1
|
Nowak AK, Giroux DJ, Eisele M, Rosenthal A, Bille A, Gill RR, Kindler HL, Pass HI, Rice D, Ripley RT, Wolf A, Friedberg J, Nishimura K, Rusch VW. The IASLC Pleural Mesothelioma Staging Project: Proposal for Revision of the TNM Stage Groupings in the Forthcoming (Ninth) Edition of the TNM Classification for Pleural Mesothelioma. J Thorac Oncol 2024:S1556-0864(24)00207-7. [PMID: 38734072 DOI: 10.1016/j.jtho.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/28/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION The eighth edition of the tumor, node and metastases (TNM) classification of pleural mesothelioma (PM) saw substantial changes in T and N components and stage groupings. The International Association for the Study of Lung Cancer collected data into a multinational database in order to further refine this classification. This 9th edition proposal incorporates changes proposed in the clinical (c)T component, but not the pathologic (p)T component, to include size criteria, and further refines TNM stage groupings for PM. METHODS Data were submitted via electronic data capture (EDC) or batch transfer from institutional databases. Survival was measured from diagnosis date. Candidate stage groups were developed using a recursive partitioning and amalgamation (RPA) algorithm applied to all cM0 cases for clinical stage and subsequently for pathological stage. Cox models were developed to estimate survival for each stage group. RESULTS Of 3598 submitted cases, 2192 were analyzable for overall cStage and 445 for overall pStage. RPA generated survival tree on OS outcomes restricted to cM0 with newly proposed (9th edition) cT and cN component-derived optimal stage groupings of: stage I (T1N0), II (T1N1; T2N0), IIIA (T1N2; T2N1/2; any T3), IIIB (any T4), and IV (any M1). Although cT and pT descriptors are different in the 9th edition, aligning pStage groupings with cStage produced better discrimination than retaining 8th edition pStage groupings. CONCLUSIONS This revision of the clinical TNM classification for PM is the first to incorporate the measurement-based proposed changes in clinical T category. The pathological TNM aligns with clinical TNM.
Collapse
Affiliation(s)
- Anna K Nowak
- Medical School, the University of Western Australia.
| | | | - Megan Eisele
- Cancer Research And Biostatistics, Seattle, Washington, USA
| | - Adam Rosenthal
- Cancer Research And Biostatistics, Seattle, Washington, USA
| | - Andrea Bille
- Thoracic Surgery, Guy's Hospital, Thoracic Surgery, London, UK
| | - Ritu R Gill
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Hedy L Kindler
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Illinois, USA
| | - Harvey I Pass
- Thoracic Surgery, NYU Langone Medical Center, New York, USA
| | - David Rice
- Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Texas, USA
| | - R Taylor Ripley
- Department of Thoracic Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Andrea Wolf
- Department of Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joseph Friedberg
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | | | - Valerie W Rusch
- Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
2
|
Gill RR, Nowak AK, Giroux DJ, Eisele M, Rosenthal A, Kindler H, Wolf A, Ripley RT, Billé A, Rice D, Opitz I, Rimner A, de Perrot M, Pass HI, Rusch VW. The International Association for the Study of Lung Cancer Mesothelioma Staging Project: Proposals for Revisions of the "T" Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Pleural Mesothelioma. J Thorac Oncol 2024:S1556-0864(24)00086-8. [PMID: 38521202 DOI: 10.1016/j.jtho.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION The primary tumor (T) component in the eighth edition of pleural mesothelioma (PM) staging system is based on pleural involvement and extent of invasion. Quantitative assessment of pleural tumor has been found to be prognostic. We explored quantitative and qualitative metrics to develop recommendations for T descriptors in the upcoming ninth edition of the PM staging system. METHODS The International Association for the Study of Lung Cancer prospectively collected data on patients with PM. Sum of maximum pleural thickness (Psum) was recorded. Optimal combinations of Psum and eighth edition cT descriptors were assessed using recursive binary splitting algorithm, with bootstrap resampling to correct for the adaptive nature of the splitting algorithm, and validated in the eighth edition data. Overall survival (OS) was calculated by the Kaplan-Meier method and differences in OS assessed by the log-rank test. RESULTS Of 7338 patients submitted, 3598 were eligible for cT analysis and 1790 had Psum measurements. Recursive partitioning identified optimal cutpoints of Psum at 12 and 30 mm, which, in combination with extent of invasion, yielded four prognostic groups for OS. Fmax greater than 5 mm indicated poor prognosis. cT4 category (based on invasion) revealed similar performance to eighth edition. Three eighth edition descriptors were eliminated based on low predictive accuracy. Eighth edition pT descriptors remained valid in ninth edition analyses. CONCLUSION Given reproducible prognostication by Psum, size criteria will be incorporated into cT1 to T3 categories in the ninth edition. Current cT4 category and all pT descriptors will be maintained, with reclassification of fissural invasion as pT2.
Collapse
Affiliation(s)
- Ritu R Gill
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Anna K Nowak
- National Centre for Asbestos Related Diseases, Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | | | - Megan Eisele
- Cancer Research And Biostatistics, Seattle, Washington
| | | | - Hedy Kindler
- Department of Medicine, Section of Hematology/Oncology, University of Chicago, Illinois
| | - Andrea Wolf
- Department of Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert T Ripley
- Department of Thoracic Surgery, Baylor College of Medicine, Houston, Texas
| | - Andre Billé
- Thoracic Surgery, Guy's Hospital, Thoracic Surgery, London, UK
| | - David Rice
- Thoracic Surgery, The University of Texas MD Anderson Cancer Center, Texas
| | - Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Switzerland
| | - Andreas Rimner
- Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc de Perrot
- Thoracic Surgery, University Health Network, Toronto General Hospital & Princess Margaret Hospital, Toronto, Canada
| | - Harvey I Pass
- Thoracic Surgery, NYU Langone Medical Center, New York
| | - Valerie W Rusch
- Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
3
|
Fong KM, Rosenthal A, Giroux DJ, Nishimura KK, Erasmus J, Lievens Y, Marino M, Marom EM, Putora PM, Singh N, Suárez F, Rami-Porta R, Detterbeck F, Eberhardt WE, Asamura H. The IASLC Lung Cancer Staging Project: Proposals for the Revision of the M Descriptors in the Forthcoming 9th edition of the TNM Classification of Lung Cancer. J Thorac Oncol 2024:S1556-0864(24)00060-1. [PMID: 38320664 DOI: 10.1016/j.jtho.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/24/2024] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION This study analyzed all metastatic categories of the current tumor, node, and metastasis (TNM) classification of non-small cell lung cancer to propose modifications of the M component in the next edition (9th) of the classification. METHODS A database of 124,581 patients diagnosed between 2011 and 2019 was established; of these, 14,937 with NSCLC in stage IVA-IVB were available for this analysis. Overall survival was calculated using the Kaplan-Meier method, and prognosis assessed using multivariable-adjusted Cox proportional hazards regression. RESULTS The 8th edition M categories demonstrated good discrimination in the 9th edition dataset. Assessments demonstrated that an increasing number of metastatic lesions was associated with decreasing prognosis; because this appears to be a continuum and adjustment for confounders was not possible, no specific lesion number was deemed appropriate for stage classification. Among tumors involving multiple metastases, decreasing prognosis was seen with an increasing number of organ systems involved. Multiple assessments, including after adjustment for potential confounders, demonstrated that patients with M1c patients who had metastases to a single extrathoracic organ system were prognostically distinct from M1c patients who had involvement of multiple extrathoracic organ systems. CONCLUSIONS These data validate the 8th edition M1a and M1b categories, that are recommended to be maintained. We propose the M1c category be divided into M1c1 (involvement of a single extrathoracic organ system) and M1c2 (involvement of multiple extrathoracic organ systems).
Collapse
Affiliation(s)
- Kwun M Fong
- Department of Thoracic Medicine, The Prince Charles Hospital, University of Queensland Thoracic Research Centre, Brisbane, Australia.
| | - Adam Rosenthal
- Cancer Research And Biostatistics (CRAB), Seattle, Washington
| | | | | | - Jeremy Erasmus
- Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Gent, Belgium
| | - Mirella Marino
- Department of Pathology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Edith M Marom
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel-Aviv University, Ramat Gan, Israel
| | - Paul Martin Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland and Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Switzerland
| | - Navneet Singh
- Lung Cancer Clinic, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Francisco Suárez
- Department of Thoracic Surgery, Clínica Santa María, Universidad de Los Andes, Santiago, Chile
| | - Ramon Rami-Porta
- Department of Thoracic Surgery, Hospital Universitari Mutua Terrassa, University of Barcelona,Terrassa, Barcelona, Spain; and Network of Centres for Biomedical Research in Respiratory Diseases (CIBERES) Lung Cancer Group, Terrassa, Barcelona, Spain
| | - Frank Detterbeck
- Department of Surgery, Division of Thoracic Surgery, Yale University School of Medicine, New Haven, CT
| | - Wilfried Ee Eberhardt
- Department of Medical Oncology, West German Cancer Center, University Medicine Essen and Ruhrlandklinik, University Duisburg-Essen
| | - Hisao Asamura
- Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Wolf AS, Rosenthal A, Giroux DJ, Nowak AK, Bille A, de Perrot M, Kindler HL, Rice D, Opitz I, Rusch VW, Pass HI. The International Association for the Study of Lung Cancer Pleural Mesothelioma Staging Project: Updated Modeling of Prognostic Factors in Pleural Mesothelioma. J Thorac Oncol 2023; 18:1689-1702. [PMID: 37567386 DOI: 10.1016/j.jtho.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION The International Association for the Study of Lung Cancer developed an international pleural mesothelioma database to improve staging. Data entered from 1995 to 2009 (training data set) were analyzed previously to evaluate supplemental prognostic factors. We evaluated these factors with new clinical data to determine whether the previous models could be improved. METHODS Patients entered into the database from 2009 to 2019 (validation cohort) were assessed for the association between previous prognosticators and overall survival using Cox proportional hazards regression with bidirectional stepwise selection. Additional variables were analyzed and models were compared using Harrell's C-index. RESULTS The training data set included 3101 patients and the validation cohort, 1733 patients. For the multivariable pathologic staging model applied to the training cohort, C-index was 0.68 (95% confidence interval [CI]: 0.656-0.705). For the validation data set (n = 497), C-index was 0.650 (95% CI: 0.614-0.685), and pathologic stage, histologic diagnosis, sex, adjuvant therapy, and platelet count were independently associated with survival. Adding anemia to the model increased the C-index to 0.652 (95% CI: 0.618-0.686). A basic presentation model including all parameters before staging yielded a C-index of 0.668 (95% CI: 0.641-0.695). In comparison, the European Organization for Research and Treatment of Cancer model yielded C-indices of 0.550 (95% CI: 0.511-0.589) and 0.577 (95% CI: 0.550-0.604) for pathologic staging and presentation models, respectively. CONCLUSIONS Although significant predictors differed slightly, the International Association for the Study of Lung Cancer training model performed well in the validation set and better than the model of the European Organization for Research and Treatment of Cancer. International collaboration is critical to improve outcomes in this rare disease.
Collapse
Affiliation(s)
- Andrea S Wolf
- Department of Thoracic Surgery, The Icahn School of Medicine at Mount Sinai, New York, New York.
| | | | | | - Anna K Nowak
- Medical School of the University of Western Australia, Crawley, Western Australia, Australia
| | - Andrea Bille
- Department of Thoracic Surgery, Guy's Hospital, London, United Kingdom
| | - Marc de Perrot
- Division of Thoracic Surgery, Toronto General Hospital, Ontario, Canada
| | - Hedy L Kindler
- Section of Hematology/Oncology, University of Chicago, Chicago, Illinois
| | - David Rice
- Department of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Valerie W Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Harvey I Pass
- Department of Cardiothoracic Surgery, New York University (NYU) Langone Medical Center, New York, New York
| |
Collapse
|
5
|
Lütt A, Tsamitros N, Wolbers T, Rosenthal A, Bröcker AL, Schöneck R, Bermpohl F, Heinz A, Beck A, Gutwinski S. An explorative single-arm clinical study to assess craving in patients with alcohol use disorder using Virtual Reality exposure (CRAVE)-study protocol. BMC Psychiatry 2023; 23:839. [PMID: 37964300 PMCID: PMC10647047 DOI: 10.1186/s12888-023-05346-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) belongs to the most burdensome clinical disorders worldwide. Current treatment approaches yield unsatisfactory long-term effects with relapse rates up to 85%. Craving for alcohol is a major predictor for relapse and can be intentionally induced via cue exposure in real life as well as in Virtual Reality (VR). The induction and habituation of craving via conditioned cues as well as extinction learning is used in Cue Exposure Therapy (CET), a long-known but rarely used strategy in Cognitive Behavioral Therapy (CBT) of AUD. VR scenarios with alcohol related cues offer several advantages over real life scenarios and are within the focus of current efforts to develop new treatment options. As a first step, we aim to analyze if the VR scenarios elicit a transient change in craving levels and if this is measurable via subjective and psychophysiological parameters. METHODS A single-arm clinical study will be conducted including n = 60 patients with AUD. Data on severity of AUD and craving, comorbidities, demographics, side effects and the feeling of presence in VR will be assessed. Patients will use a head-mounted display (HMD) to immerse themselves into three different scenarios (neutral vs. two target situations: a living room and a bar) while heart rate, heart rate variability, pupillometry and electrodermal activity will be measured continuously. Subjective craving levels will be assessed before, during and after the VR session. DISCUSSION Results of this study will yield insight into the induction of alcohol craving in VR cue exposure paradigms and its measurement via subjective and psychophysiological parameters. This might be an important step in the development of innovative therapeutic approaches in the treatment of patients with AUD. TRIAL REGISTRATION This study was approved by the Charité-Universitätsmedizin Berlin Institutional Review Board (EA1/190/22, 23.05.2023). It was registered on ClinicalTrials.gov (NCT05861843).
Collapse
Affiliation(s)
- A Lütt
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany.
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany.
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany.
| | - N Tsamitros
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - T Wolbers
- German Center for Neurodegenerative Diseases (DZNE), 39120, Magdeburg, Germany
| | - A Rosenthal
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - A L Bröcker
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - R Schöneck
- Salus Clinic Lindow, 16835, Lindow, Germany
| | - F Bermpohl
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - A Heinz
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
- German Center for Mental Health (DZPG), partner site Berlin, Berlin, Germany
| | - A Beck
- Faculty of Health, Health and Medical University, 14471, Potsdam, Germany
| | - S Gutwinski
- Psychiatric University Hospital Charité at St. Hedwig Hospital, 10115, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| |
Collapse
|
6
|
Saifi O, Lester SC, Rule WG, Breen W, Stish BJ, Rosenthal A, Munoz J, Lin Y, Johnston P, Ansell SM, Paludo J, Khurana A, Bisneto JV, Wang Y, Iqbal M, Moustafa MA, Murthy HS, Kharfan-Dabaja M, Peterson JL, Hoppe BS. Consolidative Radiotherapy for Residual PET-Avid Disease on Day +30 Post CAR T-Cell Therapy in Non-Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:S52. [PMID: 37784518 DOI: 10.1016/j.ijrobp.2023.06.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Up to30% of non-Hodgkin lymphoma (NHL) patients achieve a partial response (PR) to anti-CD19 Chimeric Antigen Receptor T-cell Therapy (CART) on day +30. Most PR patients relapse and only 30% achieve spontaneous complete response (CR) without additional therapies. This study is the first to report on the role of consolidative radiotherapy (cRT) for PR PET-avid disease on day +30 post-CART in NHL. MATERIALS/METHODS Aretrospective review across 3 institutions from 2018 to 2022 identified 60 patients with B-cell NHL who received CART and achieved PR (Deauville 4-5) with <5 PET-avid disease sites on day +30. Progression-free survival (PFS) was defined from CART infusion to any disease progression. Overall survival (OS) was defined from CART infusion to death. Local relapse-free survival (LRFS), calculated based on the total number of PR sites, was defined from CART infusion to local relapse (LR) in the PR site identified on day +30. cRT was defined as comprehensive (compRT) - treated all PR PET-avid sites - or focal (focRT). RESULTS Followingday +30 PET scan, 45 PR patients were observed and 15 received cRT. Only one patient received consolidative systemic therapy and belonged to the cRT group. Prior to CART, bridging RT was given to 13 patients (9 in observation group and 4 in cRT group). There were no significant differences in the pre-CART and day +30 baseline characteristics, including the median size and SUVmax of the PR sites, between the two groups. However, the median number of PR sites on day +30 was higher in the cRT group (2 [range 1-3] vs 1 [range 1-3], p = 0.003). The median equivalent 2 Gy dose was 39.1 (Interquartile range 36.8-41) Gy, and the most common cRT regimen was 37.5 Gy in 15 fractions. The median follow-up was 21 months. Among the observed patients, 15 (33%) achieved spontaneous CR, and 27 (60%) experienced disease progression with all relapses involving the initial PR sites. Among patients who received cRT, 10 (67%) achieved CR, and 3 (20%) had disease progression with no relapses in the radiated PR sites. None of the 10 cRT patients achieving CR relapsed or required subsequent therapies. The 2-year PFS was 80% and 37% (p = 0.012) and the 2-year OS was 78% and 43% (p = 0.12) in the cRT and observation groups, respectively. Patients consolidated with compRT (n = 12) had superior 2-year PFS (92% vs 37%, p = 0.003) and 2-year OS (86% vs 43%, p = 0.048) compared to observed or focRT patients (n = 48). There were no grade 3+ RT-related toxicities. A total of 90 PR sites were identified; 64 were observed and 26 received cRT. Fourteen (22%) observed PR sites achieved spontaneous sustained CR and 42 (66%) experienced LR. Twenty-four (92%) PR sites consolidated with cRT achieved sustained CR and none experienced LR. The 2-year LRFS was 100% in the cRT sites and 31% in the observed sites (p<0.001). CONCLUSION NHL patients who achieve PR by PET to CART are at high risk of local progression. cRT for residual PET-avid disease on day +30 post-CART appears to alter the pattern of relapse and improve LRFS and PFS.
Collapse
Affiliation(s)
- O Saifi
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - W G Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - W Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - B J Stish
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - A Rosenthal
- Division of Hematology, Mayo Clinic, Phoenix, AZ
| | - J Munoz
- Division of Hematology, Mayo Clinic, Phoenix, AZ
| | - Y Lin
- Division of Experimental Pathology, Mayo Clinic, Rochester, MN; Division of Hematology, Mayo Clinic, Rochester, MN
| | - P Johnston
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - S M Ansell
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - J Paludo
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - A Khurana
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | - Y Wang
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - M Iqbal
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - H S Murthy
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - B S Hoppe
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| |
Collapse
|
7
|
Saifi O, Rule WG, Lester SC, Laack NN, Breen W, Rosenthal A, Ansell SM, Habermann TM, Villasboas Bisneto J, Iqbal M, Alhaj Moustafa M, Tun H, Kharfan-Dabaja M, Peterson JL, Hoppe BS. The Role of Radiation Therapy in the Management of Gray Zone Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e484-e485. [PMID: 37785532 DOI: 10.1016/j.ijrobp.2023.06.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Gray zone lymphoma (GZL) is a relatively rare disease predominantly affecting young adults with purportedly poor outcomes with current treatment approaches. The role of radiation therapy (RT) in the management of GZL is not well established. This is the largest study to report on the outcomes of GZL patients treated with and without RT. MATERIALS/METHODS A retrospective review of 30 patients with GZL treated across 3 institutions from 2009 to 2021 was performed. Event-free survival (EFS) was defined from initiation of frontline chemotherapy (CHT) to disease progression/relapse, initiation of salvage therapy, or death. Local control (LC) was defined from RT start date to in-field recurrence. RESULTS The median age was 32 (range: 18-86) years, and 16 (53%) patients had early stage (I-II) disease. Bulky mediastinal disease was present in 63% of patients, and the median tumor diameter was 10 (range: 1.5-18) cm. Patients received ABVD (20%), RCHOP (33%), or REPOCH (47%) as frontline CHT. Among 25 patients with interim PET/CT scan, there were 6 rapid early responders and 14 slow early responders (SER), with 2-year EFS of 33% and 24%, respectively (p = 0.13). After the completion of CHT, 15 (50%) patients achieved complete response (CR) and 10 (33%) achieved partial response (PR), with 2-year EFS of 46% and 10%, respectively (p = 0.004). RT was given to 9 patients in CR (n = 3) or in PR (n = 6). The median RT dose was 36 (30.6-48.6) Gy, at 1.8-2 Gy/fraction. Those receiving RT had bulkier disease at diagnosis (p = 0.049) and lower rates of CR following CHT (p = 0.03). After RT, 3/6 (50%) PR patients converted to CR. At a median follow-up of 4 years, the 2-year EFS was 26% for all patients, 33% for RT and 23% for noRT (p = 0.44). Among patients who did not receive upfront RT and experienced progression (n = 17), 16 (94%) relapsed in pre-existing sites. The 5-year OS was 80% for all patients, 88% for RT and 78% for no RT (p = 0.63). Patients who achieved PR to CHT and received RT had better 2-year EFS (17% vs 0%, p = 0.007) compared to patients who did not receive RT. Similarly, patients with SER who received RT had superior 2-year EFS (33% vs 13%, p = 0.038). Patients with bulky mediastinal disease had a 2-year EFS of 43% with RT and 11% without RT (p = 0.08). After 1st line treatment, 22 (73%) patients relapsed and 18 were successfully salvaged with a sustained CR. The most common salvage regimen involved high dose CHT followed by hematopoietic cell transplantation (HCT) (n = 15). RT was given for 7 patients in the relapsed/refractory setting (consolidative peri-HCT n = 4; definitive salvage n = 3) and 5 (71%) achieved a sustained CR. Among the 16 patients who received RT in the upfront (n = 9) or salvage (n = 7) setting, 3 patients experienced in-field recurrence translating to 2-year LC of 79%. CONCLUSION GZL patients have high risk of relapse and maximal upfront combined modality therapy should be considered. RT provides good local control and improves EFS particularly for SER, PR, and bulky mediastinal disease.
Collapse
Affiliation(s)
- O Saifi
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - W G Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - N N Laack
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - W Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - A Rosenthal
- Division of Hematology, Mayo Clinic, Phoenix, AZ
| | - S M Ansell
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | - M Iqbal
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - H Tun
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - B S Hoppe
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| |
Collapse
|
8
|
Abdelhameed S, Samudio A, Rosenthal A, Davila H. Quantifying pubocervical fibromuscularis elasticity under normal and prolapse conditions by shear wave elastography and comparison with urodynamics findings. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
9
|
Flores J, Moriarty A, Lizette F, Lang A, Rosenthal A, Papadopoulos K, Beeram M, Patnaik A, Rasco D, DeBerry B, Elmi M, Drengler R, Hernandez T, Sharma M, Lakhani N, Smith L, Moreno V, Calvo E, Garcia-Foncillas J, Wick M. Identification and molecular characterization of invasive lobular breast cancer models in a panel of 180 breast XPDX models. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01121-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
10
|
Vega DM, Nishimura KK, Zariffa N, Thompson JC, Hoering A, Cilento V, Rosenthal A, Anagnostou V, Baden J, Beaver JA, Chaudhuri AA, Chudova D, Fine AD, Fiore J, Hodge R, Hodgson D, Hunkapiller N, Klass DM, Kobie J, Peña C, Pennello G, Peterman N, Philip R, Quinn KJ, Raben D, Rosner GL, Sausen M, Tezcan A, Xia Q, Yi J, Young AG, Stewart MD, Carpenter EL, Aggarwal C, Allen J. Changes in Circulating Tumor DNA Reflect Clinical Benefit Across Multiple Studies of Patients With Non-Small-Cell Lung Cancer Treated With Immune Checkpoint Inhibitors. JCO Precis Oncol 2022; 6:e2100372. [PMID: 35952319 PMCID: PMC9384957 DOI: 10.1200/po.21.00372] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 03/15/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE As immune checkpoint inhibitors (ICI) become increasingly used in frontline settings, identifying early indicators of response is needed. Recent studies suggest a role for circulating tumor DNA (ctDNA) in monitoring response to ICI, but uncertainty exists in the generalizability of these studies. Here, the role of ctDNA for monitoring response to ICI is assessed through a standardized approach by assessing clinical trial data from five independent studies. PATIENTS AND METHODS Patient-level clinical and ctDNA data were pooled and harmonized from 200 patients across five independent clinical trials investigating the treatment of patients with non-small-cell lung cancer with programmed cell death-1 (PD-1)/programmed death ligand-1 (PD-L1)-directed monotherapy or in combination with chemotherapy. CtDNA levels were measured using different ctDNA assays across the studies. Maximum variant allele frequencies were calculated using all somatic tumor-derived variants in each unique patient sample to correlate ctDNA changes with overall survival (OS) and progression-free survival (PFS). RESULTS We observed strong associations between reductions in ctDNA levels from on-treatment liquid biopsies with improved OS (OS; hazard ratio, 2.28; 95% CI, 1.62 to 3.20; P < .001) and PFS (PFS; hazard ratio 1.76; 95% CI, 1.31 to 2.36; P < .001). Changes in the maximum variant allele frequencies ctDNA values showed strong association across different outcomes. CONCLUSION In this pooled analysis of five independent clinical trials, consistent and robust associations between reductions in ctDNA and outcomes were found across multiple end points assessed in patients with non-small-cell lung cancer treated with an ICI. Additional tumor types, stages, and drug classes should be included in future analyses to further validate this. CtDNA may serve as an important tool in clinical development and an early indicator of treatment benefit.
Collapse
Affiliation(s)
| | | | | | - Jeffrey C. Thompson
- Division of Pulmonary, Allergy and Critical Care Medicine, Thoracic Oncology Group, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Antje Hoering
- Cancer Research And Biostatistics (CRAB), Seattle, WA
| | | | | | - Valsamo Anagnostou
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jonathan Baden
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ
| | - Julia A. Beaver
- Oncology Center of Excellence, Food and Drug Administration (FDA), Silver Spring, MD
| | - Aadel A. Chaudhuri
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
- Department of Computer Science and Engineering, Washington University, St Louis, MO
- Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
| | | | | | - Joseph Fiore
- Oncology Development, Bristol Myers Squibb, Princeton, NJ
| | - Rachel Hodge
- Late Oncology Statistics, Oncology Biometrics, AstraZeneca, Cambridge, United Kingdom
| | - Darren Hodgson
- Translational Medicine, Oncology Research & Development, AstraZeneca, Waltham, MA
| | - Nathan Hunkapiller
- GRAIL, Menlo Park, CA
- During the conduct of this work and development of the manuscript, N.H. was affiliated with GRAIL, Inc; however, is not affiliated with GRAIL, Inc at the time of submission
| | - Daniel M. Klass
- Assay Development, Roche Sequencing Solutions, Pleasanton, CA
| | - Julie Kobie
- Translational Oncology, Early Oncology Statistics, Merck Research Laboratories, Kenilworth, NJ
| | - Carol Peña
- Companion Diagnostics, Oncology Early Development, Merck Research Laboratories, Kenilworth, NJ
| | - Gene Pennello
- Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories, Food and Drug Administration (FDA), Silver Spring, MD
| | | | - Reena Philip
- Division of Molecular Genetics, Office of Health Technology 7 (In Vitro Diagnostics and Radiological Health), Food and Drug Administration (FDA), Silver Spring, MD
| | | | - David Raben
- Product Development Oncology, Genentech Inc, South San Francisco, CA
| | - Gary L. Rosner
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mark Sausen
- Translational Medicine, Bristol Myers Squibb, Princeton, NJ
| | | | - Qi Xia
- Product Development Data Sciences, Genentech Inc, South San Francisco, CA
| | - Jing Yi
- Product Development Oncology, Genentech Inc, South San Francisco, CA
| | - Amanda G. Young
- Research and Development, Foundation Medicine Inc, Cambridge, MA
| | | | - Erica L. Carpenter
- Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Charu Aggarwal
- Division of Hematology and Oncology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Jeff Allen
- Friends of Cancer Research, Washington, DC
| |
Collapse
|
11
|
Adriaenssens T, Van Vaerenbergh I, Reis M, Van Landuyt L, Verheyen G, Debrucker M, Camus M, Platteau P, De Vos M, Coucke W, Vanhecke E, Rosenthal A, Smitz J. P-251 Cumulus cell analysis as a non-invasive oocyte selection strategy to reduce the number of oocytes/embryos cultured and increase pregnancy rates. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Can non-invasive gene expression analysis of cumulus cells (CC) improve efficiency in ART by prioritizing oocytes for further culture and fresh single embryo transfer?
Summary answer
CC analysis can be used for the selective processing of oocytes. This may reduce culture work and improve the outcome in ICSI elective SETs (eSET).
What is known already
In an interventional, blinded, prospective cohort study (Van Vaerenbergh et al. 2021), 113 patients underwent a fresh Day3 eSET with embryos ranked and transferred based on morphology and CC gene expression (Aurora Test), while 520 control patients underwent a Day3 eSET without the Aurora Test. This resulted in a significant higher clinical pregnancy of 61% in the patients with eSET based on CC ranking applied on good morphology embryos, compared to 29% in the controls with eSET based on embryo morphology only. Live birth rate was also significantly increased, while time-to-pregnancy was significantly reduced with 3 transfer cycles.
Study design, size, duration
In a retrospective analysis, in a subset of patients with at least 6 growing follicles and at least five 2PN oocytes (n = 80), it was investigated whether the Aurora Test, used to select transferrable Day3-embryos, could also be applied to select oocytes on Day0/1. The effect of processing only the three highest ranked oocytes (based on the Aurora Test) on embryo development and clinical pregnancy was studied compared to processing all oocytes.
Participants/materials, setting, methods
Patients included in this single centre study had their first or second GnRH-antagonist ICSI cycle, were younger than 40y, had normal BMI, were stimulated with HP-hMG and scheduled for Day3 eSET. Two-sided statistical analysis (p < 0,05) was performed between a strategy of processing only the top 3 Aurora ranked oocytes, according to CC gene expression, and a strategy of processing all available oocytes.
Main results and the role of chance
On average, 8 MII oocytes were obtained per patient and the average fertilization rate was 83%. In total, 407 good quality embryos (GQE) on Day3 were generated from these 80 patients when utilising all 639 oocytes. Processing the three top-ranked oocytes only (240/639 oocytes) would have reduced the number of embryos to 169 GQE and would have resulted in 2.1 GQE on average on Day3 per patient; 75/80 (94%) patients would have had a fresh Day3 transfer resulting in a 63% clinical pregnancy rate. Processing all 639 available 2PN oocytes (standard of care) resulted in a fresh Day3 transfer in all 80 patients and a similar 64% clinical pregnancy rate (ns). However, 399 more oocytes would need to be processed. The strategy of restricting the number of oocytes to be processed would not have compromised cumulative cycle outcome. Considering all subsequent freeze/thawing cycles the cumulative clinical pregnancy rate calculated per all 80 patients would increase to 90%.
Limitations, reasons for caution
The limitation of this approach is that the Aurora Test requires individual oocyte denudation and individual oocyte vitrification. Secondly, this new strategy should be validated in a prospective study.
Wider implications of the findings
By applying this oocyte selection strategy patients would benefit from a high pregnancy rate in the fresh transfer cycle, while the lab would see reduction in embryo culture work, because freeze/thawing cycles and culture of embryos with lower competence would be prevented.
Trial registration number
NA
Collapse
Affiliation(s)
| | | | - M Reis
- Fertiga, Fertiga , Jette- Brussels, Belgium
| | | | - G Verheyen
- UZBrussel, Brussels IVF , Brussels, Belgium
| | | | - M Camus
- UZBrussel, Brussels IVF , Brussels, Belgium
| | - P Platteau
- UZBrussel, Brussels IVF , Brussels, Belgium
| | - M De Vos
- UZBrussel, Brussels IVF , Brussels, Belgium
| | - W Coucke
- Sciensano, Quality of Laboratories- , Brussels, Belgium
| | - E Vanhecke
- Fertiga, Fertiga , Jette- Brussels, Belgium
| | | | - J Smitz
- Fertiga, Fertiga , Jette- Brussels, Belgium
| |
Collapse
|
12
|
Joffe E, Nowakowski G, Tun H, Rosenthal A, Lunning M, Ramchandren R, Li CC, Zhou L, Martinez E, von Roemeling R, Earhart R, McMahon M, Isufi I, Leslie L. P1121: TAKEAIM LYMPHOMA- AN OPEN-LABEL, DOSE ESCALATION AND EXPANSION TRIAL OF EMAVUSERTIB (CA-4948) IN COMBINATION WITH IBRUTINIB IN PATIENTS WITH RELAPSED OR REFRACTORY HEMATOLOGIC MALIGNANCIES. Hemasphere 2022. [PMCID: PMC9430533 DOI: 10.1097/01.hs9.0000847352.16311.ea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
13
|
Risques R, Smith TH, Norgaard ZK, Katz R, Lo FY, Schmidt EK, Higgins JE, Filipits M, Labidi-Galy I, Cibula D, Dostálek L, Jelenek G, Plch M, Bouda J, Mustea A, Condic M, Grill S, Gleeson N, Oppelt P, Pristauz-Telsnigg G, Vanderstichele A, Obrecht S, Rosenthal A, Speiser P, Salk J. Abstract A008: TP53 field defects in uterine fluid are associated with ovarian cancer risk. Cancer Res 2022. [DOI: 10.1158/1538-7445.evodyn22-a008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract is being presented as a short talk in the scientific program. A full abstract is available in the Proffered Abstracts section (PR005) of the Conference Proceedings.
Citation Format: Rosana Risques, Thomas H. Smith, Zachary K. Norgaard, Roniz Katz, Fang Yin Lo, Elizabeth K. Schmidt, Jacob E. Higgins, Martin Filipits, Intidhar Labidi-Galy, David Cibula, Lukáš Dostálek, Gabriel Jelenek, Magdalena Plch, Jiří Bouda, Alexander Mustea, Mateja Condic, Sabine Grill, Noreen Gleeson, Peter Oppelt, Gunda Pristauz-Telsnigg, Adriaan Vanderstichele, Siel Obrecht, Adam Rosenthal, Paul Speiser, Jesse Salk. TP53 field defects in uterine fluid are associated with ovarian cancer risk [abstract]. In: Proceedings of the AACR Special Conference on the Evolutionary Dynamics in Carcinogenesis and Response to Therapy; 2022 Mar 14-17. Philadelphia (PA): AACR; Cancer Res 2022;82(10 Suppl):Abstract nr A008.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - David Cibula
- First Faculty of Medicine and General University Hospital, Prague, Czech Republic,
| | - Lukáš Dostálek
- First Faculty of Medicine and General University Hospital, Prague, Czech Republic,
| | | | - Magdalena Plch
- Masaryk Memorial Cancer Institute, Brno, Czech Republic,
| | - Jiří Bouda
- Charles University, Plzen, Czech Republic,
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Zhen DB, Whittle M, Ritch PS, Hochster HS, Coveler AL, George B, Hendifar AE, Dragovich T, Green S, Dion B, Stoll-D'Astice AC, Lee A, Thorsen SM, Rosenthal A, Hingorani SR, Chiorean EG. Phase II study of PEGPH20 plus pembrolizumab for patients (pts) with hyaluronan (HA)-high refractory metastatic pancreatic adenocarcinoma (mPC): PCRT16-001. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.4_suppl.576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
576 Background: Stromal HA poses a physical barrier and protects tumor cells from immune surveillance. PEGPH20 is a pegylated, human recombinant PH20 hyaluronidase that remodels tumor stroma. Preclinical studies of PEGPH20 showed improved infiltration of cytotoxic T-lymphocytes and delivery of chemotherapy and PD1/PD-L1 antibodies. This study aimed to evaluate the efficacy, safety, and translational biomarkers of PEGPH20 plus pembrolizumab in pts with HA-high refractory mPC. Methods: mPC pts with HA-high expression, ECOG PS 0-1, ≤ 2 prior therapies for metastatic disease, life expectancy ≥ 12 weeks were treated with PEGPH20 3 µg/kg iv on D1, D8, D15 and pembrolizumab 200 mg iv on D1 in 21-day cycles. Primary endpoint was progression-free survival (PFS). Secondary endpoints were safety, overall survival (OS), and objective response rate (ORR). Blood and tumor biopsies were collected at baseline and on-study. Translational endpoints included flow cytometry and IHC for immune subsets, T-cell receptor sequencing, immune transcriptome, circulating cytokines, and plasma and tumor HA levels. Assuming a one-sided α-level of 0.05 and power of 80%, 31 evaluable pts were needed to detect an improvement of median PFS from 3 to 6 months. Results: Between May 2019 to Nov 2019, 38 pts were screened for HA expression, and 8 pts were enrolled, with median age 68 years (range 60-73), 7 males, and median 2 prior therapies (range 1-4). The accrual was stopped early by Halozyme Pharmaceuticals due to lack of benefit from PEGPH20 added to chemotherapy in the HALO-301 study. Treatment exposure median was 2 cycles (range 1-6). Reasons for study discontinuation were disease progression (n = 4), termination by sponsor (n = 3), patient withdrawal to enroll in hospice (n = 1). Treatment related toxicities were musculoskeletal (n = 6, grade 1/2), edema (n = 2, grade 1), fatigue (n = 1, grade 3), dyspnea (n = 1, grade 2), hypothyroidism (n = 1, grade 2). Median OS was 7.2 months (95% CI 1.2-11.8), and median PFS was 1.5 months (95% CI 0.9-4.4). Best response was stable disease (n = 2, 25%) lasting 2.2 and 9 months, respectively, and no responses were noted. Patients with available molecular sequencing data had MSS tumors. Translational biomarkers will be presented. Conclusions: Pembrolizumab and PEGPH20 did not increase PFS compared to historical data among heavily pretreated mPC pts, but the median OS of 7.2 months is encouraging. Translational analyses will provide insights into immune modulatory effects from PEGPH20 that could inform future studies with stroma targeted therapies and immune checkpoint blockade in mPC. Clinical trial information: NCT03634332.
Collapse
Affiliation(s)
| | | | | | | | | | - Ben George
- Medical College of Wisconsin, Milwaukee, WI
| | | | | | | | | | | | - Arthur Lee
- Cancer Research and Biostatistics, Seattle, WA
| | | | | | | | | |
Collapse
|
15
|
Taaffe J, Croda J, Moultrie H, Silva DS, Rosenthal A, Farhat M. Advancing TB research using digitized programmatic data. Int J Tuberc Lung Dis 2021; 25:890-895. [PMID: 34686230 PMCID: PMC8544923 DOI: 10.5588/ijtld.21.0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The use of real-world data from national TB care programs has great potential to answer key research questions in TB control and is now opportune due to increasing digital data collection and storage. We summarize an expert stakeholder workshop conducted on this topic in October 2019, with perspectives from academics, national TB program officers, and data managers. We discuss challenges and opportunities in the use of TB programmatic data for research and describe digital data availability in two large, high TB burden countries, Brazil and South Africa. From this, we posit that with a standardized data collection set, improved data management, and greater collaboration, more TB programmatic data can be used for research with measurable public health impact.
Collapse
Affiliation(s)
- J Taaffe
- Office of Cyber Infrastructure and Computational Biology, Department of Health and Human Services, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - J Croda
- Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil, Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, NJ, USA, Oswaldo Cruz Foundation, Campo Grande, MS, Brazil
| | - H Moultrie
- National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - D S Silva
- Sydney Health Ethics, University of Sydney School of Public Health, Sydney, NSW, Australia
| | - A Rosenthal
- Office of Cyber Infrastructure and Computational Biology, Department of Health and Human Services, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - M Farhat
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, MA, USA
| |
Collapse
|
16
|
Saifi O, Breen W, Lester S, Rule W, Stish B, Rosenthal A, Munoz J, Murthy H, Lin Y, Kharfan-Dabaja M, Hoppe B, Peterson J. Radiation Therapy as Bridging Treatment to CAR T Cell Therapy in Non-Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Boyle EM, Rosenthal A, Wang Y, Farmer P, Rutherford M, Ashby C, Bauer M, Johnson SK, Wardell CP, Hoering A, Schinke C, Thanendrarajan S, Zangari M, Barlogie B, Davies FE, Walker BA, van Rhee F, Morgan GJ. High-risk transcriptional profiles in multiple myeloma are an acquired feature that can occur in any subtype and more frequently with each subsequent relapse. Br J Haematol 2021; 195:283-286. [PMID: 34244996 DOI: 10.1111/bjh.17670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eileen M Boyle
- Perlmutter Cancer Center, NYU Langone Medical Center, Myeloma Research Program, New York, NY, USA
| | | | - Yan Wang
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Philip Farmer
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michael Rutherford
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Cody Ashby
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michael Bauer
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sarah K Johnson
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Christopher P Wardell
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Antje Hoering
- Cancer Research and Biostatistics - CRAB, Seattle, USA
| | - Carolina Schinke
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Maurizio Zangari
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Bart Barlogie
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Faith E Davies
- Perlmutter Cancer Center, NYU Langone Medical Center, Myeloma Research Program, New York, NY, USA
| | - Brian A Walker
- Melvin and Bren Simon Comprehensive Cancer Center, Division of Hematology Oncology, Indiana University, Indianapolis, IN, USA
| | - Frits van Rhee
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Gareth J Morgan
- Perlmutter Cancer Center, NYU Langone Medical Center, Myeloma Research Program, New York, NY, USA
| |
Collapse
|
18
|
Joffe E, Ramchandren R, Nowakowski G, Rosenthal A, Tun HW, Lunning M, Mead MD, Martinez E, von Roemeling R, Leslie L. AN OPEN‐LABEL TRIAL OF ORAL CA‐4948 AN IRAK4 INHIBITOR COMBINED WITH IBRUTINIB IN ADULT PATIENTS WITH RELAPSED OR REFRACTORY HEMATOLOGIC MALIGNANCIES. Hematol Oncol 2021. [DOI: 10.1002/hon.169_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- E. Joffe
- Memorial Sloan Kettering Cancer Center Hematology Oncology‐ Lymphoma Services NY New York USA
| | - R. Ramchandren
- University of Tennessee Medical Center‐ University Cancer Specialists Hematology Medical Oncology Knoxville Tennessee USA
| | - G. Nowakowski
- Mayo Clinic‐Minnesota Rochester MN, Hematology ‐ Cancer Center Rochester Minnesota USA
| | - A. Rosenthal
- Mayo Clinic‐Arizona, Hematology Phoenix Arizona USA
| | - H. W. Tun
- Mayo Clinic Florida Hematology Oncology‐ Caner Center Jacksonville Florida USA
| | - M. Lunning
- University of Nebraska Division of Oncology & Hematology Omaha Nebraska USA
| | - M. D. Mead
- University of California Los Angeles‐ Santa Monica Medical Center Medicine, Hematology and Oncology Santa Monica California USA
| | - E. Martinez
- Curis, Clinical Development Lexington Massachusetts USA
| | | | - L. Leslie
- John Theurer Cancer Center Hackensack, NJ, Hematology Oncology Hackensack New Jersey USA
| |
Collapse
|
19
|
Tedeschi S, Pascart T, Latourte A, Godsave C, Kundaki B, Naden R, Taylor W, Dalbeth N, Neogi T, Perez-Ruiz F, Rosenthal A, Becce F, Pascual E, Andrés M, Bardin T, Doherty M, Ea HK, Filippou G, Fitzgerald J, Gutierrez M, Iagnocco A, Jansen T, Kohler M, Lioté F, Matza M, Mccarthy G, Ramonda R, Reginato A, Richette P, Singh J, Sivera F, So A, Stamp L, Yinh J, Yokose C, Terkeltaub R, Choi H, Abhishek A. POS1124 IDENTIFYING POTENTIAL CLASSIFICATION CRITERIA FOR CALCIUM PYROPHOSPHATE DEPOSITION DISEASE (CPPD): RESULTS FROM THE INITIAL PHASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Classification criteria for calcium pyrophosphate deposition disease (CPPD) will facilitate clinical research on this common crystalline arthritis. ACR/EULAR are jointly sponsoring development of CPPD classification criteria using a multi-phase process.Objectives:To report preliminary results from the first two phases of a four-phase process for developing CPPD classification criteria.Methods:CPPD classification criteria development is overseen by a 12-member Steering Committee. Item generation (Phase I) included a scoping literature review of five literature databases and contributions from a 35-member Combined Expert Committee and two Patient Research Partners. Item reduction and refinement (Phase II) involved a Combined Expert Committee meeting, discussions among Clinical, Imaging, and Laboratory Advisory Groups, and an item rating exercise to assess the influence of individual items toward classification. The Steering Committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development.Results:Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The Advisory Groups eliminated items they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases (see Table 1). As numerous imaging items were rated +3, the Steering Committee recommended focusing on imaging of the knee, wrist, and one additional affected joint for calcification suggestive of CPP crystal deposition.Conclusion:The ACR/EULAR CPPD classification criteria working group has adopted both data- and expert-driven approaches, leading to 56 candidate items broadly categorized as clinical, imaging, and laboratory features. Remaining steps for criteria development include domain establishment, item weighting through a multi-criteria decision analysis exercise, threshold score determination, and criteria validation.Table 1.Categories of items retained for future phases of classification criteria developmentAge in decade at symptom onsetAcute inflammatory arthritis (e.g. knee, wrist, 1st MTP joint*)Recurrence and pattern of joint involvement (e.g. 1 self-limited episode, >1 self-limited episode)Physical findings (e.g. palpable subcutaneous tophus*, psoriasis*)Co-morbidities and family history (e.g. Gitelman disease, hemochromatosis, familial CPPD)Osteoarthritis location and features (e.g. 2nd or 3rd MCP joint, wrist)Synovial fluid findings (e.g. CPP crystals present, CPP crystals absent on 1 occasion* or 2 occasions*, monosodium urate crystals present*)Laboratory findings (e.g. hypomagnesemia, hyperparathyroidism, rheumatoid factor*, anti-CCP*)Plain radiograph: calcification in regions of fibro- or hyaline cartilage+Plain radiograph: calcification of the synovial membrane/capsule/tendon+Conventional CT: calcification in regions of fibro- or hyaline cartilage+Conventional CT: calcification of the synovial membrane/capsule/tendon+Ultrasound: CPP crystal deposition in fibro- or hyaline cartilage+Ultrasound: CPP crystal deposition in synovial membrane/capsule/tendons+Dual-energy CT: CPP crystal deposition in fibro- or hyaline cartilage+Dual-energy CT: CPP crystal deposition in synovial membrane/capsule/tendon+*Potential negative predictor +Assessed in the knee, wrist, and/or 1 additional affected jointDisclosure of Interests:Sara Tedeschi Consultant of: NGM Biopharmaceuticals, Tristan Pascart: None declared, Augustin Latourte Consultant of: Novartis, Cattleya Godsave: None declared, Burak Kundaki: None declared, Raymond Naden: None declared, William Taylor: None declared, Nicola Dalbeth Speakers bureau: Abbvie and Janssen, Consultant of: AstraZeneca, Dyve, Selecta, Horizon, Arthrosi, and Cello Health, Tuhina Neogi: None declared, Fernando Perez-Ruiz: None declared, Ann Rosenthal: None declared, Fabio Becce Consultant of: Horizon Therapeutics, Grant/research support from: Siemens Healthineers, Eliseo Pascual: None declared, Mariano Andrés: None declared, Thomas Bardin: None declared, Michael Doherty: None declared, Hang Korng Ea: None declared, Georgios Filippou: None declared, John FitzGerald: None declared, Marwin Gutierrez: None declared, Annamaria Iagnocco: None declared, Tim Jansen Speakers bureau: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Consultant of: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Minna Kohler Speakers bureau: Lilly, Consultant of: Novartis, Frederic Lioté: None declared, Mark Matza: None declared, Geraldine McCarthy Consultant of: PK Med, Roberta Ramonda: None declared, Anthony Reginato: None declared, Pascal Richette: None declared, Jasvinder Singh Speakers bureau: Simply Speaking, Consultant of: Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, Francisca Sivera: None declared, Alexander So: None declared, Lisa Stamp: None declared, Janeth Yinh: None declared, Chio Yokose: None declared, Robert Terkeltaub Consultant of: Sobi, Horizon Therapeutics, Astra-Zeneca, Selecta, Grant/research support from: Astra-Zeneca, Hyon Choi: None declared, Abhishek Abhishek Consultant of: NGM Biopharmaceuticals.
Collapse
|
20
|
Rosenthal YS, Rosenthal A, Shalev Ram H, Ram S, Chodick G, Koren G. Association between oral contraceptives and serious infections: A population-based cohort study. Br J Clin Pharmacol 2021; 87:4241-4251. [PMID: 34018215 DOI: 10.1111/bcp.14840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/13/2020] [Accepted: 12/28/2020] [Indexed: 12/01/2022] Open
Abstract
AIMS Oral contraceptives (OC)s are commonly used worldwide. In a recent study, we showed that the use of OCs is associated with an increased risk for neutropenia. We aimed to investigate the clinical implications of this finding by examining the infection rates of 4 serious infections before, during and after OCs. METHODS A retrospective cohort study using the electronic medical records of a large health organization. We selected 2 retrospective cohorts of women aged 16-40 between years 2005 and 2019. The first cohort examined infection rates during 2 years before OC use and 2 consecutive years of adherent OC use. The second cohort included women who consumed OCs adherently for 2 years and then discontinued their use for 2 consecutive years. Women's infection rates were compared by χ2 test, results were stratified by OC type and age. RESULTS Overall, 21 595 and 20 728 women were included in Cohorts 1 and 2 respectively. We found a statistically significant higher relative risk for infection while using OCs; the overall risk ratios (95% confidence intervals) for infection in Cohorts 1 and 2 were 1.35 (1.32-1.38) and 1.27 (1.24-1.31), respectively. The overall infection risk remained statistically significant when stratified by age. CONCLUSIONS This study demonstrates a high statistically and clinically significant risk for all infections followed during OC consumption, which is likely to have major clinical and economic implications. These findings may have implications to millions of women worldwide and should lead to more research on the safety of the pill.
Collapse
Affiliation(s)
| | | | - Hila Shalev Ram
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shai Ram
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | |
Collapse
|
21
|
Cuming T, Cappello C, Bowring J, Chindawi N, Rosenthal A, Nathan M. Re: 'Outcomes following local excision of early anal squamous cell carcinomas of the anal canal and perianal margin'. Colorectal Dis 2021; 23:1268-1269. [PMID: 33529469 DOI: 10.1111/codi.15558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Tamzin Cuming
- Homerton Anogenital Neoplasia Service, Homerton University Hospital, London, UK
| | - Carmelina Cappello
- Homerton Anogenital Neoplasia Service, Homerton University Hospital, London, UK
| | - Julie Bowring
- Homerton Anogenital Neoplasia Service, Homerton University Hospital, London, UK
| | - Noreen Chindawi
- Homerton Anogenital Neoplasia Service, Homerton University Hospital, London, UK
| | - Adam Rosenthal
- Homerton Anogenital Neoplasia Service, Homerton University Hospital, London, UK.,Department of Gynaecology, University College Hospital London, London, UK
| | - Mayura Nathan
- Homerton Anogenital Neoplasia Service, Homerton University Hospital, London, UK
| |
Collapse
|
22
|
Danziger SA, McConnell M, Gockley J, Young MH, Rosenthal A, Schmitz F, Reiss DJ, Farmer P, Alapat DV, Singh A, Ashby C, Bauer M, Ren Y, Smith K, Couto SS, van Rhee F, Davies F, Zangari M, Petty N, Orlowski RZ, Dhodapkar MV, Copeland WB, Fox B, Hoering A, Fitch A, Newhall K, Barlogie B, Trotter MWB, Hershberg RM, Walker BA, Dervan AP, Ratushny AV, Morgan GJ. Bone marrow microenvironments that contribute to patient outcomes in newly diagnosed multiple myeloma: A cohort study of patients in the Total Therapy clinical trials. PLoS Med 2020; 17:e1003323. [PMID: 33147277 PMCID: PMC7641353 DOI: 10.1371/journal.pmed.1003323] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 09/18/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The tumor microenvironment (TME) is increasingly appreciated as an important determinant of cancer outcome, including in multiple myeloma (MM). However, most myeloma microenvironment studies have been based on bone marrow (BM) aspirates, which often do not fully reflect the cellular content of BM tissue itself. To address this limitation in myeloma research, we systematically characterized the whole bone marrow (WBM) microenvironment during premalignant, baseline, on treatment, and post-treatment phases. METHODS AND FINDINGS Between 2004 and 2019, 998 BM samples were taken from 436 patients with newly diagnosed MM (NDMM) at the University of Arkansas for Medical Sciences in Little Rock, Arkansas, United States of America. These patients were 61% male and 39% female, 89% White, 8% Black, and 3% other/refused, with a mean age of 58 years. Using WBM and matched cluster of differentiation (CD)138-selected tumor gene expression to control for tumor burden, we identified a subgroup of patients with an adverse TME associated with 17 fewer months of progression-free survival (PFS) (95% confidence interval [CI] 5-29, 49-69 versus 70-82 months, χ2 p = 0.001) and 15 fewer months of overall survival (OS; 95% CI -1 to 31, 92-120 versus 113-129 months, χ2 p = 0.036). Using immunohistochemistry-validated computational tools that identify distinct cell types from bulk gene expression, we showed that the adverse outcome was correlated with elevated CD8+ T cell and reduced granulocytic cell proportions. This microenvironment develops during the progression of premalignant to malignant disease and becomes less prevalent after therapy, in which it is associated with improved outcomes. In patients with quantified International Staging System (ISS) stage and 70-gene Prognostic Risk Score (GEP-70) scores, taking the microenvironment into consideration would have identified an additional 40 out of 290 patients (14%, premutation p = 0.001) with significantly worse outcomes (PFS, 95% CI 6-36, 49-73 versus 74-90 months) who were not identified by existing clinical (ISS stage III) and tumor (GEP-70) criteria as high risk. The main limitations of this study are that it relies on computationally identified cell types and that patients were treated with thalidomide rather than current therapies. CONCLUSIONS In this study, we observe that granulocyte signatures in the MM TME contribute to a more accurate prognosis. This implies that future researchers and clinicians treating patients should quantify TME components, in particular monocytes and granulocytes, which are often ignored in microenvironment studies.
Collapse
Affiliation(s)
- Samuel A. Danziger
- Bristol Myers Squibb, Seattle, Washington, United States of America
- * E-mail: (SAD); (AVR); (GJM)
| | - Mark McConnell
- Bristol Myers Squibb, Seattle, Washington, United States of America
| | - Jake Gockley
- Sage Bionetworks, Seattle, Washington, United States of America
| | - Mary H. Young
- Sage Bionetworks, Seattle, Washington, United States of America
| | - Adam Rosenthal
- Cancer Research and Biostatistics, Seattle, Washington, United States of America
| | - Frank Schmitz
- Sage Bionetworks, Seattle, Washington, United States of America
| | - David J. Reiss
- Bristol Myers Squibb, Seattle, Washington, United States of America
| | - Phil Farmer
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Daisy V. Alapat
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Amrit Singh
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Cody Ashby
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Michael Bauer
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Yan Ren
- Bristol Myers Squibb, Seattle, Washington, United States of America
| | - Kelsie Smith
- Bristol Myers Squibb, Seattle, Washington, United States of America
| | | | - Frits van Rhee
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Faith Davies
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Maurizio Zangari
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Nathan Petty
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Robert Z. Orlowski
- The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Madhav V. Dhodapkar
- Winship Cancer Institute, Emory University, Atlanta, Georgia, United States of America
| | | | - Brian Fox
- Bristol Myers Squibb, Seattle, Washington, United States of America
| | - Antje Hoering
- Cancer Research and Biostatistics, Seattle, Washington, United States of America
| | - Alison Fitch
- Bristol Myers Squibb, Seattle, Washington, United States of America
| | - Katie Newhall
- Sage Bionetworks, Seattle, Washington, United States of America
| | - Bart Barlogie
- Department of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | | | | | - Brian A. Walker
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | | | - Alexander V. Ratushny
- Bristol Myers Squibb, Seattle, Washington, United States of America
- * E-mail: (SAD); (AVR); (GJM)
| | - Gareth J. Morgan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
- * E-mail: (SAD); (AVR); (GJM)
| |
Collapse
|
23
|
Broome CM, Cunningham JM, Mullins M, Jiang X, Bylsma LC, Fryzek JP, Rosenthal A. Increased risk of thrombotic events in cold agglutinin disease: A 10-year retrospective analysis. Res Pract Thromb Haemost 2020; 4:628-635. [PMID: 32548562 PMCID: PMC7292660 DOI: 10.1002/rth2.12333] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 02/11/2020] [Accepted: 02/17/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia mediated by IgM autoantibodies that trigger hemolysis via classical complement pathway. Increased incidence of thrombotic events (TEs) has been reported in patients with other forms of hemolysis. The incidence of TEs in patients with CAD is unknown. OBJECTIVE Evaluate TE risk in patients with CAD. PATIENTS/METHODS This is a matched cohort comparison study evaluating the risk of TEs in patients with CAD and without CAD over a 10-year period. A total of 608 patients with CAD were identified in the Optum Claims-Clinical data set by reviewing clinical notes for CAD terms and matched with up to 10 patients without CAD (N = 5873). TEs were defined as the first medical claim for a TE using International Classification of Diseases, Ninth and Tenth Revision codes. Cox regression models were used to estimate time to first TE. Sensitivity analyses were conducted to estimate TE risk among patients with primary CAD. RESULTS At least 1 TE occurred in 29.6% of patients with CAD and 17.6% of patients without CAD. The proportion of patients experiencing venous, arterial, and cerebral TEs were each higher among CAD patients. The overall risk of having TEs was higher in patients with CAD (adjusted hazard ratio [aHR], 1.94; 95% confidence interval [CI], 1.64-2.30). Patients with presumed primary CAD also demonstrated an increased risk of TEs (aHR, 1.80; 95% CI, 1.46-2.22). Patients with CAD with the fewest comorbidities had 2.44-fold higher risk of having a TE (95% CI, 1.70-3.52). CONCLUSIONS Patients with CAD have an increased risk of TEs when compared with a matched non-CAD population.
Collapse
Affiliation(s)
- Catherine M. Broome
- Division of HematologyMedStar Georgetown University HospitalWashingtonDistrict of Columbia
| | - Julia M. Cunningham
- Division of HematologyMedStar Georgetown University HospitalWashingtonDistrict of Columbia
| | - Megan Mullins
- Department of EpidemiologySchool of Public HealthUniversity of MichiganAnn ArborMichigan
- EpidStrategies, A Division of ToxStrategies, Inc.Ann ArborMichigan
| | - Xiaohui Jiang
- EpidStrategies, A Division of ToxStrategies, Inc.Ann ArborMichigan
| | - Lauren C. Bylsma
- EpidStrategies, A Division of ToxStrategies, Inc.Ann ArborMichigan
| | - Jon P. Fryzek
- EpidStrategies, A Division of ToxStrategies, Inc.Ann ArborMichigan
| | | |
Collapse
|
24
|
Schraa O, Rosenthal A, Wade MJ, Rieger L, Miletić I, Alex J. Assessment of aeration control strategies for biofilm-based partial nitritation/anammox systems. Water Sci Technol 2020; 81:1757-1765. [PMID: 32644968 DOI: 10.2166/wst.2020.174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of this work was to compare the nitrogen removal in mainstream, biofilm-based partial nitritation anammox (PN/A) systems employing (1) constant setpoint dissolved oxygen (DO) control, (2) intermittent aeration, and (3) ammonia-based aeration control (ABAC). A detailed water resource recovery facility (WRRF) model was used to study the dynamic performance of these aeration control strategies with respect to treatment performance and energy consumption. The results show that constant setpoint DO control cannot meet typical regulatory limits for total ammonia nitrogen (NHx-N). Intermittent aeration shows improvement but requires optimisation of the aeration cycle. ABAC shows the best treatment performance with the advantages of continuous operation and over 20% lower average energy consumption as compared to intermittent aeration.
Collapse
Affiliation(s)
- O Schraa
- inCTRL Solutions Inc., Dundas, ON, Canada E-mail:
| | | | - M J Wade
- School of Engineering, Newcastle University, Newcastle-upon-Tyne, UK and Dept. of Mathematics and Statistics, McMaster University, Hamilton, ON, Canada
| | - L Rieger
- inCTRL Solutions Inc., Dundas, ON, Canada E-mail:
| | - I Miletić
- inCTRL Solutions Inc., Dundas, ON, Canada E-mail:
| | - J Alex
- ifak e.V., Magdeburg, Germany
| |
Collapse
|
25
|
Chiorean EG, Ritch PS, Zhen DB, Poplin E, George B, Hendifar AE, Dragovich T, Coveler AL, Stoll-D'Astice AC, Edwards S, Rosenthal A, Thorsen SM, Hingorani SR. PCRT16-001: Phase II study of PEGPH20 plus pembrolizumab for patients (pts) with hyaluronan (HA)-high refractory metastatic pancreatic ductal adenocarcinoma (mPDA). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.tps785] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS785 Background: PDA is characterized by invasiveness and therapeutic resistance in part due to a desmoplastic stroma and an immunosuppressive microenvironment ( Provenzano PP, Hingorani S. Br J Cancer 2013). PD1/PD-L1 inhibitors have no single agent activity in PDA, except for pts with mismatch repair defects. There is high need to overcome resistance to immune targeted therapies and develop biomarkers for pts selection. Stromal HA poses a physical barrier and protects tumor cells from immune surveillance ( Kultti A, et al Biomed Res Int 2014). By remodeling the tumor stroma, PEGPH20 allows infiltration of cytotoxic T lymphocytes, and improves delivery of chemotherapy and PD1/PD-L1 antibodies ( Singha NC, et al Mol Cancer Ther 2015). mPDA pts refractory to 1st line therapy have median overall survival (OS) of 6 mos. We hypothesize that stroma remodeling with PEGPH20 sensitizes PDA to immune therapy, and stroma and immunologic biomarkers will identify pts most likely to benefit. In this trial we will evaluate the efficacy, safety and translational biomarkers of PEGPH20 plus pembrolizumab in HA-high refractory mPDA. Methods: Eligible pts have ECOG PS 0-1, ≤ 2 prior therapies for mPDA, life expectancy ≥ 12 wks, able/willing to have tumor biopsies at baseline and after 6 wks of treatment. PEGPH20 dosing is 3 µg/kg iv QW and pembrolizumab 200 mg iv Q3W (2-4 hrs after PEGPH20 on wk 1) in 3-wk cycles. All pts receive prophylactic low molecular weight heparin. Primary endpoint: progression-free survival (PFS). Secondary endpoints: safety, OS, response rates. Translational endpoints: flow cytometry of peripheral and intratumoral immune cells, T-cell receptor sequencing, immune transcriptome, immune subsets IHC, circulating cytokines, serial plasma and tumor HA levels. For the primary endpoint of PFS, with a sample size of 31 evaluable pts, a one-sided α-level of 0.05, assuming 12 mos of accrual and 6 mos of follow-up, this study has 80% power to detect a difference between the null hypothesis median PFS 3 mos, versus the alternative hypothesis median PFS 6 mos. The study was activated in May 2019 and is open to accrual; 6 pts were enrolled as of 24Sept 2019. Clinical trial information: NCT03634332.
Collapse
Affiliation(s)
- E. Gabriela Chiorean
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | | | | | - Ben George
- Froedtert & the Medical College of Wisconsin, Milwaukee, WI
| | - Andrew Eugene Hendifar
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Boyle EM, Ashby C, Tytarenko RG, Deshpande S, Wang H, Wang Y, Rosenthal A, Sawyer J, Tian E, Flynt E, Hoering A, Johnson SK, Rutherford MW, Wardell CP, Bauer MA, Dumontet C, Facon T, Thanendrarajan S, Schinke CD, Zangari M, van Rhee F, Barlogie B, Cairns D, Jackson G, Thakurta A, Davies FE, Morgan GJ, Walker BA. BRAF and DIS3 Mutations Associate with Adverse Outcome in a Long-term Follow-up of Patients with Multiple Myeloma. Clin Cancer Res 2020; 26:2422-2432. [DOI: 10.1158/1078-0432.ccr-19-1507] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/11/2019] [Accepted: 01/22/2020] [Indexed: 11/16/2022]
|
27
|
Jameson GS, Borazanci E, Babiker HM, Poplin E, Niewiarowska AA, Gordon MS, Barrett MT, Rosenthal A, Stoll-D’Astice A, Crowley J, Shemanski L, Korn RL, Ansaldo K, Lebron L, Ramanathan RK, Von Hoff DD. Response Rate Following Albumin-Bound Paclitaxel Plus Gemcitabine Plus Cisplatin Treatment Among Patients With Advanced Pancreatic Cancer: A Phase 1b/2 Pilot Clinical Trial. JAMA Oncol 2020; 6:125-132. [PMID: 31580386 PMCID: PMC6777241 DOI: 10.1001/jamaoncol.2019.3394] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 06/20/2019] [Indexed: 01/05/2023]
Abstract
Importance Genomes of metastatic pancreatic cancers frequently contain intrachromosomal aberrations, indicating a DNA repair deficiency associated with sensitivity to DNA damaging agents, such as platinum. Objective To determine response rate following treatment with nab-paclitaxel plus gemcitabine plus platinum-based cisplatin for patients with metastatic pancreatic ductal adenocarcinoma (PDA). Design, Setting, and Participants This was a single-arm, open-label, phase 1b/2 clinical trial of nab-paclitaxel plus gemcitabine plus cisplatin treatment in which 25 patients with previously untreated metastatic PDA were enrolled. The trial was conducted from December 2013 to July 2016 at 3 US sites, with the last patient receiving study treatment at the end of October 2016, and the study closing January 2018. Interventions Patients were treated with nab-paclitaxel plus gemcitabine plus various doses of cisplatin, 25 mg/m2, 37.5 mg/m2, and 50 mg/m2, on days 1 and 8 of a 21-day cycle. Main Outcomes and Measures Primary end point was complete response rate as assessed by Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST), and levels of carbohydrate antigen 19-9 (or in nonexpressers, carbohydrate antigen 125 or carcinoembryonic antigen). Efficacy analysis included evaluable patients (those who received at least 1 dose of study treatment and had at least 1 postbaseline tumor assessment). Results Of 25 patients enrolled in the study, the median (range) age was 65.0 (47.0-79.0) years, 14 (56%) were men, and most (24) were white (96%). The maximum tolerable dose of cisplatin was 25 mg/m2. The most common treatment-related adverse events grade 3 or higher were thrombocytopenia (17 patients [68%]), anemia (8 patients [32%]), and neutropenia (6 patients [24%]). Fatal events occurred for 3 patients (12%); 2 were related to study participation. A median (range) of 8 (1-15) cycles was completed. The RECIST responses in 24 evaluable patients included 2 complete responses (8%), which was below the primary end point of 25%, 15 partial responses (62%), 4 stable disease (17%), and 3 progressive disease (12%), with median overall survival of 16.4 (95% CI, 10.2-25.3) months; 16 patients (64%) were alive at 1 year, 10 (40%) at 2 years, 4 (16%) at 3 years, and 1 (4%) at 4 plus years. Overall survival ranged from 36 to 59 months. Median progression-free survival was 10.1 (95% CI, 6.0-12.5) months. Thus, the overall response rate was 71%, and the disease control rate was 88%. Conclusions and Relevance This triple drug regimen showed substantial clinical activity in this small study. Although the primary end point was not reached, the high overall response rate, disease control rate, and median survival time among patients with advanced PDA treated with this combination are encouraging. The regimen is being studied in patients with PDA in the neoadjuvant setting and in patients with advanced biliary cancers. Trial Registration ClinicalTrials.gov identifier: NCT01893801.
Collapse
Affiliation(s)
- Gayle S. Jameson
- HonorHealth Research Institute, Scottsdale, Arizona
- Translational Genomics Research Institute, an Affiliate of City of Hope, Phoenix, Arizona
| | - Erkut Borazanci
- HonorHealth Research Institute, Scottsdale, Arizona
- Translational Genomics Research Institute, an Affiliate of City of Hope, Phoenix, Arizona
| | - Hani M. Babiker
- Translational Genomics Research Institute, an Affiliate of City of Hope, Phoenix, Arizona
- Comprehensive Cancer Center, The University of Arizona, Tucson
| | | | | | | | | | | | | | - John Crowley
- Cancer Research And Biostatistics, Seattle, Washington
| | | | | | | | | | | | - Daniel D. Von Hoff
- HonorHealth Research Institute, Scottsdale, Arizona
- Translational Genomics Research Institute, an Affiliate of City of Hope, Phoenix, Arizona
| |
Collapse
|
28
|
Jackson AS, Rosenthal A, Cattoni M, Bograd AJ, Farivar AS, Aye RW, Vallières E, Louie BE. Staging System for Neuroendocrine Tumors of the Lung Needs to Incorporate Histologic Grade. Ann Thorac Surg 2019; 109:1009-1018. [PMID: 31706866 DOI: 10.1016/j.athoracsur.2019.09.053] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 08/21/2019] [Accepted: 09/13/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Neuroendocrine tumors of the lung are staged with the American Joint Committee on Cancer (AJCC) TNM system for non-small cell lung cancer. However neuroendocrine tumors have a distinct clinical behavior with grade providing critical prognostic information. We aim to determine components of a tumor-specific staging system. METHODS We identified 12,415 of 58,736 neuroendocrine patients with complete 8th edition AJCC staging information in the National Cancer Database from 2004 to 2014. Data were randomized into training (n = 8324) and validation (n = 4091) sets and analyzed separately. Recursive partitioning followed by Cox regression was performed to classify by grade (G1, typical carcinoid; G2, atypical carcinoid; G3, large cell neuroendocrine), T category, and nodal status. Overall survival according to individual grade and an integrated grade-specific staging was compared by Kaplan-Meier analysis. RESULTS Overall 7524 G1, 1211 G2, and 3680 G3 tumors were analyzed with no differences between sets. Each grade was separately classified by the AJCC TNM system with poor separation of the curves and clustered survival. Recursive partitioning identified grade as the most significant factor driving overall survival. Subsequent partitions identified nodal status and then T category as additional important factors, consistent with results from the Cox regression analysis (G2 hazard ratio, 3.05 [95% confidence interval, 2.65-3.5]; G3 hazard ratio, 9.03 [95% confidence interval, 8.22-9.92]). When grade was integrated with nodal status and T category to approximate a tumor-specific staging system, distinct overall survival stratification occurred at each proposed stage. CONCLUSIONS Grade was the dominant driver of prognosis in patients with neuroendocrine tumors of the lung. Incorporation of grade with traditional TNM parameters better discriminates between stage categories compared with current AJCC staging. Future staging systems for neuroendocrine tumors of the lung should include histologic grade.
Collapse
Affiliation(s)
| | | | - Maria Cattoni
- Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Adam J Bograd
- Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington
| | | | - Ralph W Aye
- Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington
| | - Eric Vallières
- Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington
| | - Brian E Louie
- Division of Thoracic Surgery, Swedish Cancer Institute, Seattle, Washington.
| |
Collapse
|
29
|
Crosbie EJ, Ryan NAJ, Arends MJ, Bosse T, Burn J, Cornes JM, Crawford R, Eccles D, Frayling IM, Ghaem-Maghami S, Hampel H, Kauff ND, Kitchener HC, Kitson SJ, Manchanda R, McMahon RFT, Monahan KJ, Menon U, Møller P, Möslein G, Rosenthal A, Sasieni P, Seif MW, Singh N, Skarrott P, Snowsill TM, Steele R, Tischkowitz M, Evans DG. The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome. Genet Med 2019; 21:2390-2400. [PMID: 30918358 PMCID: PMC6774998 DOI: 10.1038/s41436-019-0489-y] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [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] [Received: 11/22/2018] [Accepted: 03/06/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE There are no internationally agreed upon clinical guidelines as to which women with gynecological cancer would benefit from Lynch syndrome screening or how best to manage the risk of gynecological cancer in women with Lynch syndrome. The Manchester International Consensus Group was convened in April 2017 to address this unmet need. The aim of the Group was to develop clear and comprehensive clinical guidance regarding the management of the gynecological sequelae of Lynch syndrome based on existing evidence and expert opinion from medical professionals and patients. METHODS Stakeholders from Europe and North America worked together over a two-day workshop to achieve consensus on best practice. RESULTS Guidance was developed in four key areas: (1) whether women with gynecological cancer should be screened for Lynch syndrome and (2) how this should be done, (3) whether there was a role for gynecological surveillance in women at risk of Lynch syndrome, and (4) what preventive measures should be recommended for women with Lynch syndrome to reduce their risk of gynecological cancer. CONCLUSION This document provides comprehensive clinical guidance that can be referenced by both patients and clinicians so that women with Lynch syndrome can expect and receive appropriate standards of care.
Collapse
Affiliation(s)
- Emma J Crosbie
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK.
- Directorate of Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
- Prevention Early Detection Theme, NIHR Biomedical Research Centre, The Christie NHS Foundation Trust, Manchester, UK.
| | - Neil A J Ryan
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
- Division of Evolution and Genomic Medicine, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Mark J Arends
- Division of Pathology & Centre for Comparative Pathology, Cancer Research UK Edinburgh Centre, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Tjalling Bosse
- Pathology Department, Leiden University Medical Center, Leiden, the Netherlands
| | - John Burn
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | - Robin Crawford
- Department of Gynaecological Oncology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Diana Eccles
- Faculty of Medicine, University of Southampton, University Hospital Southampton, Southampton, UK
| | - Ian M Frayling
- Institute of Cancer and Genetics, Cardiff University, Cardiff, UK
| | | | - Heather Hampel
- Division of Human Genetics, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Noah D Kauff
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Henry C Kitchener
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Sarah J Kitson
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
| | - Ranjit Manchanda
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Raymond F T McMahon
- Department of Histopathology, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, London, UK
| | - Pål Møller
- Department of Tumor Biology, Institute of Cancer Research, The Norwegian Radium Hospital, part of Oslo University Hospital, Oslo, Norway
- Research Group Inherited Cancer, Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- Center for Hereditary Tumors, Helios University Hospital Wuppertal, University of Witten-, Herdecke, Germany
| | - Gabriela Möslein
- Center for Hereditary Tumors, Helios University Hospital Wuppertal, University of Witten-, Herdecke, Germany
| | - Adam Rosenthal
- Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK
| | - Peter Sasieni
- School of Cancer and Pharmaceutical Sciences, Kings College London, London, UK
| | - Mourad W Seif
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St Mary's Hospital, Manchester, UK
- Directorate of Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Naveena Singh
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - Pauline Skarrott
- Lynch Syndrome UK, Linden House, 9/11 Main Street, Ingleton, Carnforth, UK
| | - Tristan M Snowsill
- Peninsula Technology Assessment Group (PenTAG), University of Exeter, Exeter, UK
- Health Economics Group, University of Exeter, Exeter, UK
| | - Robert Steele
- Division of Cancer, Medical Research Institute, Ninewells Hospital and Medical School, Dundee, UK
| | - Marc Tischkowitz
- Academic Laboratory of Medical Genetics, University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, UK
| | - D Gareth Evans
- Prevention Early Detection Theme, NIHR Biomedical Research Centre, The Christie NHS Foundation Trust, Manchester, UK
- Division of Evolution and Genomic Medicine, University of Manchester, St Mary's Hospital, Manchester, UK
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
30
|
Howe R, Bartholdy B, Schinke C, Rosenthal A, Lagano A, Parekh S, Steidl U. 2024 - DEFICIENCY OF THE NOVEL TUMOR SUPPRESSOR C15ORF65 CAUSES MULTIPLE MYELOMA AND PLASMA CELL MALIGNANCY. Exp Hematol 2019. [DOI: 10.1016/j.exphem.2019.06.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
31
|
Rosenthal YS, Chodick G, Rosenthal A, Shalev V, Ram HS, Koren G. Oral Contraceptives and Neutropenia: A Population-Based Cohort Study. Clin Drug Investig 2019; 39:927-930. [DOI: 10.1007/s40261-019-00818-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
32
|
Mikulasova A, Ashby C, Tytarenko RG, Qu P, Rosenthal A, Dent JA, Ryan KR, Bauer MA, Wardell CP, Hoering A, Mavrommatis K, Trotter M, Deshpande S, Yaccoby S, Tian E, Keats J, Auclair D, Jackson GH, Davies FE, Thakurta A, Morgan GJ, Walker BA. Microhomology-mediated end joining drives complex rearrangements and overexpression of MYC and PVT1 in multiple myeloma. Haematologica 2019; 105:1055-1066. [PMID: 31221783 PMCID: PMC7109748 DOI: 10.3324/haematol.2019.217927] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/13/2019] [Indexed: 12/22/2022] Open
Abstract
MYC is a widely acting transcription factor and its deregulation is a crucial event in many human cancers. MYC is important biologically and clinically in multiple myeloma, but the mechanisms underlying its dysregulation are poorly understood. We show that MYC rearrangements are present in 36.0% of newly diagnosed myeloma patients, as detected in the largest set of next generation sequencing data to date (n=1,267). Rearrangements were complex and associated with increased expression of MYC and PVT1, but not other genes at 8q24. The highest effect on gene expression was detected in cases where the MYC locus is juxtaposed next to super-enhancers associated with genes such as IGH, IGK, IGL, TXNDC5/BMP6, FAM46C and FOXO3. We identified three hotspots of recombination at 8q24, one of which is enriched for IGH-MYC translocations. Breakpoint analysis indicates primary myeloma rearrangements involving the IGH locus occur through non-homologous end joining, whereas secondary MYC rearrangements occur through microhomology-mediated end joining. This mechanism is different to lymphomas, where non-homologous end joining generates MYC rearrangements. Rearrangements resulted in overexpression of key genes and chromatin immunoprecipitation-sequencing identified that HK2, a member of the glucose metabolism pathway, is directly over-expressed through binding of MYC at its promoter.
Collapse
Affiliation(s)
- Aneta Mikulasova
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA.,Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Cody Ashby
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ruslana G Tytarenko
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pingping Qu
- Cancer Research and Biostatistics, Seattle, WA, USA
| | | | - Judith A Dent
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Katie R Ryan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michael A Bauer
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | | | - Matthew Trotter
- Celgene Institute for Translational Research Europe, Seville, Spain
| | - Shayu Deshpande
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Shmuel Yaccoby
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Erming Tian
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jonathan Keats
- Translational Genomics Research Institute, Phoenix, AZ, USA
| | | | - Graham H Jackson
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Faith E Davies
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Gareth J Morgan
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Brian A Walker
- Myeloma Center, University of Arkansas for Medical Sciences, Little Rock, AR, USA .,Division of Hematology Oncology, Indiana University, Indianapolis, IN, USA
| |
Collapse
|
33
|
Tinguely R, Rosenthal A, Simpson R, Ballinger S, Creely A, Frank S, Kuang A, Linehan B, McCarthy W, Milanese L, Montes K, Mouratidis T, Picard J, Rodriguez-Fernandez P, Sandberg A, Sciortino F, Tolman E, Zhou M, Sorbom B, Hartwig Z, White A. Neutron diagnostics for the physics of a high-field, compact, Q ≥ 1 tokamak. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
34
|
Rosenthal A, Stoddard M, Chipps L, Herrmann J. Skin cancer prevention: a review of current topical options complementary to sunscreens. J Eur Acad Dermatol Venereol 2019; 33:1261-1267. [PMID: 30801825 DOI: 10.1111/jdv.15522] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 01/29/2019] [Indexed: 02/04/2023]
Abstract
The incidence of non-melanoma skin cancer (NMSC) is dramatically increasing worldwide, despite the increased use of improved sunscreens. In 2014, the Surgeon General estimated that 2.2-5.0 million people were treated annually for NMSC. As the number of newly diagnosed skin cancers continues to rise, there is a need for additional preventative measures beyond sunscreens. Several newer topical products that focus on boosting DNA repair, modulating DNA transcription, decreasing inflammation and selectively targeting precancerous cells may play an important role in future skin cancer prevention.
Collapse
Affiliation(s)
- A Rosenthal
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.,Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology, Beverly Hills, CA, USA
| | - M Stoddard
- Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology, Beverly Hills, CA, USA
| | - L Chipps
- Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology, Beverly Hills, CA, USA.,Department of Dermatology, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - J Herrmann
- Research Department, Moy-Fincher-Chipps Facial Plastics & Dermatology, Beverly Hills, CA, USA.,Department of Dermatology, Harbor-UCLA Medical Center, Torrance, CA, USA
| |
Collapse
|
35
|
Korducki J, Tidemann A, Tarima S, Grindel S, Urbain J, Mickschl D, Rosenthal A, Burns E. NATURAL INTERFACES FOR EVALUATION AND MANAGEMENT OF SHOULDER DYSFUNCTION. Innov Aging 2018. [DOI: 10.1093/geroni/igy031.3641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | - J Urbain
- Milwaukee School of Engineering University
| | | | | | - E Burns
- Medical College Of Wisconsin
| |
Collapse
|
36
|
Walker BA, Mavrommatis K, Wardell CP, Ashby TC, Bauer M, Davies F, Rosenthal A, Wang H, Qu P, Hoering A, Samur M, Towfic F, Ortiz M, Flynt E, Yu Z, Yang Z, Rozelle D, Obenauer J, Trotter M, Auclair D, Keats J, Bolli N, Fulciniti M, Szalat R, Moreau P, Durie B, Stewart AK, Goldschmidt H, Raab MS, Einsele H, Sonneveld P, San Miguel J, Lonial S, Jackson GH, Anderson KC, Avet-Loiseau H, Munshi N, Thakurta A, Morgan G. A high-risk, Double-Hit, group of newly diagnosed myeloma identified by genomic analysis. Leukemia 2018; 33:159-170. [PMID: 29967379 PMCID: PMC6326953 DOI: 10.1038/s41375-018-0196-8] [Citation(s) in RCA: 272] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 06/07/2018] [Indexed: 12/26/2022]
Abstract
Patients with newly diagnosed multiple myeloma (NDMM) with high-risk disease are in need of new treatment strategies to improve the outcomes. Multiple clinical, cytogenetic, or gene expression features have been used to identify high-risk patients, each of which has significant weaknesses. Inclusion of molecular features into risk stratification could resolve the current challenges. In a genome-wide analysis of the largest set of molecular and clinical data established to date from NDMM, as part of the Myeloma Genome Project, we have defined DNA drivers of aggressive clinical behavior. Whole-genome and exome data from 1273 NDMM patients identified genetic factors that contribute significantly to progression free survival (PFS) and overall survival (OS) (cumulative R2 = 18.4% and 25.2%, respectively). Integrating DNA drivers and clinical data into a Cox model using 784 patients with ISS, age, PFS, OS, and genomic data, the model has a cumlative R2 of 34.3% for PFS and 46.5% for OS. A high-risk subgroup was defined by recursive partitioning using either a) bi-allelic TP53 inactivation or b) amplification (≥4 copies) of CKS1B (1q21) on the background of International Staging System III, comprising 6.1% of the population (median PFS = 15.4 months; OS = 20.7 months) that was validated in an independent dataset. Double-Hit patients have a dire prognosis despite modern therapies and should be considered for novel therapeutic approaches.
Collapse
Affiliation(s)
- Brian A Walker
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Christopher P Wardell
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - T Cody Ashby
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Michael Bauer
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Faith Davies
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Hongwei Wang
- Cancer Research and Biostatistics, Seattle, WA, USA
| | - Pingping Qu
- Cancer Research and Biostatistics, Seattle, WA, USA
| | | | - Mehmet Samur
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Maria Ortiz
- Celgene Institute of Translational Research Europe, Sevilla, Spain
| | | | | | | | | | | | - Matthew Trotter
- Celgene Institute of Translational Research Europe, Sevilla, Spain
| | | | - Jonathan Keats
- Translational Genomics Research Institute, Phoenix, AZ, USA
| | | | | | - Raphael Szalat
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Brian Durie
- Cedars-Sinai Samuel Oschin Cancer Center, Los Angeles, CA, USA
| | | | - Hartmut Goldschmidt
- Department of Medicine V, Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Marc S Raab
- Department of Medicine V, Hematology and Oncology, University Hospital of Heidelberg, Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Heidelberg, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, Wurzburg University, Wurzburg, Germany
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Jesus San Miguel
- Clinica Universidad de Navarra, Centro Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC, Pamplona, Spain
| | - Sagar Lonial
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | | | | | - Herve Avet-Loiseau
- Centre de Recherche en Cancérologie de Toulouse Institut National de la Santé et de la Recherche Médicale, U1037, Toulouse, France.,L'Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire, Toulouse, France
| | - Nikhil Munshi
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Gareth Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| |
Collapse
|
37
|
Davies FE, Rosenthal A, Rasche L, Petty NM, McDonald JE, Ntambi JA, Steward DM, Panozzo SB, van Rhee F, Zangari M, Schinke CD, Thanendrarajan S, Walker B, Weinhold N, Barlogie B, Hoering A, Morgan GJ. Treatment to suppression of focal lesions on positron emission tomography-computed tomography is a therapeutic goal in newly diagnosed multiple myeloma. Haematologica 2018; 103:1047-1053. [PMID: 29567784 PMCID: PMC6058800 DOI: 10.3324/haematol.2017.177139] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 03/08/2018] [Indexed: 01/07/2023] Open
Abstract
Fluorine-18 fluorodeoxyglucose positron emission tomography with computed tomography attenuation correction (PET-CT) in myeloma can detect and enumerate focal lesions by the quantitative characterization of metabolic activity. The aim of this study was to determine the prognostic significance of the suppression of PET-CT activity at a number of time points post therapy initiation: day 7, post induction, post transplant, and at maintenance therapy. As part of the TT4-6 trial series, 596 patients underwent baseline PET-CT and were evaluated serially during their disease course using peak standardized uptake values above background red marrow signal. We demonstrate that the presence of more than 3 focal lesions at presentation identifies a group of patients with an adverse progression-free survival and overall survival. At day 7 of therapy, patients with complete focal lesion signal suppression revert to the same prognosis as those with no lesions at diagnosis. At later time points, the continued suppression of signal remains prognostically important. We conclude that for newly diagnosed patients with focal lesions, treatment until these lesions are suppressed is an important therapeutic goal as the prognosis of these patients is the same as those without lesions at diagnosis. (clinicaltrials.gov identifiers: 00734877, 02128230, 00869232, 00871013).
Collapse
Affiliation(s)
- Faith E Davies
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Leo Rasche
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Nathan M Petty
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - James E McDonald
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - James A Ntambi
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Doug M Steward
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Susan B Panozzo
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Frits van Rhee
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Maurizio Zangari
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Carolina D Schinke
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Brian Walker
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Niels Weinhold
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Bart Barlogie
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Gareth J Morgan
- Myeloma Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
38
|
Kiechl S, Schramek D, Widschwendter M, Fourkala EO, Zaikin A, Jones A, Jaeger B, Rack B, Janni W, Scholz C, Willeit J, Weger S, Mayr A, Teschendorff A, Rosenthal A, Fraser L, Philpott S, Dubeau L, Keshtgar M, Roylance R, Jacobs IJ, Menon U, Schett G, Penninger JM. Aberrant regulation of RANKL/OPG in women at high risk of developing breast cancer. Oncotarget 2018; 8:3811-3825. [PMID: 28002811 PMCID: PMC5354797 DOI: 10.18632/oncotarget.14013] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/05/2016] [Indexed: 12/17/2022] Open
Abstract
Breast cancer is the most common female cancer, affecting approximately one in eight women during their lifetime in North America and Europe. Receptor Activator of NF-kB Ligand (RANKL), its receptor RANK and the natural antagonist osteoprotegerin (OPG) are essential regulators of bone resorption. We have initially shown that RANKL/RANK are essential for hormone-driven mammary epithelial proliferation in pregnancy and RANKL/RANK have been implicated in mammary stem cell biology. Using genetic mouse-models, we and others identified the RANKL/RANK system as a key regulator of sex hormone, BRCA1-mutation, and oncogene-driven breast cancer and we proposed that RANKL/RANK might be involved in the initiation of breast tumors. We now report that in postmenopausal women without known genetic predisposition, high RANKL and progesterone serum levels stratify a subpopulation of women at high risk of developing breast cancer 12-24 months before diagnosis (5.33-fold risk, 95%CI 1.5-25.4; P=0.02). In women with established breast cancer, we demonstrate that RANKL/OPG ratios change dependent on the presence of circulating tumor cells (CTCs). Finally, we show in a prospective human breast cancer cohort that alterations in RANKL/OPG ratios are significantly associated with breast cancer manifestation. These data indicate that the RANKL/RANK/OPG system is deregulated in post-menopausal women at high risk for breast cancer and in women with circulating tumor cells. Thus, serum levels of RANKL/OPG are potentially indicative of predisposition and progression of breast cancer in humans. Advancement of our findings towards clinical application awaits prior validation in independent patient cohorts.
Collapse
Affiliation(s)
- Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Daniel Schramek
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna, Austria.,The Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Martin Widschwendter
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom
| | - Evangelia-Ourania Fourkala
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom
| | - Alexey Zaikin
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom.,Department of Mathematics, University College London, London, United Kingdom
| | - Allison Jones
- Department of Mathematics, University College London, London, United Kingdom
| | - Bernadette Jaeger
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom
| | - Brigitte Rack
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Duesseldorf, Duesseldorf, Germany
| | | | - Johann Willeit
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Siegfried Weger
- Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
| | - Agnes Mayr
- Department of Internal Medicine, Bruneck Hospital, Bruneck, Italy
| | - Andrew Teschendorff
- Statistical Genomics Group, Paul O'Gorman Building, UCL Cancer Institute, University College London, London, United Kingdom
| | - Adam Rosenthal
- Barts Cancer Institute CR UK Centre of Excellence, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Lindsay Fraser
- Department of Mathematics, University College London, London, United Kingdom
| | - Susan Philpott
- Department of Mathematics, University College London, London, United Kingdom
| | - Louis Dubeau
- Department of Pathology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Mohammed Keshtgar
- Department of Surgery, Royal Free and University College London Medical School, London, United Kingdom
| | - Rebecca Roylance
- Barts Cancer Institute CR UK Centre of Excellence, Queen Mary University of London, Charterhouse Square, London, United Kingdom
| | - Ian J Jacobs
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom.,UNSW Australia, Sydney, New South Wales, Australia
| | - Usha Menon
- Department of Women's Cancer, EGA Institute of Women's Health, University College London, London, United Kingdom
| | - Georg Schett
- Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Josef M Penninger
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna, Austria
| |
Collapse
|
39
|
Jiang J, Adams H, Lange M, Siemann S, Feldkamp M, Schulze S, Froehler S, Yaung S, Yao L, Balasubramanyam A, Tikoo N, Achenbach H, Krügel R, Palma J, Rosenthal A. OA 10.06 Longitudinal Mutation Monitoring in Plasma by Deep Sequencing as a Potential Predictor of Disease Progression in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
40
|
Rosenthal A, Lange M, Beckert S, Hinzmann B, Woestmann C, Wehnl B, Schneider M, Meister M, Thomas M, Muley T, Warth A, Froehler S, Palma J, Herth F. P1.15-011 Longitudinal Mutation Monitoring in Plasma Without Matching Tumor Tissue by Deep Sequencing in Small Cell Lung Cancer (SCLC). J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
41
|
Maritschnegg E, Obermayr E, Holzer B, Gleeson N, Heitz F, Massuger L, Telsnigg GP, Rosenthal A, Trillsch F, Nieuwenhuysen EV, Zikan M, Speiser P, Zeillinger R. Abstract DPOC-009: DETECTION OF A CLINICALLY OCCULT OVARIAN CARCINOMA BY NEW DIAGNOSTIC TOOLS – A CASE REPORT. Clin Cancer Res 2017. [DOI: 10.1158/1557-3265.ovcasymp16-dpoc-009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
75% of ovarian cancer (OC) cases are detected at an advanced stage. State–of–the–art diagnostic tools don't show sufficient sensitivity, especially in diagnosing early–stage disease. Still, due to lack in alternatives, these methods are used for monitoring BRCA mutation carriers, who face a high penetrance of OC.
A 41–year old BRCA1 mutation carrier decided to undergo risk–reducing bilateral salpingo–oophorectomy (rrBSO), currently the only effective way of reducing the OC risk. The day before surgery, 20ml of peripheral blood were drawn to test for the presence of circulating tumor cells (CTCs) by applying a microfluidic device (Parsortix system) and subsequent qPCR. Furthermore, a lavage of the uterine cavity was performed as previously described. According to state–of–the–art techniques, no signs of cancer were present. However, microscopic malignant lesions at both ovaries and the right diaphragm were observed, and final histopathology revealed FIGO IIIB serous OC. Multiple precursor lesions (STICs) were observed in the fallopian tube. qPCR of preoperative enriched cell fraction indicated the presence of CTCs. Analysis of the lavage sample using TP53 mutation analysis revealed 17% mutant allelic fraction. The same mutation was identified in different STIC and invasive lesions.
This case shows that early detection of high–grade serous OC does not necessarily translate into a stage shift, but easier to resect disease. Considering the lag–time between STIC to clinically–overt OC development, both described methods present an opportunity for monitoring high–risk patients to delay rrBSO. Both methods proved to be able to diagnose occult OC, and even carry the potential of detecting STICs.
Citation Format: Elisabeth Maritschnegg, Eva Obermayr, Barbara Holzer, Noreen Gleeson, Florian Heitz, Leon Massuger, Gunda Pristauz Telsnigg, Adam Rosenthal, Fabian Trillsch, Els Van Nieuwenhuysen, Michael Zikan, Paul Speiser, Robert Zeillinger. DETECTION OF A CLINICALLY OCCULT OVARIAN CARCINOMA BY NEW DIAGNOSTIC TOOLS – A CASE REPORT [abstract]. In: Proceedings of the 11th Biennial Ovarian Cancer Research Symposium; Sep 12-13, 2016; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2017;23(11 Suppl):Abstract nr DPOC-009.
Collapse
Affiliation(s)
| | - Eva Obermayr
- 1Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Barbara Holzer
- 1Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Noreen Gleeson
- 2Department of Gynecology, St James's Hospital, Dublin, Ireland
| | - Florian Heitz
- 3Department of Gynaecology and Gynaecologic Oncology, Kliniken Essen Mitte, Essen, Germany
| | - Leon Massuger
- 4Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Adam Rosenthal
- 6Department of Women's Cancer, University College London, London, UK
| | - Fabian Trillsch
- 7Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg–Eppendorf, Hamburg, Germany
| | | | - Michael Zikan
- 9Department of Obstetrics and Gynecology, Charles University, Prague, Czech Republic
| | - Paul Speiser
- 1Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| | - Robert Zeillinger
- 1Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
42
|
Wells GF, Shi Y, Laureni M, Rosenthal A, Szivák I, Weissbrodt DG, Joss A, Buergmann H, Johnson DR, Morgenroth E. Comparing the Resistance, Resilience, and Stability of Replicate Moving Bed Biofilm and Suspended Growth Combined Nitritation-Anammox Reactors. Environ Sci Technol 2017; 51:5108-5117. [PMID: 28374996 DOI: 10.1021/acs.est.6b05878] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Combined partial nitritation-anammox (PN/A) systems are increasingly being employed for sustainable removal of nitrogen from wastewater, but process instabilities present ongoing challenges for practitioners. The goal of this study was to elucidate differences in process stability between PN/A process variations employing two distinct aggregate types: biofilm [in moving bed biofilm reactors (MBBRs)] and suspended growth biomass. Triplicate reactors for each process variation were studied under baseline conditions and in response to a series of transient perturbations. MBBRs displayed elevated NH4+ removal rates relative to those of suspended growth counterparts over six months of unperturbed baseline operation but also exhibited significantly greater variability in performance. Transient perturbations led to strikingly divergent yet reproducible behavior in biofilm versus suspended growth systems. A temperature perturbation prompted a sharp reduction in NH4+ removal rates with no accumulation of NO2- and rapid recovery in MBBRs, compared to a similar reduction in NH4+ removal rates but a high level of accumulation of NO2- in suspended growth reactors. Pulse additions of a nitrification inhibitor (allylthiourea) prompted only moderate declines in performance in suspended growth reactors compared to sharp decreases in NH4+ removal rates in MBBRs. Quantitative fluorescence in situ hybridization demonstrated a significant enrichment of anammox in MBBRs compared to suspended growth reactors, and conversely a proportionally higher AOB abundance in suspended growth reactors. Overall, MBBRs displayed significantly increased susceptibility to transient perturbations employed in this study compared to that of suspended growth counterparts (stability parameter), including significantly longer recovery times (resilience). No significant difference in the maximal impact of perturbations (resistance) was apparent. Taken together, our results suggest that aggregate architecture (biofilm vs suspended growth) in PN/A processes exerts an unexpectedly strong influence on process stability.
Collapse
Affiliation(s)
- G F Wells
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
- Department of Civil and Environmental Engineering, Northwestern University , Evanston, Illinois 60208, United States
| | - Y Shi
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
- Department of Environmental Science and Engineering, Shandong University , Jinan, China
| | - M Laureni
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
- Institute of Environmental Engineering, ETH Zürich , 8093 Zürich, Switzerland
| | - A Rosenthal
- Department of Civil and Environmental Engineering, Northwestern University , Evanston, Illinois 60208, United States
| | - I Szivák
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
| | - D G Weissbrodt
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
- Institute of Environmental Engineering, ETH Zürich , 8093 Zürich, Switzerland
| | - A Joss
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
| | - H Buergmann
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
| | - D R Johnson
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
- Department of Environmental Systems Science, ETH Zürich , 8093 Zürich, Switzerland
| | - E Morgenroth
- Eawag, Swiss Federal Institute of Aquatic Science and Technology , 8600 Dübendorf, Switzerland
- Institute of Environmental Engineering, ETH Zürich , 8093 Zürich, Switzerland
| |
Collapse
|
43
|
Jameson GS, Borazanci EH, Babiker HM, Poplin E, Niewiarowska AA, Gordon MS, Barrett MT, Ansaldo K, Lebron L, Stoll AC, Rosenthal A, Shemanski LR, Korn RL, Ramanathan RK, Von Hoff DD. A phase Ib/II pilot trial with nab-paclitaxel plus gemcitabine plus cisplatin in patients (pts) with stage IV pancreatic cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.341] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
341 Background: Genomes of metastatic pancreatic cancers frequently contain intrachromosomal aberrations indicating DNA repair abnormalities associated with sensitivity to DNA damaging agents such as the platinums. Cisplatin was added to a nab-paclitaxel + gemcitabine regimen, which has been determined to improve survival over gemcitabine alone (NEJM 2013; 369:1691-1703). The objectives are to determine the efficacy and safety of nab-paclitaxel and gemcitabine plus cisplatin in patients with Stage IV pancreatic cancer. Methods: Eligibility criteria included Stage IV adenocarcinoma of the pancreas, no prior chemotherapy for systemic disease, KPS ≥ 70; life expectancy ≥ 12 weeks and measurable disease. Doses are nab-paclitaxel 125 mg/m2 undiluted, gemcitabine 1000 mg/m2 in 500 ml of normal saline (NS), each infused over 30 minutes on days 1 and 8 of a 21 day cycle, along with 3 different dose levels of cisplatin (25, 37.5 or 50 mg/m2) in 500 ml of NS infused over 60 minutes, after the nab-paclitaxel infusion. Pre and post cisplatin hydration was given. The maximum tolerated dose and phase II dose of cisplatin is 25 mg/m2. Results: 25 pts were treated; 24 were evaluable (baseline and ≥ 1 follow up CT scan). The most common drug related grade (gr) 3 - 4 adverse events (AEs), n = 25, were thrombocytopenia 76% (gr 3 = 36%, gr 4 = 40%) with no serious bleeding events, anemia 32% (gr 3 = 32%, gr 4 = 0%), neutropenia 24% (gr 3 = 20%, gr 4 = 4%), infection 20% (gr 3 = 16%, gr 4 = 4%), and diarrhea 16% (gr 3 = 16%, gr 4 = 0%). Peripheral neuropathy ≥ gr 3 was seen in only 1 pt (gr 3 = 4%). Grade 5 AEs were infection (1), cardiac arrest (1), and stroke (1). Median time on therapy was 5.5 months, range (1 – 9.5). By RECIST 1.1 criteria, 2 pts had complete response (8.3%), 15 partial response (62.5%), 4 stable disease (16.7%), and 3 progressive disease (12.5%). Median overall survival to date as of 11/10/16 is 16.5 months. Conclusions: Although a small study, the high response rate and landmark evolving median survival are very encouraging. This regimen is being expanded in patients with stage IV pancreatic cancer, neoadjuvant and adjuvant settings. Clinical trial information: NCT01893801.
Collapse
Affiliation(s)
| | | | | | | | | | - Michael S. Gordon
- Pinnacle Oncology Hematology/Honor Health Research Institute, Scottsdale, AZ
| | | | | | | | | | | | | | | | | | - Daniel D. Von Hoff
- Translational Genomics Research Institute (TGen) and HonorHealth, Phoenix and Scottsdale, AZ
| |
Collapse
|
44
|
Speiser S, Geisler S, Speiser L, Heinze G, Rosenthal A, Speiser P. Short-term Efficacy of trichloroacetic acid in the treatment of cervical intraepithelial neoplasia. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1582214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
45
|
Wick MJ, Vaught T, Meade J, Gamez L, Farley M, Tolcher AW, Rasco D, Patnaik A, Drengler RL, Rosenthal A, Papadopoulos KP. Abstract P3-03-05: Establishment and evaluation of ER+ breast cancer models using an optimized methodology for exogenous hormone delivery. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-03-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Preclinical in vivo models of estrogen receptor positive (ER+) breast cancer rely on exogenous supplementation of hormones for growth. This requirement leads to animal toxicity and mortality over time, limiting development and drug testing in these types of models. Efficacy of test agents, particularly endocrine therapies, may also be altered in these models due to excessive hormone exposure, highlighting the need to improve methods for the establishment and testing of ER+ breast models.
We have developed an alternative method of hormone supplementation in ER+ breast cancer models and optimized this method for testing of endocrine therapies. Using two cell-based breast models, we demonstrated improved breast tumor take and time to tumor volume endpoint while reducing animal toxicity and mortality associated with standard hormone supplementation. Subsequent studies identified the lowest effective dose (LED) of supplement for hormone dependent model growth with a preclinically relevant time to tumor volume endpoint. Activity of endocrine therapies including tamoxifen, letrozole, fulvestrant and exemestane were compared at the standard and LED hormone concentrations. In these studies tamoxifen treatment resulted in tumor regressions which was not appreciably improved using the LED dose of supplement. However letrozole activity was improved in the LED study suggesting hormone supplementation can impact activity of some agents. Using this process we also generated a panel of ER+ patient-derived xenograft (PDX) models, including two novel hormone therapy responsive models from chemo-naïve or hormone therapy pretreated patients, designated ST986 and ST2177, respectively.
This improved method of hormone supplementation diminishes the adverse effects of standard hormone supplementation and provides utility for development of anticancer therapies in ER+ breast models.
Citation Format: Wick MJ, Vaught T, Meade J, Gamez L, Farley M, Tolcher AW, Rasco D, Patnaik A, Drengler RL, Rosenthal A, Papadopoulos KP. Establishment and evaluation of ER+ breast cancer models using an optimized methodology for exogenous hormone delivery. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-03-05.
Collapse
Affiliation(s)
- MJ Wick
- START, San Antonio, TX; START Center, San Antonio, TX
| | - T Vaught
- START, San Antonio, TX; START Center, San Antonio, TX
| | - J Meade
- START, San Antonio, TX; START Center, San Antonio, TX
| | - L Gamez
- START, San Antonio, TX; START Center, San Antonio, TX
| | - M Farley
- START, San Antonio, TX; START Center, San Antonio, TX
| | - AW Tolcher
- START, San Antonio, TX; START Center, San Antonio, TX
| | - D Rasco
- START, San Antonio, TX; START Center, San Antonio, TX
| | - A Patnaik
- START, San Antonio, TX; START Center, San Antonio, TX
| | - RL Drengler
- START, San Antonio, TX; START Center, San Antonio, TX
| | - A Rosenthal
- START, San Antonio, TX; START Center, San Antonio, TX
| | | |
Collapse
|
46
|
Rosenthal A, Luthi J, Belohlavek M, Kortüm KM, Mookadam F, Mayo A, Fonseca R, Bergsagel PL, Reeder CB, Mikhael JR, Stewart AK. Carfilzomib and the cardiorenal system in myeloma: an endothelial effect? Blood Cancer J 2016; 6:e384. [PMID: 26771810 PMCID: PMC4742629 DOI: 10.1038/bcj.2015.112] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 11/30/2015] [Accepted: 12/04/2015] [Indexed: 11/09/2022] Open
Abstract
Carfilzomib (Cfz) has been associated with an ~5% incidence of unexplained and unpredictable cardiovascular toxicity in clinical trials. We therefore implemented a detailed, prospective, clinical cardiac and renal evaluation of 62 Cfz-treated myeloma patients, including serial blood pressure (BP), creatinine, troponin, NT-proBNP and pre- and post-treatment echocardiograms, including ejection fraction (EF), average global longitudinal strain and compliance. Pre-treatment elevations in NT-proBNP and BP, as well as abnormal cardiac strain were common. A rise in NT-proBNP occurred frequently post-treatment often without corresponding cardiopulmonary symptoms. A rise in creatinine was common, lessened with hydration and often reversible. All patients had a normal EF pre-treatment. Five patients experienced a significant cardiac event (four decline in EF and one myocardial infarction), of which 2 (3.2%) were considered probably attributable to Cfz. None were rechallenged with Cfz. The ideal strategy for identifying patients at risk for cardiac events, and parameters by which to monitor for early toxicity have not been established; however, it appears baseline echocardiographic testing is not consistently predictive of toxicity. The toxicities observed suggest an endothelial mechanism and further clinical trials are needed to determine whether or not this represents a class effect or is Cfz specific.
Collapse
Affiliation(s)
- A Rosenthal
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - J Luthi
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - M Belohlavek
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - K M Kortüm
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - F Mookadam
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - A Mayo
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - R Fonseca
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - P L Bergsagel
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - C B Reeder
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - J R Mikhael
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - A K Stewart
- Division of Hematology Oncology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| |
Collapse
|
47
|
Song H, Dicks E, Ramus SJ, Tyrer JP, Intermaggio MP, Hayward J, Edlund CK, Conti D, Harrington P, Fraser L, Philpott S, Anderson C, Rosenthal A, Gentry-Maharaj A, Bowtell DD, Alsop K, Cicek MS, Cunningham JM, Fridley BL, Alsop J, Jimenez-Linan M, Høgdall E, Høgdall CK, Jensen A, Kjaer SK, Lubiński J, Huzarski T, Jakubowska A, Gronwald J, Poblete S, Lele S, Sucheston-Campbell L, Moysich KB, Odunsi K, Goode EL, Menon U, Jacobs IJ, Gayther SA, Pharoah PDP. Contribution of Germline Mutations in the RAD51B, RAD51C, and RAD51D Genes to Ovarian Cancer in the Population. J Clin Oncol 2015; 33:2901-7. [PMID: 26261251 PMCID: PMC4554751 DOI: 10.1200/jco.2015.61.2408] [Citation(s) in RCA: 227] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The aim of this study was to estimate the contribution of deleterious mutations in the RAD51B, RAD51C, and RAD51D genes to invasive epithelial ovarian cancer (EOC) in the population and in a screening trial of individuals at high risk of ovarian cancer. PATIENTS AND METHODS The coding sequence and splice site boundaries of the three RAD51 genes were sequenced and analyzed in germline DNA from a case-control study of 3,429 patients with invasive EOC and 2,772 controls as well as in 2,000 unaffected women who were BRCA1/BRCA2 negative from the United Kingdom Familial Ovarian Cancer Screening Study (UK_FOCSS) after quality-control analysis. RESULTS In the case-control study, we identified predicted deleterious mutations in 28 EOC cases (0.82%) compared with three controls (0.11%; P < .001). Mutations in EOC cases were more frequent in RAD51C (14 occurrences, 0.41%) and RAD51D (12 occurrences, 0.35%) than in RAD51B (two occurrences, 0.06%). RAD51C mutations were associated with an odds ratio of 5.2 (95% CI, 1.1 to 24; P = .035), and RAD51D mutations conferred an odds ratio of 12 (95% CI, 1.5 to 90; P = .019). We identified 13 RAD51 mutations (0.65%) in unaffected UK_FOCSS participants (RAD51C, n = 7; RAD51D, n = 5; and RAD51B, n = 1), which was a significantly greater rate than in controls (P < .001); furthermore, RAD51 mutation carriers were more likely than noncarriers to have a family history of ovarian cancer (P < .001). CONCLUSION These results confirm that RAD51C and RAD51D are moderate ovarian cancer susceptibility genes and suggest that they confer levels of risk of EOC that may warrant their use alongside BRCA1 and BRCA2 in routine clinical genetic testing.
Collapse
Affiliation(s)
- Honglin Song
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Ed Dicks
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Susan J Ramus
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jonathan P Tyrer
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Maria P Intermaggio
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jane Hayward
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Christopher K Edlund
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - David Conti
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Patricia Harrington
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Lindsay Fraser
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Susan Philpott
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Christopher Anderson
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Adam Rosenthal
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Aleksandra Gentry-Maharaj
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - David D Bowtell
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Kathryn Alsop
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Mine S Cicek
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Julie M Cunningham
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Brooke L Fridley
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jennifer Alsop
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Mercedes Jimenez-Linan
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Estrid Høgdall
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Claus K Høgdall
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Allan Jensen
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Susanne Krüger Kjaer
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jan Lubiński
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Tomasz Huzarski
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Anna Jakubowska
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Jacek Gronwald
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Samantha Poblete
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Shashi Lele
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Lara Sucheston-Campbell
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Kirsten B Moysich
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Kunle Odunsi
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Ellen L Goode
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Usha Menon
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Ian J Jacobs
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| | - Simon A Gayther
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY.
| | - Paul D P Pharoah
- Honglin Song, Ed Dicks, Jonathan P. Tyrer, Patricia Harrington, Jennifer Alsop, and Paul D.P. Pharoah, University of Cambridge; Mercedes Jimenez-Linan, Addenbrooke's Hospital, Cambridge; Jane Hayward, Lindsay Fraser, Susan Philpott, Christopher Anderson, Adam Rosenthal, Aleksandra Gentry-Maharaj, Usha Menon, and Ian J. Jacobs, University College London; David D. Bowtell, Imperial College London, London; Ian J. Jacobs, University of Manchester and Manchester Academic Health Science Centre, Manchester, United Kingdom; Susan J. Ramus, Maria P. Intermaggio, Christopher K. Edlund, David Conti, and Simon A. Gayther, University of Southern California, Los Angeles, CA; David D. Bowtell and Kathryn Alsop, Peter MacCallum Cancer Centre, East Melbourne; David D. Bowtell, University of Melbourne, Melbourne, Victoria, Australia; Mine S. Cicek, Julie M. Cunningham, and Ellen L. Goode, Mayo Clinic, Rochester, MN; Brooke L. Fridley, University of Kansas Medical Center, Kansas City, KS; Estrid Høgdall, Allan Jensen, and Susanne Krüger, Danish Cancer Society Research Center; Estrid Høgdall, Herlev Hospital, University of Copenhagen; Claus K. Høgdall and Susanne Krüger, Rigshospitalet, Copenhagen, Denmark; Jan Lubiński, Tomasz Huzarski, Anna Jakubowska, and Jacek Gronwald, Pomeranian Medical University, Szczecin, Poland; and Samantha Poblete, Shashi Lele, Lara Sucheston-Campbell, Kirsten B. Moysich, and Kunle Odunsi, Roswell Park Cancer Institute, Buffalo, NY
| |
Collapse
|
48
|
Jameson GS, Borazanci E, Poplin E, Barrett MT, Crowley J, Rosenthal A, Stoll-D'Astice A, Ansaldo KL, Boone S, Lebron L, Ramanathan RK, Korn RL, Von Hoff DD. Abstract LB-003: High complete and partial response rate in a phase Ib pilot trial with cisplatin plus albumin-bound paclitaxel and gemcitabine in patients with advanced pancreatic cancer. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-lb-003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The genomes of metastatic pancreatic cancers contain a myriad of intrachromosomal aberrations indicating a likely high prevalence of DNA repair deficiencies indicating sensitivity to DNA damaging agents such as the platinum’s. Because of this, the drug cisplatin was added to an albumin-bound paclitaxel + gemcitabine regimen, which has already been determined to improve survival over gemcitabine alone in a randomized phase III trial (NEJM 2013; 369:1691-1703).
Objectives: To determine the efficacy and safety of albumin-bound paclitaxel and gemcitabine plus cisplatin for patients with advanced pancreatic cancer
Methods: Eligibility criteria included Stage IV pancreatic cancer, no prior chemotherapy for systemic disease, KPS ≥ 70; life expectancy ≥ 12 weeks and measurable disease. The doses were albumin-bound paclitaxel 125 mg/m2 undiluted, gemcitabine 1000 mg/m2 in 500 ml of normal saline (NS), each infused over 30 minutes on days 1 and 8 of a 21 day cycle, along with 3 different dose levels of cisplatin (25, 37.5 or 50 mg/m2) in 500 ml of NS infused over 60 minutes, after the nab-paclitaxel infusion. Pre and post cisplatin hydration was given.
Results: To date, 10 patients have been entered on study with all patients being evaluable, (baseline and at least one follow up CT scans completed). There have been 2 complete responses (20%), 6 partial responses (PR), (60%), 1 stable disease (10%), and 1 patient with progressive disease (10%), by RECIST 1.1 criteria. An exponential decrease in CA19-9 correlating with the t1/2 of the marker was noted. Response was seen rapidly with PR observed at the first staging evaluation at 9 weeks in 7 of 10 patients. The 8th patient achieved a PR at 18 weeks. Serious adverse events occurred in 4 patients: non-neutropenic sepsis/pneumonia (n = 1), and non-neutropenic bacteremia (n = 1) in the cisplatin 25 mg/m2 cohort; clostridium difficile colitis (n = 1) with cisplatin 37.5 mg/m2; and neutropenic fever/pneumonia (n = 1) with cisplatin 50mg/m2.
Discussion: The study has completed phase Ib and will be expanded at the phase II dose of cisplatin 25 mg/m2 for a total of 25 patients. If this favorable response rate is confirmed, this 3 drug regimen could be further developed both for patients with advanced disease as well as in neoadjuvant and adjuvant settings.
Supported by grants from the Seena Magowitz Foundation and the SU2C Dream Team
Citation Format: Gayle S. Jameson, Erkut Borazanci, Elizabeth Poplin, Michael T. Barrett, John Crowley, Adam Rosenthal, Amy Stoll-D'Astice, Karen L. Ansaldo, Steven Boone, Leticia Lebron, Ramesh K. Ramanathan, Ronald L. Korn, Daniel D. Von Hoff. High complete and partial response rate in a phase Ib pilot trial with cisplatin plus albumin-bound paclitaxel and gemcitabine in patients with advanced pancreatic cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-003. doi:10.1158/1538-7445.AM2015-LB-003
Collapse
Affiliation(s)
- Gayle S. Jameson
- 1Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | - Erkut Borazanci
- 1Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | | | | | | | | | | | - Karen L. Ansaldo
- 1Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | - Steven Boone
- 1Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | - Leticia Lebron
- 1Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | | | - Ronald L. Korn
- 1Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| | - Daniel D. Von Hoff
- 5TGen/Virginia G Piper Cancer Center at Scottsdale Healthcare, Scottsdale, AZ
| |
Collapse
|
49
|
Khan R, Dhodapkar M, Rosenthal A, Heuck C, Papanikolaou X, Qu P, van Rhee F, Zangari M, Jethava Y, Epstein J, Yaccoby S, Hoering A, Crowley J, Petty N, Bailey C, Morgan G, Barlogie B. Four genes predict high risk of progression from smoldering to symptomatic multiple myeloma (SWOG S0120). Haematologica 2015; 100:1214-21. [PMID: 26022710 DOI: 10.3324/haematol.2015.124651] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 05/21/2015] [Indexed: 11/09/2022] Open
Abstract
Multiple myeloma is preceded by an asymptomatic phase, comprising monoclonal gammopathy of uncertain significance and smoldering myeloma. Compared to the former, smoldering myeloma has a higher and non-uniform rate of progression to clinical myeloma, reflecting a subset of patients with higher risk. We evaluated the gene expression profile of smoldering myeloma plasma cells among 105 patients enrolled in a prospective observational trial at our institution, with a view to identifying a high-risk signature. Baseline clinical, bone marrow, cytogenetic and radiologic data were evaluated for their potential to predict time to therapy for symptomatic myeloma. A gene signature derived from four genes, at an optimal binary cut-point of 9.28, identified 14 patients (13%) with a 2-year therapy risk of 85.7%. Conversely, a low four-gene score (< 9.28) combined with baseline monoclonal protein < 3 g/dL and albumin ≥ 3.5 g/dL identified 61 patients with low-risk smoldering myeloma with a 5.0% chance of progression at 2 years. The top 40 probe sets showed concordance with indices of chromosome instability. These data demonstrate high discriminatory power of a gene-based assay and suggest a role for dysregulation of mitotic checkpoints in the context of genomic instability as a hallmark of high-risk smoldering myeloma.
Collapse
Affiliation(s)
- Rashid Khan
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Christoph Heuck
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Xenofon Papanikolaou
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pingping Qu
- Cancer Research And Biostatistics, Seattle, WA, USA
| | - Frits van Rhee
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Maurizio Zangari
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Yogesh Jethava
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Joshua Epstein
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Shmuel Yaccoby
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - John Crowley
- Cancer Research And Biostatistics, Seattle, WA, USA
| | - Nathan Petty
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Clyde Bailey
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Gareth Morgan
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Bart Barlogie
- Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
50
|
Heuck CJ, Weinhold N, Thanendrarajan S, Stein CK, Van Rhee F, Rosenthal A, Jethava Y, Khan R, Hoering A, Davies FE, Barlogie B, Morgan GJ. Impact of total therapies on clinical outcome of myeloma stratified by risk and molecular subgroups. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.8586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Niels Weinhold
- Myeloma Institute for Research and Therapy, Little Rock, AR
| | | | | | - Frits Van Rhee
- University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Yogesh Jethava
- University of Arkansas for Medical Sciences, Little Rock, AR
| | - Rashid Khan
- University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Faith E Davies
- Myeloma Institute for Research and Therapy, Little Rock, AR
| | | | - Gareth John Morgan
- Centre for Myeloma Research, Institute of Cancer Research, London, United Kingdom
| |
Collapse
|