients, we can contribute to the awareness of this specific pathology.
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Affiliation(s)
- João Vasco Barreira
- CUF Oncologia, Lisboa, Portugal.
- Universidade Católica Portuguesa, Lisboa, Portugal.
| | - José Leão Mendes
- Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal
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3
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Hamouz M, Hammouz RY, Bajwa MA, Alsayed AW, Orzechowska M, Bednarek AK. A Functional Genomics Review of Non-Small-Cell Lung Cancer in Never Smokers. Int J Mol Sci 2023; 24:13314. [PMID: 37686122 PMCID: PMC10488233 DOI: 10.3390/ijms241713314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/24/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
There is currently a dearth of information regarding lung cancer in never smokers (LCINS). Additionally, there is a difference in somatic mutations, tumour mutational burden, and chromosomal aberrations between smokers and never smokers (NS), insinuating a different disease entity in LCINS. A better understanding of actionable driver alterations prevalent in LCINS and the genomic landscape will contribute to identifying new molecular targets of relevance for NS that will drastically improve outcomes. Differences in treatment outcomes between NS and smokers, as well as sexes, with NSCLC suggest unique tumour characteristics. Epidermal growth factor receptor (EGFR) tyrosine kinase mutations and echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase (EML4-ALK) gene rearrangements are more common in NS and have been associated with chemotherapy resistance. Moreover, NS are less likely to benefit from immune mediators including PD-L1. Unravelling the genomic and epigenomic underpinnings of LCINS will aid in the development of not only novel targeted therapies but also more refined approaches. This review encompasses driver genes and pathways involved in the pathogenesis of LCINS and a deeper exploration of the genomic landscape and tumour microenvironment. We highlight the dire need to define the genetic and environmental aspects entailing the development of lung cancer in NS.
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4
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Carroll NM, Burnett-Hartman AN, Rendle KA, Neslund-Dudas CM, Greenlee RT, Honda SA, Vachani A, Ritzwoller DP. Smoking status and the association between patient-level factors and survival among lung cancer patients. J Natl Cancer Inst 2023; 115:937-948. [PMID: 37228018 PMCID: PMC10407692 DOI: 10.1093/jnci/djad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Declines in the prevalence of cigarette smoking, advances in targeted therapies, and implementation of lung cancer screening have changed the clinical landscape for lung cancer. The proportion of lung cancer deaths is increasing in those who have never smoked cigarettes. To better understand contemporary patterns in survival among patients with lung cancer, a comprehensive evaluation of factors associated with survival, including differential associations by smoking status, is needed. METHODS Patients diagnosed with lung cancer between January 1, 2010, and September 30, 2019, were identified. We estimated all-cause and lung cancer-specific median, 5-year, and multivariable restricted mean survival time (RMST) to identify demographic, socioeconomic, and clinical factors associated with survival, overall and stratified by smoking status (never, former, and current). RESULTS Analyses included 6813 patients with lung cancer: 13.9% never smoked, 54.2% formerly smoked, and 31.9% currently smoked. All-cause RMST through 5 years for those who never, formerly, and currently smoked was 32.1, 25.9, and 23.3 months, respectively. Lung cancer-specific RMST was 36.3 months, 30.3 months, and 26.0 months, respectively. Across most models, female sex, younger age, higher socioeconomic measures, first-course surgery, histology, and body mass index were positively associated, and higher stage was inversely associated with survival. Relative to White patients, Black patients had increased survival among those who formerly smoked. CONCLUSIONS We identify actionable factors associated with survival between those who never, formerly, and currently smoked cigarettes. These findings illuminate opportunities to address underlying mechanisms driving lung cancer progression, including use of first-course treatment, and enhanced implementation of tailored smoking cessation interventions for individuals diagnosed with cancer.
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Affiliation(s)
- Nikki M Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
| | - Andrea N Burnett-Hartman
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Katharine A Rendle
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Stacey A Honda
- Hawaii Permanente Medical Group, Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
| | - Anil Vachani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Debra P Ritzwoller
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
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5
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Yu H, Zhang Y, Zhang L, Yang R, Liao Z, Zhou T. Circular RNA circENTPD7 suppresses the accumulation of PTEN to promote cell proliferation in non-small cell lung cancer. Genet Mol Biol 2022; 45:e20220023. [PMID: 35993557 PMCID: PMC9393877 DOI: 10.1590/1678-4685-gmb-2022-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022] Open
Abstract
The oncogenic role of circular RNA ENTPD7 (circENTPD7) in cancer biology has been reported in glioblastoma, while its role in non-small cell lung cancer (NSCLC) is unknown. This study was performed to investigate the involvement of circENTPD7 in NSCLC. NSCLC tissues and paired non-tumor tissues were collected from 64 NSCLC patients and the expression of circENTPD7 and PTEN were determined by RT-qPCR. Expression levels of PTEN protein in these tissue samples were measured by ELISA. The 64 NSCLC patients were subjected to a follow-up study to explore the role of circENTPD7 in predicting the survival of NSCLC. Overexpression of circENTPD7 was achieved in NSCLC cells, and the effects of overexpression of circENTPD7 on the expression of PTEN were measured by RT-qPCR and Western blot at mRNA and protein level, respectively. Cell proliferation was assessed by CCK-8 assay. CircENTPD7 was upregulated in NSCLC and high expression levels of circENTPD7 predicts the poor survival rate of NSCLC cells. In NSCLC tissues, circENTPD7 was inversely correlated with PTEN protein but not mRNA. In NSCLC tissues, overexpression of circENTPD7 resulted in downregulation of PTEN, but did not alter the expression of PTEN mRNA. Cell proliferation analysis showed that overexpression of circENTPD7 promoted the proliferation of NSCLC cells and reduced the inhibitory effects of overexpression of PTEN on cell proliferation. CircENTPD7 may suppress the accumulation of PTEN to promote cell proliferation in NSCLC.
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Affiliation(s)
- Hongwei Yu
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Department of Radiotherapy, Guangzhou City, P.R. China
| | - Yibin Zhang
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Department of Radiotherapy, Guangzhou City, P.R. China
| | - Lu Zhang
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Department of Radiotherapy, Guangzhou City, P.R. China
| | - Rufei Yang
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Department of Radiotherapy, Guangzhou City, P.R. China
| | - Zhiwei Liao
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Department of Radiotherapy, Guangzhou City, P.R. China
| | - Tongchong Zhou
- Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Department of Radiotherapy, Guangzhou City, P.R. China
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6
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Hunihan L, Zhao D, Lazowski H, Li M, Qian Y, Abriola L, Surovtseva YV, Muthusamy V, Tanoue LT, Gould Rothberg BE, Schalper KA, Herbst RS, Wilson FH. RASGRF1 Fusions Activate Oncogenic RAS Signaling and Confer Sensitivity to MEK Inhibition. Clin Cancer Res 2022; 28:3091-3103. [PMID: 35247929 PMCID: PMC9288503 DOI: 10.1158/1078-0432.ccr-21-4291] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/28/2022] [Accepted: 02/25/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE The identification of actionable oncogenic alterations has enabled targeted therapeutic strategies for subsets of patients with advanced malignancies, including lung adenocarcinoma (LUAD). We sought to assess the frequency of known drivers and identify new candidate drivers in a cohort of LUAD from patients with minimal smoking history. EXPERIMENTAL DESIGN We performed genomic characterization of 103 LUADs from patients with ≤10 pack-year smoking history. Tumors were subjected to targeted molecular profiling and/or whole-exome sequencing and RNA sequencing in search of established and previously uncharacterized candidate drivers. RESULTS We identified an established oncogenic driver in 98 of 103 tumors (95%). From one tumor lacking a known driver, we identified a novel gene rearrangement between OCLN and RASGRF1. The encoded OCLN-RASGRF1 chimera fuses the membrane-spanning portion of the tight junction protein occludin with the catalytic RAS-GEF domain of the RAS activator RASGRF1. We identified a similar SLC4A4-RASGRF1 fusion in a pancreatic ductal adenocarcinoma cell line lacking an activating KRAS mutation and an IQGAP1-RASGRF1 fusion from a sarcoma in The Cancer Genome Atlas. We demonstrate these fusions increase cellular levels of active GTP-RAS, induce cellular transformation, and promote in vivo tumorigenesis. Cells driven by RASGRF1 fusions are sensitive to targeting of the RAF-MEK-ERK pathway in vitro and in vivo. CONCLUSIONS Our findings credential RASGRF1 fusions as a therapeutic target in multiple malignancies and implicate RAF-MEK-ERK inhibition as a potential treatment strategy for advanced tumors harboring these alterations. See related commentary by Moorthi and Berger, p. 2983.
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Affiliation(s)
- Lisa Hunihan
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT,Department of Genetics, Yale School of Medicine, New Haven, CT,Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT
| | - Dejian Zhao
- Department of Genetics, Yale School of Medicine, New Haven, CT,Yale Center for Genome Analysis, Yale School of Medicine, New Haven, CT
| | - Heather Lazowski
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT
| | - Man Li
- Center for Precision Cancer Modeling, Yale Cancer Center, Yale School of Medicine, New Haven, CT
| | - Yuping Qian
- Center for Precision Cancer Modeling, Yale Cancer Center, Yale School of Medicine, New Haven, CT
| | - Laura Abriola
- Center for Molecular Discovery, Yale University, West Haven, CT
| | | | - Viswanathan Muthusamy
- Center for Precision Cancer Modeling, Yale Cancer Center, Yale School of Medicine, New Haven, CT
| | - Lynn T. Tanoue
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT
| | - Bonnie E. Gould Rothberg
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT
| | | | - Roy S. Herbst
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT
| | - Frederick H. Wilson
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT,Department of Genetics, Yale School of Medicine, New Haven, CT,Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT
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7
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Schmid S, Jiang M, Brown MC, Fares A, Garcia M, Soriano J, Dong M, Thomas S, Kohno T, Leal LF, Diao N, Xie J, Wang Z, Zaridze D, Holcatova I, Lissowska J, Świątkowska B, Mates D, Savic M, Wenzlaff AS, Harris CC, Caporaso NE, Ma H, Fernandez-Tardon G, Barnett MJ, Goodman G, Davies MP, Pérez-Ríos M, Taylor F, Duell EJ, Schoettker B, Brenner H, Andrew A, Cox A, Ruano-Ravina A, Field JK, Le Marchand L, Wang Y, Chen C, Tardon A, Shete S, Schabath MB, Shen H, Landi MT, Ryan BM, Schwartz AG, Qi L, Sakoda LC, Brennan P, Yang P, Zhang J, Christiani DC, Reis RM, Shiraishi K, Hung RJ, Xu W, Liu G. Accounting for EGFR Mutations in Epidemiologic Analyses of Non-Small Cell Lung Cancers: Examples Based on the International Lung Cancer Consortium Data. Cancer Epidemiol Biomarkers Prev 2022; 31:679-687. [PMID: 35027437 PMCID: PMC9063819 DOI: 10.1158/1055-9965.epi-21-0747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/28/2021] [Accepted: 01/05/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Somatic EGFR mutations define a subset of non-small cell lung cancers (NSCLC) that have clinical impact on NSCLC risk and outcome. However, EGFR-mutation-status is often missing in epidemiologic datasets. We developed and tested pragmatic approaches to account for EGFR-mutation-status based on variables commonly included in epidemiologic datasets and evaluated the clinical utility of these approaches. METHODS Through analysis of the International Lung Cancer Consortium (ILCCO) epidemiologic datasets, we developed a regression model for EGFR-status; we then applied a clinical-restriction approach using the optimal cut-point, and a second epidemiologic, multiple imputation approach to ILCCO survival analyses that did and did not account for EGFR-status. RESULTS Of 35,356 ILCCO patients with NSCLC, EGFR-mutation-status was available in 4,231 patients. A model regressing known EGFR-mutation-status on clinical and demographic variables achieved a concordance index of 0.75 (95% CI, 0.74-0.77) in the training and 0.77 (95% CI, 0.74-0.79) in the testing dataset. At an optimal cut-point of probability-score = 0.335, sensitivity = 69% and specificity = 72.5% for determining EGFR-wildtype status. In both restriction-based and imputation-based regression analyses of the individual roles of BMI on overall survival of patients with NSCLC, similar results were observed between overall and EGFR-mutation-negative cohort analyses of patients of all ancestries. However, our approach identified some differences: EGFR-mutated Asian patients did not incur a survival benefit from being obese, as observed in EGFR-wildtype Asian patients. CONCLUSIONS We introduce a pragmatic method to evaluate the potential impact of EGFR-status on epidemiological analyses of NSCLC. IMPACT The proposed method is generalizable in the common occurrence in which EGFR-status data are missing.
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Affiliation(s)
- Sabine Schmid
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
- Department of Medical Oncology, Cantonal Hospital St.Gallen, St.Gallen, Switzerland
| | - Mei Jiang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M. Catherine Brown
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
| | - Aline Fares
- Division of Medical Oncology, Hospital de Base de São José do Rio Preto, SP, Brazil
| | - Miguel Garcia
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
| | - Joelle Soriano
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
- University of Ottawa, Ottawa, ON Canada
| | - Mei Dong
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sera Thomas
- Lunenfeld-Tanenbaum Research Institute, Sinai Health Systems, Toronto, Canada
| | - Takashi Kohno
- Division of Genome Biology, National Cancer Centre Research Institute, Tokyo, Japan
| | - Leticia Ferro Leal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | - Nancy Diao
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Juntao Xie
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Zhichao Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - David Zaridze
- Russian N.N. Blokhin Cancer Research Centre, Moscow, Russian Federation
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology
| | | | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - Milan Savic
- Department of Thoracic Surgery, Clinical Center of Serbia, Belgrade, Serbia
| | - Angela S. Wenzlaff
- Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Curtis C. Harris
- Laboratory of Human Carcinogenesis, Centre for Cancer Research, National Institutes of Health, Bethesda, MD, USA
| | - Neil E. Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Hongxia Ma
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Guillermo Fernandez-Tardon
- IUOPA, University of Oviedo, and ISPA (Health Research Institute of the Principality of Asturias) and CIBERESP, Asturias, Spain
| | - Matthew J. Barnett
- Program in Biostatistics Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Michael P.A. Davies
- Roy Castle Lung Cancer Research Programme, The University of Liverpool, Department of Molecular and Clinical Cancer Medicine, Liverpool, UK
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago de Compostela, Spain
| | - Fiona Taylor
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
- Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Eric J. Duell
- Catalan Institute of Oncology (ICO), Barcelona, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Ben Schoettker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network of Aging Research, Heidelberg University, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network of Aging Research, Heidelberg University, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Angela Cox
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública, CIBERESP, Santiago de Compostela, Spain
| | - John K. Field
- Roy Castle Lung Cancer Research Programme, The University of Liverpool, Department of Molecular and Clinical Cancer Medicine, Liverpool, UK
| | | | - Ying Wang
- American Cancer Society, Atlanta, GA, USA
| | - Chu Chen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Adonina Tardon
- IUOPA, University of Oviedo, and ISPA (Health Research Institute of the Principality of Asturias) and CIBERESP, Asturias, Spain
| | - Sanjay Shete
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Matthew B Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Hongbing Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Brid M. Ryan
- Laboratory of Human Carcinogenesis, Centre for Cancer Research, National Institutes of Health, Bethesda, MD, USA
| | - Ann G. Schwartz
- Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Lihong Qi
- The University of California Davis Medical Sciences, Davis, California, USA
| | - Lori C. Sakoda
- Kaiser Permanente Northern California, Division of Research, Oakland, California, USA
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Ping Yang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jie Zhang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | | | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Life and Health Sciences Research Institute (ICVS), Medical School, University of Minho, Braga, Portuga
- ICVS/3B’s-PT Government Associate Laboratory, Braga, Portugal
| | - Kouya Shiraishi
- Division of Genome Biology, National Cancer Centre Research Institute, Tokyo, Japan
| | - Rayjean J. Hung
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health Systems, Toronto, Canada
| | - Wei Xu
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Geoffrey Liu
- The Princess Margaret Cancer Centre and University Health Network, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Makarem M, Ezeife DA, Smith AC, Li JJN, Law JH, Tsao MS, Leighl NB. Reflex ROS1 IHC Screening with FISH Confirmation for Advanced Non-Small Cell Lung Cancer-A Cost-Efficient Strategy in a Public Healthcare System. Curr Oncol 2021; 28:3268-3279. [PMID: 34449580 PMCID: PMC8395515 DOI: 10.3390/curroncol28050284] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022] Open
Abstract
ROS1 rearrangements are identified in 1-2% of lung adenocarcinoma cases, and reflex testing is guideline-recommended. We developed a decision model for population-based ROS1 testing from a Canadian public healthcare perspective to determine the strategy that optimized detection of true-positive (TP) cases while minimizing costs and turnaround time (TAT). Eight diagnostic strategies were compared, including reflex single gene testing via immunohistochemistry (IHC) screening, fluorescence in-situ hybridization (FISH), next-generation sequencing (NGS), and biomarker-informed (EGFR/ALK/KRAS wildtype) testing initiated by pathologists and clinician-initiated strategies. Reflex IHC screening with FISH confirmation of positive cases yielded the best results for TAT, TP detection rate, and cost. IHC screening saved CAD 1,000,000 versus reflex FISH testing. NGS was the costliest reflex strategy. Biomarker-informed testing was cost-efficient but delayed TAT. Clinician-initiated testing was the least costly but resulted in long TAT and missed TP cases, highlighting the importance of reflex testing. Thus, reflex IHC screening for ROS1 with FISH confirmation provides a cost-efficient strategy with short TAT and maximizes the number of TP cases detected.
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Affiliation(s)
- Maisam Makarem
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (M.M.); (A.C.S.); (J.J.N.L.); (J.H.L.); (M.-S.T.)
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Doreen A. Ezeife
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 4N2, Canada;
| | - Adam C. Smith
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (M.M.); (A.C.S.); (J.J.N.L.); (J.H.L.); (M.-S.T.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Janice J. N. Li
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (M.M.); (A.C.S.); (J.J.N.L.); (J.H.L.); (M.-S.T.)
| | - Jennifer H. Law
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (M.M.); (A.C.S.); (J.J.N.L.); (J.H.L.); (M.-S.T.)
| | - Ming-Sound Tsao
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (M.M.); (A.C.S.); (J.J.N.L.); (J.H.L.); (M.-S.T.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Natasha B. Leighl
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C1, Canada; (M.M.); (A.C.S.); (J.J.N.L.); (J.H.L.); (M.-S.T.)
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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9
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Jiang M, Fares AF, Shepshelovich D, Yang P, Christiani D, Zhang J, Shiraishi K, Ryan BM, Chen C, Schwartz AG, Tardon A, Shete S, Schabath MB, Teare MD, Le Marchand L, Zhang ZF, Field JK, Brenner H, Diao N, Xie J, Kohno T, Harris CC, Wenzlaff AS, Fernandez-Tardon G, Ye Y, Taylor F, Wilkens LR, Davies M, Liu Y, Barnett MJ, Goodman GE, Morgenstern H, Holleczek B, Thomas S, Brown MC, Hung RJ, Xu W, Liu G. The relationship between body-mass index and overall survival in non-small cell lung cancer by sex, smoking status, and race: A pooled analysis of 20,937 International lung Cancer consortium (ILCCO) patients. Lung Cancer 2021; 152:58-65. [PMID: 33352384 PMCID: PMC8042597 DOI: 10.1016/j.lungcan.2020.11.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/22/2020] [Accepted: 11/25/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The relationship between Body-Mass-Index (BMI) and lung cancer prognosis is heterogeneous. We evaluated the impact of sex, smoking and race on the relationship between BMI and overall survival (OS) in non-small-cell-lung-cancer (NSCLC). METHODS Data from 16 individual ILCCO studies were pooled to assess interactions between BMI and the following factors on OS: self-reported race, smoking status and sex, using Cox models (adjusted hazard ratios; aHR) with interaction terms and adjusted penalized smoothing spline plots in stratified analyses. RESULTS Among 20,937 NSCLC patients with BMI values, females = 47 %; never-smokers = 14 %; White-patients = 76 %. BMI showed differential survival according to race whereby compared to normal-BMI patients, being underweight was associated with poor survival among white patients (OS, aHR = 1.66) but not among black patients (aHR = 1.06; pinteraction = 0.02). Comparing overweight/obese to normal weight patients, Black NSCLC patients who were overweight/obese also had relatively better OS (pinteraction = 0.06) when compared to White-patients. BMI was least associated with survival in Asian-patients and never-smokers. The outcomes of female ever-smokers at the extremes of BMI were associated with worse outcomes in both the underweight (pinteraction<0.001) and obese categories (pinteraction = 0.004) relative to the normal-BMI category, when compared to male ever-smokers. CONCLUSION Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers. Black-patients had more favorable outcomes in the extremes of BMI when compared to White-patients. Body composition in Black-patients, and NSCLC subtypes more commonly seen in Asian-patients and never-smokers, may account for differences in these BMI-OS relationships.
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Affiliation(s)
- Mei Jiang
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada; State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Aline F Fares
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Hospital de Base, São José do Rio Preto, São Paulo, Brazil
| | | | | | - David Christiani
- Environmental Health Department, Harvard TH Chan School of Public Health and Harvard Medical School, Boston, MA, USA
| | - Jie Zhang
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, USA; Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Kouya Shiraishi
- Division of Genome Biology, National Cancer Research Institute, Tokyo, Japan
| | - Brid M Ryan
- Centre for Cancer Research, National Institutes of Health, Bethesda, MD, USA
| | - Chu Chen
- Program in Epidemiology, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology and Department of Otolaryngology: Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | - Ann G Schwartz
- Barbara Ann Karmanos Cancer Institute, Wayne State University Detroit, MI, USA
| | | | - Sanjay Shete
- University of Texas MD Anderson Cancer Center, Texas, USA
| | | | | | | | - Zuo-Feng Zhang
- University of California Los Angeles School of Public Health, CA, USA
| | - John K Field
- The Roy Castle Lung Cancer Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, UK
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nancy Diao
- Environmental Health Department, Harvard TH Chan School of Public Health and Harvard Medical School, Boston, MA, USA
| | - Juntao Xie
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Takashi Kohno
- Division of Genome Biology, National Cancer Research Institute, Tokyo, Japan
| | - Curtis C Harris
- Centre for Cancer Research, National Institutes of Health, Bethesda, MD, USA
| | - Angela S Wenzlaff
- Barbara Ann Karmanos Cancer Institute, Wayne State University Detroit, MI, USA
| | | | - Yuanqing Ye
- University of Texas MD Anderson Cancer Center, Texas, USA
| | | | | | - Michael Davies
- The Roy Castle Lung Cancer Programme, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, UK
| | - Yi Liu
- Mayo Clinic, Rochester, MI, USA; PLA Hospital, Beijing, China
| | - Matt J Barnett
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Sera Thomas
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - M Catherine Brown
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Rayjean J Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Departments of Medical Biophysics, Pharmacology and Toxicity, and IMS, University of Toronto, Toronto, ON, Canada.
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10
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Yue N, Ye M, Zhang R, Guo Y. MiR-449b-5p targets lncRNA PSMG3-AS1 to suppress cancer cell proliferation in lung adenocarcinoma. BMC Pulm Med 2020; 20:152. [PMID: 32471413 PMCID: PMC7260832 DOI: 10.1186/s12890-020-01189-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/18/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND PSMG3-AS1 has been characterized as an oncogenic lncRNA in breast cancer, while its role in other cancers is unknown. This study investigated the role of PSMG3-AS1 in lung adenocarcinoma (LUAD). METHODS This study included 64 LUAD patients (42 males and 22 females) who were enrolled between May 2012 and May 2014. RT-qPCR was used to evaluate the expression levels of lncRNA. Cell proliferation analysis was performed using CCK-8 kit. RESULTS We found that upregulation of PSMG3-AS1 in LUAD predicted the poor survival of patients. MiR-449b-5p is downregulated in LUAD and the expression levels of LUAD were inversely correlated with the expression levels of PSMG3-AS1. MiR-449b-5p was predicted to target PSMG3-AS1, and overexpression of miR-449b-5p resulted in the downregulation of PSMG3-AS1 in LUAD cells. Cell proliferation analysis showed that overexpression of PSMG3-AS1 resulted in increased rate of cell proliferation. Overexpression of miR-449b-5p reduced the enhancing effects of PSMG3-AS1 on cell proliferation. CONCLUSIONS Therefore, miR-449b-5p may target PSMG3-AS1 in LUAD to suppress cancer cell proliferation.
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Affiliation(s)
- Na Yue
- Department of Pathology, the 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), NO.789 East Suzhou Street, New Urban Area, Urumqi, 830000, Xinjiang, China
| | - Ming Ye
- Department of Pathology, the 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), NO.789 East Suzhou Street, New Urban Area, Urumqi, 830000, Xinjiang, China
| | - Ran Zhang
- Department of Pathology, the 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), NO.789 East Suzhou Street, New Urban Area, Urumqi, 830000, Xinjiang, China
| | - Yunquan Guo
- Department of Pathology, the 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), NO.789 East Suzhou Street, New Urban Area, Urumqi, 830000, Xinjiang, China.
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11
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Zhang Z, Nong L, Chen ML, Gu XL, Zhao WW, Liu MH, Cheng WW. Long Noncoding RNA SNHG10 Sponges miR-543 to Upregulate Tumor Suppressive SIRT1 in Nonsmall Cell Lung Cancer. Cancer Biother Radiopharm 2020; 35:771-775. [PMID: 32319822 DOI: 10.1089/cbr.2019.3334] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Long noncoding RNA SNHG10 has been reported to promote the development of liver cancer. While by analyzing The Cancer Genome Atlas (TCGA) dataset we observed the downregulation of SNHG10 in non-small cell lung cancer (NSCLC). This study aimed to investigate the roles of SNHG10 in NSCLC. Materials and Methods: This study included 60 pairs of NSCLC and nontumor tissue samples collected from 60 NSCLC patients (males and females, 39-66 years, 50.9 ± 5.5 years). Gene expression was detected by quantitative polymerase chain reaction and western blot. Overexpression experiments were used to analyze gene interactions. Effects of cell transfections on cell proliferation were analyzed by performing CCK-8 cell proliferation assays. Results: We confirmed the downregulation of SNHG10 in NSCLC. In addition, low expression level of SNHG10 predicted the poor survival of NSCLC patients. SNHG10 can directly interact with miR-543, while overexpression of miR-543 failed to downregulate SNHG10. However, SNHG10 overexpression led to upregulation of sirtuin 1 (SIRT1), a downstream target of miR-543. Cell proliferation assay showed that SNHG10 and SIRT1 overexpression led to the decreased proliferation rate of NSCLC cells. In contrast, miR-543 over-expression played an opposite role and reduced the effects of SNHG10 and SIRT1 overexpression. Conclusions: In conclusion, SNHG10 sponges miR-543 to upregulate tumor suppressive SIRT1 in NSCLC to suppress cell proliferation.
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Affiliation(s)
- Zhe Zhang
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Li Nong
- Department of Oncology, The Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meng-Lei Chen
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao-Li Gu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei-Wei Zhao
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ming-Hui Liu
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wen-Wu Cheng
- Department of Integrated Therapy, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
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12
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Kakinuma R, Muramatsu Y, Asamura H, Watanabe SI, Kusumoto M, Tsuchida T, Kaneko M, Tsuta K, Maeshima AM, Ishii G, Nagai K, Yamaji T, Matsuda T, Moriyama N. Low-dose CT lung cancer screening in never-smokers and smokers: results of an eight-year observational study. Transl Lung Cancer Res 2020; 9:10-22. [PMID: 32206549 PMCID: PMC7082286 DOI: 10.21037/tlcr.2020.01.13] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background This was an observational study of Japanese participants who underwent low-dose computed tomographic (LDCT) lung cancer screening between February 2004 and March 2012, to evaluate the lung cancers in never-smokers and smokers. Methods The study population consisted of a total of 12,114 subjects [never-smokers, 6,021 (49.70%); smokers with <30 pack-years of smoking, 3,785 (31.24%); smokers with ≥30 pack-years of smoking, 2,305 (19.03%); unknown smoking status, 3 (0.02%)]. The odds ratio (OR) of lung cancer detection according to the smoking status adjusted for age and gender was evaluated. Results A total of 152 lung cancers were diagnosed in 133 patients [never-smokers, 66 (49.6%); smokers with <30 pack-years of smoking, 31 (23.3%); smokers with ≥30 pack-years of smoking, 36 (27.1%)]; therefore, 72.9% of lung cancer patients did not meet the National Lung Screening Trial (NLST) criterion of smokers with ≥30 pack-years of smoking. The OR of lung cancer detection in smokers with ≥30 pack-years of smoking was higher than that in the never-smokers (OR =1.71, 95% CI: 1.04-2.82, P=0.03) and that in smokers with <30 pack-years of smoking (OR =1.71, 95% CI: 1.04-2.80, P=0.03), while the OR of lung cancer detection in smokers with <30 pack-years of smoking was the same as that in the never-smokers (OR =1.00, 95% CI: 0.62-1.61, P=0.99). Conclusions Although the OR of lung cancer detection in smokers with ≥30 pack-years of smoking was higher than that in the never-smokers and smokers with <30 pack-years of smoking, approximately 70% of lung cancer patients might be missed if we only adopted the NLST criterion of smokers with ≥30 pack-years of smoking. Therefore, never-smokers and smokers with <30 pack-years of smoking should be included in the target population for LDCT lung cancer screening in Japan.
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Affiliation(s)
- Ryutaro Kakinuma
- Cancer Screening Division, National Cancer Center, Research Center for Cancer Prevention and Screening, Tokyo, Japan.,Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.,Tokyo Clinic, Tokyo, Japan.,E-Medical Tokyo, Tokyo, Japan
| | - Yukio Muramatsu
- Cancer Screening Division, National Cancer Center, Research Center for Cancer Prevention and Screening, Tokyo, Japan.,E-Medical Tokyo, Tokyo, Japan
| | - Hisao Asamura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.,Division of General Thoracic Surgery, Department of Surgery, Keio University, School of Medicine, Tokyo, Japan
| | - Shun-Ichi Watanabe
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiko Kusumoto
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Takaaki Tsuchida
- Division of Respiratory Endoscopy, Department of Endoscopy, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiro Kaneko
- Division of Respiratory Endoscopy, Department of Endoscopy, National Cancer Center Hospital, Tokyo, Japan.,Tokyo Health Service Association, Tokyo, Japan
| | - Koji Tsuta
- Division of Pathology, National Cancer Center Hospital, Tokyo, Japan.,Department of Pathology and Laboratory Medicine, Kansai Medical University, Hirakata, Japan
| | | | - Genichiro Ishii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center, Kashiwa, Japan
| | - Kanji Nagai
- Department of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan.,Nakano Sun Clinic, Tokyo, Japan
| | - Taiki Yamaji
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.,Division of Epidemiology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Takahisa Matsuda
- Cancer Screening Center, National Cancer Center Hospital, Tokyo, Japan.,Department of Endoscopy, National Cancer Center Hospital, Tokyo, Japan.,Division of Screening Technology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Noriyuki Moriyama
- Cancer Screening Division, National Cancer Center, Research Center for Cancer Prevention and Screening, Tokyo, Japan.,Department of Radiology, Tokyo Midtown Medical Center, Tokyo, Japan
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13
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Corrales L, Rosell R, Cardona AF, Martín C, Zatarain-Barrón ZL, Arrieta O. Lung cancer in never smokers: The role of different risk factors other than tobacco smoking. Crit Rev Oncol Hematol 2020; 148:102895. [PMID: 32062313 DOI: 10.1016/j.critrevonc.2020.102895] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/21/2020] [Accepted: 01/29/2020] [Indexed: 12/16/2022] Open
Abstract
Lung cancer (LC), the leading cause of cancer-related deaths worldwide, is a complex and highly heterogeneous disease. Additional to its biological complexity, LC patients are often confronted with a high degree of stigma, mostly from the association of the disease with tobacco. Nonetheless, a proportion of LC patients are never-smokers, a population which we are beginning to comprehensively explore. Several risk factors have been linked to LC in never-smokers. Studies have consistently shown that radon exposure and domestic fuel smoke increase LC risk. Additionally, infections such as Mycobacterium tuberculosis, and Human Papilloma Virus are also risk factors. Other less conclusive associations include inflammatory diseases such as asthma and sarcoidosis. Moreover, we are now aware that molecular characteristics of LC vary widely according to smoking history, with important therapeutic implications. This review comprehensively assesses the current knowledge in terms of risk factors and disease characteristics in the never-smoker lung cancer population.
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Affiliation(s)
- Luis Corrales
- Centro de Investigación y Manejo del Cáncer (CIMCA), San José, Costa Rica; Hospital San Juan de Dios, San José, Costa Rica
| | - Rafael Rosell
- Catalan Institute of Oncology, Germans Trias i Pujol Research Institute and Hospital Campus Can Ruti Barcelona, Spain
| | - Andrés F Cardona
- Foundation for Clinical and Applied Cancer Research (FICMAC), Bogotá, Colombia; Clinical and Traslational Oncology Group, Institute of Oncology, Clínica del Country, Bogotá, Colombia
| | - Claudio Martín
- Medical Oncology Department, Thoracic Oncology Section, Instituto Fleming, Buenos Aires, Argentina
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Abstract
INTRODUCTION Median age at diagnosis of lung cancer is 70 years. Its presentation in patients 40 or younger is uncommon and it has been proposed that maybe it is a different disease due to its clinical characteristics and genetic makeup. There are a limited number of studies in this population and they report different clinic-pathological characteristics in comparison with older patients. METHODS We described the incidence of lung cancer patients diagnosed at age 40 or younger at the Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima-Peru; from 2009 to 2017 and evaluated the characteristic of NSCLC. Epidemiologic and clinic-pathological data was collected from clinical files. Analysis was carried out using SPSSvs19 software. RESULTS We identified 3823 patients with lung cancer seen at INEN during the study period. Among these, 166 (4.3%) patients were 40 years or younger, and 137/166 (82.5%) were NSCLC. Median age at diagnosis was 36 years (range 14-40 years) and 59.1% of patients were female. A smoking history was present in 14.4% of patients. Frequent symptoms at diagnosis were cough (62.0%), chest pain (51.8%) and dyspnea (40.9%). Adenocarcinoma was the most common histological type (63.3%). Most patients had advanced disease at diagnosis (84.7%). The median overall survival was 8.2 months. CONCLUSIONS The proportion of young patients with lung cancer in our population is higher than that reported in the most recent literature. Lung cancer in the young is mostly sporadic, more frequent in women, usually adenocarcinoma type and it presents with advanced disease, resulting in a very poor survival.
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15
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Andrews Wright NM, Goss GD. Third-generation epidermal growth factor receptor tyrosine kinase inhibitors for the treatment of non-small cell lung cancer. Transl Lung Cancer Res 2019; 8:S247-S264. [PMID: 31857949 PMCID: PMC6894985 DOI: 10.21037/tlcr.2019.06.01] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mutations in the epidermal growth factor receptor (EGFR) gene are the most common targetable genomic drivers of non-small cell lung cancer (NSCLC), occurring in approximately 50% and 10-15% of adenocarcinomas of the lung in Asian and Western populations, respectively. The most common EGFR-activating mutations, the exon 19 deletion and the L858R point mutation occurring in the receptor tyrosine kinase domain, are susceptible to inhibition. The first EGFR tyrosine kinase inhibitors (TKIs) to be evaluated were the reversible first-generation EGFR TKIs, gefitinib and erlotinib, followed by the irreversible second-generation EGFR TKIs, afatinib and dacomitinib. The study of acquired resistance mechanisms to first- and second-generation EGFR TKIs in patients with activating EGFR-mutated NSCLC identified the gatekeeper T790M point mutation, present in over 50% of cases, as the most common mechanism of acquired resistance. The need to overcome this resistance mechanism led to the development of third-generation EGFR TKIs, of which osimertinib is the only one to date with regulatory approval. In this review, we present the clinical context leading to the development of third-generation EGFR TKIs, the mode of action of these inhibitors and the clinical data supporting their use. We review third-generation TKI agents that are approved, in development, and those that failed in clinical trials. Finally, we will touch upon ongoing studies and future directions, such as combination treatment strategies, currently being explored to improve the efficacy of treatment with third-generation EGFR TKIs.
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Affiliation(s)
| | - Glenwood D Goss
- The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- The University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada
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16
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Jiang SX, Walton RN, Hueniken K, Baek J, McCartney A, Labbé C, Smith E, Chan SWS, Chen R, Brown C, Patel D, Liang M, Eng L, Sacher A, Bradbury P, Leighl NB, Shepherd FA, Xu W, Liu G, Hurry M, O'Kane GM. Real-world health utility scores and toxicities to tyrosine kinase inhibitors in epidermal growth factor receptor mutated advanced non-small cell lung cancer. Cancer Med 2019; 8:7542-7555. [PMID: 31650705 PMCID: PMC6912023 DOI: 10.1002/cam4.2603] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/09/2019] [Accepted: 09/11/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND As the treatment landscape in patients with non-small cell lung cancer (NSCLC) harboring mutations in the epidermal growth factor receptor (EGFRm) continues to evolve, real-world health utility scores (HUS) become increasingly important for economic analyses. METHODS In an observational cohort study, questionnaires were completed in EGFRm NSCLC outpatients, to include demographics, EQ-5D-based HUS and patient-reported toxicity and symptoms. Clinical and radiologic characteristics together with outcomes were extracted from chart review. The impact of health states, treatment type, toxicities, and clinical variables on HUS were evaluated. RESULTS Between 2014 and 2018, a total of 260 patients completed 994 encounters. Across treatment groups, patients with disease progression had lower HUS compared to controlled disease (0.771 vs 0.803; P = .01). Patients predominantly received gefitinib as the first-line EGFR tyrosine kinase inhibitor (TKI) (n = 157, mean-HUS = 0.798), whereas osimertinib (n = 62, mean-HUS = 0.806) and chemotherapy (n = 38, mean-HUS = 0.721) were more likely used in subsequent treatment lines. In longitudinal analysis, TKIs retained high HUS (>0.78) compared to chemotherapy (HUS < 0.74). There were no differences between the frequency or severity of toxicity scores in patients receiving gefitinib compared to osimertinib; however, TKI therapy resulted in fewer toxicities than chemotherapy (P < .05), with the exception of worse diarrhea and skin rash (P < .001). Severity in toxicities inversely correlated with HUS (P < .001). Clinico-demographic factors significantly affecting HUS included age, Eastern Cooperative Oncology Group Performance Score (ECOG PS), disease state, treatment group, and metastatic burden. CONCLUSIONS In a real-world EGFRm population, patients treated with gefitinib or osimertinib had similar HUS and toxicities, scores which were superior to chemotherapy. Health utility scores inversely correlated with patient-reported toxicity scores. In the era of targeted therapies, future economic analyses should incorporate real-world HUS.
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Affiliation(s)
- Shirley Xue Jiang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Katrina Hueniken
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Justine Baek
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alexandra McCartney
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Catherine Labbé
- Insitut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Elliot Smith
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sze Wah Samuel Chan
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - RuiQi Chen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Catherine Brown
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Devalben Patel
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Mindy Liang
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Adrian Sacher
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Penelope Bradbury
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Natasha B Leighl
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Frances A Shepherd
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Wei Xu
- Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Biostatistics, Princess Margaret Cancer Centre and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Grainne M O'Kane
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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17
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Moldaver D, Hurry M, Evans WK, Cheema PK, Sangha R, Burkes R, Melosky B, Tran D, Boehm D, Venkatesh J, Walisser S, Orava E, Grima D. Development, validation and results from the impact of treatment evolution in non-small cell lung cancer (iTEN) model. Lung Cancer 2019; 139:185-194. [PMID: 31812889 DOI: 10.1016/j.lungcan.2019.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Treatment of advanced NSCLC (aNSCLC) is rapidly evolving, as new targeted and immuno-oncology (I-O) treatments become available. The iTEN model was developed to predict the cost and survival benefits of changing aNSCLC treatment patterns from a Canadian healthcare system perspective. This report describes iTEN model development and validation. MATERIALS & METHODS A discrete event patient simulation of aNSCLC was developed. A modified Delphi process using Canadian clinical experts informed the development of treatment sequences that included commonly used, Health Canada approved treatments of aNSCLC. Treatment efficacy and the timing of progression and death were estimated from published Kaplan-Meier progression free and overall survival data. Costs (2018 CDN$) included were: drug acquisition and administration, imaging, monitoring, adverse events, physician visits, best supportive care, and end-of-life. RESULTS AND CONCLUSION Clinical validity of the iTEN model was assessed by comparing model survival predictions to published real-world evidence (RWE). Four RWE studies that reported the overall survival of patients treated with a broad sampling of common aNSCLC treatment patterns were used for validation. The validation coefficient of determination was R2 = 0.95, with the model generally producing estimates that were neither optimistic nor conservative. The model estimated that current Canadian practice patterns yield a median survival of almost 13 months, a five-year survival rate of 3% and a life-time per-treated-patient cost of $110,806. Cost and survival estimates are presented and were found to vary by aNSCLC subtype. In conclusion, the iTEN model is a reliable tool for forecasting the impact on cost and survival of new treatments for aNSCLC.
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Affiliation(s)
| | | | | | | | | | | | | | - Diana Tran
- Cornerstone Research Group, Burlington, Ontario, Canada
| | - Darryl Boehm
- Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada
| | - Jaya Venkatesh
- Saskatchewan Cancer Agency, Regina, Saskatchewan, Canada
| | - Susan Walisser
- BC Cancer (Retired), Vancouver, British Columbia, Canada
| | - Erik Orava
- AstraZeneca Canada, Mississauga, Ontario, Canada
| | - Daniel Grima
- Cornerstone Research Group, Burlington, Ontario, Canada.
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18
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Grosse C, Soltermann A, Rechsteiner M, Grosse A. Oncogenic driver mutations in Swiss never smoker patients with lung adenocarcinoma and correlation with clinicopathologic characteristics and outcome. PLoS One 2019; 14:e0220691. [PMID: 31386689 PMCID: PMC6684066 DOI: 10.1371/journal.pone.0220691] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 07/22/2019] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Lung cancer in never smokers is recognized as a distinct molecular, clinicopathologic and epidemiologic entity. The aim of the study was to investigate the molecular profile in Swiss never smokers with lung adenocarcinoma and to correlate the mutation status with clinicopathologic and demographic patient characteristics and outcome. METHODS One hundred thirty-eight never smokers diagnosed with lung adenocarcinoma at the University Hospital Zurich between 2011-2018 were included in the study. Data from the electronic medical records were reviewed to characterize clinicopathologic and demographic features, molecular profile, treatment and outcome. RESULTS The majority of patients were female (58.7%) with a median age at diagnosis of 64.5 years (range, 27.1-94.2 years). The most common mutations were EGFR (58.7%) followed by ALK (12.3%), TP53 (5.8%), MET (5.8%), KRAS (4.3%), ERBB2 (4.3%), PIK3CA (2.9%), BRAF (2.2%), ROS1 (1.4%), RET (1.4%), CTNNB1 (0.7%), PARP1 (0.7%), TET1 (0.7%) and PIK3CG (0.7%). Median overall survival (mOS) was 51.0 months (mo). Early clinical stage (p = 0.002) and treatment with targeted therapy (HR 2.53, 95% CI 1.35-4.74, p = 0.004) were independently associated with longer mOS. Patients with oncogenic driver mutations had significantly longer mOS (52.2 mo) compared to patients without mutations (16.9 mo) (HR 3.38, 95% CI 1.52-7.55, p = 0.003). Besides, patients with EGFR mutated (57.8 mo) or ALK rearranged (59.9 mo) tumors had significantly longer mOS compared to the EGFR wildtype (35.0 mo), ALK wildtype (46.5 mo) and pan-negative (16.9 mo) cohorts (HR 2.35, 95% CI 1.37-4.04, p = 0.002; HR 7.80, 95% CI 3.28-18.55, p < 0.001; HR 3.96, 95% CI 1.21-12.95, p = 0.023 and HR 34.78, 95% CI 3.48-34.65, p = 0.003). CONCLUSION Never smokers with lung adenocarcinoma display distinct clinicopathologic and molecular features and are characterized by a high incidence of targetable mutations. Never smokers with targetable mutations have significantly longer survival compared to patients without mutations.
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Affiliation(s)
- Claudia Grosse
- Institute of Pathology and Molecular Pathology, Clinical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Alex Soltermann
- Institute of Pathology and Molecular Pathology, Clinical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Markus Rechsteiner
- Institute of Pathology and Molecular Pathology, Diagnostic Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Alexandra Grosse
- Institute of Pathology and Molecular Pathology, Clinical Pathology, University Hospital Zurich, Zurich, Switzerland
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19
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Cavic M, Spasic J, Krivokuca A, Boljevic I, Kuburovic M, Radosavljevic D, Jankovic R. TP53 and DNA-repair gene polymorphisms genotyping as a low-cost lung adenocarcinoma screening tool. J Clin Pathol 2018; 72:75-80. [PMID: 30467244 DOI: 10.1136/jclinpath-2018-205553] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 12/16/2022]
Abstract
AIM TP53 and DNA repair polymorphisms have been proposed as cancer risk factors. This study evaluated the usability of TP53 Arg72Pro single-nucleotide polymorphism, X RCC1 Arg399Gln and RAD51 G135C as a low-cost lung adenocarcinoma screening tool. PATIENTS AND METHODS This case-control study included 78 atients with lung adenocarcinoma and 79 healthy matched controls. TP53, XRCC1 and RAD51 genotyping was done by PCR followed by restriction length polymorphism. Descriptive analyses included genotype and allelic frequencies and deviations of the frequencies from those expected under Hardy-Weinberg equilibrium were assessed using the χ2 test. The OR and 95% CIs were calculated as an estimate of relative risk, with significance set at p value <0.05. RESULTS The TP53 codon 72 Pro allele and the XRCC1 codon 399 Arg allele in a homozygous state were associated with lung adenocarcinoma (p=0.037; OR (95% CI) 2.42 (1.10 to 5.31)), that is, p=0.037; OR (95% CI) 2.16 (1.08 to 4.33), respectively. Also, carriers of the TP53 codon 72 Pro allele and the XRCC1 codon 399 ArgArg genotype older than 50 showed an even higher risk of developing lung adenocarcinoma (p=0.03 in both cases). CONCLUSIONS The TP53 codon 72 Arg allele and XRCC1 codon 399 Gln allele are likely to have a protective effect against lung adenocarcinoma, especially in individuals older than 50 years of age. XRCC1 and TP53 genotyping might be a useful low-cost tool for evaluating individual lung cancer risk, leading to earlier detection and management of this disease.
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Affiliation(s)
- Milena Cavic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Jelena Spasic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ana Krivokuca
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Ivana Boljevic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Mira Kuburovic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Davorin Radosavljevic
- Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Radmila Jankovic
- Department of Experimental Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
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