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Darst BF, Shen J, Madduri RK, Rodriguez AA, Xiao Y, Sheng X, Saunders EJ, Dadaev T, Brook MN, Hoffmann TJ, Muir K, Wan P, Le Marchand L, Wilkens L, Wang Y, Schleutker J, MacInnis RJ, Cybulski C, Neal DE, Nordestgaard BG, Nielsen SF, Batra J, Clements JA, Cancer BioResource AP, Grönberg H, Pashayan N, Travis RC, Park JY, Albanes D, Weinstein S, Mucci LA, Hunter DJ, Penney KL, Tangen CM, Hamilton RJ, Parent MÉ, Stanford JL, Koutros S, Wolk A, Sørensen KD, Blot WJ, Yeboah ED, Mensah JE, Lu YJ, Schaid DJ, Thibodeau SN, West CM, Maier C, Kibel AS, Cancel-Tassin G, Menegaux F, John EM, Grindedal EM, Khaw KT, Ingles SA, Vega A, Rosenstein BS, Teixeira MR, Kogevinas M, Cannon-Albright L, Huff C, Multigner L, Kaneva R, Leach RJ, Brenner H, Hsing AW, Kittles RA, Murphy AB, Logothetis CJ, Neuhausen SL, Isaacs WB, Nemesure B, Hennis AJ, Carpten J, Pandha H, De Ruyck K, Xu J, Razack A, Teo SH, Newcomb LF, Fowke JH, Neslund-Dudas C, Rybicki BA, Gamulin M, Usmani N, Claessens F, Gago-Dominguez M, Castelao JE, Townsend PA, Crawford DC, Petrovics G, Casey G, Roobol MJ, Hu JF, Berndt SI, Van Den Eeden SK, Easton DF, Chanock SJ, Cook MB, Wiklund F, Witte JS, Eeles RA, Kote-Jarai Z, Watya S, Gaziano JM, Justice AC, Conti DV, Haiman CA. Evaluating approaches for constructing polygenic risk scores for prostate cancer in men of African and European ancestry. Am J Hum Genet 2023; 110:1200-1206. [PMID: 37311464 PMCID: PMC10357473 DOI: 10.1016/j.ajhg.2023.05.010] [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: 01/20/2022] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
Genome-wide polygenic risk scores (GW-PRSs) have been reported to have better predictive ability than PRSs based on genome-wide significance thresholds across numerous traits. We compared the predictive ability of several GW-PRS approaches to a recently developed PRS of 269 established prostate cancer-risk variants from multi-ancestry GWASs and fine-mapping studies (PRS269). GW-PRS models were trained with a large and diverse prostate cancer GWAS of 107,247 cases and 127,006 controls that we previously used to develop the multi-ancestry PRS269. Resulting models were independently tested in 1,586 cases and 1,047 controls of African ancestry from the California Uganda Study and 8,046 cases and 191,825 controls of European ancestry from the UK Biobank and further validated in 13,643 cases and 210,214 controls of European ancestry and 6,353 cases and 53,362 controls of African ancestry from the Million Veteran Program. In the testing data, the best performing GW-PRS approach had AUCs of 0.656 (95% CI = 0.635-0.677) in African and 0.844 (95% CI = 0.840-0.848) in European ancestry men and corresponding prostate cancer ORs of 1.83 (95% CI = 1.67-2.00) and 2.19 (95% CI = 2.14-2.25), respectively, for each SD unit increase in the GW-PRS. Compared to the GW-PRS, in African and European ancestry men, the PRS269 had larger or similar AUCs (AUC = 0.679, 95% CI = 0.659-0.700 and AUC = 0.845, 95% CI = 0.841-0.849, respectively) and comparable prostate cancer ORs (OR = 2.05, 95% CI = 1.87-2.26 and OR = 2.21, 95% CI = 2.16-2.26, respectively). Findings were similar in the validation studies. This investigation suggests that current GW-PRS approaches may not improve the ability to predict prostate cancer risk compared to the PRS269 developed from multi-ancestry GWASs and fine-mapping.
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Affiliation(s)
- Burcu F Darst
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA.
| | - Jiayi Shen
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Yukai Xiao
- Argonne National Laboratory, Lemont, IL, USA
| | - Xin Sheng
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Peggy Wan
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Lynne Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | | | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - David E Neal
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK; University of Cambridge, Department of Oncology, Addenbrooke's Hospital, Cambridge, UK; Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Sune F Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Jyotsna Batra
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia; Translational Research Institute, Brisbane, QLD, Australia
| | - Judith A Clements
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, Australia; Translational Research Institute, Brisbane, QLD, Australia
| | - Australian Prostate Cancer BioResource
- Translational Research Institute, Brisbane, QLD, Australia; Australian Prostate Cancer Research Centre-Qld, Queensland University of Technology, Brisbane, QLD, Australia; Prostate Cancer Research Program, Monash University, Melbourne, VIC, Australia; Dame Roma Mitchell Cancer Centre, University of Adelaide, Adelaide, SA, Australia; Chris O'Brien Lifehouse and The Kinghorn Cancer Centre, Sydney, NSW, Australia
| | - Henrik Grönberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Nora Pashayan
- University College London, Department of Applied Health Research, London, UK; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn L Penney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Catherine M Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Robert J Hamilton
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Surgery (Urology), University of Toronto, Toronto, ON, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Laval, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Karina D Sørensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; International Epidemiology Institute, Rockville, MD, USA
| | - Edward D Yeboah
- University of Ghana Medical School, Accra, Ghana; Korle Bu Teaching Hospital, Accra, Ghana
| | - James E Mensah
- University of Ghana Medical School, Accra, Ghana; Korle Bu Teaching Hospital, Accra, Ghana
| | - Yong-Jie Lu
- Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | - Daniel J Schaid
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Catharine M West
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Radiotherapy Related Research, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | | | - Adam S Kibel
- Division of Urologic Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Géraldine Cancel-Tassin
- CeRePP, Tenon Hospital, Paris, France; Sorbonne Universite, GRC 5 Predictive Onco-urology, Tenon Hospital, Paris, France
| | - Florence Menegaux
- "Exposome and Heredity", CESP (UMR 1018), Faculté de Médecine, Université Paris-Saclay, Inserm, Gustave Roussy, Villejuif, France
| | - Esther M John
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA; Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, UK
| | - Sue A Ingles
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago De Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago De Compostela, Spain; Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Barry S Rosenstein
- Department of Radiation Oncology and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal; Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lisa Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Chad Huff
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Luc Multigner
- University Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Rennes, France
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Robin J Leach
- Department of Urology, Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Ann W Hsing
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Rick A Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Adam B Murphy
- Department of Urology, Northwestern University, Chicago, IL, USA
| | - Christopher J Logothetis
- The University of Texas M. D. Anderson Cancer Center, Department of Genitourinary Medical Oncology, Houston, TX, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - William B Isaacs
- James Buchanan Brady Urological Institute, Johns Hopkins Hospital and Medical Institution, Baltimore, MD, USA
| | - Barbara Nemesure
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anselm J Hennis
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA; Chronic Disease Research Centre and Faculty of Medical Sciences, University of the West Indies, Bridgetown, Barbados
| | - John Carpten
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hardev Pandha
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford, Surrey, UK
| | - Kim De Ruyck
- Ghent University, Faculty of Medicine and Health Sciences, Basic Medical Sciences, Gent, Belgium
| | - Jianfeng Xu
- Program for Personalized Cancer Care and Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA
| | - Azad Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Cancer Research Malaysia (CRM), Outpatient Centre, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Lisa F Newcomb
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Urology, University of Washington, Seattle, WA, USA
| | - Jay H Fowke
- Division of Epidemiology, Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Benjamin A Rybicki
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Marija Gamulin
- Department of Oncology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Nawaid Usmani
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada; Division of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Leuven, Belgium
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, Santiago de Compostela, Spain; University of California San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica Galicia Sur (IISGS), Vigo (Pontevedra), Spain
| | - Paul A Townsend
- Division of Cancer Sciences, Manchester Cancer Research Centre, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Health Innovation Manchester, University of Manchester, Manchester, UK; The University of Surrey, Guildford, Surrey, UK
| | - Dana C Crawford
- Case Western Reserve University, Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Cleveland, OH, USA
| | - Gyorgy Petrovics
- Center for Prostate Disease Research, Uniformed Services University, Bethesda, MD, USA
| | - Graham Casey
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Monique J Roobol
- 109 Department of Urology, Erasmus University Medical Center, Cancer Institute, Rotterdam, the Netherlands
| | - Jennifer F Hu
- The University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephen K Van Den Eeden
- Division of Research, Kaiser Permanente, Northern California, Oakland, CA, USA; Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - John S Witte
- Department of Epidemiology and Population Health, Department of Biomedical Data Science, Stanford Cancer Institute, Stanford, CA, USA
| | - Rosalind A Eeles
- The Institute of Cancer Research, Sutton, London, UK; Royal Marsden NHS Foundation Trust, London, UK
| | | | - Stephen Watya
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - John M Gaziano
- VA Boston Healthcare System, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Amy C Justice
- VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, New Haven, CT, USA
| | - David V Conti
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christopher A Haiman
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Darst BF, Shen J, Madduri RK, Rodriguez AA, Xiao Y, Sheng X, Saunders EJ, Dadaev T, Brook MN, Hoffmann TJ, Muir K, Wan P, Le Marchand L, Wilkens L, Wang Y, Schleutker J, MacInnis RJ, Cybulski C, Neal DE, Nordestgaard BG, Nielsen SF, Batra J, Clements JA, Grönberg H, Pashayan N, Travis RC, Park JY, Albanes D, Weinstein S, Mucci LA, Hunter DJ, Penney KL, Tangen CM, Hamilton RJ, Parent MÉ, Stanford JL, Koutros S, Wolk A, Sørensen KD, Blot WJ, Yeboah ED, Mensah JE, Lu YJ, Schaid DJ, Thibodeau SN, West CM, Maier C, Kibel AS, Cancel-Tassin G, Menegaux F, John EM, Grindedal EM, Khaw KT, Ingles SA, Vega A, Rosenstein BS, Teixeira MR, Kogevinas M, Cannon-Albright L, Huff C, Multigner L, Kaneva R, Leach RJ, Brenner H, Hsing AW, Kittles RA, Murphy AB, Logothetis CJ, Neuhausen SL, Isaacs WB, Nemesure B, Hennis AJ, Carpten J, Pandha H, De Ruyck K, Xu J, Razack A, Teo SH, Newcomb LF, Fowke JH, Neslund-Dudas C, Rybicki BA, Gamulin M, Usmani N, Claessens F, GagoDominguez M, Castelao JE, Townsend PA, Crawford DC, Petrovics G, Casey G, Roobol MJ, Hu JF, Berndt SI, Van Den Eeden SK, Easton DF, Chanock SJ, Cook MB, Wiklund F, Witte JS, Eeles RA, Kote-Jarai Z, Watya S, Gaziano JM, Justice AC, Conti DV, Haiman CA. Evaluating Approaches for Constructing Polygenic Risk Scores for Prostate Cancer in Men of African and European Ancestry. medRxiv 2023:2023.05.12.23289860. [PMID: 37292833 PMCID: PMC10246022 DOI: 10.1101/2023.05.12.23289860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Genome-wide polygenic risk scores (GW-PRS) have been reported to have better predictive ability than PRS based on genome-wide significance thresholds across numerous traits. We compared the predictive ability of several GW-PRS approaches to a recently developed PRS of 269 established prostate cancer risk variants from multi-ancestry GWAS and fine-mapping studies (PRS 269 ). GW-PRS models were trained using a large and diverse prostate cancer GWAS of 107,247 cases and 127,006 controls used to develop the multi-ancestry PRS 269 . Resulting models were independently tested in 1,586 cases and 1,047 controls of African ancestry from the California/Uganda Study and 8,046 cases and 191,825 controls of European ancestry from the UK Biobank and further validated in 13,643 cases and 210,214 controls of European ancestry and 6,353 cases and 53,362 controls of African ancestry from the Million Veteran Program. In the testing data, the best performing GW-PRS approach had AUCs of 0.656 (95% CI=0.635-0.677) in African and 0.844 (95% CI=0.840-0.848) in European ancestry men and corresponding prostate cancer OR of 1.83 (95% CI=1.67-2.00) and 2.19 (95% CI=2.14-2.25), respectively, for each SD unit increase in the GW-PRS. However, compared to the GW-PRS, in African and European ancestry men, the PRS 269 had larger or similar AUCs (AUC=0.679, 95% CI=0.659-0.700 and AUC=0.845, 95% CI=0.841-0.849, respectively) and comparable prostate cancer OR (OR=2.05, 95% CI=1.87-2.26 and OR=2.21, 95% CI=2.16-2.26, respectively). Findings were similar in the validation data. This investigation suggests that current GW-PRS approaches may not improve the ability to predict prostate cancer risk compared to the multi-ancestry PRS 269 constructed with fine-mapping.
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Affiliation(s)
- Burcu F. Darst
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Jiayi Shen
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Yukai Xiao
- Argonne National Laboratory, Lemont, IL, USA
| | - Xin Sheng
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Thomas J. Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Peggy Wan
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Lynne Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | | | - Robert J. MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - David E. Neal
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK
- University of Cambridge, Department of Oncology, Addenbrooke’s Hospital, Cambridge, UK
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge UK
| | - Børge G. Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Copenhagen, Denmark
| | - Sune F. Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Copenhagen, Denmark
| | - Jyotsna Batra
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Judith A. Clements
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Australian Prostate Cancer BioResource
- Translational Research Institute, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Queensland University of Technology, Brisbane; Prostate Cancer Research Program, Monash University, Melbourne; Dame Roma Mitchell Cancer Centre, University of Adelaide, Adelaide; Chris O’Brien Lifehouse and The Kinghorn Cancer Centre, Sydney, Australia
| | - Henrik Grönberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Nora Pashayan
- University College London, Department of Applied Health Research, London, UK
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Lorelei A. Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David J. Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn L. Penney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
| | | | - Robert J. Hamilton
- Dept. of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Canada
- Dept. of Surgery (Urology), University of Toronto, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Laval, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Janet L. Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Karina D. Sørensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - William J. Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- International Epidemiology Institute, Rockville, MD, USA
| | - Edward D. Yeboah
- University of Ghana Medical School, Accra, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
| | - James E. Mensah
- University of Ghana Medical School, Accra, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
| | - Yong-Jie Lu
- Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | - Daniel J. Schaid
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Stephen N. Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Catharine M. West
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Radiotherapy Related Research, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | | | - Adam S. Kibel
- Division of Urologic Surgery, Brigham and Womens Hospital, Boston, MA, USA
| | - Géraldine Cancel-Tassin
- CeRePP, Tenon Hospital, Paris, France
- Sorbonne Universite, GRC 5 Predictive Onco-urology, Tenon Hospital, Paris, France
| | - Florence Menegaux
- “Exposome and Heredity”, CESP (UMR 1018), Faculté de Médecine, Université Paris-Saclay, Inserm, Gustave Roussy, Villejuif, France
| | - Esther M. John
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, UK
| | - Sue A. Ingles
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago De Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago De Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Spain
| | - Barry S. Rosenstein
- Department of Radiation Oncology and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manuel R. Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - NC-LA PCaP Investigators
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lisa Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Chad Huff
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Luc Multigner
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Rennes, France
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Robin J. Leach
- Department of Urology, Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio Texas, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Ann W. Hsing
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Rick A. Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Adam B. Murphy
- Department of Urology, Northwestern University, Chicago, IL, USA
| | - Christopher J. Logothetis
- The University of Texas M. D. Anderson Cancer Center, Department of Genitourinary Medical Oncology, Houston, TX, USA
| | - Susan L. Neuhausen
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - William B. Isaacs
- James Buchanan Brady Urological Institute, Johns Hopkins Hospital and Medical Institution, Baltimore, MD, USA
| | - Barbara Nemesure
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anselm J. Hennis
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
- Chronic Disease Research Centre and Faculty of Medical Sciences, University of the West Indies, Bridgetown, Barbados
| | - John Carpten
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hardev Pandha
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford, Surrey, UK
| | - Kim De Ruyck
- Ghent University, Faculty of Medicine and Health Sciences, Basic Medical Sciences, Gent, Belgium
| | - Jianfeng Xu
- Program for Personalized Cancer Care and Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA
| | - Azad Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Cancer Research Malaysia (CRM), Outpatient Centre, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Canary PASS Investigators
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Lisa F. Newcomb
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Jay H. Fowke
- Division of Epidemiology, Department of Preventive Medicine, The University of Tennessee Health Science Center, TN, USA
| | | | | | - Marija Gamulin
- Department of Oncology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Nawaid Usmani
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Leuven, Belgium
| | - Manuela GagoDominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, Santiago de Compostela, Spain
- University of California San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica Galicia Sur (IISGS), Vigo (Pontevedra), Spain
| | - Paul A. Townsend
- Division of Cancer Sciences, Manchester Cancer Research Centre, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Health Innovation Manchester, University of Manchester, UK
- The University of Surrey, Guildford, Surrey, UK
| | - Dana C. Crawford
- Case Western Reserve University, Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Cleveland, OH, USA
| | - Gyorgy Petrovics
- Center for Prostate Disease Research, Uniformed Services University, Bethesda, MD, USA
| | - Graham Casey
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Monique J. Roobol
- 109 Department of Urology, Erasmus University Medical Center, Cancer Institute, Rotterdam, The Netherlands
| | - Jennifer F. Hu
- The University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephen K. Van Den Eeden
- Division of Research, Kaiser Permanente, Northern California, Oakland, CA, USA
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Douglas F. Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - John S. Witte
- Department of Epidemiology and Population Health, Department of Biomedical Data Science, Stanford Cancer Institute, Stanford, CA, USA
| | - Rosalind A. Eeles
- The Institute of Cancer Research, Sutton, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | | | - Stephen Watya
- School of Public Health, Makerere University College of Health Sciences, Kampala Uganda
| | - John M. Gaziano
- VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Amy C. Justice
- VA Connecticut Healthcare System, West Haven, CT, USA
- Yale School of Medicine, New Haven, CT, USA
| | - David V. Conti
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christopher A. Haiman
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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3
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Vona B, Schwartzbaum DA, Rodriguez AA, Lewis SS, Toosi MB, Radhakrishnan P, Bozan N, Akın R, Doosti M, Manju R, Duman D, Sineni CJ, Nampoothiri S, Karimiani EG, Houlden H, Bademci G, Tekin M, Girisha KM, Maroofian R, Douzgou S. Biallelic KITLG variants lead to a distinct spectrum of hypomelanosis and sensorineural hearing loss. J Eur Acad Dermatol Venereol 2022; 36:1606-1611. [PMID: 35543077 PMCID: PMC9546089 DOI: 10.1111/jdv.18207] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Background Pathogenic variants in KITLG, a crucial protein involved in pigmentation and neural crest cell migration, cause non‐syndromic hearing loss, Waardenburg syndrome type 2, familial progressive hyperpigmentation and familial progressive hyper‐ and hypopigmentation, all of which are inherited in an autosomal dominant manner. Objectives To describe the genotypic and clinical spectrum of biallelic KITLG‐variants. Methods We used a genotype‐first approach through the GeneMatcher data sharing platform to collect individuals with biallelic KITLG variants and reviewed the literature for overlapping reports. Results We describe the first case series with biallelic KITLG variants; we expand the known hypomelanosis spectrum to include a ‘sock‐and‐glove‐like’, symmetric distribution, progressive repigmentation and generalized hypomelanosis. We speculate that KITLG biallelic loss‐of‐function variants cause generalized hypomelanosis, whilst variants with residual function lead to a variable auditory‐pigmentary disorder mostly reminiscent of Waardenburg syndrome type 2 or piebaldism. Conclusions We provide consolidating evidence that biallelic KITLG variants cause a distinct auditory‐pigmentary disorder. We evidence a significant clinical variability, similar to the one previously observed in KIT‐related piebaldism.
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Affiliation(s)
- B Vona
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany.,Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - D A Schwartzbaum
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - A A Rodriguez
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - S S Lewis
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - M B Toosi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - P Radhakrishnan
- Suma Genomics Private Limited and Manipal Center for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, India
| | - N Bozan
- Department of Otolaryngology, Yuzuncu Yıl University Faculty of Medicine, Van, Turkey
| | - R Akın
- Department of Otolaryngology, Yuzuncu Yıl University Faculty of Medicine, Van, Turkey
| | - M Doosti
- Department of Medical Genetics, Next Generation Genetic Polyclinic, Mashhad, Iran
| | - R Manju
- Renai Medicity, Cochin, Kerala, India
| | - D Duman
- Department of Audiology, Ankara University Faculty of Health Sciences, Ankara, Turkey
| | - C J Sineni
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - S Nampoothiri
- Department of Paediatric Genetics, Amrita Institute of Medical Sciences and Research Centre, Kochi, India
| | - E G Karimiani
- Department of Medical Genetics, Next Generation Genetic Polyclinic, Mashhad, Iran.,Molecular and Clinical Sciences Institute, St. George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.,Innovative medical research center, Mashhad branch, Islamic Azad University, Mashhad, Iran
| | - H Houlden
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, UK
| | - G Bademci
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M Tekin
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India.,Suma Genomics Private Limited and Manipal Center for Biotherapeutics Research, Manipal Academy of Higher Education, Manipal, India
| | - R Maroofian
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, UK
| | - S Douzgou
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.,Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK
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4
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Darst BF, Madduri RK, Rodriguez AA, Sheng X, Eeles RA, Kote-Jarai Z, Gaziano JM, Justice AC, Conti DV, Haiman CA. Abstract PO-163: Genome-wide polygenic risk score of prostate cancer in African and European ancestry men. Cancer Epidemiol Biomarkers Prev 2022. [DOI: 10.1158/1538-7755.disp21-po-163] [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] Open
Abstract
Abstract
Genome-wide polygenic risk scores (PRS) are reported to have higher performance than standard genome-wide significant PRS across numerous complex traits. We evaluated the ability of genome-wide PRS to evaluate prostate cancer risk compared to our recently developed and highly predictive multi-ancestry PRS of 269 fine-mapped and established prostate cancer risk variants. Genome-wide PRS approaches included LDpred2, PRS-CSx, and EB-PRS. Models were trained using the largest and most diverse prostate cancer GWAS to date of 107,247 cases and 127,006 controls, which was previously used to develop the multi-ancestry PRS of 269 variants. For each approach, we constructed the PRS using population-specific weights (i.e., African or European) and multi-ancestry weights, which were calculated across men from African, European, East Asian, and Hispanic populations in our previous GWAS. Resulting models were tested in independent samples of 1,586 cases and 1,047 controls of African ancestry from the California Uganda Study and 8,045 cases and 191,835 controls of European ancestry from the UK Biobank. Across all approaches, multi-ancestry weighted PRS had either similar or stronger performance compared to population-specific weighted PRS, both in terms of area under the curve (AUC) and odds of prostate cancer. Among the genome-wide PRS approaches, PRS-CSx constructed with multi-ancestry weights had the best performance, with AUCs of 0.656 (95% CI=0.635-0.677) in African and 0.844 (95% CI=0.840-0.848) in European ancestry men. Based on PRS-CSx, African and European ancestry men in the top 90-100% PRS decile relative to men in the median 40-60% PRS category had odds of prostate cancer of 2.67 (95% CI=2.00-3.55) and 4.17 (95% CI=3.87-4.50), respectively. However, the PRS constructed using 269 fine-mapped variants had larger AUCs in both African (0.679, 95% CI=0.659-0.700) and European ancestry men (0.845, 95% CI=0.841-0.849), with African and European ancestry men in the top PRS decile having larger odds of prostate cancer (3.53, 95% CI=2.66-4.69 and 4.20, 95% CI=3.89-4.53, respectively). We are currently further validating these findings in diverse men from Million Veteran's Program. This investigation suggests that genome-wide PRS may not improve the ability to distinguish prostate cancer compared to our genome-wide significant PRS and that a multi-ancestry approach to constructing PRS leads to similar or better performance than a population-specific approach.
Citation Format: Burcu F. Darst, Ravi K Madduri, Alexis A. Rodriguez, Xin Sheng, Rosalind A. Eeles, Zsofia Kote-Jarai, John M. Gaziano, Amy C. Justice, David V. Conti, Christopher A. Haiman. Genome-wide polygenic risk score of prostate cancer in African and European ancestry men [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-163.
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Affiliation(s)
| | | | | | - Xin Sheng
- 1University of Southern California, Los Angeles, CA,
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5
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Creamer SL, Patel TA, Ensor JE, Rodriguez AA, Niravath PA, Darcourt JG, Kaklamani VG, Meisel JL, Li X, Zhao J, Kuhn JG, Rosato RR, Qian W, Belcheva A, Boone T, Chang J. Abstract P6-17-26: Care 001: multi-center randomized open-label phase II trial of neoadjuvant trastuzumab emtansine (T-DM1) in combination with lapatinib and nab-paclitaxel compared with paclitaxel, trastuzumab and pertuzumab in HER2-neu over-expressed breast cancer patients (TEAL study). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-26] [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
Background: We conducted a multicenter, randomized open-label phase II neoadjuvant study of trastuzumab-emtansine (T-DM1), Lapatinib (L) and Nab Paclitaxel (Nab-P) compared to standard of care (SOC) Paclitaxel (Pac), Trastuzumab (T), and Pertuzumab (P) in patients with HER2 over-expressed breast cancer.
Methods: Patients in the experimental arm received a biologic window of targeted therapies alone for 6 weeks (T-DM1 and L) followed by T-DM1 3.0 mg/kg Q3W, L 750mg oral daily and Nab-P 80 mg/m2 weekly (QW) X 12 weeks. Patients in SOC arm received targeted therapies alone for 6 weeks (T and P) followed by Pac 80mg/m2QW, T 2mg/kg QW, and P 420mg Q3W X 12 weeks. The primary objective was to evaluate the proportion of patients with residual cancer burden (RCB) 0 or 1. Key secondary objectives included correlative assessments of PIK3CA mutations, PTEN expression, and HER2 subtypes which are being reported.
Results: Thirty of the 33 enrolled patients were evaluable. Patient demographics were well balanced. HER2 subtypes and altered PIK3CA (low PTEN or PIK3CA mutations) pathway were not statistically different between both arms. We have previously reported that all patients achieved RCB 0 & I in the T-DM1, L and Nab-P arm, compared to SOC (100% vs. 62.5%, p 0.0035). In the SOC arm, the 6 week change in tumor size on breast MRI during targeted biologic window treatment is significantly different between the responders and non-responders based on two-sided Wilcoxon rank-sum test (p =0.0065). Consistent with literature, among ER positive patients treated with SOC, PTEN low expressers were less likely to respond (0%, 0 of 2) than PTEN high expressers (67%, 2 of 3). In the experimental arm, all patients responded regardless of PTEN. There was only 1 PIK3CA mutation on the experimental arm where all responded.
Table 1:Breast MRI Tumor Size Standard of Care ArmResponseNMeanStandard Deviation95% CL MeanMinimumMaximumNo6-0.13330.4457-0.60110.3344-1.00.3Yes52.58001.88330.24154.91850.24.9Sixteen patients total were present in standard of care arm but 5 had incomplete imaging data.
Conclusions: TDM1 plus L and Nab-P therapy was well tolerated with noteworthy responses in all patients, including in PTEN low expressers. Change in tumor size at 6 weeks of biologic therapies was significant between responders and non-responders and can be evaluated as a surrogate for future studies.
Citation Format: Creamer SL, Patel TA, Ensor JE, Rodriguez AA, Niravath PA, Darcourt JG, Kaklamani VG, Meisel JL, Li X, Zhao J, Kuhn JG, Rosato RR, Qian W, Belcheva A, Boone T, Chang J. Care 001: multi-center randomized open-label phase II trial of neoadjuvant trastuzumab emtansine (T-DM1) in combination with lapatinib and nab-paclitaxel compared with paclitaxel, trastuzumab and pertuzumab in HER2-neu over-expressed breast cancer patients (TEAL study) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-17-26.
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Affiliation(s)
- SL Creamer
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - TA Patel
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - JE Ensor
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - AA Rodriguez
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - PA Niravath
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - JG Darcourt
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - VG Kaklamani
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - JL Meisel
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - X Li
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - J Zhao
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - JG Kuhn
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - RR Rosato
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - W Qian
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - A Belcheva
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - T Boone
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
| | - J Chang
- Houston Methodist Cancer Center, Houston, TX; Houston Methodist Research Institute, Houston, TX; The University of Texas Health Science Center, San Antonio, TX; Winship Cancer Institute Emory University School of Medicine, Atlanta, GA; Affiliated Hospital of Qingdao University, Qingdao, China
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6
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Patel A, Mukherjee A, Hwang D, Ensor J, Patel TA, Chang JC, Rodriguez AA. Abstract P1-02-06: Serial monitoring of circulating tumor DNA in patients with metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-02-06] [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
Background: For patients with MBC, there is currently no evidence that changing therapy on the basis of biomarker results improves outcome. Clinical benefit of treatment is defined as complete response, objective response, or stable disease as determined by RECIST criteria on radiological evaluation. Serial measurements of serum biomarkers such as CA2729 and CTCs have proven unsuccessful in predicting clinical benefit. Circulating tumor DNA(ctDNA) has emerged as a potential biomarker that may predict response to therapy or progression of disease. The present retrospective study was conducted to evaluate the relationship between change in ctDNA with clinical benefit determined by clinical and radiological evaluations of patients with MBC patients.
Methods: We conducted a retrospective, single-institutional study to determine if serial monitoring of ctDNA allele frequency levels predict clinical benefit of a treatment. 55 patients with measurable MBC who had serial monitoring of ctDNA between August 2014 and May 2016 were included. The median age was 55.9 (27–94) years). Clinical outcomes were determined as per standard guidelines. The analysis was performed on all cases that had serial measurements of ctDNA with no change in therapy in between and the repeat blood draw was done within 30 days of repeat radiographic evaluation. The dataset contained 125 observations from 48 unique patients. The relationship between the change in ctDNA and clinical benefit was analyzed using a generalized linear model with a random subject effect to account for the intrapatient dependence occurring from obtaining multiple evaluations from the same patient. A logit link function was used akin to logistic regression and a compound symmetric correlation structure was assumed.
Results: 68.8% of the cases were hormone receptor-positive, 18.8% HER2-positive, and 27.1% TNBC. The treatments received were 58.4% hormonal therapy, 31.2% chemotherapy, 26.4% included anti-HER2 therapy, 2 cases were on targeted therapy, and 1 case was not on any treatment. Three patients had stage 4 disease in complete remission. ctDNA analysis was repeated on average 4 days prior to radiological evaluation. The average time between repeat assessments was 108.5 days. 93% of the patients had a genomic alteration detected at some point during their course of disease. The most common mutations detected were TP53 41.7%, PIK3CA 35.4%, ESR1 18.8%, and ERBB2 amplifications 6.3%. A dichotomized change in ctDNA is a significant predictor of clinical benefit (p < 0.0001). The intrapatient correlation is estimated to be 0.273 for the transformed variable. The model yields a predicted probability of clinical benefit of 26.9% when the increase in ctDNA is greater than or equal to 0.5 and when the increase in ctDNA is less than 0.5, the a predicted probability of clinical benefit is 78.4%. The concordance of change in ctDNA and change in CA 27-29 was 76.2%.
Conclusions: Serial evaluation of serum ctDNA may be useful to evaluate molecular response to treatment which may correlate with clinical benefit and potentially guide treatment decisions. Early indication that a chosen therapy is not effective may lead to avoidance of overtreatment and initiation of an alternative regimen. Further, prospective studies are needed.
Citation Format: Patel A, Mukherjee A, Hwang D, Ensor J, Patel TA, Chang JC, Rodriguez AA. Serial monitoring of circulating tumor DNA in patients with metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-02-06.
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Affiliation(s)
- A Patel
- Houston Methodist Cancer Center, Houston, TX
| | - A Mukherjee
- Houston Methodist Cancer Center, Houston, TX
| | - D Hwang
- Houston Methodist Cancer Center, Houston, TX
| | - J Ensor
- Houston Methodist Cancer Center, Houston, TX
| | - TA Patel
- Houston Methodist Cancer Center, Houston, TX
| | - JC Chang
- Houston Methodist Cancer Center, Houston, TX
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Liang DH, Patel A, Ensor JE, Patel TA, Chang JC, Rodriguez AA. Abstract P6-03-05: Cell-free DNA as molecular tool for monitoring disease progression and response to therapy in breast cancer patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-03-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: Identification of cancer-specific genes from breast cancer cells was instrumental in the advancement of targeted breast cancer therapy. However, with genomic heterogeneity within the breast cancer and evolution of cancer over time, genomic sequencing obtained from a single biopsy site may not capture the complete genomic profile. Thus, circulating cell-free DNA (cfDNA), isolated from plasma, is potentially a non-invasive source of identifying cancer-specific genomic alterations and may provide comprehensive genomic data throughout a patient's clinical course as they undergo anti-cancer therapy.
Method: We performed a retrospective chart review of 100 patients with stage 4 or high-risk stage 3 breast cancer who were tested for cfDNA genomic alterations. The most common actionable cancer specific genomic alterations were identified. In 23 patients who also had genomic analysis from tumor DNA (tDNA), an analysis using the Cohen's Kappa statistic was performed to determine the degree of agreement between genomic alterations found in tDNA and cfDNA. The proportion of patients with clinical disease progression between two cohorts determined by change in mutant allele frequency was compared using two-sided Fisher's exact test. Patients who received targeted therapy based on the identified genomic alteration were followed to determine response to therapy.
Results: In cfDNA of 100 breast cancer patients, the most commonly found cancer specific genomic alterations were TP53, PIK3CA, EGFR amplification, and ERBB2 amplification, with incidence rates 27%, 22%, 9%, and 7%, respectively. In tDNA of 23 patients, incidence rates were 65%, 26%, 9%, and 13%. PIK3CA and ERBB2 amplification demonstrated robust agreement between tDNA and cfDNA (Cohen's Kappa= 0.64 and 0.77, respectively). TP53 and EGFR amplification demonstrated poor agreement between tDNA and cfDNA (Cohen's Kappa= 0.18 and 0.33, respectively). There were 22 patients who had baseline and post-therapy mutant allele frequency measurements of TP53 and PIK3CA. Directional change of mutant allele frequency was closely associated with patient's response to therapy (p=0.0017). 8 out of 8 patients (100%) who had progression of disease had increase in mutant allele frequency. 10 out of 14 patients (71%) of patients who responded to therapy had decrease in mutant allele frequency. 6 patients who were found to have ERBB2 amplification were initiated on anti-HER2 cancer therapy. 5 of 6 patients (83%) had clinical response to therapy, while one patient had progression of disease. 3 patients who were found to have EGFR amplification (2 in cfDNA, 1 in tDNA) were initiated on anti-EGFR therapy. 2 of 3 patients (67%) had clinical response to therapy, while one patient had progression of disease.
Conclusion: There is no definite agreement between genomic alterations found in tDNA and those found in cfDNA. Whether this is due to tumor heterogeneity or tumor evolution over time with administration of anti-cancer treatment remains unknown. However, identification of selected cancer specific genomic alterations from cfDNA may be a non-invasive tool to monitor disease progression and response to breast cancer therapy.
Citation Format: Liang DH, Patel A, Ensor JE, Patel TA, Chang JC, Rodriguez AA. Cell-free DNA as molecular tool for monitoring disease progression and response to therapy in breast cancer patients. [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 P6-03-05.
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Affiliation(s)
- DH Liang
- Houston Methodist Hospital, Houston, TX; Houston Methodist Cancer Center, Houston, TX
| | - A Patel
- Houston Methodist Hospital, Houston, TX; Houston Methodist Cancer Center, Houston, TX
| | - JE Ensor
- Houston Methodist Hospital, Houston, TX; Houston Methodist Cancer Center, Houston, TX
| | - TA Patel
- Houston Methodist Hospital, Houston, TX; Houston Methodist Cancer Center, Houston, TX
| | - JC Chang
- Houston Methodist Hospital, Houston, TX; Houston Methodist Cancer Center, Houston, TX
| | - AA Rodriguez
- Houston Methodist Hospital, Houston, TX; Houston Methodist Cancer Center, Houston, TX
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Rodriguez AA, Berquist W, Bingham D. Gastric outlet obstruction caused by heterotopic pancreas in an adolescent. Dig Dis Sci 2015; 60:835-7. [PMID: 25107445 DOI: 10.1007/s10620-014-3314-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 07/21/2014] [Accepted: 07/24/2014] [Indexed: 12/17/2022]
Affiliation(s)
- Alexis A Rodriguez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Lucile Packard Children's Hospital, Stanford University Medical Center, Stanford, CA, USA,
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Garapati S, Burns CS, Rodriguez AA. Field- and temperature-dependent 13C NMR studies of the EDTA-Zn2+ complex: insight into structure and dynamics via relaxation measurements. J Phys Chem B 2014; 118:12960-4. [PMID: 25325430 DOI: 10.1021/jp507674a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The relaxation rates for the three different carbon types in EDTA (carbonyl, CH2 central, and CH2 lateral) were measured with and without Zn(2+) as a function of field strength and temperature. The use of different field strengths in combination with NOE measurements allowed for the contribution of each relaxation mechanism (chemical shift anisotropy; spin rotation; dipole-dipole) to the total relaxation rate for each carbon to be determined. Temperature studies allowed for determination of the activation energy (Ea) for the motions of each carbon type. The most surprising result was the observation that the τ(c) decreases significantly for the lateral carbon upon addition of Zn(2+) at neutral pH, going from 54 to 8.6 ps at 298 K. This appears to be a pH-dependent phenomenon as other reports indicate that τ(c) increases for the lateral carbon upon addition of Zn(2+) under strongly basic conditions.
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Affiliation(s)
- Sriramya Garapati
- Department of Chemistry, East Carolina University , Greenville, North Carolina 27858, United States
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Affiliation(s)
- Alexis A Rodriguez
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Lucile Packard Children's Hospital, Stanford University, 750 Welch Rd. Suite 116, Palo Alto, CA, USA,
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Awada A, Spector N, El-Hariry I, Rodriguez AA, Erban JK, Cortes J, Gomez H, Kong A, Hickish T, Fein L, Vahdat L, MacPherson I, Canon JL, Mansoor S, Giovanne A, McAdam K, Vukovic VM, Yalcin I, Bradley R, Proia D, Mano MS, Perez EA, Cameron DA. Abstract P2-16-23: The ENCHANT-1 trial (NCT01677455): An open label multicenter phase 2 proof of concept study evaluating first line ganetespib monotherapy in women with metastatic HER2 positive or triple negative breast cancer (TNBC). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-16-23] [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: Hsp90 is a molecular chaperone protein required for the stabilization and activation of many proteins, referred to as Hsp90 ‘clients’, such as HER2, HIF1-a, EGFR, ER, PI3K, AKT, P53 and VEGFR. The drug candidate, ganetespib is a novel triazolone inhibitor of Hsp90, with over 700 patients treated to date. Ganetespib has shown activity in preclinical models of HER2+, ER+/PR+ and TNBC. Early clinical trials documented ganetespib single agent activity in heavily pretreated HER2+ and TNBC patients. Ganetespib has been well tolerated in clinical trials with a favorable safety profile. This efficacy-screening study is designed to provide further evidence of ganetespib activity and identify potentially predictive biomarkers in metastatic breast cancer (BC).
Methods: The ENCHANT-1 Trial is an international, first-line 2-cohort Phase 2 study in BC patients: Cohort A, HER2 amplified (n = 35), and Cohort B, TNBC (n = 35). Patients who present with previously untreated metastatic disease are eligible for treatment with ganetespib at 150 mg/m2 twice weekly on 3 out of 4 wks, for a total of up to 12 wks. Primary endpoint: ORR assessed using RECIST1.1 criteria. Key secondary endpoints include metabolic response as assessed by PET/CT at wk 3 utilizing modified EORTC criteria. Disease progression (PD) at wk 3 by PET imaging indicates discontinuation of study therapy, and is performed to quickly offer patients with metabolic PD a standard of care treatment.
The study is designed as Simon 2-stage requiring at least one OR in 15 patients for the respective cohort to expand to 35 patients. A Steering Committee is established to oversee the overall study and review the interim results.
Results: The study was initiated in 23 centers globally. At the time of submission, a total of 17 patients had been enrolled; TNBC (n = 15) and HER2 (n = 2). Here we report the interim analysis in the TNBC cohort. The median age was 54 years (range 30 -77) with ECOG PS 0 (n = 7/15). Most patients (n = 9) presented with de novo metastatic disease. 5 patients were not evaluable for PET assessment (3 had not yet reached wk 3 and 2 withdrawn before wk 3 for clinical progression), and 9 patients were not evaluable for objective response at wk 6 (3 withdrawn before or at wk 3 for clinical progression and 6 had not yet reached wk 6 evaluation). In the 10 patients with evaluable PET imaging, 9 patients achieved metabolic (m) response (2 mPR, 4 mSD with dominant tumor shrinkage and 3 SD) and one patient with mPD. In the 6 patients evaluable for OR at wk 6, one patient achieved PR, 2 SD and 3 PD. Treatment with ganetespib was well tolerated; the most common AEs were mild or moderate diarrhea (8/15, 53%), fatigue (5/15, 33%), decreased appetite (4/15, 27%), insomnia (4/15, 27%), and nausea (4/15, 27%).
Conclusion: Ganetespib single agent was generally well tolerated and showed anti-tumor activity TNBC patients as early as 3 weeks following treatment. PET seems to be a good tool to screen antitumor activity of new agents in early settings rather that in heavily pretreated patients. The TNBC cohort has met the protocol criteria for proceeding to stage 2.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-16-23.
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Affiliation(s)
- A Awada
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - N Spector
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - I El-Hariry
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - AA Rodriguez
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - JK Erban
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - J Cortes
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - H Gomez
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - A Kong
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - T Hickish
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - L Fein
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - L Vahdat
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - I MacPherson
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - J-L Canon
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - S Mansoor
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - A Giovanne
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - K McAdam
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - VM Vukovic
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - I Yalcin
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - R Bradley
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - D Proia
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - MS Mano
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - EA Perez
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
| | - DA Cameron
- Jules Bordet Institute, Brussels, Belgium; Duke University Medical Center, Durham; Synta Pharmaceuticals Inc, Lexington; The Methodist Hospital Research Institute, Houston; Tufts Medical Center, Boston; Vall d'Hebron University Hospital, Barcelona; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Churchill Hospital, Oxford University Hospitals NHS Trust and University of Oxford, Oxford, United Kingdom; The Royal Bournemouth Hospital, Bournemouth, Dorset, United Kingdom; Centro Oncológico de Rosario, Rosario Santa Fe, Argentina; Weill Cornell Medical College, New York; The Beatson Institute for Cancer Research, Glasgow, United Kingdom; Grand Hôpital de Charleroi, Charleroi, Belgium; Georgia Cancer Specialists, Atlanta; Hospital Central de la Fuerza Aérea del Perú, Lima, Peru; Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, United Kingdom; Instituto do Cancer do Estado de São Paulo, São Paulo, Brazil; Mayo Clinic, Jacksonville; Edinburgh University, Edinburgh, United Kingdom
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12
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Tanei T, Rodriguez AA, Dobrolecki L, Choi DS, Landis M, Chang JC. Abstract P5-03-03: Antitumor Activity and Cancer Stem Cells Effect of Cetuximab in Combination with Ixabepilone in Triple Negative Breast Cancers (TNBC). Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p5-03-03] [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
Purpose: The ErbB family, including EGFR, has been demonstrated to play key roles in metastasis, tumorigenesis, cell proliferation, and drug resistance. Recently, these characteristics have been linked to a small subpopulation of cells classified as cancer stem cells (CSCs) which are believed to be responsible for tumor initiation and maintenance. Ixabepilone is the microtubule-stabilizing agent has been expected to be more sensitive than the conventional taxanes. The aim of this study was to investigate whether the EGFR monoclonocal antibody cetuximab, in combination with ixabepilone is a more effective treatment, and kill cancer stem cells more effectively as compared to chemotherapy alone in TNBC.
Experimental Design and Results: Breast CSC populations were evaluated with FACS analysis (CD44+ and CD24−/low, or Aldefluor+) and mammosphere formation efficiency (MSFE). In vitro, we demonstrated that in triple negative cell lines (MDA-MB-231 and SUM159), cancer stem cell populations were decreased after treatment of cetuximab, or cetuximab plus ixabepilone. In vivo, cetuximab in combination with ixabepilone treatment caused significant tumor regression (cetuximab vs. cetuximab+ ixabepilone; tumor volume fold change P <0.05 (MDA-MB-231), P <0.0001 (SUM159) in triple negative breast cancer xenografts. Thus, cetuximab decreased CSC population in xenograft tumors. Decrease in autophagy (LC3b, p62 and autophagosomes) were seen in cetuximab-treated tumors.
Conclusions: These studies demonstrate that cetuximab in combination with ixabepilone is more effective than chemotherapy alone in TNBC by affecting CSCs, as well as bulk tumor. These data support a neoadjuvant phase II study comparing ixabepilone vs. ixabepilone +cetuximab in TNBC patients.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-03-03.
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Affiliation(s)
- T Tanei
- The Methodist Hospital Research Institute and Weill Cornell Medical School, Houston, TX
| | - AA Rodriguez
- The Methodist Hospital Research Institute and Weill Cornell Medical School, Houston, TX
| | - L Dobrolecki
- The Methodist Hospital Research Institute and Weill Cornell Medical School, Houston, TX
| | - DS Choi
- The Methodist Hospital Research Institute and Weill Cornell Medical School, Houston, TX
| | - M Landis
- The Methodist Hospital Research Institute and Weill Cornell Medical School, Houston, TX
| | - JC Chang
- The Methodist Hospital Research Institute and Weill Cornell Medical School, Houston, TX
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13
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Chen AC, Paulino AC, Schwartz MR, Rodriguez AA, Bass BL, Chang JC, Teh BS. Abstract P6-07-11: Is the prognosis of lymphotropic invasive micropapillary carcinoma worse than invasive ductal carcinoma?: A population-based study of 645 patients. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p6-07-11] [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
Purpose: Invasive micropapillary carcinoma (IMPC) is an uncommon distinct variant of breast carcinoma and is associated with an increased risk for regional lymph node metastases. Therefore, IMPC is considered to have an unfavorable prognosis when compared to invasive ductal carcinoma (IDC). The prognostic factors for IMPC are not well characterized due to the relative scarcity of cases reported in the literature.
Methods: We analyzed the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database to evaluate prognostic factors of a population of 645 breast IMPC patients and 300,060 breast IDC patients reported between 2001 and 2008. Using univariate and multivariate analyses, hazard ratios (HR) were calculated for disease-specific (DSS) and overall survival (OS) for these patients using parameters such as patient age at diagnosis, histological grade, ER status, PR status, tumor size, and degree of lymph node positivity. Subset analysis of high grade, lymph node-positive patients was performed to compare DSS and OS between IMPC and IDC.
Results: The 5-year DSS and OS for IMPC patients were 92.1% and 84.6% compared to 5-year DSS and OS of 88.5% and 80.2% for IDC patients. At presentation, TNM staging of IMPC cases was similar to IDC except for a higher percentage of LN metastases (52.4% in IMPC vs. 34.7% in IDC). Of those with known estrogen receptor (ER) status, 84.2% of IMPC cases were ER-positive, which was associated with better DSS (Hazard Ratio (HR) 0.36, p < 0.002) and OS (HR 0.62, p = 0.072). Patients with four or more positive lymph nodes had worse DSS (HR 7.1, p < 0.0001) and OS (HR 3.2, p < 0.0001) than node-negative patients, but those with one to three positive lymph nodes had similar DSS (HR 1.04, p = 0.96) and OS (HR 0.99, p = 0.97) as node-negative patients. In the subset of patients with high grade, node-positive breast carcinoma, patients with micropapillary histology had better DSS (p < 0.03) and a trend towards better OS (p = 0.12) than high grade, node-positive invasive ductal carcinoma. This subset of IMPC patients also had a higher percentage of ER-positive tumors (77%) compared to IDC patients (56%).
Conclusions: While IMPC has a high propensity for lymph node metastasis, it has a disease-specific and overall prognosis that compares favorably to IDC. The higher percentage of hormone-receptor positivity may account for this survival advantage, even in high grade, node-positive disease. Therefore, estrogen-receptor-negativity or having four or more positive lymph nodes at presentation may potentially serve as prognostic markers for IMPC patients. In this study population, patients with one to three positive lymph nodes have DSS and OS similar to node-negative patients. Additional clinical studies are warranted to further investigate this observation. This is the largest study of IMPC to date, and these findings help our understanding of this uncommon histological variant of breast cancer.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-07-11.
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Affiliation(s)
- AC Chen
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
| | - AC Paulino
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
| | - MR Schwartz
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
| | - AA Rodriguez
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
| | - BL Bass
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
| | - JC Chang
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
| | - BS Teh
- Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX
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14
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Yu KD, Zhu R, Zhan M, Shao ZM, Yang W, Symmans WF, Rodriguez AA, Makris A, Wong ST, Chang JC. Abstract P3-06-14: Identification of Prognosis-Relevant Subgroups in Patients with Chemoresistant Triple Negative Breast Cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-06-14] [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
Purpose: Triple-negative breast cancer (TNBC) is a highly heterogeneous disease. TNBC patients with pathologic complete response (pCR) have excellent survival, but those with residual disease after neoadjuvant chemotherapy have significantly worse outcome. However, some patients having extensive residual cancer burden after neoadjuvant chemotherapy do not relapse, and we hypothesize that there may be subgroups with diverse prognosis among these chemoresistant TNBC patients.
Methods: Forty-nine cases with residual cancer from 111 TNBC patients treated with neoadjuvant chemotherapy (in M.D. Anderson Cancer Center, 2000–2006) constituted the discovery cohort. Twenty-five chemoresistant samples from 47 neoadjuvant chemotherapy-treated TNBC (in Baylor College of Medicine and Methodist Hospital, 2002–2006) were chosen for validation. Extended validation was performed in 269 operable TNBC predicted to be chemoresistant (using a JAMA-published genomic predictor) from public databases.
Results: By comparing the gene expression data from cases in relapse with those from un-relapsed cases, we established a 7-gene prognostic signature (including AR, ESR2, GATA3, GBX2, KRT16, MMP28, and WNT11) using dChip and gene enrichment analyses. In the discovery cohort, the signature showed positive predictive value (PPV; i.e., cumulative relapse rate of patients predicted to relapse in 3 years) of 95.4% and negative predictive values (NPV; i.e., relapse-free survival of patients predicted not to relapse in 3 years) of 100%. In the validation cohort, the classifier predicted correctly with PPV of 75.0% and NPV of 76.9% at 3 years. Compared with patients predicted not to relapse, those predicted to relapse had a hazard ratio of 3.37 (95% CI, 1.15–9.85) for disease recurrence or death in 3 years. In an extended validation cohort of 269 patients, our signature discriminated chemoresistant TNBC in overall cohort (PPV, 52.4%; NPV, 77.7%; log rank P < 0.0001), or each subset (e.g., log rank p = 0.001 for Rotterdam set; p = 0.013 for Frankfurt set), with adjusted overall hazard ratio of 2.07 (95% CI, 1.26–3.39). This signature was the only marker that could effectively predict the relapse in patients with chemoresistant TNBC. Of note, the subgroup predicted not to relapse was characterized by high expression of luminal-like genes (AR, GATA3), while the subgroup predicted to have high possibility of relapse was characterized by high expression of cancer stem cell and epithelial-to-mesenchymal transition associated genes (WNT11, MMP28). The former corresponded to the luminal AR subtype and the latter to the mesenchymal stem-like subtype, according to Pietenpol's TNBC subtype classification.
Conclusion: We developed a clinically useful prognostic signature for chemoresistant TNBC. For these chemoresistant TNBC patients, new therapeutic strategies targeting AR-activation or cancer stem cells need to be developed.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-14.
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Affiliation(s)
- K-D Yu
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - R Zhu
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - M Zhan
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - Z-M Shao
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - W Yang
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - WF Symmans
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - AA Rodriguez
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - A Makris
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - ST Wong
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
| | - JC Chang
- Shanghai Cancer Center and Cancer Institute of Fudan University, Shanghai, China; The Methodist Hospital, Houston, TX; The University of Texas MD Anderson Cancer Center, Houston, TX; Mount Vernon Cancer Centre, United Kingdom; The Methodist Hospital Research Institute, Houston, TX
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Rimawi MF, Rodriguez AA, Yang WT, Gonzalez-Angulo AM, Nangia JR, Wang T, Speers C, Mills G, Hilsenbeck SG, Brown PH, Chang JC. P3-14-09: A Phase II Preoperative Study of Dasatinib, a Multi-Targeted Tyrosine Kinase Inhibitor, in Locally Advanced “Triple-Negative” Breast Cancer Patients. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p3-14-09] [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
Background: We previously reported that kinases (Src, Yes-1, cKIT, Abl, and EPH4) were druggable in triple negative breast cancer (TNBC). In this clinical trial, we sought to translate these findings by treating TNBC patients with dasatinib, a multi-targeted kinase inhibitor against these targets.
Methods: Women with stage II-III TNBC were eligible. Patients received dasatinib at 100 mg daily for 3 to 4 weeks before standard-of-care definitive surgery and chemotherapy. Biopsies were performed at baseline, week 1, and at the time of surgery. A cohort of patients had positron emission mammography (PEM; baseline and at 2–3 weeks of dasatinib therapy). This study was designed to detect an increase in clinical response rate from 10% to 25%, using a Simon optimal two stage design, with one-sided alpha=5% and power=80%. At least 3 responses out of 22 patients were needed to proceed to the second stage.
Results: 22 patients were enrolled (Table 1). Median tumor size was 7.0 cm (range 2.4-25 cm). Adverse events were modest, mainly grade 1–2 (headache: 45%, abnormal LFTs: 55%, GI: 23%, fatigue: 18%). One patient had a myocardial infarction 24 hours after starting dasatinib. Out of 22 patients, 2 (9%) had a clinical partial response after 3–4 weeks of therapy, 15 had stable disease (68%), while 5 had progressive disease (23%). Of the 8 patients who received paired PEM imaging, metabolic responses were observed in 2 patients (25%). Conclusion: A short course of dasatinib led to clinical responses in 2 out of 22 patients with TNBC, and the study did not proceed to second stage. Since TNBC is a heterogeneous disease, biomarker studies including sequencing of candidate genes like B-RAF for inactivating mutations might enable selection of those TNBC patients who could benefit from dasatinib.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-14-09.
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Affiliation(s)
- MF Rimawi
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - AA Rodriguez
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - WT Yang
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - AM Gonzalez-Angulo
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - JR Nangia
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - T Wang
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - C Speers
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - G Mills
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - SG Hilsenbeck
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - PH Brown
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
| | - JC Chang
- 1Baylor College of Medicine, Houston, TX; The Methodist Hospital, Houston, TX; M.D. Anderson Cancer Center, Houston, TX
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Rodriguez AA, Makris A, Harrison MK, Ostler PJ, Froehlich A, Pavlick A, Wong H, Tsimelzon A, Sexton K, Hilsenbeck SG, Lewis MT, Rimawi M, Osborne CK, Chang JC. BRCA1 gene expression signature predicts for anthracycline-chemosensitivity in triple-negative breast cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-6039] [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
Abstract #6039
Background: We used a previously published gene expression signature that can identify tumors from BRCA1 mutation carriers to evaluate its predictive value in triple-negative breast cancer as a marker for chemosensitivity to anthracycline-based chemotherapy. We proposed that based on preclinical evidence suggesting that BRCA1-deficient breast cancer cells are sensitive to DNA damaging drugs such as cisplatin and anthracyclines this gene expression profile may identify tumors with anthracycline chemosensitivity. Two previously published studies defined a gene expression signature associated with BRCA1 germline mutation.(1,2) In these studies, sporadic tumors were misclassified as BRCA1 tumors and further analysis revealed methylation of the BRCA1 promoter region and decreased BRCA1 gene expression. This finding suggests the possibility of identifying sporadic tumors with decreased BRCA1 activity.
 Methods: We selected from our database of a locally advanced breast cancer neoadjuvant trial all cases of triple negative breast cancer that received 4 cycles of doxorubicin/cyclophosphamide(AC, 60/200 mg/m2, every 3 weeks) prior to surgery. Pathologic response to chemotherapy was disappearance of all invasive cancer or microscopic residual disease. Tumoral gene expression profile previously obtained using Affymetrix U133A Chip was analyzed for an optimal set of 100 most differentially expressed genes distinguishing BRCA1 and sporadic triple negative tumors according to the previously identified gene signature by van't Veer et al.1 We performed unsupervised clustering to determine if this signature could classify a subtype of triple-negative tumors with "BRCAness" and to test our hypothesis that BRCA1-like tumors are more sensitive to AC. We then performed a supervised analysis to determine the most differentially expressed genes that could prospectively identify triple-negative sporadic tumors with “BRCAness” and tumors from BRCA1 germline carriers that are sensitive to anthracyclines.
 Results: Of the 66 patients enrolled in our neoadjuvant trial, 12 patient's tumors were triple negative and received preoperative AC. By unsupervised clustering, the gene expression pattern associated with BRCA1 cancers subdivided these sporadic cancers in to two groups: Group A(6/7 pathologic responders), and group B(5/5 non-pathologic responders). By supervised analysis, the most differentially overexpressed gene from the BRCA1 profile for AC sensitivity was YWHAH(14-3-3 eta polypeptide), while DKK3(Inhibitor of Wnt and Notch signaling pathway) and RPL23A were most overexpressed in all cases with adriamycin-resistance(p<0.01).
 Discussion: Triple negative sporadic breast cancer displaying “BRCAness” appear to be sensitive to AC chemotherapy. YWHAH, DKK3, and RPL23A are differentially expressed in anthracycline-sensitive versus resistant tumors. These three genes can potentially identify triple-negative breast cancers that exhibit “BRCAness” and sensitivity to DNA-damaging chemotherapy such as cisplatin, anthracycline, or PARP inhibitors.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 6039.
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Affiliation(s)
| | - A Makris
- 2 Mount Vernon Hospital, Middlesex, UK
| | | | - PJ Ostler
- 2 Mount Vernon Hospital, Middlesex, UK
| | | | - A Pavlick
- 1 Baylor College of Medicine, Houston, TX
| | - H Wong
- 1 Baylor College of Medicine, Houston, TX
| | | | - K Sexton
- 1 Baylor College of Medicine, Houston, TX
| | | | - MT Lewis
- 1 Baylor College of Medicine, Houston, TX
| | - M Rimawi
- 1 Baylor College of Medicine, Houston, TX
| | - CK Osborne
- 1 Baylor College of Medicine, Houston, TX
| | - JC Chang
- 1 Baylor College of Medicine, Houston, TX
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Abstract
MOTIVATION Availability of large volumes of genomic and enzymatic data for taxonomically and phenotypically diverse organisms allows for exploration of the adaptive mechanisms that led to diversification of enzymatic functions. We present Chisel, a computational framework and a pipeline for an automated, high-resolution analysis of evolutionary variations of enzymes. Chisel allows automatic as well as interactive identification, and characterization of enzymatic sequences. Such knowledge can be utilized for comparative genomics, microbial diagnostics, metabolic engineering, drug design and analysis of metagenomes. RESULTS Chisel is a comprehensive resource that contains 8575 clusters and subsequent computational models specific for 939 distinct enzymatic functions and, when data is sufficient, their taxonomic variations. Application of Chisel to identification of enzymatic sequences in newly sequenced genomes, analysis of organism-specific metabolic networks, 'binning' of metagenomes and other biological problems are presented. We also provide a thorough analysis of Chisel performance with other similar resources and manual annotations on Shewanella oneidensis MR1 genome.
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Affiliation(s)
- Alexis A Rodriguez
- Mathematics and Computer Science Division, Argonne National Laboratory, 9700 S. Cass Ave., Argonne, IL 60439, USA
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Nichols KB, Rodriguez AA. Comparison of and Investigation into the Size Effects on the Rotational Dynamics of Two Spherical Molecules: CCl4 and C60. J Phys Chem A 2005; 109:3009-14. [PMID: 16833624 DOI: 10.1021/jp045899b] [Citation(s) in RCA: 3] [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: 11/29/2022]
Abstract
13C spin-lattice relaxation measurements were performed on CCl4 and C60, two spherical molecules, to investigate the role of molecular size on reorientational dynamics. Measurements were taken at common temperatures and in a common environment; deuterated chlorobenzene-d5. Our data indicate that both CCl4 and C6) reorient in the small-step diffusion limit. Correlation times for CCl4 were found to be smaller in CBZ than in the neat and much shorter than predicted by viscosity arguments. We have attributed the higher rotational freedom to higher "free volume" or lower solute-solvent contact probability, in CBZ than in the neat. Experimental tau C values for CCl4 and C60 in CBZ were found to be much different than those predicted by hydrodynamics. Pure inertia differences did not explain the disparities in the correlation times. However, a very reasonable explanation for our experimental findings was found by considering the solvent-to-probe molecular volume ratio and its effect on rotational diffusion. We applied four hydrodynamic-based theories to our data and found that the model by Gierer-Wirtz best duplicated our experimental observations. The success of this model suggests that the relative size of solute and solvent molecules, as well as events at the microscopic level, rather than bulk properties, are excellent descriptors of the factors affecting rotational diffusion.
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Affiliation(s)
- Kyle B Nichols
- Department of Chemistry, East Carolina University, Greenville, North Carolina 27858, USA
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Kearse KP, Smith NL, Semer DA, Eagles L, Finley JL, Kazmierczak S, Kovacs CJ, Rodriguez AA, Kellogg-Wennerberg AE. Monoclonal antibody DS6 detects a tumor-associated sialoglycotope expressed on human serous ovarian carcinomas. Int J Cancer 2000; 88:866-72. [PMID: 11093807 DOI: 10.1002/1097-0215(20001215)88:6<866::aid-ijc5>3.0.co;2-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A newly developed murine monoclonal antibody, DS6, immunohistochemically reacts with an antigen, CA6, that is expressed by human serous ovarian carcinomas but not by normal ovarian surface epithelium or mesothelium. CA6 has a limited distribution in normal adult tissues and is most characteristically detected in fallopian tube epithelium, inner urothelium and type 2 pneumocytes. Pre-treatment of tissue sections with either periodic acid or neuraminidase from Vibrio cholerae abolishes immunoreactivity with DS6, indicating that CA6 is a neuraminidase-sensitive and periodic acid-sensitive sialic acid glycoconjugate ("sialoglycotope"). SDS-PAGE of OVCAR5 cell lysates has revealed that the CA6 epitope is expressed on an 80 kDa non-disulfide-linked glycoprotein containing N-linked oligosaccharides. Two-dimensional non-equilibrium pH gradient gel electrophoresis indicates an isoelectric point of approximately 6.2 to 6.5. Comparison of the immunohistochemical distribution of CA6 in human serous ovarian adenocarcinomas has revealed similarities to that of CA125; however, distinct differences and some complementarity of antigen expression were revealed by double-label, 2-color immunohistochemical studies. The DS6-detected CA6 antigen appears to be distinct from other well-characterized tumor-associated antigens, including MUC1, CA125 and the histo-blood group-related antigens sLea, sLex and sTn.
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Affiliation(s)
- K P Kearse
- Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC 27858-4354, USA
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20
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Affiliation(s)
- J S Levin
- Lemuel Shattuck Hospital, Boston, Massachusetts, USA
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21
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O'Donnell TF, Rodriguez AA, Fortunato JE, Welch HJ, Mackey WC. Management of recurrent carotid stenosis: should asymptomatic lesions be treated surgically? J Vasc Surg 1996; 24:207-12. [PMID: 8752030 DOI: 10.1016/s0741-5214(96)70095-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to determine factors that may influence patient selection for surgery in recurrent carotid stenosis (RCS) and to contrast the results of primary and secondary carotid endarterectomy (CENDX) with regard to operative morbidity and stroke prevention. METHODS Forty-eight patients who underwent CENDX for RCS (RCS-OP group) were compared with a contemporaneous group of 40 patients who on at least one post-CENDX duplex ultrasonography study had a greater than 50% stenosis but did not undergo operation (RCS-NO-OP group). This latter group was drawn from 1053 follow-up duplex studies in 348 patients who underwent primary CENDX between the years 1983 and 1993. Each of these two groups was compared with a metanalysis of six key series derived from the literature. RESULTS No significant differences were seen in the demographics or the incidence of risk factors between the two groups except for a higher incidence of coronary artery disease (p < 0.03) and peripheral vascular disease (p < 0.001) in the RCS-OP group. The operation-specific stroke rate was 2.1%, and the 30-day mortality was also 2.1%. Symptomatic RCS was the indication in 56% of cases. Important anatomic differences were found between groups. The duplex/arteriographic degree of stenosis was greater than 90% in 75% of the patients in the RCS-OP group, whereas only 10% of the patients in the RCS-NO-OP group had greater than 80% stenosis, most being in the 50% to 80% range. An unexpected finding was the sudden progression to occlusion in 10 (25%) of 40 in the RCS-NO-OP group, with 2 (5%) of 10 of the occlusions presenting as unheralded strokes. Overall, a stroke without an antecedent transient ischemic attack occurred in 3 (7.5%) of 40 of patients in the RCS-NO-OP group, all in patients with greater than 75% stenosis on their last documented scan preceding the stroke. CONCLUSION Given the relatively low stroke rate with surgery in the RCS-OP group (2.1%) and the higher incidence of unheralded strokes (7.5%) in the RCS-NO-OP group, a more aggressive approach may be warranted in patients with asymptomatic high-grade (> 75%) RCS, a strategy not unlike that adopted for primary CENDX.
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Affiliation(s)
- T F O'Donnell
- Department of Surgery, Tufts University School of Medicine, Boston, MA, USA
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22
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Rodriguez AA, Whitehead CM, McLaughlin RL, Umphrey SE, Welch HJ, O'Donnell TF. Duplex-derived valve closure times fail to correlate with reflux flow volumes in patients with chronic venous insufficiency. J Vasc Surg 1996; 23:606-10. [PMID: 8627895 DOI: 10.1016/s0741-5214(96)80039-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The best way to quantitate venous reflux is still a matter of debate. Duplex-derived valve closure time (VCTs) have been used recently because they can be measured easily. We examined the relationships between VCT and duplex-obtained quantitation of venous volume and between VCT and air plethysmography (APG). Sixty-nine legs in 45 patients with varying clinical degrees of chronic venous insufficiency were studied by duplex scan and APG. VCTs were compared with duplex-derived flow calculations and with APG-derived venous filling index and residual volume fraction. The patient's mean age was 47.5 +/- 13.9 years; the mean duration of their symptoms was 13 +/- 4 years. Twenty percent had a history of deep venous thrombosis, and 29% had undergone venous surgery. No correlation was found between VCT and flow volume or between VCT and flow at peak reflux at any of the anatomic locations studied: saphenofemoral junction, greater saphenous vein, lesser saphenous vein, superficial femoral vein, profunda femoris vein, and popliteal vein. Likewise, no correlation was found between total VCT and APG-derived venous filling index or between total flow volumes and APG-derived residual volume fraction. Total VCT and total flow volumes did, however, have a moderate correlation (r = 0.65; p = 0.0003). Duplex-derived VCTs, although extremely useful in determining the presence of reflux, do not correlate with the magnitude of reflux, and should not be used to quantitate the degree of reflux.
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Affiliation(s)
- A A Rodriguez
- Department of Surgery, Tufts University School of Medicine, Boston, MA 02111, USA
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23
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Affiliation(s)
- A A Rodriguez
- Department of Rehabilitation Medicine, University of Wisconsin-Madison Medical School, Madison 53792, USA
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24
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Balingit AG, Slack MC, Allen S, Caravalho J, Rivera JE, Rodriguez AA. Right ventricular 201T1 uptake on myocardial perfusion single photon emission computed tomography imaging. Semin Nucl Med 1995; 25:348-51. [PMID: 8545639 DOI: 10.1016/s0001-2998(95)80008-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- A G Balingit
- Nuclear Medicine Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA
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25
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Rodriguez AA, Gardner GP, LaMorte WW, Obi-Tabot ET, Valeri CR, Hirsch EF. Comparison of skeletal muscle laser Doppler flowmetry to changes in central hemodynamics in detecting the physiological response to moderate hemorrhage. J Surg Res 1995; 58:189-92. [PMID: 7861771 DOI: 10.1006/jsre.1995.1029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Previous studies have demonstrated that laser Doppler (LD) flowmetry is a useful technique for following changes in blood flow in a tissue bed, but the potential role of LD flowmetry in management of the critically ill patient is unclear. This study sought to establish the sensitivity of LD flowmetry compared to changes in centrally measured hemodynamic parameters in response to a mild hemorrhagic episode. In order to establish the correlation between LD flow and actual blood flow, livers from Sprague-Dawley rats were isolated and perfused via the portal vein with citrate anti-coagulated rat blood. Changes in LD flow were recorded while changing blood flow via the perfusion pump. There was a strong correlation between pump flow and LD flow (for N = 5 livers, r > 0.9; P < 0.05). This relationship was stable at hematocrits > 20. The second part of this study tested the sensitivity of LD flowmetry in anesthesized baboons. An LD probe was placed on the surface of the gracilis muscle of the adult male baboons. LD flow and hemodynamic parameters were measured following two episodes of bleeding and reinfusing 250 cc of blood. During the first bleed there were significant changes in heart rate (97 + 8 to 159 + 12), mean arterial pressure (125 + 6 to 105 + 9), and LD flow (20.6 + 4.6 to 11.9 + 3.6); these parameters returned to normal after reinfusion of blood. During the second bleed, the only parameters that showed significant changes were heart rate (118 + 5 to 135 + 12) and LD flow (17.5 + 8 to 10.7 + 3.4).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A A Rodriguez
- Division of Surgery, Boston University School of Medicine, Massachusetts 02118
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26
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Abstract
A 42-year-old woman presented with intermittent low back and left lower extremity pain. The blood flow and blood pool images of bone scintigraphy showed a large focus of increased activity in the right lower abdomen. Computed tomography showed an enlarged uterus displaced to the right side of the pelvis. At surgery, the uterus was found to be involved with adenomyosis. Three-phase bone scintigraphy consisting of blood flow and blood pool images over the anterior pelvis may be a valuable diagnostic aid in the evaluation of lower back or pelvic pain of a woman.
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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27
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Taniguchi MH, Hayes J, Rodriguez AA. Reliability determination of F mean response latency. Arch Phys Med Rehabil 1993; 74:1139-43. [PMID: 8239950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Two hundred consecutive ulnar F wave latencies were evaluated in 30 healthy controls (C) and in 9 patients with mild neuropathy (N). The primary study objective was to determine the F wave sample size required to obtain a reliable F mean latency. A secondary objective was to explore the diagnostic utility of three F wave parameters: the minimal F wave latency (Fmin), the average F wave latency (Fmean), and the minimal-maximal F wave latency difference (Frange). For the control group, the Fmean reliability estimates as measured by intraclass correlation coefficients were 0.87, 0.97, and 0.99 with 1, 5, and 10 responses, respectively; for the N group, the corresponding values were 0.73, 0.93, and 0.96. Fmean was abnormal in 89% of the subjects with mild neuropathy whereas Frange and Fmin were abnormal in 67% and 33%, respectively. The study suggests (1) a reliable F mean latency can be obtained by averaging ten F responses; and (2) Fmean and Frange offers promise in increasing the diagnostic utility of the F response in identifying mild neuropathies.
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Affiliation(s)
- M H Taniguchi
- Department of Rehabilitation Medicine, Columbus Childrens Hospital, OH 43205
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28
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Cordts PR, Hanrahan LM, Rodriguez AA, Woodson J, LaMorte WW, Menzoian JO. A prospective, randomized trial of Unna's boot versus Duoderm CGF hydroactive dressing plus compression in the management of venous leg ulcers. J Vasc Surg 1992; 15:480-6. [PMID: 1538504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Leg ulcers caused by chronic venous insufficiency plague an estimated 500,000 Americans, but there have been few improvements in conservative treatment in this century, and Unna's boot continues to be a mainstay of therapy. A recent report suggests that Duoderm CGF dressing provides greater patient comfort and enhanced compliance, but Duoderm alone (without compression) resulted in slower healing compared with Unna's boot. We enrolled 30 patients (30 ulcers) in a clinical trial to compare Duoderm CGF plus compression (Coban wrap) to Unna's boot. No significant difference was observed between the two groups with respect to age, sex, initial ulcer area, ulcer duration, or extent of venous insufficiency by duplex scan. Eight of 16 ulcers (50%) in the Duoderm group healed completely versus 6 of 14 ulcers (43%) in the Unna's boot group (p = 0.18). Healing rates (square centimeters per week) correlated significantly with initial ulcer area and initial ulcer perimeter for both groups but best correlated with initial ulcer perimeter (r = 0.88 with Duoderm, p less than 0.0001; r = 0.80 with Unna's boot, p less than 0.002). After adjusting for differences in initial ulcer perimeter, healing rates were significantly faster for patients on Duoderm than patients on Unna's boot during the first 4 weeks of therapy (0.384 +/- 0.059 cm2/wk/cm perimeter for Duoderm versus 0.135 +/- 0.043 cm2/wk/cm perimeter for Unna's boot; p = 0.002). At 12 weeks patients on Duoderm again appeared to heal faster than those on Unna's boot, although the result did not reach statistical significance (0.049 +/- 0.007 cm2/wk/cm perimeter for Duoderm versus 0.020 +/- 0.017 for Unna's boot, p = 0.11).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P R Cordts
- Section of Vascular Surgery, Boston University School of Medicine, MA
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29
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Rivera-Rodriguez JE, Rodriguez AA, Turnbull GL, Moreno AJ. Scintigraphic evaluation with Tc-99m MDP and Ga-67 citrate in a case of pediatric T-cell lymphoma. Clin Nucl Med 1992; 17:61-4. [PMID: 1544266 DOI: 10.1097/00003072-199201000-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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30
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Abstract
Lack of a reproducible model to quantitatively assess hepatocellular injury following ischemia has made it difficult to assess new strategies for minimizing hepatic injury. We studied the progression of hepatocellular injury after ischemia and ischemia with reperfusion in rats. Irreversible injury was quantitated using a triphenyltetrazolium chloride assay that was shown to correlate with ultrastructural changes. Adenosine triphosphate decreased to 36% of basal values after 30 minutes, but returned to normal with reperfusion with no decrease in viability. In contrast, viability fell by 30% after 60 minutes of ischemia, and by 64% when 60 minutes of ischemia was followed by reperfusion. We conclude that reperfusion of ischemic liver increases the degree of irreversible damage. The model employed here seems to be useful for studying ischemic and reperfusion injury in the liver.
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Affiliation(s)
- A A Rodriguez
- Department of Surgery, Sears Surgical Laboratory, Boston University School of Medicine, MA 02118
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31
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Hanrahan LM, Araki CT, Rodriguez AA, Kechejian GJ, LaMorte WW, Menzoian JO. Distribution of valvular incompetence in patients with venous stasis ulceration. J Vasc Surg 1991; 13:805-11; discussion 811-2. [PMID: 2038103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Valvular incompetence associated with venous ulceration can occur in the superficial, deep, or perforating systems. Duplex imaging was used to evaluate 95 extremities (78 patients) with current venous ulceration to determine the location of incompetence in each extremity. In addition, in 91 of the 95 extremities the area of the venous ulcer was evaluated for the presence of perforating veins or any other superficial veins or both conditions. Sixty-three (66.3%) of the 95 extremities had multisystem incompetence (superficial and perforating plus superficial and deep plus perforating and deep plus superficial and perforating and deep), whereas single system incompetence (superficial plus perforating plus deep) was seen in only 26 (27.3%). Isolated deep incompetence was identified in only two extremities (2.1%). Furthermore, 45% (41/91) of the ulcers had no duplex evidence of any venous abnormality in the ulcer bed. These data show that the site of valvular incompetence occurred in multiple locations, that isolated valvular incompetence of the deep venous system was uncommon, and that perforating veins were not always in the ulcer bed itself. Because standard venous surgery has traditionally been directed toward only one system, this may provide one explanation for ulcer recurrence. Therefore complete venous evaluation with duplex imaging allowing for surgical intervention directed specifically to the sites of involvement in each system is recommended.
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Affiliation(s)
- L M Hanrahan
- Division of Surgery, Boston University School of Medicine, MA 02118
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32
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Hanrahan LM, Kechejian GJ, Cordts PR, Rodriguez AA, Araki CA, LaMorte WW, Menzoian JO. Patterns of venous insufficiency in patients with varicose veins. Arch Surg 1991; 126:687-90; discussion 690-1. [PMID: 2039354 DOI: 10.1001/archsurg.1991.01410300029003] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The nature and distribution of venous disease surrounding the development of varicose veins and its treatment is controversial. Using duplex ultrasonography, we evaluated 54 lower extremities in 32 patients with varicose veins who were symptomatic and had obvious varicose veins by clinical examination. Twenty-eight percent had greater saphenous trunk incompetence, 2% had lesser saphenous trunk incompetence, and 96% had branch disease. Deep valvular incompetence was seen in 41%, saphenofemoral junction incompetence in 46%, and incompetence of one or more perforators in 46% of the extremities. Thirty-three percent demonstrated no evidence of associated saphenofemoral junction, deep vein, or perforating vein incompetence, while 20% had concurrent saphenofemoral junction, deep vein, and perforating vein incompetence. These data support the heterogeneity of venous disease seen in patients with varicose veins and suggest that surgical therapy be directed to a patient's specific pattern of incompetence rather than routine saphenofemoral junction ligation or stripping of the greater saphenous trunk.
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Affiliation(s)
- L M Hanrahan
- Department of Surgery, Boston University Medical Center, MA 02118
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33
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Abstract
The purpose of this study was to determine whether quantitative motor unit analysis in postpolio individuals correlates with muscle strength, endurance, work capacity, or power spectral characteristics of surface EMG and to determine whether power spectrum differentiates postpolio from control subjects. This study was designed to compare these variables in 34 symptomatic postpolio, 16 asymptomatic postpolio, and 41 control subjects. Quantitative motor unit analysis of the quadriceps femoris muscle was performed using a concentric needle electrode. Isometric knee extension peak torque, endurance (time to exhaustion) at 40% of maximal torque, work capacity (tension time index), and recovery of force through 10 minutes post-exhaustion were determined. Median frequency of the surface power spectrum was determined during the above testing. Power spectrum histograms were compared at the onset and termination of endurance exercise. Motor unit action potential variables did not correlate with isometric peak torque, tension time index, endurance time, recovery of strength, or with median frequency. Surface power spectrum did not differentiate postpolio from control subjects.
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Affiliation(s)
- A A Rodriguez
- Department of Rehabilitation Medicine, University of Wisconsin-Madison Medical School 53792
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34
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Affiliation(s)
- M A Toney
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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35
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Moreno AJ, Toney MA, Griffith JC, Rodriguez AA, Turnbull GL. Serendipitous finding of transitional cell carcinoma of the kidney on bone and gallium imaging. Clin Nucl Med 1991; 16:165-6. [PMID: 2032429 DOI: 10.1097/00003072-199103000-00006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 50-year-old woman presented with low back pain. Bone scintigraphy showed a focus of increased activity in the upper pole of the left kidney. Subsequent Ga-67 citrate scintigraphy demonstrated this same abnormal focus as a region of increased activity. Ultrasonography showed a renal mass in the upper pole of the left kidney. At surgery a transitional cell carcinoma of the upper pole of the left kidney was found.
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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36
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Hanrahan LM, Araki CT, Fisher JB, Rodriguez AA, Walker TG, Woodson J, LaMorte WW, Menzoian JO. Evaluation of the perforating veins of the lower extremity using high resolution duplex imaging. J Cardiovasc Surg (Torino) 1991; 32:87-97. [PMID: 2010459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this study was to evaluate duplex imaging as a means of assessing perforating veins in patients with longstanding venous stasis ulceration. Thirty patients with nonhealing venous stasis ulcers and twenty normal volunteers serving as controls were evaluated with a standard 8-MHz imaging probe and integrated pulsed Doppler. The internal diameter of perforating veins was measured and perforators were grouped into one of four categories based on functional criteria: competent perforator with venous flow (C); incompetent perforator with venous flow (IC); competent perforator with arteriovenous flow (C-AVC); incompetent perforator with arteriovenous flow (IC-AVC). Sixteen of the patients with ulcers were subsequently studied by ascending venography and in 11 patients, intraoperative identification of perforating veins was made during the Rob procedure. In this subset of patients the vessel was categorized as competent or incompetent regardless of flow signal. There were significant differences in mean perforator diameter between ulcer patients and normal volunteers. Duplex imaging identified 93 perforators and venography a total of 70. In all 16 extremities, duplex imaging made the diagnosis of significant perforating vein incompetence, verified by venography. Intraoperative findings demonstrated an excellent correlation with duplex imaging. We believe duplex imaging to be a promising new modality for evaluation of the perforating veins of the lower extremity.
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Affiliation(s)
- L M Hanrahan
- Division of Surgery, Boston University School of Medicine, Massachusetts
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37
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Woodson J, Rodriguez AA, Menzoian JO. The use of internal jugular vein as interposition graft for femoral vein reconstruction following traumatic venous injury: a useful approach in selected cases. Ann Vasc Surg 1990; 4:494-7. [PMID: 2223549 DOI: 10.1016/s0890-5096(07)60077-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Complex venous injuries remain a controversial and interesting challenge to the vascular and trauma surgeon. Data from the Vietnam Vascular Registry, combined with experience from recent civilian series, seem to indicate that the best results are obtained when venous repair is undertaken. This is especially true of combined arterial and venous injury where compromised venous outflow may lead to limb loss in spite of patent arterial reconstruction. The larger size of veins, however, has required the construction of complex and time-consuming panel and spiral-vein grafts. This makes them far from ideal in the trauma treatment setting, where minimization of blood loss and operating room time are high priorities. We present a case of combined injury to both femoral artery and vein, where the femoral vein injury was repaired using autologous internal jugular vein as interposition graft while the arterial injury was repaired with autologous saphenous vein from the opposite limb. The avoidance of prosthetics, ease of harvest, size match, and little associated morbidity all make a strong case for use of the internal jugular vein where speedy reconstruction of large venous conduits is indicated.
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Affiliation(s)
- J Woodson
- Division of Surgery, Boston University School of Medicine, Massachusetts 02118-2393
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38
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Agre JC, Rodriquez AA, Sperling KB, Rodriguez AA. Plasma lipid and lipoprotein concentrations in symptomatic postpolio patients. Arch Phys Med Rehabil 1990; 71:393-4. [PMID: 2334282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study reports lipid and lipoprotein concentrations in postpolio patients seen in our postpolio clinic who were evaluated for complaints of progressive weakness, fatigue, and/or pain. Concentrations of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were determined after an overnight fast. Sixty-four patients (24 men and 40 women) with a mean age of 48 +/- 10 years were studied. Mean (+/- SD) lipid concentrations (mg/dL) for men and women, respectively, were 220 +/- 46 and 213 +/- 43 for TC; 38.5 +/- 8.6 and 59.1 +/- 18.1 for HDL-C; 148 +/- 46 and 129 +/- 36 for LDL-C; and 205 +/- 107 and 105 +/- 55 for TG. Hyperlipidemia was found in 16 of 24 men and 10 of 40 women. In the men, mean HDL-C concentration was in the lowest decile of our hospital laboratory's reference range, whereas mean TC/HDL-C ratio was elevated above the recommended value. It is suggested that lipid and lipoprotein concentrations be evaluated in postpolio patients because a high prevalence of lipid/lipoprotein disorders was found in our subjects. Further research is needed on this topic.
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Affiliation(s)
- J C Agre
- Department of Rehabilitation Medicine, University of Wisconsin-Madison Medical School 53792
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39
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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40
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Diaz-Ball FL, Moreno AJ, Toney MA, Rodriguez AA, Turnbull GL. One-dose technetium-99m pertechnetate imaging in acute testicular torsion followed by manual detorsion. Clin Nucl Med 1990; 15:76-9. [PMID: 2155731 DOI: 10.1097/00003072-199002000-00002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The role of technetium-99m pertechnetate imaging in acute testicular torsion is well appreciated. Manual testicular detorsion under local anesthesia may be performed in the nuclear medicine clinic by the urology service immediately following initial diagnostic scintigraphy. Following manual testicular detorsion, continued images of the testes are obtained up to 30 minutes without having to reinject the patient with technetium-99m pertechnetate. Reperfusion of the affected testicle will be dramatically noted if the manual detorsion is successful. Four cases are presented to illustrate this.
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Affiliation(s)
- F L Diaz-Ball
- Department of Surgery, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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41
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Moreno AJ, Ortenzo CA, Rodriguez AA, Kyte FM, Turnbull GL. Gallbladder perforation seen on hepatobiliary imaging following morphine sulfate injection. Clin Nucl Med 1989; 14:651-3. [PMID: 2791419 DOI: 10.1097/00003072-198909000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A case of gallbladder perforation imaged during morphine-augmented cholescintigraphy is presented. Tc-99m DISIDA imaging dramatically demonstrated the bile leak. Whether morphine sulfate contributed to the perforation of the gallbladder is debatable.
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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42
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 77920-5001
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Abstract
An 8-year-old boy presented with elevated temperature, malaise, hepatosplenomegaly, mesenteric adenitis, and septic shock. Cultures of biopsied abdominal lymph nodes as well as the blood grew Yersinia pestes. The boy's condition improved after two weeks of chloramphenicol and cefotaxime (Claforan). Two days after stopping intravenous antibiotic therapy, the patient again became febrile and complained of abdominal pain. Abdominal imaging with 111In-labeled leukocytes did not show any abnormalities, however, 67Ga-citrate scintigraphy demonstrated an abnormal focus of increased radiopharmaceutical uptake within a confluence of necrosed lymph nodes within the right upper quadrant of the abdomen. In addition, abnormal 67Ga-uptake was seen within the left hip region. Correlative imaging with computed tomography is also presented.
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, TX 79920-5001
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Abstract
Six cases of osteomyelitis due to Coccidioides immitis are presented. The cases reported demonstrate the importance of performing both bone and gallium imaging to avoid missing the osseous coccidioidal lesions.
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Affiliation(s)
- A J Moreno
- Department of Medicine, William Beaumont Army Medical Center, El Paso, Texas 79920-5001
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Moreno AJ, Rodriguez AA, Spicer MJ, Jackson RE, Byrd BF, Turnbull GL. The value of obtaining renal images following brain scintigraphy with technetium-99m glucoheptonate. Clin Nucl Med 1986; 11:560-3. [PMID: 3742911 DOI: 10.1097/00003072-198608000-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The value of adding an extra view of the kidneys immediately following brain imaging with Tc-99m glucoheptonate was investigated in a two-year retrospective study at our institution. Between October 1982 and October 1984, 561 individuals underwent Tc-99m glucoheptonate brain imaging with the added renal view. Twenty-nine of these individuals (5.2%) demonstrated renal abnormalities. The abnormal renal findings were clinically correlated in 24 of these persons. Sixteen (67%) of these 24 individuals were unaware of any renal abnormality. Useful information can be obtained from renal images incidental to brain imaging at no added expense or radiation exposure to the patient, and at a minimal cost in time to the imaging clinic.
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Moreno AJ, Parker AL, Rodriguez AA, Sorensen KA, Turnbull GL. Combined common bile duct and gastric outlet obstruction demonstrated during hepatobiliary scintigraphy. Eur J Nucl Med 1985; 10:563-5. [PMID: 4040859 DOI: 10.1007/bf00252755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A 64-year-old man presented with jaundice. Hepatobiliary imaging using 99mTc-DISIDA revealed complete hepatobiliary tract obstruction with a photopenic area corresponding to a dilated gallbladder and a large photopenic region corresponding to a distended stomach as a result of gastric outlet obstruction. At surgery, carcinoma of the head of the pancreas was found to be the cause of the combined common bile duct and gastric outlet obstruction.
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Villarejos VM, Rodriguez AA, Gutierez DA. Letter: Chloroguine and HBs-Ag carrier status. Lancet 1975; 1:745-6. [PMID: 47508 DOI: 10.1016/s0140-6736(75)91657-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Gòmez Echevarria AH, Santin Gòmez JM, Fernàndez LA, Pèrez Rodriguez R, Banderas NP, Garcia AB, Cabrera Jimènez M, Rodriguez AA, Hernàndez Valdès A, Micò GS, Machado RG. [Disodium cromoglycate: preliminary report of its clinical trial in Cuba]. Alergia 1973; 21:21-30. [PMID: 4201688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Jatene AD, Rodriguez AA, Aquino MM, Galantyer M, Ginaque R. [Coronary perfusion during surgery of the aortic valva. Importance of the anatomic factor]. Arq Bras Cardiol 1967; 20:193-8. [PMID: 5595717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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