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A. Dariush

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Ali HR, Dariush A, Thomas J, Provenzano E, Dunn J, Hiller L, Vallier AL, Abraham J, Piper T, Bartlett JMS, Cameron DA, Hayward L, Brenton JD, Pharoah PDP, Irwin MJ, Walton NA, Earl HM, Caldas C. Lymphocyte density determined by computational pathology validated as a predictor of response to neoadjuvant chemotherapy in breast cancer: secondary analysis of the ARTemis trial. Ann Oncol 2017;28:1832-1835. [PMID: 28525534 PMCID: PMC5834010 DOI: 10.1093/annonc/mdx266] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open

Abstract

BACKGROUND

We have previously shown lymphocyte density, measured using computational pathology, is associated with pathological complete response (pCR) in breast cancer. The clinical validity of this finding in independent studies, among patients receiving different chemotherapy, is unknown.

PATIENTS AND METHODS

The ARTemis trial randomly assigned 800 women with early stage breast cancer between May 2009 and January 2013 to three cycles of docetaxel, followed by three cycles of fluorouracil, epirubicin and cyclophosphamide once every 21 days with or without four cycles of bevacizumab. The primary endpoint was pCR (absence of invasive cancer in the breast and lymph nodes). We quantified lymphocyte density within haematoxylin and eosin (H&E) whole slide images using our previously described computational pathology approach: for every detected lymphocyte the average distance to the nearest 50 lymphocytes was calculated and the density derived from this statistic. We analyzed both pre-treatment biopsies and post-treatment surgical samples of the tumour bed.

RESULTS

Of the 781 patients originally included in the primary endpoint analysis of the trial, 609 (78%) were included for baseline lymphocyte density analyses and a subset of 383 (49% of 781) for analyses of change in lymphocyte density. The main reason for loss of patients was the availability of digitized whole slide images. Pre-treatment lymphocyte density modelled as a continuous variable was associated with pCR on univariate analysis (odds ratio [OR], 2.92; 95% CI, 1.78-4.85; P < 0.001) and after adjustment for clinical covariates (OR, 2.13; 95% CI, 1.24-3.67; P = 0.006). Increased pre- to post-treatment lymphocyte density showed an independent inverse association with pCR (adjusted OR, 0.1; 95% CI, 0.033-0.31; P < 0.001).

CONCLUSIONS

Lymphocyte density in pre-treatment biopsies was validated as an independent predictor of pCR in breast cancer. Computational pathology is emerging as a viable and objective means of identifying predictive biomarkers for cancer patients.

CLINICALTRIALS.GOV

NCT01093235.

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Affiliation(s)

H. R. Ali Li Ka Shing Centre, Cancer Research UK Cambridge Institute Department of Pathology
A. Dariush Institute of Astronomy, University of Cambridge, Cambridge
J. Thomas Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
E. Provenzano Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Department of Histopathology, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
J. Dunn Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
L. Hiller Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
A.-L. Vallier Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
J. Abraham Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
T. Piper Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
J. M. S. Bartlett Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh Ontario Institute for Cancer Research, Toronto, Canada
D. A. Cameron Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
L. Hayward Edinburgh Cancer Research Centre, Western General Hospital, Edinburgh
J. D. Brenton Li Ka Shing Centre, Cancer Research UK Cambridge Institute Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
P. D. P. Pharoah Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
M. J. Irwin Institute of Astronomy, University of Cambridge, Cambridge
N. A. Walton Institute of Astronomy, University of Cambridge, Cambridge
H. M. Earl Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge
C. Caldas Li Ka Shing Centre, Cancer Research UK Cambridge Institute Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Cambridge Experimental Cancer Medicine Centre and NIHR Cambridge Biomedical Research Centre, Cambridge

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Negrello M, Hopwood R, De Zotti G, Cooray A, Verma A, Bock J, Frayer DT, Gurwell MA, Omont A, Neri R, Dannerbauer H, Leeuw LL, Barton E, Cooke J, Kim S, da Cunha E, Rodighiero G, Cox P, Bonfield DG, Jarvis MJ, Serjeant S, Ivison RJ, Dye S, Aretxaga I, Hughes DH, Ibar E, Bertoldi F, Valtchanov I, Eales S, Dunne L, Driver SP, Auld R, Buttiglione S, Cava A, Grady CA, Clements DL, Dariush A, Fritz J, Hill D, Hornbeck JB, Kelvin L, Lagache G, Lopez-Caniego M, Gonzalez-Nuevo J, Maddox S, Pascale E, Pohlen M, Rigby EE, Robotham A, Simpson C, Smith DJB, Temi P, Thompson MA, Woodgate BE, York DG, Aguirre JE, Beelen A, Blain A, Baker AJ, Birkinshaw M, Blundell R, Bradford CM, Burgarella D, Danese L, Dunlop JS, Fleuren S, Glenn J, Harris AI, Kamenetzky J, Lupu RE, Maddalena RJ, Madore BF, Maloney PR, Matsuhara H, Michaowski MJ, Murphy EJ, Naylor BJ, Nguyen H, Popescu C, Rawlings S, Rigopoulou D, Scott D, Scott KS, Seibert M, Smail I, Tuffs RJ, Vieira JD, van der Werf PP, Zmuidzinas J. The Detection of a Population of Submillimeter-Bright, Strongly Lensed Galaxies. Science 2010;330:800-4. [DOI: 10.1126/science.1193420] [Citation(s) in RCA: 294] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]

Affiliation(s)

Mattia Negrello Department of Physics and Astronomy, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
R. Hopwood Department of Physics and Astronomy, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
G. De Zotti Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Padova, Vicolo Osservatorio 5, I-35122 Padova, Italy Scuola Internazionale Superiore di Studi Avanzati, Via Bonomea 265, I-34136 Trieste, Italy
A. Cooray Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA
A. Verma Oxford Astrophysics, Denys Wilkinson Building, University of Oxford, Keble Road, Oxford OX1 3RH, UK
J. Bock Jet Propulsion Laboratory (JPL), Pasadena, CA 91009, USA California Institute of Technology, Pasadena, CA 91125, USA
D. T. Frayer National Radio Astronomy Observatory, Post Office Box 2, Green Bank, WV 24944, USA
M. A. Gurwell Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138, USA
A. Omont Institut d’Astrophysique de Paris, Universitte Pierre et Marie Curie and CNRS, 98 bis boulevard Arago, 75014 Paris, France
R. Neri Institut de Radioastronomie Millimétrique (IRAM), 300 rue de la piscine, 38406 Saint-Martin d'Hères, France
H. Dannerbauer Laboratoire Astrophysique, Instrumentation et Modélisation Paris Sarclay, Commissariat à l’Énergie Atomique (CEA)/Direction des Sciences de la Matière–CNRS–Université Paris Diderot, Institut de Recherche sur les lois fondamentales d l’Universe/Service d’Astrophysique, CEA Saclay, Orme des Merisiers, F-91191 Gif-sur-Yvette Cedex, France
L. L. Leeuw Physics Department, University of Johannesburg, Post Office Box 524, Auckland Park 2006, South Africa SETI Institute, 515 North Whisman Avenue, Mountain View, CA 94043, USA
E. Barton Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA
J. Cooke Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA California Institute of Technology, Pasadena, CA 91125, USA
S. Kim Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA
E. da Cunha Department of Physics, University of Crete, 71003 Heraklion, Greece
G. Rodighiero Dipartimento di Astronomia, Universitá di Padova, Vicolo Osservatorio 2, I-35122 Padova, Italy
P. Cox Institut de Radioastronomie Millimétrique (IRAM), 300 rue de la piscine, 38406 Saint-Martin d'Hères, France
D. G. Bonfield Centre for Astrophysics Research, Science and Technology Research Institute, University of Hertfordshire, Herts AL10 9AB, UK
M. J. Jarvis Centre for Astrophysics Research, Science and Technology Research Institute, University of Hertfordshire, Herts AL10 9AB, UK
S. Serjeant Department of Physics and Astronomy, The Open University, Walton Hall, Milton Keynes, MK7 6AA, UK
R. J. Ivison UK Astronomy Technology Center, Royal Observatory Edinburgh, Edinburgh EH9 3HJ, UK Scottish Universities Physics Alliance, Institute for Astronomy, University of Edinburgh, Royal Observatory, Edinburgh EH9 3HJ, UK
S. Dye School of Physics and Astronomy, Cardiff University, The Parade, Cardiff CF24 3AA, UK
I. Aretxaga Instituto Nacional de Astrofísica, Óptica y Electrónica, Apartado Postal 51 y 216, 72000 Puebla, Mexico
D. H. Hughes Instituto Nacional de Astrofísica, Óptica y Electrónica, Apartado Postal 51 y 216, 72000 Puebla, Mexico
E. Ibar UK Astronomy Technology Center, Royal Observatory Edinburgh, Edinburgh EH9 3HJ, UK
F. Bertoldi Argelander-Institut für Astronomie, Universität Bonn, Auf dem Hügel 71, 53121 Bonn, Germany
I. Valtchanov Herschel Science Centre, European Space Astronomy Centre, European Space Agency (ESA), Post Office Box 78, 28691 Villanueva de la Cañada, Madrid, Spain
S. Eales School of Physics and Astronomy, Cardiff University, The Parade, Cardiff CF24 3AA, UK
L. Dunne School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
S. P. Driver Scottish Universities Physics Alliance, School of Physics and Astronomy, University of St. Andrews, North Haugh, St. Andrews, KY16 9SS, UK
R. Auld School of Physics and Astronomy, Cardiff University, The Parade, Cardiff CF24 3AA, UK
S. Buttiglione Istituto Nazionale di Astrofisica, Osservatorio Astronomico di Padova, Vicolo Osservatorio 5, I-35122 Padova, Italy
A. Cava Instituto de Astrofísica de Canarias, C/Vía Láctea s/n, E-38200 La Laguna, Spain Departamento de Astrofísica, Universidad de La Laguna (ULL), E-38205 La Laguna, Tenerife, Spain
C. A. Grady Eureka Scientific, 2452 Delmer Street, Suite 100, Oakland, CA 94602, USA Goddard Space Flight Center, Code 667, Greenbelt Road, Greenbelt, MD 20771, USA
D. L. Clements Astrophysics Group, Physics Department, Blackett Lab, Imperial College London, Prince Consort Road, London SW7 2AZ, UK
A. Dariush School of Physics and Astronomy, Cardiff University, The Parade, Cardiff CF24 3AA, UK
J. Fritz Sterrenkundig Observatorium, Universiteit Gent, Krijgslaan 281 S9, B-9000 Gent, Belgium
D. Hill Scottish Universities Physics Alliance, School of Physics and Astronomy, University of St. Andrews, North Haugh, St. Andrews, KY16 9SS, UK
J. B. Hornbeck Department of Physics and Astronomy, University of Louisville, Louisville, KY 40292, USA
L. Kelvin Scottish Universities Physics Alliance, School of Physics and Astronomy, University of St. Andrews, North Haugh, St. Andrews, KY16 9SS, UK
G. Lagache Institut d’Astrophysique Spatiale (IAS), Bâtiment 121, F-91405 Orsa, France Université Paris–Sud 11 and CNRS (UMR 8617), 91400 Orsay, France
M. Lopez-Caniego Instituto de Fisica de Cantabria, Consejo Superior de Investigaciones Científicas–Universidad de Cantabria, Avenue de Los Castros s/n, Santander 39005, Spain
J. Gonzalez-Nuevo Scuola Internazionale Superiore di Studi Avanzati, Via Bonomea 265, I-34136 Trieste, Italy
S. Maddox School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
E. Pascale School of Physics and Astronomy, Cardiff University, The Parade, Cardiff CF24 3AA, UK
M. Pohlen School of Physics and Astronomy, Cardiff University, The Parade, Cardiff CF24 3AA, UK
E. E. Rigby School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
A. Robotham Scottish Universities Physics Alliance, School of Physics and Astronomy, University of St. Andrews, North Haugh, St. Andrews, KY16 9SS, UK
C. Simpson Astrophysics Research Institute, Liverpool John Moores University Twelve Quays House, Egerton Wharf, Birkenhead CH41 1LD, UK
D. J. B. Smith School of Physics and Astronomy, University of Nottingham, University Park, Nottingham NG7 2RD, UK
P. Temi Astrophysics Branch, NASA Ames Research Center, Mail Stop 245-6, Moffett Field, CA 94035, USA
M. A. Thompson Centre for Astrophysics Research, Science and Technology Research Institute, University of Hertfordshire, Herts AL10 9AB, UK
B. E. Woodgate NASA Goddard Space Flight Center, Code 667, Greenbelt Road, Greenbelt, MD 20771, USA
D. G. York Department of Astrophysics and The Enrico Fermi Institute, University of Chicago, 5640 South Ellis Avenue, Chicago, IL 60637, USA
J. E. Aguirre Department of Physics and Astronomy, University of Pennsylvania, Philadephia, PA 19104, USA
A. Beelen Université Paris–Sud 11 and CNRS (UMR 8617), 91400 Orsay, France
A. Blain California Institute of Technology, Pasadena, CA 91125, USA
A. J. Baker Rutgers University, Department of Physics and Astronomy, 136 Frelinghuysen Road, Piscataway, NJ 08854–8019, USA
M. Birkinshaw H. H. Wills Physics Laboratory, University of Bristol, Tyndall Avenue, Bristol BS8 1TL, UK
R. Blundell Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138, USA
C. M. Bradford Jet Propulsion Laboratory (JPL), Pasadena, CA 91009, USA California Institute of Technology, Pasadena, CA 91125, USA
D. Burgarella Laboratoire d’Astrophysique de Marseille, UMR6110 CNRS, and Aix-Marseille Université, 38 rue F. Joliot-Curie, F-13388 Marseille, France
L. Danese Scuola Internazionale Superiore di Studi Avanzati, Via Bonomea 265, I-34136 Trieste, Italy
J. S. Dunlop UK Astronomy Technology Center, Royal Observatory Edinburgh, Edinburgh EH9 3HJ, UK
S. Fleuren School of Mathematical Sciences, Queen Mary, University of London, Mile End Road, London E1 4NS, UK
J. Glenn University of Colorado, Center for Astrophysics and Space Astronomy, 389-UCB, Boulder, CO 80303, USA
A. I. Harris Department of Astronomy, University of Maryland, College Park, MD 20742, USA
J. Kamenetzky University of Colorado, Center for Astrophysics and Space Astronomy, 389-UCB, Boulder, CO 80303, USA
R. E. Lupu Department of Physics and Astronomy, University of Pennsylvania, Philadephia, PA 19104, USA
R. J. Maddalena National Radio Astronomy Observatory, Post Office Box 2, Green Bank, WV 24944, USA
B. F. Madore Observatories of the Carnegie Institution, 813 Santa Barbara Street, Pasadena, CA 91101, USA
P. R. Maloney University of Colorado, Center for Astrophysics and Space Astronomy, 389-UCB, Boulder, CO 80303, USA
H. Matsuhara Institute for Space and Astronautical Science, Japan Aerospace Exploration Agency, 3-1-1 Yoshinodai, Chuo-ku, Sagamihara 252-5210, Japan
M. J. Michaowski Scottish Universities Physics Alliance, Institute for Astronomy, University of Edinburgh, Royal Observatory, Edinburgh EH9 3HJ, UK
E. J. Murphy Infrared Processing and Analysis Center, Pasadena, CA 91125, USA
B. J. Naylor Jet Propulsion Laboratory (JPL), Pasadena, CA 91009, USA
H. Nguyen Jet Propulsion Laboratory (JPL), Pasadena, CA 91009, USA
C. Popescu Jeremiah Horrocks Institute, University of Central Lancashire, Preston PR1 2HE, UK
S. Rawlings Oxford Astrophysics, Denys Wilkinson Building, University of Oxford, Keble Road, Oxford OX1 3RH, UK
D. Rigopoulou Oxford Astrophysics, Denys Wilkinson Building, University of Oxford, Keble Road, Oxford OX1 3RH, UK Space Science and Technology Department, Rutherford Appleton Laboratory, Chilton, Didcot, Oxfordshire OX11 0QX, UK
D. Scott University of British Columbia, 6224 Agricultural Road, Vancouver BC V6T 1Z1, Canada
K. S. Scott Department of Physics and Astronomy, University of Pennsylvania, Philadephia, PA 19104, USA
M. Seibert Observatories of the Carnegie Institution, 813 Santa Barbara Street, Pasadena, CA 91101, USA
I. Smail Institute for Computational Cosmology, Durham University, Durham DH1 3LE, UK
R. J. Tuffs Max-Planck-Institut f¨r Kernphysik (MPIK), Saupfercheckweg 1, 69117 Heidelberg, Germany
J. D. Vieira California Institute of Technology, Pasadena, CA 91125, USA
P. P. van der Werf Scottish Universities Physics Alliance, Institute for Astronomy, University of Edinburgh, Royal Observatory, Edinburgh EH9 3HJ, UK Leiden Observatory, Leiden University, Post Office Box 9513, NL-2300 RA Leiden, Netherlands
J. Zmuidzinas Jet Propulsion Laboratory (JPL), Pasadena, CA 91009, USA California Institute of Technology, Pasadena, CA 91125, USA

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