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Lo B, Nordan T, Sparks A, Lee L, Zhan Y, Chen FY, Couper GS, Kawabori M. Donor Age More Than 20 Years Greater Than Recipient Age Is Associated With Worse 5 Year Survival in Young Adult Heart Transplantation. ASAIO J 2024:00002480-990000000-00462. [PMID: 38595112 DOI: 10.1097/mat.0000000000002203] [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: 04/11/2024] Open
Abstract
Prior studies indicate donor age-recipient age (DA-RA) difference may be of prognostic value in adolescents, although not adults. We aim to analyze the relationship between DA-RA difference and long-term survival of young adult heart transplantation (HTx) recipients. First-time, single-organ HTx recipients aged 18-30 who underwent HTx between 2010 and 2020 were analyzed from the United Network for Organ Sharing (UNOS) registry. Four cohorts were created based on DA-RA difference. The primary outcome was 5 year post-HTx survival. Secondary outcome was post-HTx complications. One thousand eight hundred three donor-recipient pairs were divided into four groups: DA-RA < 0, 0 ≤ DA-RA < 10, 10 ≤ DA-RA < 20, and DA-RA ≥ 20 with 682 (37.8%), 651 (36.1%), 356 (19.7%), 114 (6.3%) pairs in each cohort, respectively. The estimated 5 year survival of the DA-RA ≥ 20 cohort was 66.5% compared to the other three groups at ~75%. After adjustment, DA-RA ≥ 20 was independently associated with worse survival compared to DA-RA < 0 (adjusted hazard ratio [HR] = 1.55; 95% confidence interval [CI] = 1.06-2.27; log-rank p = 0.008). There was no significant difference in complication incidence across cohorts. Among young adults, accepting a donor heart more than 20 years older than the recipient was associated with worse 5 year survival. We did not detect a significant difference up to 20 years. This information may help guide appropriate donor selection in the young adult population.
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Affiliation(s)
- Bryan Lo
- From the Division of Cardiac Surgery, CardioVascular Center, Tufts Medical Center, Boston, Massachusetts
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Morrison T, Lo B, Deharvengt SJ, Lazaridis N, Tsongalis GJ. Internal Standards for Limit Controls and Absolute Abundance Measurement of Oncogenic Fusions and Mutations. J Appl Lab Med 2024; 9:175-179. [PMID: 38167771 DOI: 10.1093/jalm/jfad108] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/30/2023] [Indexed: 01/05/2024]
Affiliation(s)
| | - Bryan Lo
- Molecular Oncology Diagnostics Laboratory, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Eastern Ontario Laboratory Association, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Sophie J Deharvengt
- Clinical Genomics and Advanced Technology, Department of Pathology and Laboratory Medicine, Dartmouth Health System, Lebanon, NH, United States
- The Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | | | - Gregory J Tsongalis
- Clinical Genomics and Advanced Technology, Department of Pathology and Laboratory Medicine, Dartmouth Health System, Lebanon, NH, United States
- The Geisel School of Medicine at Dartmouth, Hanover, NH, United States
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Hyrcza MD, Martins-Filho SN, Spatz A, Wang HJ, Purgina BM, Desmeules P, Park PC, Bigras G, Jung S, Cutz JC, Xu Z, Berman DM, Sheffield BS, Cheung CC, Leduc C, Hwang DM, Ionescu D, Klonowski P, Chevarie-Davis M, Chami R, Lo B, Stockley TL, Tsao MS, Torlakovic E. Canadian Multicentric Pan-TRK (CANTRK) Immunohistochemistry Harmonization Study. Mod Pathol 2024; 37:100384. [PMID: 37972928 DOI: 10.1016/j.modpat.2023.100384] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/19/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
Tumor-agnostic testing for NTRK1-3 gene rearrangements is required to identify patients who may benefit from TRK inhibitor therapies. The overarching objective of this study was to establish a high-quality pan-TRK immunohistochemistry (IHC) screening assay among 18 large regional pathology laboratories across Canada using pan-TRK monoclonal antibody clone EPR17341 in a ring study design. TRK-fusion positive and negative tumor samples were collected from participating sites, with fusion status confirmed by panel next-generation sequencing assays. Each laboratory received: (1) unstained sections from 30 cases of TRK-fusion-positive or -negative tumors, (2) 2 types of reference standards: TRK calibrator slides and IHC critical assay performance controls (iCAPCs), (3) EPR17341 antibody, and (4) suggestions for developing IHC protocols. Participants were asked to optimize the IHC protocol for their instruments and detection systems by using iCAPCs, to stain the 30 study cases, and to report the percentage scores for membranous, cytoplasmic, and nuclear staining. TRK calibrators were used to assess the analytical sensitivity of IHC protocols developed by using the 2 reference standards. Fifteen of 18 laboratories achieved diagnostic sensitivity of 100% against next-generation sequencing. The diagnostic specificity ranged from 40% to 90%. The results did not differ significantly between positive scores based on the presence of any type of staining vs the presence of overall staining in ≥1% of cells. The median limit of detection measured by TRK calibrators was 76,000 molecules/cell (range 38,000 to >200,000 molecules/cell). Three different patterns of staining were observed in 19 TRK-positive cases, cytoplasmic-only in 7 samples, nuclear and cytoplasmic in 9 samples, and cytoplasmic and membranous in 3 samples. The Canadian multicentric pan-TRK study illustrates a successful strategy to accelerate the multicenter harmonization and implementation of pan-TRK immunohistochemical screening that achieves high diagnostic sensitivity by using laboratory-developed tests where laboratories used centrally developed reference materials. The measurement of analytical sensitivity by using TRK calibrators provided additional insights into IHC protocol performance.
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Affiliation(s)
- Martin D Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute, Calgary, Alberta, Canada
| | - Sebastiao N Martins-Filho
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Alan Spatz
- McGill University Health Center, Lady Davis Institute, McGill University, Montreal, Quebec, Canada
| | - Han-Jun Wang
- McGill University Health Center, Lady Davis Institute, McGill University, Montreal, Quebec, Canada
| | - Bibianna M Purgina
- Department of Pathology and Laboratory Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Patrice Desmeules
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Paul C Park
- Shared Health, Department of Pathology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gilbert Bigras
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Sungmi Jung
- Department of Pathology, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Jean-Claude Cutz
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Zhaolin Xu
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David M Berman
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Brandon S Sheffield
- Department of Pathology, William Osler Health System, Brampton, Ontario, Canada
| | - Carol C Cheung
- University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Charles Leduc
- Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - David M Hwang
- Department of Laboratory Medicine and Pathobiology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Diana Ionescu
- Department of Pathology and Laboratory Medicine, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul Klonowski
- Department of Pathology and Laboratory Medicine, University of Calgary Cumming School of Medicine Diagnostic and Scientific Centre, Calgary, Alberta, Canada
| | - Myriam Chevarie-Davis
- Département de Pathologie et Biologie Cellulaire, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada
| | - Rose Chami
- Department of Laboratory Medicine and Pathobiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Bryan Lo
- Department of Pathology and Laboratory Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Tracy L Stockley
- University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Ming-Sound Tsao
- University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Emina Torlakovic
- Department of Pathology and Laboratory Medicine, Royal University Hospital, Saskatchewan Health Authority, and College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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Husereau D, Bombard Y, Stockley T, Carter M, Davey S, Lemaire D, Nohr E, Park P, Spatz A, Williams C, Pollett A, Lo B, Yip S, El Hallani S, Feilotter H. Future Role of Health Technology Assessment for Genomic Medicine in Oncology: A Canadian Laboratory Perspective. Curr Oncol 2023; 30:9660-9669. [PMID: 37999120 PMCID: PMC10670221 DOI: 10.3390/curroncol30110700] [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: 08/15/2023] [Revised: 10/23/2023] [Accepted: 10/28/2023] [Indexed: 11/25/2023] Open
Abstract
Genome-based testing in oncology is a rapidly expanding area of health care that is the basis of the emerging area of precision medicine. The efficient and considered adoption of novel genomic medicine testing is hampered in Canada by the fragmented nature of health care oversight as well as by lack of clear and transparent processes to support rapid evaluation, assessment, and implementation of genomic tests. This article provides an overview of some key barriers and proposes approaches to addressing these challenges as a potential pathway to developing a national approach to genomic medicine in oncology.
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Affiliation(s)
- Don Husereau
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1G 5Z3, Canada
| | - Yvonne Bombard
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada;
- Genomics Health Services Research Program, Li Ka Shing Knowledge Institute, Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1T8, Canada
| | - Tracy Stockley
- Division of Clinical Laboratory Genetics, Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada;
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Michael Carter
- Department of Pathology and Laboratory Medicine, Nova Scotia Health (Central Zone), Halifax, NS B3H 1V8, Canada;
| | - Scott Davey
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (S.D.); (C.W.); (H.F.)
- Division of Cancer Biology and Genetics, Queen’s University Cancer Research Institute, Queen’s University, Kingston, ON K7L 3N6, Canada
- Departments of Oncology and Biomedical and Molecular Sciences, Queen’s University Cancer Research Institute, Queen’s University, Kingston, ON K7L 2V7, Canada
| | - Diana Lemaire
- Ontario Institute for Cancer Research, 661 University Ave, Toronto, ON M5G 0A3, Canada
| | - Erik Nohr
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada;
- Alberta Precision Laboratories, Foothills Medical Center, 1403 29 St NW, Calgary, AB T2N 2T9, Canada
| | - Paul Park
- Department of Pathology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3A 1R9, Canada;
| | - Alan Spatz
- Division of Pathology, McGill University Health Center, 1001 Decarie Blvd., Montreal, QC H4A 3J, Canada;
- OPTILAB-MUHC & Department of Laboratory Medicine, 1001 Decarie Blvd., Montreal, QC H4A 3J, Canada
- Research Molecular Pathology Center, Lady Davis Institute, 3755 Côte Ste-Catherine Road, Montreal, QC H3T 1E2, Canada
| | - Christine Williams
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (S.D.); (C.W.); (H.F.)
- Ontario Institute for Cancer Research, 661 University Ave, Toronto, ON M5G 0A3, Canada
| | - Aaron Pollett
- Pathology & Laboratory Medicine, Sinai Health System, Toronto, ON M5G 1X5, Canada;
- Laboratory Medicine & Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Bryan Lo
- The Ottawa General Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada;
| | - Stephen Yip
- Department of Pathology & Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada;
| | - Soufiane El Hallani
- Alberta Precision Laboratory, Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R7, Canada;
| | - Harriet Feilotter
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (S.D.); (C.W.); (H.F.)
- Ontario Institute for Cancer Research, 661 University Ave, Toronto, ON M5G 0A3, Canada
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Phillips WJ, Lo B, Corredor ALG, Gomes M, Wheatley-Price P. A rare case of false negative ROS1 fusion in metastatic pulmonary adenocarcinoma: Case report and lessons learned. Clin Lung Cancer 2023:S1525-7304(23)00056-6. [PMID: 37100730 DOI: 10.1016/j.cllc.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/09/2023]
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Stockley TL, Lo B, Box A, Gomez Corredor A, DeCoteau J, Desmeules P, Feilotter H, Grafodatskaya D, Hawkins C, Huang WY, Izevbaye I, Lepine G, Papadakis AI, Park PC, Sheffield BS, Tran-Thanh D, Yip S, Sound Tsao M. Consensus Recommendations to Optimize the Detection and Reporting of NTRK Gene Fusions by RNA-Based Next-Generation Sequencing. Curr Oncol 2023; 30:3989-3997. [PMID: 37185415 PMCID: PMC10136625 DOI: 10.3390/curroncol30040302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
The detection of gene fusions by RNA-based next-generation sequencing (NGS) is an emerging method in clinical genetic laboratories for oncology biomarker testing to direct targeted therapy selections. A recent Canadian study (CANTRK study) comparing the detection of NTRK gene fusions on different NGS assays to determine subjects’ eligibility for tyrosine kinase TRK inhibitor therapy identified the need for recommendations for best practices for laboratory testing to optimize RNA-based NGS gene fusion detection. To develop consensus recommendations, representatives from 17 Canadian genetic laboratories participated in working group discussions and the completion of survey questions about RNA-based NGS. Consensus recommendations are presented for pre-analytic, analytic and reporting aspects of gene fusion detection by RNA-based NGS.
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Stockley TL, Lo B, Box A, Corredor AG, DeCoteau J, Desmeules P, Feilotter H, Grafodatskaya D, Greer W, Hawkins C, Huang WY, Izevbaye I, Lépine G, Martins Filho SN, Papadakis AI, Park PC, Riviere JB, Sheffield BS, Spatz A, Spriggs E, Tran-Thanh D, Yip S, Zhang T, Torlakovic E, Tsao MS. CANTRK: A Canadian Ring Study to Optimize Detection of NTRK Gene Fusions by Next-Generation RNA Sequencing. J Mol Diagn 2023; 25:168-174. [PMID: 36586421 DOI: 10.1016/j.jmoldx.2022.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/01/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
The Canadian NTRK (CANTRK) study is an interlaboratory comparison ring study to optimize testing for neurotrophic receptor tyrosine kinase (NTRK) fusions in Canadian laboratories. Sixteen diagnostic laboratories used next-generation sequencing (NGS) for NTRK1, NTRK2, or NTRK3 fusions. Each laboratory received 12 formalin-fixed, paraffin-embedded tumor samples with unique NTRK fusions and two control non-NTRK fusion samples (one ALK and one ROS1). Laboratories used validated protocols for NGS fusion detection. Panels included Oncomine Comprehensive Assay v3, Oncomine Focus Assay, Oncomine Precision Assay, AmpliSeq for Illumina Focus, TruSight RNA Pan-Cancer Panel, FusionPlex Lung, and QIAseq Multimodal Lung. One sample was withdrawn from analysis because of sample quality issues. Of the remaining 13 samples, 6 of 11 NTRK fusions and both control fusions were detected by all laboratories. Two fusions, WNK2::NTRK2 and STRN3::NTRK2, were not detected by 10 laboratories using the Oncomine Comprehensive or Focus panels, due to absence of WNK2 and STRN3 in panel designs. Two fusions, TPM3::NTRK1 and LMNA::NTRK1, were challenging to detect on the AmpliSeq for Illumina Focus panel because of bioinformatics issues. One ETV6::NTRK3 fusion at low levels was not detected by two laboratories using the TruSight Pan-Cancer Panel. Panels detecting all fusions included FusionPlex Lung, Oncomine Precision, and QIAseq Multimodal Lung. The CANTRK study showed competency in detection of NTRK fusions by NGS across different panels in 16 Canadian laboratories and identified key test issues as targets for improvements.
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Affiliation(s)
- Tracy L Stockley
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
| | - Bryan Lo
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Adrian Box
- Alberta Precision Labs, Calgary, Alberta, Canada
| | | | - John DeCoteau
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Patrice Desmeules
- IUCPQ-UL, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada
| | - Harriet Feilotter
- Kingston Health Sciences Centre, Kingston, Ontario, Canada; Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Daria Grafodatskaya
- Hamilton Health Sciences Centre, Hamilton, Ontario, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Wenda Greer
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Cynthia Hawkins
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Weei Yuarn Huang
- Nova Scotia Health Authority, Halifax, Nova Scotia, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Iyare Izevbaye
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Sebastiao N Martins Filho
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Paul C Park
- Shared Health Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - Alan Spatz
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Danh Tran-Thanh
- CHUM-Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Stephen Yip
- BC Cancer, Vancouver, British Columbia, Canada; Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Tong Zhang
- Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Emina Torlakovic
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ming Sound Tsao
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Misky AM, Lo B, Engel LS. Utility of fructosamine to assess glycemic control. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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El Hajj EC, Zia AW, Bilalis M, Ataei A, Lo B, Engel LS. Hepatitis C recurrence after complete resolution. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00292-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Keller BA, Pastukhova E, Lo B, Sekhon HS, Flood TA. Molecular Pathogenesis of Penile Squamous Cell Carcinoma. Arch Pathol Lab Med 2022:486472. [PMID: 36136297 DOI: 10.5858/arpa.2021-0592-ra] [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] [Accepted: 04/25/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Penile squamous cell carcinomas (PSCCs) are divided into tumors that are human papillomavirus (HPV) associated and those that are non-HPV associated. HPV and non-HPV PSCCs each display unique pathogenic mechanisms, histologic subtypes, and clinical behaviors. Treatment of localized PSCC tumors is linked to significant physical and psychological morbidity, and management of advanced disease is often treatment refractory. The identification of novel actionable mutations is of critical importance so that translational scientists and clinicians alike can pursue additional therapeutic options. OBJECTIVE.— To provide an update on the molecular pathogenesis associated with PSCC. A special emphasis is placed on next-generation sequencing data and its role in identifying potential therapeutic targets. DATA SOURCES.— A literature review using the PubMed search engine to access peer-reviewed literature published on PSCC. CONCLUSIONS.— Our understanding of the genetic and molecular mechanisms that underlie PSCC pathogenesis continues to evolve. PSCC tumorigenesis is mediated by multiple pathways, and mutations of oncogenic significance have been identified that may represent targets for personalized therapy. Preliminary results of treatment with immune checkpoint inhibition and tyrosine kinase inhibitors have produced variable clinical results. Further insight into the pathogenesis of PSCC will help guide clinical trials and develop additional precision medicine approaches.
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Affiliation(s)
- Brian A Keller
- From the Division of Anatomical Pathology (Keller, Sekhon, Flood), Department of Pathology and Laboratory Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
| | - Elena Pastukhova
- The University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada (Pastukhova)
| | - Bryan Lo
- The Molecular Oncology Diagnostics Laboratory (Lo), Department of Pathology and Laboratory Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
| | - Harman S Sekhon
- From the Division of Anatomical Pathology (Keller, Sekhon, Flood), Department of Pathology and Laboratory Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
| | - Trevor A Flood
- From the Division of Anatomical Pathology (Keller, Sekhon, Flood), Department of Pathology and Laboratory Medicine, The Ottawa Hospital/University of Ottawa, Ottawa, Ontario, Canada
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Keyhanian K, Phillips WJ, Yeung BS, Gomes M, Lo B, Sekhon HS. Neuroendocrine differentiation distinguishes basaloid variant of lung squamous cell carcinoma. Diagn Pathol 2022; 17:46. [PMID: 35538551 PMCID: PMC9088121 DOI: 10.1186/s13000-022-01223-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/28/2021] [Accepted: 04/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Neuroendocrine (NE) differentiation is widely studied in non-small cell lung carcinomas (NSCLC) however, its significance remains unclear in basaloid squamous cell carcinomas (B-SqCC). This study aims to assess the extent of NE differentiation in B-SqCC and characterize the underlying molecular process. Methods This study evaluated resected B-SqCC, small cell lung cancer (SCLC) and poorly differentiated SqCC (PD-SqCC) from 2005 to 2020 at the Ottawa Hospital. Samples were subject to pathological review, immunohistochemistry (IHC) and survival analysis. Gene expression analysis was performed on B-SqCC samples exhibiting NE+ and NE- regions (paired samples) to identify differentially expressed genes (DEGs). These DEGs were subsequently validated in unpaired B-SqCC and TCGA samples. Results B-SqCC cases were more likely to exhibit nuclear molding, resetting and peripheral palisading than PD-SqCC. B-SqCC were also more likely to demonstrate NE differentiation compared to PD-SqCC (p = 0.006). Pure basaloid squamous cell carcinoma (PB-SqCC) experienced poorer disease-free survival (HR = 3.12, p = 0.043) adjusted for stage. Molecular characterization of paired B-SqCC samples demonstrated DEGs implicated in NOTCH signaling, SCLC and pulmonary neuroendocrine differentiation. Hierarchical clustering using discovered DEGs in unpaired B-SqCC samples distinguished tumors based on NE status (p = 0.048). Likewise, clustering The Cancer Genome Atlas (TCGA) samples with DEGs distinguished B-SqCC from SqCC samples (p = 0.0094). Conclusion This study provides IHC and molecular evidence of significant NE-differentiation in B-SqCC and demonstrates their aggressive clinical behavior. These findings suggest that B-SqCC are biologically distinct from SqCC and share characteristics with SCLC. Supplementary Information The online version contains supplementary material available at 10.1186/s13000-022-01223-6.
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Affiliation(s)
- Kianoosh Keyhanian
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital/Eastern Ontario Regional Laboratory Association, Critical Care Wing, Rm 4220, Box 117, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - William J Phillips
- Department of Pathology and Laboratory Medicine, University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.,Department of Medicine, Univeristy of Ottawa, Faculty of Medicine, Ottawa, ON, K1H 8M5, Canada
| | - Benjamin S Yeung
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Marcio Gomes
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital/Eastern Ontario Regional Laboratory Association, Critical Care Wing, Rm 4220, Box 117, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Bryan Lo
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital/Eastern Ontario Regional Laboratory Association, Critical Care Wing, Rm 4220, Box 117, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Harmanjatinder S Sekhon
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital/Eastern Ontario Regional Laboratory Association, Critical Care Wing, Rm 4220, Box 117, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada. .,Department of Pathology and Laboratory Medicine, University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
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Park PC, Kurek KC, DeCoteau J, Howlett CJ, Hawkins C, Izevbaye I, Carter MD, Redpath M, Lo B, Alex D, Yousef G, Yip S, Maung R. CAP-ACP Workload Model for Advanced Diagnostics in Precision Medicine. Am J Clin Pathol 2022; 158:105-111. [PMID: 35195689 DOI: 10.1093/ajcp/aqac012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/14/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES In precision medicine, where oncologic management is tailored to the individual's clinical and genetic profiles, advanced diagnostic testing provides prognostic information and guides management in a growing number of malignancies. There is a need to capture the work pathologists perform to meet this demand by providing medically relevant, timely, and accurate testing results. This work includes not only direct patient consults (interpretation of results and issuing reports) but the administrative and medical oversight as well as the research needed to provide the necessary quality assurance, quality control, direction, and framework for the laboratory. METHODS An expert panel of Canadian pathologists involved in advanced diagnostics was convened to establish and beta test a model for workload assessment in advanced diagnostics. RESULTS All aspects of the advanced diagnostics workload were detailed and applied to models based on members' experience, including medical oversight, administration, and the introduction of new testing and platforms. Models for biomarker testing were developed for simple and complex or multiplexed assays, and a detailed model was developed to assess the workload for next-generation sequencing-based assays. CONCLUSIONS This paper provides the first detailed proposal for capturing an advanced diagnostic workload to enable appropriate pathologist allotment for performing all the steps required to run an advanced diagnostic service.
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Affiliation(s)
| | - Kyle C Kurek
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada
| | - John DeCoteau
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Christopher J Howlett
- Department of Pathology and Laboratory Medicine, London Health Sciences Centre and Western University, London, Canada
| | | | - Iyare Izevbaye
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
| | | | | | - Bryan Lo
- The Ottawa General Hospital, Ottawa, Canada
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13
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Stewart DJ, Maziak DE, Moore SM, Brule SY, Gomes M, Sekhon H, Dennie C, Lo B, Fung-Kee-Fung M, Bradford JP, Reaume MN. The need for speed in advanced non-small cell lung cancer: A population kinetics assessment. Cancer Med 2021; 10:9040-9046. [PMID: 34766461 PMCID: PMC8683556 DOI: 10.1002/cam4.4411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/13/2021] [Accepted: 10/16/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Systemic therapy prolongs overall survival (OS) in advanced non-small cell lung cancer (NSCLC), but diagnostic tests, staging and molecular profiling take time, and this can delay therapy initiation. OS approximates first-order kinetics. METHODS We used OS of chemo-naive NSCLC patients on a placebo/best supportive care trial arm to estimate % of patients dying while awaiting therapy. We digitized survival curves from eight studies, calculated OS half-life, then estimated the proportion surviving after different times of interest (tn ) using the formula: X = exp - t n ∗ 0 .693 / t 1 / 2 , where EXP signifies exponential, * indicates multiplication, 0.693 is the natural log of 2, and t1/2 is the survival half-life in weeks. RESULTS Across trials, the OS half-life for placebo/best supportive care in previously untreated NSCLC was 19.5 weeks. Hence, based on calculations using the formula above, if therapy were delayed by 1, 2, 3, or 4 weeks then 4%, 7%, 10%, and 13% of all patients, respectively, would die while awaiting treatment. Others would become too sick to consider therapy even if still alive. CONCLUSIONS This quantifies why rapid baseline testing and prompt therapy initiation are important in advanced NSCLC. It also illustrates why screening procedures for clinical trial inclusion must be faster. Otherwise, it is potentially hazardous for a patient to be considered for a trial due to risk of death or deterioration while awaiting eligibility assessment. It is also important to not delay initiation of systemic therapy for procedures that add relatively little value, such as radiotherapy for small, asymptomatic brain metastases.
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Affiliation(s)
- David J Stewart
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Donna E Maziak
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Sara M Moore
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephanie Y Brule
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Marcio Gomes
- Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada
| | - Harman Sekhon
- Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada
| | - Carole Dennie
- Department of Diagnostic Imaging, University of Ottawa, Ottawa, Ontario, Canada
| | - Bryan Lo
- Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael Fung-Kee-Fung
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
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14
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Bartlett J, Amemiya Y, Arts H, Bayani J, Eng B, Grafodatskaya D, Kamel Reid S, Lariviere M, Lo B, McClure R, Mittal V, Sadikovic B, Sadis S, Seth A, Smith J, Zhang X, Feilotter H. Multisite verification of the accuracy of a multi-gene next generation sequencing panel for detection of mutations and copy number alterations in solid tumours. PLoS One 2021; 16:e0258188. [PMID: 34597339 PMCID: PMC8486135 DOI: 10.1371/journal.pone.0258188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/22/2021] [Indexed: 11/29/2022] Open
Abstract
Molecular variants including single nucleotide variants (SNVs), copy number variants (CNVs) and fusions can be detected in the clinical setting using deep targeted sequencing. These assays support low limits of detection using little genomic input material. They are gaining in popularity in clinical laboratories, where sample volumes are limited, and low variant allele fractions may be present. However, data on reproducibility between laboratories is limited. Using a ring study, we evaluated the performance of 7 Ontario laboratories using targeted sequencing panels. All laboratories analysed a series of control and clinical samples for SNVs/CNVs and gene fusions. High concordance was observed across laboratories for measured CNVs and SNVs. Over 97% of SNV calls in clinical samples were detected by all laboratories. Whilst only a single CNV was detected in the clinical samples tested, all laboratories were able to reproducibly report both the variant and copy number. Concordance for information derived from RNA was lower than observed for DNA, due largely to decreased quality metrics associated with the RNA components of the assay, suggesting that the RNA portions of comprehensive NGS assays may be more vulnerable to variations in approach and workflow. Overall the results of this study support the use of the OFA for targeted sequencing for testing of clinical samples and suggest specific internal quality metrics that can be reliable indicators of assay failure. While we believe this evidence can be interpreted to support deep targeted sequencing in general, additional studies should be performed to confirm this.
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Affiliation(s)
- John Bartlett
- Diagnostic Development, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom
| | - Yutaka Amemiya
- SRI Genomics Laboratory and Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Heleen Arts
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jane Bayani
- Diagnostic Development, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Barry Eng
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Daria Grafodatskaya
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Suzanne Kamel Reid
- Department of Clinical Laboratory Genetics, The University Health Network, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Mathieu Lariviere
- Thermo Fisher Scientific, South San Francisco, CA, United States of America
| | - Bryan Lo
- Dept of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Rebecca McClure
- Health Sciences North/Horizon Sante-Nord, Sudbury, Ontario, Canada
| | - Vinay Mittal
- Thermo Fisher Scientific, South San Francisco, CA, United States of America
| | - Bekim Sadikovic
- Molecular Diagnostics Laboratoroy, Victoria Hospital, London Health Sciences Centre, London, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
| | - Seth Sadis
- Thermo Fisher Scientific, South San Francisco, CA, United States of America
| | - Arun Seth
- SRI Genomics Laboratory and Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Jeff Smith
- Thermo Fisher Scientific, South San Francisco, CA, United States of America
| | - Xiao Zhang
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Harriet Feilotter
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
- Laboratory Genetics, Kingston Health Sciences Center, Kingston Ontario, Canada
- * E-mail:
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15
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Selvarajah S, Plante S, Speevak M, Vaags A, Hamelinck D, Butcher M, McCready E, Grafodatskaya D, Blais N, Tran-Thanh D, Weng X, Nassabein R, Greer W, Walton RN, Lo B, Demetrick D, Santos S, Sadikovic B, Zhang X, Zhang T, Spence T, Stockley T, Feilotter H, Joubert P. A Pan-Canadian Validation Study for the Detection of EGFR T790M Mutation Using Circulating Tumor DNA From Peripheral Blood. JTO Clin Res Rep 2021; 2:100212. [PMID: 34590051 PMCID: PMC8474449 DOI: 10.1016/j.jtocrr.2021.100212] [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: 05/11/2021] [Revised: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Genotyping circulating tumor DNA (ctDNA) is a promising noninvasive clinical tool to identify the EGFR T790M resistance mutation in patients with advanced NSCLC with resistance to EGFR inhibitors. To facilitate standardization and clinical adoption of ctDNA testing across Canada, we developed a 2-phase multicenter study to standardize T790M mutation detection using plasma ctDNA testing. METHODS In phase 1, commercial reference standards were distributed to participating clinical laboratories, to use their existing platforms for mutation detection. Baseline performance characteristics were established using known and blinded engineered plasma samples spiked with predetermined concentrations of T790M, L858R, and exon 19 deletion variants. In phase II, peripheral blood collected from local patients with known EGFR activating mutations and progressing on treatment were assayed for the presence of EGFR variants and concordance with a clinically validated test at the reference laboratory. RESULTS All laboratories in phase 1 detected the variants at 0.5 % and 5.0 % allele frequencies, with no false positives. In phase 2, the concordance with the reference laboratory for detection of both the primary and resistance mutation was high, with next-generation sequencing and droplet digital polymerase chain reaction exhibiting the best overall concordance. Data also suggested that the ability to detect mutations at clinically relevant limits of detection is generally not platform-specific, but rather impacted by laboratory-specific practices. CONCLUSIONS Discrepancies among sending laboratories using the same assay suggest that laboratory-specific practices may impact performance. In addition, a negative or inconclusive ctDNA test should be followed by tumor testing when possible.
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Affiliation(s)
- Shamini Selvarajah
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Sophie Plante
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, Quebec, Canada
| | - Marsha Speevak
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Vaags
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Darren Hamelinck
- Department of Laboratory Medicine and Genetics, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Martin Butcher
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth McCready
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Daria Grafodatskaya
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
- Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Normand Blais
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Danh Tran-Thanh
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Xiaoduan Weng
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Rami Nassabein
- Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Wenda Greer
- Queen Elizabeth II Health Sciences Center, Department of Pathology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Bryan Lo
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Doug Demetrick
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
- Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada
- Department of Medical Genetics, University of Calgary, Calgary, Alberta, Canada
| | - Stephanie Santos
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada
| | - Bekim Sadikovic
- Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, Ontario, Canada
| | - Xiao Zhang
- Laboratory Genetics, Kingston Health Sciences Center, Kingston, Ontario, Canada
| | - Tong Zhang
- Department of Clinical Laboratory Genetics, University Health Network, Toronto, Ontario, Canada
| | - Tara Spence
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Tracy Stockley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Department of Clinical Laboratory Genetics, University Health Network, Toronto, Ontario, Canada
| | - Harriet Feilotter
- Laboratory Genetics, Kingston Health Sciences Center, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, Quebec, Canada
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16
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Karol D, McKinnon M, Mukhtar L, Awan A, Lo B, Wheatley-Price P. The Impact of Foundation Medicine Testing on Cancer Patients: A Single Academic Centre Experience. Front Oncol 2021; 11:687730. [PMID: 34381713 PMCID: PMC8350441 DOI: 10.3389/fonc.2021.687730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of Next-Generation Sequencing (NGS) has recently allowed significant improvements in cancer treatment. Foundation Medicine® (FM) provides a genomic profiling test based on NGS for a variety of cancers. However, it is unclear if the Foundation Medicine test would result in a better outcome than the standard on-site molecular testing. In this retrospective chart review, we identified the FM cases from an academic Canadian hospital and determined whether these test results improved treatment options for those patients. MATERIALS AND METHODS A retrospective analysis was performed on patients with solid tumors who had FM testing between May 1, 2014 and May 1, 2018. Clinical factors and outcomes were measured using descriptive statistics using Microsoft Excel® Software. RESULTS Out of 66 FM tests, eight patients (= 12%) had a direct change in therapy based on the FM tests. Identified were 285 oncogenic mutations (median 1, range 0-31); where TP53 (n = 31, 10.9%), CDKN2A (n = 19, 6.7%), KRAS (n = 16, 5.6%) and APC (n = 9, 3.2%) were the most common FM mutations identified. CONCLUSION A small proportion of FM reports identified actionable mutations and led to direct treatment change. FM testing is expensive and a few of the identified mutations are now part of routine on-site testing. NGS testing is likely to become more widespread, but this research suggests that its true clinical impact may be restricted to a minority of patients.
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Affiliation(s)
- Dalia Karol
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Lenah Mukhtar
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Arif Awan
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Bryan Lo
- Department of Anatomical Pathology, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paul Wheatley-Price
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
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17
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Lemire G, Zheng B, Ediae GU, Zou R, Bhola PT, Chisholm C, de Nanassy J, Lo B, Wang C, Shril S, El Desoky S, Shalaby M, Kari JA, Wang X, Kernohan KD, Boycott KM, Hildebrandt F, Sawyer SL. Homozygous WNT9B variants in two families with bilateral renal agenesis/hypoplasia/dysplasia. Am J Med Genet A 2021; 185:3005-3011. [PMID: 34145744 DOI: 10.1002/ajmg.a.62398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/09/2021] [Accepted: 06/05/2021] [Indexed: 11/06/2022]
Abstract
WNT9B plays a key role in the development of the mammalian urogenital system. It is essential for the induction of mesonephric and metanephric tubules, the regulation of renal tubule morphogenesis, and the regulation of renal progenitor cell expansion and differentiation. To our knowledge, WNT9B has not been associated with renal defects in humans; however, WNT9B-/- mice have renal agenesis/hypoplasia and reproductive tract abnormalities. We report four individuals from two unrelated consanguineous families with bilateral renal agenesis/hypoplasia/dysplasia and homozygous variants in WNT9B. The proband from Family 1 has bilateral renal cystic dysplasia and chronic kidney disease. He has two deceased siblings who presented with bilateral renal hypoplasia/agenesis. The three affected family members were homozygous for a missense variant in WNT9B (NM_003396.2: c.949G>A/p.(Gly317Arg)). The proband from Family 2 has renal hypoplasia/dysplasia, chronic kidney disease, and is homozygous for a nonsense variant in WNT9B (NM_003396.2: c.11dupC/p.(Pro5Alafs*52)). Two of her siblings died in the neonatal period, one confirmed to be in the context of oligohydramnios. The proband's unaffected brother is also homozygous for the nonsense variant in WNT9B, suggesting nonpenetrance. We propose a novel association of WNT9B and renal anomalies in humans. Further study is needed to delineate the contribution of WNT9B to genitourinary anomalies in humans.
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Affiliation(s)
- Gabrielle Lemire
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada.,Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Bixia Zheng
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Grace U Ediae
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada
| | - Ruobing Zou
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada
| | - Priya T Bhola
- Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Caitlin Chisholm
- Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Joseph de Nanassy
- Department of Pathology, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Bryan Lo
- Department of Pathology, The Ottawa Hospital, Ottawa, Canada
| | - Chunyan Wang
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shirlee Shril
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sherif El Desoky
- Pediatric Nephrology Center of Excellence and Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Shalaby
- Pediatric Nephrology Center of Excellence and Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jameela A Kari
- Pediatric Nephrology Center of Excellence and Pediatric Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Xueqi Wang
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada
| | | | - Kristin D Kernohan
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada.,Newborn Screening Ontario, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Kym M Boycott
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada.,Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Friedhelm Hildebrandt
- Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sarah L Sawyer
- Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada.,Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
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18
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Jamee M, Hosseinzadeh S, Sharifinejad N, Zaki-Dizaji M, Matloubi M, Hasani M, Baris S, Alsabbagh M, Lo B, Azizi G. Comprehensive comparison between 222 CTLA-4 haploinsufficiency and 212 LRBA deficiency patients: a systematic review. Clin Exp Immunol 2021; 205:28-43. [PMID: 33788257 DOI: 10.1111/cei.13600] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
Cytotoxic T lymphocyte antigen 4 (CTLA-4) haploinsufficiency (CHAI) and lipopolysaccharide-responsive beige-like anchor (LRBA) deficiency (LATAIE) are newly identified inborn errors of immunity with shared molecular pathomechanisms and clinical manifestations. In this review, we aimed to provide differential comparisons regarding demographic, clinical, immunological and molecular characteristics between these two similar conditions. A literature search was conducted in PubMed, Web of Science and Scopus databases and included studies were systematically evaluated. Overall, 434 (222 CHAI and 212 LATAIE) patients were found in 101 eligible studies. The CHAI patients were mainly reported from North America and western Europe, while LATAIE patients were predominantly from Asian countries. In CHAI, positive familial history (P < 0·001) and in LATAIE, consanguineous parents (P < 0·001) were more common. In CHAI patients the rates of granulomas (P < 0·001), malignancies (P = 0·001), atopy (P = 0·001), cutaneous disorders (P < 0·001) and neurological (P = 0·002) disorders were higher, while LATAIE patients were more commonly complicated with life-threatening infections (P = 0·002), pneumonia (P = 0·006), ear, nose and throat disorders (P < 0·001), organomegaly (P = 0·023), autoimmune enteropathy (P = 0·038) and growth failure (P < 0·001). Normal lymphocyte subsets and immunoglobulins except low serum levels of CD9+ B cells (14·0 versus 38·4%, P < 0·001), natural killer (NK) cells (21 versus 41·1%, P < 0·001), immunoglobulin (Ig)G (46·9 versus 41·1%, P = 0·291) and IgA (54·5 versus 44·7%, P = 0·076) were found in the majority of CHAI and LATAIE patients, respectively. The most frequent biological immunosuppressive agents prescribed for CHAI and LATAIE patients were rituximab and abatacept, respectively. Further investigations into the best conditioning and treatment regimens pre- and post-transplantation are required to improve the survival rate of transplanted CHAI and LATAIE patients.
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Affiliation(s)
- M Jamee
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran.,Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Hosseinzadeh
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - N Sharifinejad
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - M Zaki-Dizaji
- Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - M Matloubi
- Medical Immunology Department, School of Medicine, Iran University of Medical Science, Tehran, Iran
| | - M Hasani
- CinnaGen Medical Biotechnology Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - S Baris
- Pediatric Allergy and Immunology, Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Marmara University Hospital, Istanbul, Turkey
| | - M Alsabbagh
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - B Lo
- Division of Translational Medicine, Research Branch, Sidra Medicine, Doha, Qatar
| | - G Azizi
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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19
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Weberpals JI, Pugh TJ, Marco-Casanova P, Goss GD, Andrews Wright N, Rath P, Torchia J, Fortuna A, Jones GN, Roudier MP, Bernard L, Lo B, Torti D, Leon A, Marsh K, Hodgson D, Duciaume M, Howat WJ, Lukashchuk N, Lazic SE, Whelan D, Sekhon HS. Tumor genomic, transcriptomic, and immune profiling characterizes differential response to first-line platinum chemotherapy in high grade serous ovarian cancer. Cancer Med 2021; 10:3045-3058. [PMID: 33811746 PMCID: PMC8085970 DOI: 10.1002/cam4.3831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/18/2021] [Accepted: 02/09/2021] [Indexed: 01/01/2023] Open
Abstract
Background In high grade serous ovarian cancer (HGSOC), there is a spectrum of sensitivity to first line platinum‐based chemotherapy. This study molecularly characterizes HGSOC patients from two distinct groups of chemotherapy responders (good vs. poor). Methods Following primary debulking surgery and intravenous carboplatin/paclitaxel, women with stage III–IV HGSOC were grouped by response. Patients in the good response (GR) and poor response (PR) groups respectively had a progression‐free intervals (PFI) of ≥12 and ≤6 months. Analysis of surgical specimens interrogated genomic and immunologic features using whole exome sequencing. RNA‐sequencing detected gene expression outliers and inference of immune infiltrate, with validation by targeted NanoString arrays. PD‐L1 expression was scored by immunohistochemistry (IHC). Results A total of 39 patient samples were analyzed (GR = 20; PR = 19). Median PFI for GR and PR patient cohorts was 32 and 3 months, respectively. GR tumors were enriched for loss‐of‐function BRCA2 mutations and had a significantly higher nonsynonymous mutation rate compared to PR tumors (p = 0.001). Samples from the PR cohort were characterized by mutations in MGA and RAD51B and trended towards a greater rate of amplification of PIK3CA, MECOM, and ATR in comparison to GR tumors. Gene expression analysis by NanoString correlated increased PARP4 with PR and increased PD‐L1 and EMSY with GR. There was greater tumor immune cell infiltration and higher immune cell PD‐L1 protein expression in the GR group. Conclusions Our research demonstrates that tumors from HGSOC patients responding poorly to first line chemotherapy have a distinct molecular profile characterized by actionable drug targets including PARP4.
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Affiliation(s)
- Johanne I Weberpals
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Trevor J Pugh
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | - Glenwood D Goss
- Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Department of Medicine, Division of Medical Oncology, University of Ottawa, Ottawa, ON, Canada
| | | | - Prisni Rath
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | | | | | - Gemma N Jones
- Translational Medicine, R&D Oncology, AstraZeneca, Cambridge, UK
| | | | - Laurence Bernard
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Bryan Lo
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON, Canada
| | - Dax Torti
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Alberto Leon
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Kayla Marsh
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Darren Hodgson
- Translational Medicine, R&D Oncology, AstraZeneca, Cambridge, UK
| | - Marc Duciaume
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - William J Howat
- Translational Medicine, R&D Oncology, AstraZeneca, Cambridge, UK
| | | | - Stanley E Lazic
- Quantitative Biology, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - Doreen Whelan
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Harmanjatinder S Sekhon
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
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20
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Selvarajah S, Plante S, Speevak M, Vaags A, Mccready E, Grafodatskaya D, Blais N, Tran-Thanh D, Greer W, Lo B, Demetrick D, Sadikovic B, Walton R, Stockley T, Feilotter H, Joubert P. FP07.08 A Pan-Canadian Validation Study for the Detection of EGFR-T790M Mutations Using Circulating Tumour DNA (ctDNA) from Blood. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Keller BA, Laight BJ, Varette O, Broom A, Wedge MÈ, McSweeney B, Cemeus C, Petryk J, Lo B, Burns B, Nessim C, Ong M, Chica RA, Atkins HL, Diallo JS, Ilkow CS, Bell JC. Personalized oncology and BRAF K601N melanoma: model development, drug discovery, and clinical correlation. J Cancer Res Clin Oncol 2021; 147:1365-1378. [PMID: 33555379 DOI: 10.1007/s00432-021-03545-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Mutations in BRAF are the most prominent activating mutations in melanoma and are increasingly recognized in other cancers. There is currently no accepted treatment regimen for patients with mutant BRAFK601N melanoma, and the study of melanoma driven by BRAF mutations at the 601 locus is lacking due to a paucity of cellular model systems. Therefore, we sought to better understand the treatment and clinical approach to patients with mutant BRAFK601N melanoma and subsequently develop a novel personalized oncology platform for rare or treatment-refractory cancers. METHODS We developed and characterized the first patient-derived, naturally occurring BRAFK601N melanoma model, described herein as OHRI-MEL-13, and assessed efficacy using the Prestwick Chemical Library and select targeted therapeutics. RESULTS OHRI-MEL-13 exhibits loss of heterozygosity of BRAF, closely mimics the original tumor's gene expression profile, is tumorigenic in immune-deficient murine models, and is available for public accession through American Type Culture Collection. We present in silico modeling data, which illustrates the therapeutic failure of BRAFV600E-targeted therapies in BRAFK601N mutants. Our platform elucidated a unique role for MEK inhibition with cobimetinib, which resulted in short-term clinical success by reducing the metastatic burden. CONCLUSION Our model of BRAFK601N-activated melanoma was developed, thoroughly characterized, and made available for public accession. This model served to demonstrate the feasibility of a novel personalized oncology platform that could be optimized at an institutional level for rare variant or treatment-refractory cancers. We also demonstrate the clinical utility of monotherapy MEK inhibition in a case of BRAFK601N melanoma.
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Affiliation(s)
- Brian A Keller
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada.
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada.
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada.
| | - Brian J Laight
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Oliver Varette
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada
| | - Aron Broom
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, 10 Marie-Curie Private, Ottawa, K1N 6N5, Canada
| | - Marie-Ève Wedge
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada
| | - Benjamin McSweeney
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Catia Cemeus
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Julia Petryk
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Bryan Lo
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Molecular Oncology Diagnostics Laboratory, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Bruce Burns
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Carolyn Nessim
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Division of General Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Michael Ong
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Roberto A Chica
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, 10 Marie-Curie Private, Ottawa, K1N 6N5, Canada
| | - Harold L Atkins
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada
- The Ottawa Hospital Blood and Marrow Transplant Program, The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H 8L6, Canada
| | - Jean-Simon Diallo
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada
| | - Carolina S Ilkow
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada
| | - John C Bell
- Centre for Innovative Cancer Therapeutics, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H 8L6, Canada
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, K1H 8M5, Canada
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22
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Phillips WJ, Baghai T, Ong M, Lo B, Ibrahim AM, Smith TKT, Song X. A Contemporary Report of Clinical Outcomes in Patients with Melanoma Brain Metastases. ACTA ACUST UNITED AC 2021; 28:428-439. [PMID: 33450821 PMCID: PMC7903273 DOI: 10.3390/curroncol28010045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022]
Abstract
Background: Brain metastases are observed in more than 40% of all patients with stage 4 melanoma. In recent years, more extensive use of stereotactic radiation (STRT) and the advent of immune checkpoint inhibitors have positively impacted outcomes in patients with metastatic melanoma.brain metastases. Here, we examined real world clinical outcomes of patients presenting with melanoma brain metastases (MBMs). Methods: This retrospective review evaluated MBMs patients treated at The Ottawa Hospital from April 2000 to July 2017. Clinical, radiologic, pathologic and treatment information were gathered from the electronic medical records. The primary outcome was overall survival. The proportional Cox regression model was employed for survival data, while the Fisher’s exact and Mann–Whitney U tests analyzed the relationship between categorical and continuous data, respectively. Results: This retrospective study included 276 patients. Brain metastases were detected symptomatically in 191 patients (69.2%); the rates of detection by routine screening were 4.6% in the pre-2012 era and 11.7% in the contemporary era (p = 0.029). Median survival was three months. Predictors of overall survival were age, higher lactate dehydrogenase (LDH) values, multiple brain lesions, more extensive extracranial disease, neurological symptoms, infratentorial lesions and treatment type. Multivariable analysis demonstrated that stereotactic radiotherapy (STRT) was associated with a hazard ratio of 0.401 (p < 0.001) for survival; likewise, immune checkpoint inhibitor therapy was associated with a hazard ratio of 0.375 (p < 0.001). Conclusion: The findings from this study as “real world” data are consistent with results of pivotal clinical trials in MBMs patients and support contemporary locoregional and immunotherapy practices.
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Affiliation(s)
- William J. Phillips
- Faculty of Medicine, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (W.J.P.); (T.K.T.S.)
| | - Tabassom Baghai
- The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (T.B.); (M.O.); (B.L.); (A.M.I.)
| | - Michael Ong
- The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (T.B.); (M.O.); (B.L.); (A.M.I.)
| | - Bryan Lo
- The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (T.B.); (M.O.); (B.L.); (A.M.I.)
| | - Andrea M. Ibrahim
- The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (T.B.); (M.O.); (B.L.); (A.M.I.)
| | - Tyler K. T. Smith
- Faculty of Medicine, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (W.J.P.); (T.K.T.S.)
| | - Xinni Song
- The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada; (T.B.); (M.O.); (B.L.); (A.M.I.)
- Correspondence: ; Tel.: +613-737-7700; Fax: +613-247-3511
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23
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Karimnezhad A, Palidwor GA, Thavorn K, Stewart DJ, Campbell PA, Lo B, Perkins TJ. Accuracy and reproducibility of somatic point mutation calling in clinical-type targeted sequencing data. BMC Med Genomics 2020; 13:156. [PMID: 33059707 PMCID: PMC7560075 DOI: 10.1186/s12920-020-00803-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022] Open
Abstract
Background Treating cancer depends in part on identifying the mutations driving each patient’s disease. Many clinical laboratories are adopting high-throughput sequencing for assaying patients’ tumours, applying targeted panels to formalin-fixed paraffin-embedded tumour tissues to detect clinically-relevant mutations. While there have been some benchmarking and best practices studies of this scenario, much variant calling work focuses on whole-genome or whole-exome studies, with fresh or fresh-frozen tissue. Thus, definitive guidance on best choices for sequencing platforms, sequencing strategies, and variant calling for clinical variant detection is still being developed. Methods Because ground truth for clinical specimens is rarely known, we used the well-characterized Coriell cell lines GM12878 and GM12877 to generate data. We prepared samples to mimic as closely as possible clinical biopsies, including formalin fixation and paraffin embedding. We evaluated two well-known targeted sequencing panels, Illumina’s TruSight 170 hybrid-capture panel and the amplification-based Oncomine Focus panel. Sequencing was performed on an Illumina NextSeq500 and an Ion Torrent PGM respectively. We performed multiple replicates of each assay, to test reproducibility. Finally, we applied four different freely-available somatic single-nucleotide variant (SNV) callers to the data, along with the vendor-recommended callers for each sequencing platform. Results We did not observe major differences in variant calling success within the regions that each panel covers, but there were substantial differences between callers. All had high sensitivity for true SNVs, but numerous and non-overlapping false positives. Overriding certain default parameters to make them consistent between callers substantially reduced discrepancies, but still resulted in high false positive rates. Intersecting results from multiple replicates or from different variant callers eliminated most false positives, while maintaining sensitivity. Conclusions Reproducibility and accuracy of targeted clinical sequencing results depend less on sequencing platform and panel than on variability between replicates and downstream bioinformatics. Differences in variant callers’ default parameters are a greater influence on algorithm disagreement than other differences between the algorithms. Contrary to typical clinical practice, we recommend employing multiple variant calling pipelines and/or analyzing replicate samples, as this greatly decreases false positive calls.
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Affiliation(s)
- Ali Karimnezhad
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H8L6, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, K1H8M5, Canada
| | - Gareth A Palidwor
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H8L6, Canada
| | - Kednapa Thavorn
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H8L6, Canada.,School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G5Z3, Canada
| | | | - Pearl A Campbell
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H8L6, Canada
| | - Bryan Lo
- The Ottawa Hospital, 501 Smyth Road, Ottawa, K1H8L6, Canada
| | - Theodore J Perkins
- Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, K1H8L6, Canada. .,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, 451 Smyth Road, Ottawa, K1H8M5, Canada.
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24
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Yang Y, Komisar V, Shishov N, Lo B, Korall AM, Feldman F, Robinovitch SN. The Effect of Fall Biomechanics on Risk for Hip Fracture in Older Adults: A Cohort Study of Video-Captured Falls in Long-Term Care. J Bone Miner Res 2020; 35:1914-1922. [PMID: 32402136 PMCID: PMC7689902 DOI: 10.1002/jbmr.4048] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/19/2020] [Accepted: 05/04/2020] [Indexed: 11/19/2022]
Abstract
Over 95% of hip fractures in older adults are caused by falls, yet only 1% to 2% of falls result in hip fracture. Our current understanding of the types of falls that lead to hip fracture is based on reports by the faller or witness. We analyzed videos of real-life falls in long-term care to provide objective evidence on the factors that separate falls that result in hip fracture from falls that do not. Between 2007 and 2018, we video-captured 2377 falls by 646 residents in two long-term care facilities. Hip fracture was documented in 30 falls. We analyzed each video with a structured questionnaire, and used generalized estimating equations (GEEs) to determine relative risk ratios (RRs) for hip fracture associated with various fall characteristics. All hip fractures involved falls from standing height, and pelvis impact with the ground. After excluding falls from lower than standing height, risk for hip fracture was higher for sideways landing configurations (RR = 5.50; 95% CI, 2.36-12.78) than forward or backward, and for falls causing hip impact (3.38; 95% CI, 1.49-7.67). However, hip fracture risk was just as high in falls initially directed sideways as forward (1.14; 95% CI, 0.49-2.67), due to the tendency for rotation during descent. Falling while using a mobility aid was associated with lower fracture risk (0.30; 95% CI, 0.09-1.00). Seventy percent of hip fractures involved impact to the posterolateral aspect of the pelvis. Hip protectors were worn in 73% of falls, and hip fracture risk was lower in falls where hip protectors were worn (0.45; 95% CI, 0.21-0.99). Age and sex were not associated with fracture risk. There was no evidence of spontaneous fractures. In this first study of video-captured falls causing hip fracture, we show that the biomechanics of falls involving hip fracture were different than nonfracture falls for fall height, fall direction, impact locations, and use of hip protectors. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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Affiliation(s)
- Yijian Yang
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.,Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Vicki Komisar
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Nataliya Shishov
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Bryan Lo
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Alexandra Mb Korall
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.,George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
| | - Fabio Feldman
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.,Fraser Health Authority, Surrey, BC, Canada
| | - Stephen N Robinovitch
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.,School of Engineering, Simon Fraser University, Burnaby, BC, Canada
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25
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Kisteneff A, Gil S, O'Connell K, Edwards J, Lo B, Derber C. 335 HIV Post Exposure Prophylaxis in the Emergency Department: Barriers and Missed Opportunities. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Stewart DJ, Maziak D, Gomes M, Fung-Kee-Fung M, Dennie C, Sekhon H, Lo B, Bradford JP, Moore S, Reaume N. Abstract 5489: The cost of delaying therapy for advanced non-small cell lung cancer (NSCLC): a population kinetics assessment. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-5489] [Citation(s) in RCA: 1] [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: 11/16/2022]
Abstract
Abstract
Background: Systemic therapy prolongs overall survival (OS) in advanced NSCLC. The best outcome requires the best therapy choice. To choose the best therapy requires baseline diagnostic tests, staging and molecular profiling, but patients are at risk of deteriorating and dying while awaiting testing prior to therapy initiation. OS follows first order kinetics. We used population kinetics assessments to estimate % of patients dying while awaiting therapy initiation.
Method: For 1st line studies in advanced NSCLC that included a placebo or best supportive care (BSC) arm we digitized published OS curves, used GraphPad Prism 7 for exponential decay nonlinear regression analysis, calculated OS half-life (t1/2) and assessed data fit to 1 and 2 phase decay models. The proportion of patients “x” surviving after a time of interest tn was calculated by the Excel formula x =EXP(-tn*0.693/t1/2) where * indicates multiplication and 0.693 is the natural logarithm of 2.
Results: We identified 7 trials and a meta-analysis. Across studies, the median OS t1/2 with 1st line placebo/BSC was 19.3 weeks. Hence, by 1, 2, 3 and 4 weeks after study entry 4%, 7%, 10% and 13% of patients, respectively, would have died (ie, 4% of the remaining patients with each passing week). This is in keeping with most OS curves showing rapid decline from the outset. OS curves fit 2 phase decay models in 5 studies, indicating a distinct short survival subgroup (on average, 89% of patients in these trials) and a longer surviving subgroup (potentially from having initiated systemic therapy when progression was detected). The short survival subgroup had a median OS t1/2 across studies of 11.3 weeks. The earliest deaths would be expected to occur predominantly in this short survival subgroup, in which 5%, 9%, 13% and 17% had died by 1, 2, 3 and 4 weeks respectively.
Conclusions: Since OS follows first order kinetics, OS decline was probably following approximately the same rate prior to patient inclusion on these trials. In addition, since patients may deteriorate rapidly, others may have become too sick to consider therapy even if still alive. Rapid deterioration and short OS help explain why less than 25% of Ontario patients make it on to systemic therapy for advanced NSCLC despite the therapy being government funded. Since diagnostic, staging and molecular profiling procedures are needed before optimal therapy can start, these procedures must happen rapidly. It also illustrates why we must make screening procedures for clinical trial inclusion much faster. Otherwise patients are at risk of deteriorating rapidly or dying while awaiting eligibility assessment. It is also important to not delay initiation of systemic therapy for procedures such as radiotherapy for asymptomatic brain metastases. Any inefficiency that delays systemic therapy initiation may worsen patient outcome.
Citation Format: David J. Stewart, Donna Maziak, Marcio Gomes, Michael Fung-Kee-Fung, Carole Dennie, Harman Sekhon, Bryan Lo, John-Peter Bradford, Sara Moore, Neil Reaume. The cost of delaying therapy for advanced non-small cell lung cancer (NSCLC): a population kinetics assessment [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5489.
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Affiliation(s)
| | | | | | | | | | | | - Bryan Lo
- 1University of Ottawa, Ottawa, Ontario, Canada
| | | | - Sara Moore
- 1University of Ottawa, Ottawa, Ontario, Canada
| | - Neil Reaume
- 1University of Ottawa, Ottawa, Ontario, Canada
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27
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Salcedo A, Tarabichi M, Espiritu SMG, Deshwar AG, David M, Wilson NM, Dentro S, Wintersinger JA, Liu LY, Ko M, Sivanandan S, Zhang H, Zhu K, Ou Yang TH, Chilton JM, Buchanan A, Lalansingh CM, P'ng C, Anghel CV, Umar I, Lo B, Zou W, Simpson JT, Stuart JM, Anastassiou D, Guan Y, Ewing AD, Ellrott K, Wedge DC, Morris Q, Van Loo P, Boutros PC. A community effort to create standards for evaluating tumor subclonal reconstruction. Nat Biotechnol 2020; 38:97-107. [PMID: 31919445 PMCID: PMC6956735 DOI: 10.1038/s41587-019-0364-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 11/18/2019] [Indexed: 02/03/2023]
Abstract
Tumor DNA sequencing data can be interpreted by computational methods that analyze genomic heterogeneity to infer evolutionary dynamics. A growing number of studies have used these approaches to link cancer evolution with clinical progression and response to therapy. Although the inference of tumor phylogenies is rapidly becoming standard practice in cancer genome analyses, standards for evaluating them are lacking. To address this need, we systematically assess methods for reconstructing tumor subclonality. First, we elucidate the main algorithmic problems in subclonal reconstruction and develop quantitative metrics for evaluating them. Then we simulate realistic tumor genomes that harbor all known clonal and subclonal mutation types and processes. Finally, we benchmark 580 tumor reconstructions, varying tumor read depth, tumor type and somatic variant detection. Our analysis provides a baseline for the establishment of gold-standard methods to analyze tumor heterogeneity.
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Affiliation(s)
- Adriana Salcedo
- Ontario Institute for Cancer Research, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Maxime Tarabichi
- The Francis Crick Institute, London, UK
- Wellcome Trust Sanger Institute, Hinxton, UK
| | | | - Amit G Deshwar
- The Edward S. Rogers Senior Department of Electrical & Computer Engineering, Toronto, Canada
| | - Matei David
- Ontario Institute for Cancer Research, Toronto, Canada
| | | | - Stefan Dentro
- The Francis Crick Institute, London, UK
- Wellcome Trust Sanger Institute, Hinxton, UK
| | | | - Lydia Y Liu
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Minjeong Ko
- Ontario Institute for Cancer Research, Toronto, Canada
| | | | - Hongjiu Zhang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Kaiyi Zhu
- Department of Systems Biology, Columbia University, New York, NY, USA
- Center for Cancer Systems Therapeutics, Columbia University, New York, NY, USA
- Department of Electrical Engineering, Columbia University, New York, NY, USA
| | - Tai-Hsien Ou Yang
- Department of Systems Biology, Columbia University, New York, NY, USA
- Center for Cancer Systems Therapeutics, Columbia University, New York, NY, USA
- Department of Electrical Engineering, Columbia University, New York, NY, USA
| | - John M Chilton
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
| | - Alex Buchanan
- Oregon Health & Sciences University, Portland, OR, USA
| | | | | | | | - Imaad Umar
- Ontario Institute for Cancer Research, Toronto, Canada
| | - Bryan Lo
- Ontario Institute for Cancer Research, Toronto, Canada
| | - William Zou
- Ontario Institute for Cancer Research, Toronto, Canada
| | | | - Joshua M Stuart
- Department of Biomolecular Engineering, Center for Biomolecular Sciences and Engineering, University of California, Santa Cruz, Santa Cruz, CA, USA
| | - Dimitris Anastassiou
- Department of Systems Biology, Columbia University, New York, NY, USA
- Center for Cancer Systems Therapeutics, Columbia University, New York, NY, USA
- Department of Electrical Engineering, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, USA
| | - Yuanfang Guan
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Electronic Engineering and Computer Science, University of Michigan, Ann Arbor, MI, USA
| | - Adam D Ewing
- Mater Research Institute, University of Queensland, Woolloongabba, Queensland, Australia
| | - Kyle Ellrott
- Department of Biochemistry and Molecular Biology, The Pennsylvania State University, University Park, PA, USA
- Oregon Health & Sciences University, Portland, OR, USA
| | - David C Wedge
- Big Data Institute, University of Oxford, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Quaid Morris
- Ontario Institute for Cancer Research, Toronto, Canada
- Donnelly Centre, University of Toronto, Toronto, Canada
- Computational and Systems Biology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Vector Institute for Artificial Intelligence, Toronto, Canada
| | - Peter Van Loo
- The Francis Crick Institute, London, UK
- Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Paul C Boutros
- Department of Medical Biophysics, University of Toronto, Toronto, Canada.
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada.
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Urology, University of California, Los Angeles, Los Angeles, CA, USA.
- Institute for Precision Health, University of California, Los Angeles, Los Angeles, CA, USA.
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA.
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Spence T, Stickle N, Yu C, Chow H, Feilotter H, Lo B, McCready E, Sadikovic B, Siu LL, Bedard PL, Stockley TL. Inter-laboratory proficiency testing scheme for tumour next-generation sequencing in Ontario: a pilot study. ACTA ACUST UNITED AC 2019; 26:e717-e732. [PMID: 31896942 DOI: 10.3747/co.26.5379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background A pilot inter-laboratory proficiency scheme for 5 Ontario clinical laboratories testing tumour samples for the Ontario-wide Cancer Targeted Nucleic Acid Evaluation (octane) study was undertaken to assess proficiency in the identification and reporting of next-generation sequencing (ngs) test results in solid tumour testing from archival formalin-fixed, paraffin-embedded (ffpe) tissue. Methods One laboratory served as the reference centre and provided samples to 4 participating laboratories. An analyte-based approach was applied: each participating laboratory received 10 ffpe tissue specimens profiled at the reference centre, with tumour site and histology provided. Laboratories performed testing per their standard ngs tumour test protocols. Items returned for assessment included genes and variants that would be typically reported in routine clinical testing and variant call format (vcf) files to allow for assessment of ngs technical quality. Results Two main aspects were assessed:■ Technical quality and accuracy of identification of exonic variants■ Site-specific reporting practicesTechnical assessment included evaluation of exonic variant identification, quality assessment of the vcf files to evaluate base calling, variant allele frequency, and depth of coverage for all exonic variants. Concordance at 100% was observed from all sites in the technical identification of 98 exonic variants across the 10 cases. Variability between laboratories in the choice of variants considered clinically reportable was significant. Of the 38 variants reported as clinically relevant by at least 1 site, only 3 variants were concordantly reported by all participating centres as clinically relevant. Conclusions Although excellent technical concordance for ngs tumour profiling was observed across participating institutions, differences in the reporting of clinically relevant variants were observed, highlighting reporting as a gap where consensus on the part of Ontario laboratories is needed.
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Affiliation(s)
- T Spence
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - N Stickle
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - C Yu
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - H Chow
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - H Feilotter
- Kingston, ON: Molecular Diagnostics, Kingston Health Sciences Centre (Feilotter); Department of Pathology and Molecular Medicine, Queen's University (Feilotter)
| | - B Lo
- Ottawa, ON: Molecular Oncology Diagnostics Laboratory, The Ottawa Hospital (Lo); Department of Pathology and Laboratory Medicine, University of Ottawa (Lo)
| | - E McCready
- Hamilton, ON: Hamilton Health Sciences and St. Joseph's Healthcare (McCready); Department of Pathology and Molecular Medicine, McMaster University (McCready)
| | - B Sadikovic
- London, ON: Pathology and Laboratory Medicine Program, London Health Sciences Centre (Sadikovic); Department of Pathology and Laboratory Medicine, Western University (Sadikovic)
| | - L L Siu
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - P L Bedard
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
| | - T L Stockley
- Toronto, ON: Advanced Molecular Diagnostics Laboratory, Princess Margaret Cancer Centre, University Health Network (Spence, Stockley); Bioinformatics and HPC Core, Princess Margaret Cancer Centre, University Health Network (Stickle); Cancer Genomics Program, Princess Margaret Cancer Centre, University Health Network (Yu, Chow, Siu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network (Siu, Bedard); Department of Medicine, University of Toronto (Siu, Bedard); Department of Clinical Laboratory Genetics, University Health Network (Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Stockley)
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Malone ER, Saleh RR, Yu C, Ahmed L, Pugh T, Torchia J, Bartlett J, Virtanen C, Hotte SJ, Hilton J, Welch S, Robinson A, McCready E, Lo B, Sadikovic B, Feilotter H, Hanna TP, Kamel-Reid S, Stockley TL, Siu LL, Bedard PL. OCTANE (Ontario-wide Cancer Targeted Nucleic Acid Evaluation): a platform for intraprovincial, national, and international clinical data-sharing. ACTA ACUST UNITED AC 2019; 26:e618-e623. [PMID: 31708655 DOI: 10.3747/co.26.5235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer is a genetic disease resulting from germline or somatic genetic aberrations. Rapid progress in the field of genomics in recent years is allowing for increased characterization and understanding of the various forms of the disease. The Ontario-wide Cancer Targeted Nucleic Acid Evaluation (octane) clinical trial, open at cancer centres across Ontario, aims to increase access to genomic sequencing of tumours and to facilitate the collection of clinical data related to enrolled patients and their clinical outcomes. The study is designed to assess the clinical utility of next-generation sequencing (ngs) in cancer patient care, including enhancement of treatment options available to patients. A core aim of the study is to encourage collaboration between cancer hospitals within Ontario while also increasing international collaboration in terms of sharing the newly generated data. The single-payer provincial health care system in Ontario provides a unique opportunity to develop a province-wide registry of ngs testing and a repository of genomically characterized, clinically annotated samples. It also provides an important opportunity to use province-wide real-world data to evaluate outcomes and the cost of ngs for patients with advanced cancer. The octane study is attempting to translate knowledge to help deliver precision oncology in a Canadian environment. In this article, we discuss the background to the study and its implementation, current status, and future directions.
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Affiliation(s)
- E R Malone
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - R R Saleh
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - C Yu
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - L Ahmed
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - T Pugh
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - J Torchia
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - J Bartlett
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - C Virtanen
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - S J Hotte
- Hamilton, ON-Laboratory Genetic Services Division, Hamilton Regional Laboratory Medicine Program (McCready); McMaster University (Hotte); Juravinski Cancer Centre (Hotte)
| | - J Hilton
- Ottawa, ON-The Ottawa Hospital Research Institute (Lo); University of Ottawa (Hilton); The Ottawa Hospital Cancer Program (Hilton)
| | - S Welch
- London, ON-Department of Pathology and Laboratory Medicine, Western University, and Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre (Sadikovic); University of Western Ontario (Welch); London Health Sciences Health Centre (Welch)
| | - A Robinson
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - E McCready
- Hamilton, ON-Laboratory Genetic Services Division, Hamilton Regional Laboratory Medicine Program (McCready); McMaster University (Hotte); Juravinski Cancer Centre (Hotte)
| | - B Lo
- Ottawa, ON-The Ottawa Hospital Research Institute (Lo); University of Ottawa (Hilton); The Ottawa Hospital Cancer Program (Hilton)
| | - B Sadikovic
- London, ON-Department of Pathology and Laboratory Medicine, Western University, and Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre (Sadikovic); University of Western Ontario (Welch); London Health Sciences Health Centre (Welch)
| | - H Feilotter
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - T P Hanna
- Kingston, ON-Department of Pathology and Molecular Medicine, Queen's University (Feilotter); Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University (Hanna, Robinson); Kingston General Hospital (Hanna, Robinson)
| | - S Kamel-Reid
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - T L Stockley
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - L L Siu
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
| | - P L Bedard
- Toronto, ON-Laboratory Medicine Program, University Health Network (Kamel-Reid, Stockley); Department of Laboratory Medicine and Pathobiology, University of Toronto (Kamel-Reid, Stockley); Cancer Genomics Program, Princess Margaret Cancer Centre (Ahmed, Bedard, Kamel-Reid, Pugh, Siu, Stockley, Yu); Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre (Bedard, Malone, Saleh, Siu); Department of Medicine, University of Toronto (Bedard); Department of Medical Biophysics, University of Toronto (Kamel-Reid, Pugh, Siu); Princess Margaret Research Institute, Princess Margaret Cancer Centre (Pugh); Bioinformatics and High Performance Computing Core, University Health Network (Virtanen); Ontario Institute for Cancer Research (Torchia, Bartlett)
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Lo B, Zhang Y, Inan OT, Ellul J. Guest Editorial: Special Issue on Pervasive Sensing and Machine Learning for Mental Health. IEEE J Biomed Health Inform 2019. [DOI: 10.1109/jbhi.2019.2944778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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McCloskey CW, Cook DP, Kelly BS, Azzi F, Allen CH, Forsyth A, Upham J, Rayner KJ, Gray DA, Boyd RW, Murugkar S, Lo B, Trudel D, Senterman MK, Vanderhyden BC. Metformin Abrogates Age-Associated Ovarian Fibrosis. Clin Cancer Res 2019; 26:632-642. [PMID: 31597663 DOI: 10.1158/1078-0432.ccr-19-0603] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 06/02/2019] [Accepted: 10/04/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE The ovarian cancer risk factors of age and ovulation are curious because ovarian cancer incidence increases in postmenopausal women, long after ovulations have ceased. To determine how age and ovulation underlie ovarian cancer risk, we assessed the effects of these risk factors on the ovarian microenvironment. EXPERIMENTAL DESIGN Aged C57/lcrfa mice (0-33 months old) were generated to assess the aged ovarian microenvironment. To expand our findings into human aging, we assembled a cohort of normal human ovaries (n = 18, 21-71 years old). To validate our findings, an independent cohort of normal human ovaries was assembled (n = 9, 41-82 years old). RESULTS We first validated the presence of age-associated murine ovarian fibrosis. Using interdisciplinary methodologies, we provide novel evidence that ovarian fibrosis also develops in human postmenopausal ovaries across two independent cohorts (n = 27). Fibrotic ovaries have an increased CD206+:CD68+ cell ratio, CD8+ T-cell infiltration, and profibrotic DPP4+αSMA+ fibroblasts. Metformin use was associated with attenuated CD8+ T-cell infiltration and reduced CD206+:CD68+ cell ratio. CONCLUSIONS These data support a novel hypothesis that unifies the primary nonhereditary ovarian cancer risk factors through the development of ovarian fibrosis and the formation of a premetastatic niche, and suggests a potential use for metformin in ovarian cancer prophylaxis.See related commentary by Madariaga et al., p. 523.
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Affiliation(s)
- Curtis W McCloskey
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - David P Cook
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Brendan S Kelly
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada.,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Feryel Azzi
- Institut du Cancer de Montréal and Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Department of Pathology and Cellular Biology, Université de Montréal, Montréal, Quebec, Canada
| | | | - Amanda Forsyth
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeremy Upham
- Department of Physics and School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, Canada
| | - Katey J Rayner
- University of Ottawa Heart Institute, Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, Ottawa, Ontario, Canada
| | - Douglas A Gray
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada
| | - Robert W Boyd
- Department of Physics and School of Electrical Engineering and Computer Science, University of Ottawa, Ottawa, Canada
| | | | - Bryan Lo
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada.,Molecular Oncology Diagnostics Laboratory, Division of Anatomical Pathology, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dominique Trudel
- Institut du Cancer de Montréal and Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.,Department of Pathology and Cellular Biology, Université de Montréal, Montréal, Quebec, Canada
| | - Mary K Senterman
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Barbara C Vanderhyden
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada. .,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Chen S, Dickson BC, Mohammed S, Aldape K, Swanson D, Coulombe J, Zakhari N, Karimi S, Nassiri F, Zadeh G, Mamatjan Y, Wang T, Lo B, Woulfe J. A dural-based spindle cell neoplasm characterized by a novel MN1-KMT2A fusion gene. Neuro Oncol 2019; 21:1082-1083. [PMID: 31095693 DOI: 10.1093/neuonc/noz091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Suzan Chen
- Neurosciences Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Safraz Mohammed
- Division of Neurosurgery, Department of Surgery, University of Ottawa, The Ottawa Hospital Civic Campus, Ottawa, Ontario, Canada
| | - Kenneth Aldape
- Laboratory of Pathology, National Cancer Institute/Center for Cancer Research, Bethesda, Maryland, USA
| | - David Swanson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Josee Coulombe
- Neurosciences Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Nader Zakhari
- Division of Neuroradiology Department of Radiology University of Ottawa, The Ottawa Hospital Civic and General Campus, Ottawa, Ontario, Canada
| | - Shirin Karimi
- Princess Margaret Cancer Center, MacFeeters-Hamilton Center for Neuro-Oncology Research, Toronto, Ontario, Canada
| | - Farshad Nassiri
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Yasin Mamatjan
- Princess Margaret Cancer Center, MacFeeters-Hamilton Center for Neuro-Oncology Research, Toronto, Ontario, Canada
| | - Tao Wang
- Department of Pathology and Molecular Medicine, Queen's University, Richardson Laboratory, Kingston, Ontario, Canada
| | - Bryan Lo
- Division of Anatomical Pathology, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - John Woulfe
- Neurosciences Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Eastern Ontario Regional Laboratory Association/Association des Laboratoires Régionaux de l'Est de l'Ontario (EORLA/ALREO), The Ottawa Hospital, Civic Campus, Laboratory Medicine Building, Ottawa, Ontario, Canada
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Campbell PA, Thavorn K, Lo B, Karimnezhad A, Perkins TJ, Urquhart R, Kamel-Reid S, Sekhon H, Stewart DJ. Abstract 3355: Challenges in the implementation of molecular diagnostic testing for non-small cell lung cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3355] [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
Next generation sequencing (NGS) has been used to catalogue genetic mutations in cancer. Recent studies employing NGS have identified specific genetic mutations that reliably predict therapeutic success with targeted treatment in many forms of cancer, and particularly in non-small cell lung cancer (NSCLC). Importantly, patients with oncogenic driver mutations have better tumor control with targeted agents than with chemotherapy, while those lacking such a mutation derive more benefit from chemotherapy. To detect actionable mutations, all patients with metastatic disease must be tested. Mutation assays are generally developed using tissues derived from surgical samples. However, for many patients with metastatic NSCLC the only tissue available is from fine needle aspirates (FNAs). Given the limited number and heterogeneity of cells found in FNAs and the expanding number of clinically actionable mutations, the development and implementation of testing strategies that rapidly and accurately define driver mutations in NSCLC remains a challenge.
Our project focuses on the identification of best methods (pre-analytical, analytical, and bioinformatic) to identify driver mutations in lung FNAs to standardize targeted NGS testing for NSCLC. The overarching goal of this project is to develop a strategy for Canada-wide implementation of the developed test. As a first step in this process, our team organized a stakeholder meeting to: A) Identify potential individual and/or system level challenges and barriers to implementation of standardized protocols for molecular oncology diagnostics; B) Outline guidelines and strategies to overcome identified challenges and barriers; and C) Initiate a research project to further study the barriers and facilitators of implementing Canada-wide diagnostic testing strategies for personalized cancer care. For this presentation, we will outline key challenges that impact implementation of the new test, including tumor characteristics (cellularity, heterogeneity); cost and reimbursement issues; required turn around times; bioinformatic requirements; testing strategy (technical limitations of test, panel size); technical staffing and infrastructure requirements; and barriers to implementation of the test into routine standard of care. Finally, we will present a preliminary workflow map, which builds upon the Lung Cancer Pathway Maps provided by Cancer Care Ontario (https://www.cancercareontario.ca/en/pathway-maps/lung-cancer) and addresses these barriers and explores various scenarios for implementation of new testing strategies.
Citation Format: Pearl A. Campbell, Kednapa Thavorn, Bryan Lo, Ali Karimnezhad, Theodore J. Perkins, Robin Urquhart, Suzanne Kamel-Reid, Harmanjatinder Sekhon, David J. Stewart. Challenges in the implementation of molecular diagnostic testing for non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3355.
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Affiliation(s)
| | - Kednapa Thavorn
- 1Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Bryan Lo
- 2Eastern Ontario Regional Laboratories Association, Ottawa, Ontario, Canada
| | - Ali Karimnezhad
- 1Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | | | - Suzanne Kamel-Reid
- 4Toronto General Hospital/Research Institute (UHN), Toronto, Ontario, Canada
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Abstract
e13586 Background: Brain metastases are observed in more than 40% of all patients with stage IV melanoma. In recent years, more extensive use of stereotactic radiation (STRT) and the advent of immune checkpoint inhibitors and BRAF targeted therapies have positively impacted outcomes in patients with metastatic melanoma (MBM) In this study, we examined real-world clinical outcomes of patients presented with melanoma brain metastases (MBM). Methods: This retrospective review evaluated MBM patients treated at the Ottawa Hospital. Clinical, radiologic, and pathologic variables were collected from the electronic medical records from January 2000 to June 2018. Results: A total of 277 patients fulfilled the inclusion criteria. Median overall survival was 4 months. LDH was the only significant prognostic factor in this study. Over 65% of brain metastases were detected due to the presence of neurological symptoms, while surveillance and restaging identified asymptomatic brain metastases in the remaining patients. Detection by neurological symptoms was related to larger (p < 0.001) and haemorrhagic (p = 0.032) intra-cranial lesions as well as decreased overall survival (HR = 1.2, p = 0.018). With regards to locoregional treatment STRT radiation outperformed WBRT alone in patients with single and oligo (2-6 lesions) brain lesions (HR = 0.149, p = 0.001 for oligo; HR = 0.149, p = 0.003 for single) and was associated with approximately a 3-fold increase in median survival. STRT was used 2-fold less frequently in patients with more than one lesion (54.8% in single; 31.7% in oligo). In patients receiving systemic therapy, immunotherapy is the only modality demonstrated overall survival benefit compared to no systemic treatment (HR = 0.511, p = 0.014). Furthermore, patients receiving STRT in combination with immunotherapy outperformed patients receiving STRT with WBRT (HR = 0.389, p = 0.009). Conclusions: Results from this study support the consideration of routine screening of high-risk asymptomatic patients, the increased use of STRT in patients with multiple intra-cranial lesions. The efficacy of immunotherapy in patients with MBM is consistent with current clinical trial data.
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Affiliation(s)
| | - Bryan Lo
- The Ottawa Hospital, Ottawa, ON, Canada
| | - Michael Ong
- The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
| | | | - Xinni Song
- The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada
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Yip S, Christofides A, Banerji S, Downes MR, Izevbaye I, Lo B, MacMillan A, McCuaig J, Stockley T, Yousef GM, Spatz A. A Canadian guideline on the use of next-generation sequencing in oncology. Curr Oncol 2019; 26:e241-e254. [PMID: 31043833 PMCID: PMC6476432 DOI: 10.3747/co.26.4731] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Rapid advancements in next-generation sequencing (ngs) technology have created an unprecedented opportunity to decipher the molecular profile of tumours to more effectively prevent, diagnose, and treat cancer. Oncologists now have the option to order molecular tests that can guide treatment decisions. However, to date, most oncologists have received limited training in genomics, and they are now faced with the challenge of understanding how such tests and their interpretation align with patient management. Guidance on how to effectively use ngs technology is therefore needed to aid oncologists in applying the results of genomic tests. The Canadian guideline presented here describes best practices and unmet needs related to ngs-based testing for somatic variants in oncology, including clinical application, assay and sample selection, bioinformatics and interpretation of reports performed by laboratories, patient communication, and clinical trials.
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Affiliation(s)
- S Yip
- Cancer Genetics and Genomics Lab, BC Cancer, Vancouver, BC
| | | | - S Banerji
- Department of Medical Oncology, CancerCare Manitoba, Winnipeg, MB
| | - M R Downes
- Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON
| | - I Izevbaye
- Division of Molecular Pathology, Laboratory Medicine and Pathology, University of Alberta Hospital, Edmonton, AB
| | - B Lo
- Molecular Diagnostics, The Ottawa Hospital, Ottawa, ON
| | - A MacMillan
- Provincial Medical Genetics Program, St. John's, NL
| | - J McCuaig
- Princess Margaret Cancer Centre, Toronto, ON
| | - T Stockley
- Department of Laboratory Medicine and Pathobiology, University of Toronto and University Health Network, Toronto, ON
| | - G M Yousef
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON
| | - A Spatz
- Departments of Pathology and Oncology, McGill University, McGill University Health Centre and Lady Davis Institute, Montreal, QC
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Weberpals JI, Pugh T, Goss GD, Lo B, Andrews Wright N, Bernard L, Torti D, Torchia J, Rath P, Leon A, Marsh K, Hodgson DR, Jones GN, Duciaume M, Howat WJ, Marco-Casanova P, Roudier MP, Whelan D, Sekhon HS. Tumor molecular profiling to differentiate extreme responses to first-line platinum-based chemotherapy in suboptimally debulked serous ovarian cancer patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Trevor Pugh
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | - Bryan Lo
- The Ottawa Hospital, Ottawa, ON, Canada
| | | | | | - Dax Torti
- PM-OICR TGL, Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada
| | - Jonathon Torchia
- PM-OICR TGL, Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada
| | - Prisni Rath
- Ontario Institute of Cancer Research, Toronto, ON, Canada
| | - Alberto Leon
- Ontario Institute of Cancer Research, Toronto, ON, Canada
| | - Kayla Marsh
- Ontario Institute of Cancer Research, Toronto, ON, Canada
| | | | - Gemma N Jones
- Oncology Translational Science, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Marc Duciaume
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - William J Howat
- Oncology Translational Science, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | | | - Martine P Roudier
- Oncology Translational Science, IMED Biotech Unit, AstraZeneca, Cambridge, United Kingdom
| | - Doreen Whelan
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Sy O, Diongue K, Ahmed CB, Ba O, Moulay FC, Lo B, Ndiaye D. [Vulvovaginal candidiasis in pregnant women in the Mère et Enfant Hospital center in Nouakchott, Mauritania]. J Mycol Med 2018; 28:345-348. [PMID: 29548876 DOI: 10.1016/j.mycmed.2018.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/26/2018] [Accepted: 02/12/2018] [Indexed: 11/18/2022]
Abstract
AIM To determine the prevalence and the associated risk factors of vulvovaginal candidiasis in pregnant women in Mauritania. PATIENTS AND METHOD The study was carried out at the laboratory of the Mère et Enfant Center in Nouakchott, from November 1, 2016 to February 5, 2017. It concerned all pregnant women in the third trimester that came to the natal consultation at the gynecology service. These women must have given their informed consent in written form. After completing the survey to collect epidemiological and clinical data, a sample was collected to perform fresh direct examination and culture on Sabouraud-Chloramphenicol media. RESULTS Two hundred pregnant women were included in the study. Culture on Sabouraud-Chloramphenicol media was positive in 52 patients corresponding to a prevalence of 26%. The germ tube test was positive for 61.5% of isolated Candida. Clinical signs are dominated by leucorrhea (56%), pelvic pain (25%) and vulvar pruritus (11%). Among women with positive culture, 55.76% had received local antifungal treatment in the form of an ovula during pregnancy. CONCLUSION This study shows that vulvovaginal candidiasis is frequent in pregnant women attending gynecology at the Mère et Enfant Hospital Center in Nouakchott.
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Affiliation(s)
- O Sy
- Laboratoire du centre hospitalier Mère et Enfant de Nouakchott, BP 40028, Nouakchott, Mauritanie.
| | - K Diongue
- Service de parasitologie-mycologie, faculté de médecine, de pharmacie et d'odontologie, l'université Cheikh Anta Diop, BP 5005, Dakar, Sénégal
| | - C B Ahmed
- Département de biologie, faculté des sciences et techniques, université de Nouakchott, Al Aasrya, Mauritanie
| | - O Ba
- Département des sciences fondamentales, faculté de médecine, université de Nouakchott, Al Aasrya, Mauritanie
| | - F C Moulay
- Département de biologie, faculté des sciences et techniques, université de Nouakchott, Al Aasrya, Mauritanie
| | - B Lo
- Département des sciences fondamentales, faculté de médecine, université de Nouakchott, Al Aasrya, Mauritanie
| | - D Ndiaye
- Service de parasitologie-mycologie, faculté de médecine, de pharmacie et d'odontologie, l'université Cheikh Anta Diop, BP 5005, Dakar, Sénégal
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Lo B, Vester-Andersen MK, Vind I, Prosberg M, Dubinsky M, Siegel CA, Bendtsen F, Burisch J. Changes in Disease Behaviour and Location in Patients With Crohn's Disease After Seven Years of Follow-Up: A Danish Population-based Inception Cohort. J Crohns Colitis 2018; 12:265-272. [PMID: 29506105 DOI: 10.1093/ecco-jcc/jjx138] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/05/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Crohn's disease [CD] is a progressive inflammatory bowel disease that can lead to complications such as strictures or penetrating disease, and ultimately surgery. Few population-based studies have investigated the predictors for disease progression and surgery in CD according to the Montreal classification. We aimed to identify clinical predictors associated with complicated CD in a Danish population-based inception cohort during the biologic era. METHODS All incident patients with CD in a well-defined Copenhagen area, between 2003 and 2004, were followed prospectively until 2011. Disease progression was defined as the development of bowel stricture [B2] or penetrating disease [B3] in patients initially diagnosed with non-stricturing/non-penetrating disease [B1]. Associations between disease progression and/or resection, and multiple covariates, were investigated by Cox regression analyses. RESULTS In total, 213 CD patients were followed. A total of 177 [83%] patients had B1 at diagnosis. Patients who changed location had increased risk of disease progression (hazard ratio [HR] = 3.1, 95% CI: 1.12,8.52). Biologic treatment was associated with lower risk of change in location [HR = 0.3, 95% CI: 0.1-0.7]. Colonic involvement [L2 or L3 vs L1] was associated with a lower risk of surgery (HR = 0.34/0.22, 95% CI: [0.13,0.86]/[0.08,0.60]). All CD patients who progressed in behaviour or changed location had an increased risk of surgery [p < 0.05]. CONCLUSIONS This population-based inception cohort study demonstrates that changes in disease location or behaviour in patients with CD increase their risk of resection. Our findings highlight the protective effect of biologic treatment with regard to change in disease location, which might ultimately improve the disease course for CD patients.
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Affiliation(s)
- B Lo
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - M K Vester-Andersen
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Medical Department, Zealand University Hospital, Køge [Koege], Denmark
| | - I Vind
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - M Prosberg
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - M Dubinsky
- Susan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C A Siegel
- Dartmouth-Hitchcock Medical Center, Section of Gastroenterology and Hepatology, Lebanon, NH, USA
| | - F Bendtsen
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - J Burisch
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Lo B, Prosberg MV, Gluud LL, Chan W, Leong RW, van der List E, van der Have M, Sarter H, Gower-Rousseau C, Peyrin-Biroulet L, Vind I, Burisch J. Systematic review and meta-analysis: assessment of factors affecting disability in inflammatory bowel disease and the reliability of the inflammatory bowel disease disability index. Aliment Pharmacol Ther 2018; 47:6-15. [PMID: 28994131 DOI: 10.1111/apt.14373] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 07/31/2017] [Accepted: 09/20/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The Inflammatory Bowel Disease Disability Index (IBD-DI) has recently been developed for patients with Crohn's disease (CD) and ulcerative colitis (UC). AIM To assess the severity of disability and associated factors using the IBD-DI, and review the validity of the IBD-DI as a tool. METHOD Systematic review of cross-sectional studies. Patients included had UC or CD and were classified as active, in remission, or needing surgery, biological and/or steroid treatment. We included studies assessing disability using the IBD-DI and that were captured by electronic and manual searches (January 2017). The possibility of bias was evaluated with the Newcastle-Ottawa Scale. RESULTS Nine studies were included with 3167 patients. Comparatively, patients with active disease had higher disability rates than those in remission (SMD [CI95] = 1.49[1.11, 1.88], I2 = 94%, P<.01), while patients on biological treatment had lower disability rates than those receiving corticosteroid treatment (SMD [CI95] = -0.22[-0.36, -0.08], I2 = 0%, P<.01). Disease activity and unemployment were found to be associated factors. The IBD-DI scored "good" for internal consistency, "fair" to "excellent" for intra-rater reliability and "excellent" for inter-rater reliability. Construct validity was "moderately strong" to "very strong" and structural validity was found to be mainly unidimensional. The IBD-DI had excellent responsiveness, while its interpretability was only useful on a group level. CONCLUSIONS This systematic review and meta-analysis found a significant association between disease activity, treatment received and disability; although significant heterogeneity was found. The IBD-DI is reliable and valid, but further studies are needed to measure its interpretability.
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Affiliation(s)
- B Lo
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - M V Prosberg
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - L L Gluud
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - W Chan
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.,Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia
| | - R W Leong
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia
| | - E van der List
- Gastroenterology and Liver Services, Concord Hospital, Sydney, Australia
| | - M van der Have
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands
| | - H Sarter
- Public Health Unit, Epimad Registry, Lille University Hospital, Lille, France
| | - C Gower-Rousseau
- Public Health Unit, Epimad Registry, Lille University Hospital, Lille, France
| | - L Peyrin-Biroulet
- Inserm U954 and Department of Gastroenterology, University Hospital Nancy and Lorraine University, Vandoeuvre-lès-Nancy, France
| | - I Vind
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - J Burisch
- Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Weberpals JI, Lo B, Duciaume MM, Spaans JN, Clancy AA, Dimitroulakos J, Goss GD, Sekhon HS. Vulvar Squamous Cell Carcinoma (VSCC) as Two Diseases: HPV Status Identifies Distinct Mutational Profiles Including Oncogenic Fibroblast Growth Factor Receptor 3. Clin Cancer Res 2017; 23:4501-4510. [PMID: 28377483 DOI: 10.1158/1078-0432.ccr-16-3230] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 01/30/2017] [Accepted: 03/31/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Patients with advanced or recurrent invasive vulvar squamous cell carcinoma (VSCC) have limited treatment options and a grave prognosis. Understanding the genomic landscape may facilitate the identification of new therapies and improve clinical outcomes.Experimental Design: A retrospective chart review and molecular analysis of patients with VSCC from 2000 to 2016 was performed at the Ottawa Hospital Research Institute. The presence of oncogenic human papillomavirus (HPV) was determined by nested PCR and amplified DNA was sequenced using the Ion AmpliSeq Cancer Hotspot v2 Panel. The patients were divided into two groups according to HPV status (HPV-positive versus HPV-negative) and clinical outcome correlated with mutation status using descriptive statistics.Results: In 43 VSCC patients, there was a high mutation rate in both HPV-positive (73%) and HPV-negative (90%) disease with the two subgroups expressing distinct genetic profiles. HPV-positive tumors were characterized by oncogenic mutations in PIK3CA (27%), FGFR3 (14%), and PTEN (9%), whereas HPV-negative tumors were found to have mutations in TP53 (57%), HRAS (24%), PI3KCA (19%), and CDKN2A (14%). Mutation S249C in FGFR3 occurred in 14% of HPV-positive tumors. While there were notable differences in the occurrence of TP53, HRAS, PTEN, and FGFR3 mutations according to HPV status, only the rate of TP53 mutations was statistically significant (P = 0.0004). No significant difference in prognosis was found between patients with HPV-positive and HPV-negative VSCC.Conclusions: HPV-positive VSCC is characterized by oncogenic FGFR3 mutations that helps classify this subtype as a separate disease. Inhibitors of FGFR3 merit consideration as a therapeutic strategy in this neglected cancer in women. Clin Cancer Res; 23(15); 4501-10. ©2017 AACR.
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Affiliation(s)
- Johanne I Weberpals
- Division of Gynaecologic Oncology, The Ottawa Hospital, Ottawa, Canada. .,Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada
| | - Bryan Lo
- Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada.,Molecular Oncology Diagnostics Laboratory, The Ottawa Hospital, Ottawa, Ontario.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Marc M Duciaume
- Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada
| | - Johanna N Spaans
- Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada
| | - Aisling A Clancy
- Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Ontario
| | - Jim Dimitroulakos
- Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada
| | - Glenwood D Goss
- Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada.,Division of Medical Oncology, University of Ottawa, Ottawa, Canada
| | - Harman S Sekhon
- Ottawa Hospital Research Institute, Centre for Cancer Therapeutics, Ottawa, Canada.,Molecular Oncology Diagnostics Laboratory, The Ottawa Hospital, Ottawa, Ontario.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
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Smiley S, Marginean C, Lo B. Abstract A40: Gene expression profiling of pancreatic cancer precursors directly from formalin fixed paraffin embedded (FFPE) tissue without nucleic acid extraction. Cancer Res 2016. [DOI: 10.1158/1538-7445.panca16-a40] [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
Gene expression analysis of pancreatic intraepithelial neoplasia (PanINs), the pancreatic ductal adenocarcinoma precursor, has been challenging because extracting and purifying RNA from pancreatic tissue is difficult. Since the pancreas is rich in ribonucleases and PanINs are typically very small lesions, attempts to purify RNA of sufficient quality and quantity for microarray or RNAseq are usually unsuccessful. This is especially true if the starting material is formalin fixed paraffin embedded tissue, where the fixation process introduces further degradation of the RNA. We sought to solve this problem of PanIN gene expression profiling by using the HTG Edgeseq instrument platform. This instrument is designed to work with small FFPE specimens and perform RNA profiling even when RNA is partially degraded by employing a novel extraction free hybridization approach. In our pilot study, we show that the HTG Edgeseq can be used to profile ~2500 genes from a cohort of microdissected low and high grade PanIN from FFPE of human pancreatic adenocarcinoma resections. We speculate that most of these PanIN lesions would not have been amenable to other gene expression methodologies and that the PanIN data from the HTG Edgeseq will contribute to our understanding of the molecular pathways that underlie pancreatic cancer.
Citation Format: Sheila Smiley, Celia Marginean, Bryan Lo.{Authors}. Gene expression profiling of pancreatic cancer precursors directly from formalin fixed paraffin embedded (FFPE) tissue without nucleic acid extraction. [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2016 May 12-15; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2016;76(24 Suppl):Abstract nr A40.
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Affiliation(s)
- Sheila Smiley
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | | | - Bryan Lo
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Weberpals J, Clancy A, Lo B, Sekhon H, Dimitroulakos J, Goss G, Spaans J, Duciaume M. Defining the genomic landscape of vulvar squamous cell carcinoma (VSCC) using next generation sequencing: the role of HPV infection. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kwasnicki RM, Hettiaratchy S, Okogbaa J, Lo B, Yang GZ, Darzi A. Return of functional mobility after an open tibial fracture: a sensor-based longitudinal cohort study using the Hamlyn Mobility Score. Bone Joint J 2015. [PMID: 26224831 DOI: 10.1302/0301-620x.97b8.35491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this study we quantified and characterised the return of functional mobility following open tibial fracture using the Hamlyn Mobility Score. A total of 20 patients who had undergone reconstruction following this fracture were reviewed at three-month intervals for one year. An ear-worn movement sensor was used to assess their mobility and gait. The Hamlyn Mobility Score and its constituent kinematic features were calculated longitudinally, allowing analysis of mobility during recovery and between patients with varying grades of fracture. The mean score improved throughout the study period. Patients with more severe fractures recovered at a slower rate; those with a grade I Gustilo-Anderson fracture completing most of their recovery within three months, those with a grade II fracture within six months and those with a grade III fracture within nine months. Analysis of gait showed that the quality of walking continued to improve up to 12 months post-operatively, whereas the capacity to walk, as measured by the six-minute walking test, plateaued after six months. Late complications occurred in two patients, in whom the trajectory of recovery deviated by > 0.5 standard deviations below that of the remaining patients. This is the first objective, longitudinal assessment of functional recovery in patients with an open tibial fracture, providing some clarification of the differences in prognosis and recovery associated with different grades of fracture.
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Affiliation(s)
- R M Kwasnicki
- Imperial College London, 3rd Floor Paterson Centre, Praed Street, Paddington, W2 1NY, UK
| | - S Hettiaratchy
- Imperial College London, 3rd Floor Paterson Centre, Praed Street, Paddington, W2 1NY, UK
| | - J Okogbaa
- Stanford University, Stanford, California, USA
| | - B Lo
- Imperial College London, 3rd Floor Paterson Centre, Praed Street, Paddington, W2 1NY, UK
| | - G-Z Yang
- Imperial College London, 3rd Floor Paterson Centre, Praed Street, Paddington, W2 1NY, UK
| | - A Darzi
- Imperial College London, 3rd Floor Paterson Centre, Praed Street, Paddington, W2 1NY, UK
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Lo B. Informed consent. Front Radiat Ther Oncol 2015; 20:54-7. [PMID: 3949178 DOI: 10.1159/000411947] [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] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kebe M, Yahya S, Lo B, Ball M. [Artificial skin depigmentation complications in Nouakchott, Mauritania]. Mali Med 2015; 30:38-42. [PMID: 29927157] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In order to study the complications of artificial depigmentation (AD) in Mauritania, we conducted a descriptive cross-sectional study among women in the Dermatology Department of Nouakchott national hospital from July to September 2012. The objective of the study was to determine the prevalence of complications of AD. Of the 394 patients who consulted during the study period, we identified 164 users of depigmentation products. The average age of users of AD is 30.38 years, ranging from 13 to 70 years. The levels of study are most represented 40.2% in the primary and secondary in 41.5%. The majority of users are of the white Moorish ethnic group (34.8%) followed by the Fulani ethnic group (26.8%). 56% of patients were married, 24% were single. 52% of married patients say their spouses disapprove of this practice. 49.4% of patients are undergo artificial depigmentation to be beautiful. 96.3% of these users had one or more complications. Complications noted during this study are dermatophytes (30.5%), superficial or deep folliculitis (7.9%), bacterial dermohipodermitis (erysipelas: 2.4%), exogenous ochronosis (26. 2%), black spots (83.5%). The women's main motivation is aesthetic (49.4%). Among users, 73.8% know the side effects without this discouraging this practice. Most often these side effects do not motivate a consultation and are well tolerated by patients who accept them as ransom AD. Despite the high prevalence of light-skinned subjects, in Mauritania artificial depigmentation remains a common practice.
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Affiliation(s)
- M Kebe
- Service Dermatologie CHN, Centre hospitalier national (CHN), BP 612 Nouakchott-Mauritanie, Tel : 0022245252135
| | - S Yahya
- Service Dermatologie CHN, Centre hospitalier national (CHN), BP 612 Nouakchott-Mauritanie, Tel : 0022245252135
| | - B Lo
- Département de la Santé Publique, Faculté de Médecine de Nouakchott
| | - M Ball
- Service Dermatologie CHN, Centre hospitalier national (CHN), BP 612 Nouakchott-Mauritanie, Tel : 0022245252135
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Atallah L, Wiik A, Lo B, Cobb JP, Amis AA, Yang GZ. Gait asymmetry detection in older adults using a light ear-worn sensor. Physiol Meas 2014; 35:N29-40. [DOI: 10.1088/0967-3334/35/5/n29] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Lo B, Viotti M, Strasser G, Mellman I. Abstract A41: Inhibition of Lkb1 in cultured embryonic pancreas destabilizes tissue architecture to generate precancerous-like lesions. Cancer Res 2013. [DOI: 10.1158/1538-7445.fbcr13-a41] [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
The tumor suppressor Lkb1 is a regulator of cellular energy, proliferation, and polarity, yet the mechanism by which it controls tissue morphogenesis or cancer remains poorly defined. By culturing embryonic tissues from mice harboring a mutant Lkb1 that can be rapidly inhibited, we have previously shown that acute loss of Lkb1 results in destabilized tissue architecture and the formation of highly dynamic pancreatic cysts (Lo et al, JCB 2012). Remarkably, the pancreatic cysts evolve within a few days into precancerous-like lesions that we now demonstrate to have a transcriptional profile that is strikingly similar to those reported for mouse and human PanINs (Pancreatic Intraepithelial Neoplasias). Utilizing fluorescence activated cell sorting, we have begun to track gene expression signatures associated with canonical signaling pathways in both single cells and subsets of cells from the embryonic explants. Since our experimental system offers precise temporal control and accessibility to manipulation within a tissue context, we are able to gain unprecedented insight into the earliest events in pancreatic oncogenesis.
Citation Format: Bryan Lo, Manuel Viotti, Geraldine Strasser, Ira Mellman. Inhibition of Lkb1 in cultured embryonic pancreas destabilizes tissue architecture to generate precancerous-like lesions. [abstract]. In: Proceedings of the Third AACR International Conference on Frontiers in Basic Cancer Research; Sep 18-22, 2013; National Harbor, MD. Philadelphia (PA): AACR; Cancer Res 2013;73(19 Suppl):Abstract nr A41.
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Affiliation(s)
- Bryan Lo
- Genentech, South San Francisco, CA
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Oh J, Wu N, Baravalle G, Cohn B, Ma J, Lo B, Mellman I, Ishido S, Anderson M, Shin JS. MARCH1-mediated MHCII ubiquitination promotes dendritic cell selection of natural regulatory T cells. ACTA ACUST UNITED AC 2013; 210:1069-77. [PMID: 23712430 PMCID: PMC3674695 DOI: 10.1084/jem.20122695] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Ubiquitination of MHCII molecules on dendritic cells is essential for the development of natural regulatory T cells Membrane-associated RING-CH1 (MARCH1) is an E3 ubiquitin ligase that mediates ubiquitination of MHCII in dendritic cells (DCs). MARCH1-mediated MHCII ubiquitination in DCs is known to regulate MHCII surface expression, thereby controlling DC-mediated T cell activation in vitro. However, its role at steady state or in vivo is not clearly understood. Here, we show that MARCH1 deficiency resulted in a substantial reduction in the number of thymus-derived regulatory T cells (T reg cells) in mice. A specific ablation of MHCII ubiquitination also significantly reduced the number of thymic T reg cells. Indeed, DCs deficient in MARCH1 or MHCII ubiquitination both failed to generate antigen-specific T reg cells in vivo and in vitro, although both exhibited an increased capacity for antigen presentation in parallel with the increased surface MHCII. Thus, MARCH1-mediated MHCII ubiquitination in DCs is required for proper production of naturally occurring T reg cells, suggesting a role in balancing immunogenic and regulatory T cell development.
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Affiliation(s)
- Jaehak Oh
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA
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Lo B, Strasser G, Sagolla M, Austin CD, Junttila M, Mellman I. Lkb1 regulates organogenesis and early oncogenesis along AMPK-dependent and -independent pathways. ACTA ACUST UNITED AC 2013; 199:1117-30. [PMID: 23266956 PMCID: PMC3529533 DOI: 10.1083/jcb.201208080] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A combination of ex vivo embryonic tissue culture, genetic manipulation, and chemical genetics reveals novel details of Lkb1-mediated regulation of tissue morphogenesis. The tumor suppressor Lkb1/STK11/Par-4 is a key regulator of cellular energy, proliferation, and polarity, yet its mechanisms of action remain poorly defined. We generated mice harboring a mutant Lkb1 knockin allele that allows for rapid inhibition of Lkb1 kinase. Culturing embryonic tissues, we show that acute loss of kinase activity perturbs epithelial morphogenesis without affecting cell polarity. In pancreas, cystic structures developed rapidly after Lkb1 inhibition. In lung, inhibition resulted in cell-autonomous branching defects. Although the lung phenotype was rescued by an activator of the Lkb1 target adenosine monophosphate–activated kinase (AMPK), pancreatic cyst development was independent of AMPK signaling. Remarkably, the pancreatic phenotype evolved to resemble precancerous lesions, demonstrating that loss of Lkb1 was sufficient to drive the initial steps of carcinogenesis ex vivo. A similar phenotype was induced by expression of mutant K-Ras with p16/p19 deletion. Combining culture of embryonic tissues with genetic manipulation and chemical genetics thus provides a powerful approach to unraveling developmental programs and understanding cancer initiation.
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Affiliation(s)
- Bryan Lo
- Genentech, South San Francisco, CA 94080, USA
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Graffeo C, Ford L, Lo B, Ansari S, Devine A. 375 Mortality Outcomes From Post-Cardiac Arrest Therapeutic Hypothermia in a Community-Based, Multiple Hospital System. Ann Emerg Med 2012. [DOI: 10.1016/j.annemergmed.2012.06.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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