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Othman J, Potter N, Ivey A, Jovanovic J, Runglall M, Freeman SD, Gilkes A, Thomas I, Johnson S, Canham J, Cavenagh J, Kottaridis P, Arnold C, Ommen HB, Overgaard UM, Dennis M, Burnett A, Wilhelm-Benartzi C, Dillon R, Russell NH. Postinduction molecular MRD identifies patients with NPM1 AML who benefit from allogeneic transplant in first remission. Blood 2024; 143:1931-1936. [PMID: 38364112 DOI: 10.1182/blood.2023023096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/19/2023] [Accepted: 01/23/2024] [Indexed: 02/18/2024] Open
Abstract
ABSTRACT Selection of patients with NPM1-mutated acute myeloid leukemia (AML) for allogeneic transplant in first complete remission (CR1-allo) remains controversial because of a lack of robust data. Consequently, some centers consider baseline FLT3-internal tandem duplication (ITD) an indication for transplant, and others rely on measurable residual disease (MRD) status. Using prospective data from the United Kingdom National Cancer Research Institute AML17 and AML19 studies, we examined the impact of CR1-allo according to peripheral blood NPM1 MRD status measured by quantitative reverse transcription polymerase chain reaction after 2 courses of induction chemotherapy. Of 737 patients achieving remission, MRD was positive in 19%. CR1-allo was performed in 46% of MRD+ and 17% of MRD- patients. We observed significant heterogeneity of overall survival (OS) benefit from CR1-allo according to MRD status, with substantial OS advantage for MRD+ patients (3-year OS with CR1-allo vs without: 61% vs 24%; hazard ratio [HR], 0.39; 95% confidence interval [CI], 0.24-0.64; P < .001) but no benefit for MRD- patients (3-year OS with CR1-allo vs without: 79% vs 82%; HR, 0.82; 95% CI, 0.50-1.33; P = .4). Restricting analysis to patients with coexisting FLT3-ITD, again CR1-allo only improved OS for MRD+ patients (3-year OS, 45% vs 18%; compared with 83% vs 76% if MRD-); no interaction with FLT3 allelic ratio was observed. Postinduction molecular MRD reliably identifies those patients who benefit from allogeneic transplant in first remission. The AML17 and AML19 trials were registered at www.isrctn.com as #ISRCTN55675535 and #ISRCTN78449203, respectively.
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Affiliation(s)
- Jad Othman
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nicola Potter
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Adam Ivey
- Alfred Hospital and Monash University, Melbourne, Australia
| | - Jelena Jovanovic
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Manohursingh Runglall
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sylvie D Freeman
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Amanda Gilkes
- Department of Haematology, Cardiff University, Cardiff, United Kingdom
| | - Ian Thomas
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Sean Johnson
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Joanna Canham
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Jamie Cavenagh
- Department of Haemato-Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Panagiotis Kottaridis
- Department of Haematology, University College London Hospital NHS Foundation Trust, London, United Kingdom
| | - Claire Arnold
- Clinical Haematology, Belfast City Hospital, Belfast, United Kingdom
| | - Hans Beier Ommen
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Mike Dennis
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Alan Burnett
- Paul O'Gorman Leukaemia Centre, Glasgow University, Glasgow, United Kingdom
| | | | - Richard Dillon
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Nigel H Russell
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Russell NH, Wilhelm-Benartzi C, Othman J, Dillon R, Knapper S, Batten LM, Canham J, Hinson EL, Betteridge S, Overgaard UM, Gilkes A, Potter N, Mehta P, Kottaridis P, Cavenagh J, Hemmaway C, Arnold C, Freeman SD, Dennis M. Fludarabine, Cytarabine, Granulocyte Colony-Stimulating Factor, and Idarubicin With Gemtuzumab Ozogamicin Improves Event-Free Survival in Younger Patients With Newly Diagnosed AML and Overall Survival in Patients With NPM1 and FLT3 Mutations. J Clin Oncol 2024:JCO2300943. [PMID: 38215358 DOI: 10.1200/jco.23.00943] [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] [Received: 04/28/2023] [Revised: 09/07/2023] [Accepted: 10/20/2023] [Indexed: 01/14/2024] Open
Abstract
PURPOSE To determine the optimal induction chemotherapy regimen for younger adults with newly diagnosed AML without known adverse risk cytogenetics. PATIENTS AND METHODS One thousand thirty-three patients were randomly assigned to intensified (fludarabine, cytarabine, granulocyte colony-stimulating factor, and idarubicin [FLAG-Ida]) or standard (daunorubicin and Ara-C [DA]) induction chemotherapy, with one or two doses of gemtuzumab ozogamicin (GO). The primary end point was overall survival (OS). RESULTS There was no difference in remission rate after two courses between FLAG-Ida + GO and DA + GO (complete remission [CR] + CR with incomplete hematologic recovery 93% v 91%) or in day 60 mortality (4.3% v 4.6%). There was no difference in OS (66% v 63%; P = .41); however, the risk of relapse was lower with FLAG-Ida + GO (24% v 41%; P < .001) and 3-year event-free survival was higher (57% v 45%; P < .001). In patients with an NPM1 mutation (30%), 3-year OS was significantly higher with FLAG-Ida + GO (82% v 64%; P = .005). NPM1 measurable residual disease (MRD) clearance was also greater, with 88% versus 77% becoming MRD-negative in peripheral blood after cycle 2 (P = .02). Three-year OS was also higher in patients with a FLT3 mutation (64% v 54%; P = .047). Fewer transplants were performed in patients receiving FLAG-Ida + GO (238 v 278; P = .02). There was no difference in outcome according to the number of GO doses, although NPM1 MRD clearance was higher with two doses in the DA arm. Patients with core binding factor AML treated with DA and one dose of GO had a 3-year OS of 96% with no survival benefit from FLAG-Ida + GO. CONCLUSION Overall, FLAG-Ida + GO significantly reduced relapse without improving OS. However, exploratory analyses show that patients with NPM1 and FLT3 mutations had substantial improvements in OS. By contrast, in patients with core binding factor AML, outcomes were excellent with DA + GO with no FLAG-Ida benefit.
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Affiliation(s)
- Nigel H Russell
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Jad Othman
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
| | - Richard Dillon
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
| | - Steven Knapper
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Leona M Batten
- Centre for Trials Research, Cardiff University, Cardiff, United Kindgom
| | - Joanna Canham
- Centre for Trials Research, Cardiff University, Cardiff, United Kindgom
| | - Emily L Hinson
- Centre for Trials Research, Cardiff University, Cardiff, United Kindgom
| | - Sophie Betteridge
- Centre for Trials Research, Cardiff University, Cardiff, United Kindgom
| | | | - Amanda Gilkes
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Nicola Potter
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
| | - Priyanka Mehta
- University Hospitals of Bristol and Weston NHS Trust, Bristol, United Kingdom
| | | | - Jamie Cavenagh
- Department of Haematology, St Bartholomew's Hospital, London, United Kingdom
| | | | | | - Sylvie D Freeman
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Mike Dennis
- The Christie NHS Foundation Trust, Manchester, United Kingdom
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Othman J, Wilhelm-Benartzi C, Dillon R, Knapper S, Freeman SD, Batten LM, Canham J, Hinson EL, Wych J, Betteridge S, Villiers W, Kleeman M, Gilkes A, Potter N, Overgaard UM, Mehta P, Kottaridis P, Cavenagh J, Hemmaway C, Arnold C, Dennis M, Russell NH. A randomized comparison of CPX-351 and FLAG-Ida in adverse karyotype AML and high-risk MDS: the UK NCRI AML19 trial. Blood Adv 2023; 7:4539-4549. [PMID: 37171402 PMCID: PMC10425682 DOI: 10.1182/bloodadvances.2023010276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023] Open
Abstract
Liposomal daunorubicin and cytarabine (CPX-351) improved overall survival (OS) compared with 7+3 chemotherapy in older patients with secondary acute myeloid leukemia (AML); to date, there have been no randomized studies in younger patients. The high-risk cohort of the UK NCRI AML19 trial (ISRCTN78449203) compared CPX-351 with FLAG-Ida in younger adults with newly diagnosed adverse cytogenetic AML or high-risk myelodysplastic syndromes (MDS). A total of 189 patients were randomized (median age, 56 years). Per clinical criteria, 49% of patients had de novo AML, 20% had secondary AML, and 30% had high-risk MDS. MDS-related cytogenetics were present in 73% of the patients, with a complex karyotype in 49%. TP53 was the most common mutated gene, in 43%. Myelodysplasia-related gene mutations were present in 75 (44%) patients. The overall response rate (CR + CRi) after course 2 was 64% and 76% for CPX-351 and FLAG-Ida, respectively. There was no difference in OS (13.3 months vs 11.4 months) or event-free survival in multivariable analysis. However, relapse-free survival was significantly longer with CPX-351 (median 22.1 vs 8.35 months). There was no difference between the treatment arms in patients with clinically defined secondary AML or those with MDS-related cytogenetic abnormalities; however, an exploratory subgroup of patients with MDS-related gene mutations had significantly longer OS with CPX-351 (median 38.4 vs 16.3 months). In conclusion, the OS of younger patients with adverse risk AML/MDS was not significantly different between CPX-351 and FLAG-Ida.
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Affiliation(s)
- Jad Othman
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Richard Dillon
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Steve Knapper
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Sylvie D. Freeman
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
| | - Leona M. Batten
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Joanna Canham
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Emily L. Hinson
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Julie Wych
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Sophie Betteridge
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - William Villiers
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
| | - Michelle Kleeman
- Genomics Facility, NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, United Kingdom
| | - Amanda Gilkes
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Nicola Potter
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
| | | | - Priyanka Mehta
- Bristol Haematology and Oncology Centre, University Hospitals of Bristol and Weston NHS Trust, Bristol, United Kingdom
| | | | - Jamie Cavenagh
- Department of Haemato-Oncology, Barts Health NHS Trust, St Bartholomew’s Hospital, London, United Kingdom
| | - Claire Hemmaway
- Department of Haematology, Auckland Hospital, Auckland, New Zealand
| | - Claire Arnold
- Clinical Haematology, Belfast City Hospital, Belfast, Northern Ireland
| | - Mike Dennis
- The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Nigel H. Russell
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - UK National Cancer Research Institute Acute Myeloid Leukaemia Working Group
- Department of Medical and Molecular Genetics, Kings College London, London, United Kingdom
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
- School of Medicine, Cardiff University, Cardiff, United Kingdom
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom
- Genomics Facility, NIHR Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, United Kingdom
- Copenhagen University Hospital, Copenhagen, Denmark
- Bristol Haematology and Oncology Centre, University Hospitals of Bristol and Weston NHS Trust, Bristol, United Kingdom
- Department of Haematology, University College Hospital, London, United Kingdom
- Department of Haemato-Oncology, Barts Health NHS Trust, St Bartholomew’s Hospital, London, United Kingdom
- Department of Haematology, Auckland Hospital, Auckland, New Zealand
- Clinical Haematology, Belfast City Hospital, Belfast, Northern Ireland
- The Christie NHS Foundation Trust, Manchester, United Kingdom
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Mukherjee S, Lanfredini S, Cox C, Thapa A, Hughes S, Bangs F, Willenbrock F, Wilhelm-Benartzi C, Abraham AG, Owens R, Sabbagh A, Maughan T, Hurt C, O'Neill E. Translational analysis from SCALOP trial: CCL5 as a prognostic biomarker and a potentially actionable target in locally advanced pancreatic cancer (LAPC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.740] [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: 11/20/2022] Open
Abstract
740 Background: SCALOP was a multi-centre phase II RCT where 114 patients with LAPC were received 3 cycles of Gemcitabine and Capecitabine (GEMCAP) and those with stable/responding disease (n = 74) were randomised to Gem-RT or Cap-RT. The trial showed superiority of Cap-RT. Baseline blood samples of randomised patients were analysed for 35 circulating biomarkers. In vivo study was undertaken with candidate biomarker (CCL5) to test actionability. Methods: Patient bloods were tested using R&D multiplexed magnetic Luminex assays and IGF-1, TGF-b1 and b-NGF DuoSet ELISA. Orthotropic KrasG12D;P53R172H;PDXcre (KPC) tumors were implanted in Bl6-mice and treated with Gem, CCR5-inhibitor (CCR5i) maraviroc (MV), PD1 inhibitor (PD1i), PD1i+MV alone and in combination with MRI guided small animal Radiotherapy (RT). Immunophenotyping was performed by IHC and Aurora Cytek spectral flow cytometry. Results: Baseline biomarker data was available on 63/74 randomised patients. Of the 35 biomarkers tested, only CCL5 was found to be significantly associated with OS with a median OS of 18.5 (95% CI: 11.76-21.32) vs 11.3 (9.86-15.51) months (low vs high), and HR 1.37 (95% CI:1.04-3.65; p = 0.037) in the Cox multivariable model. Treatment of orthotopic KPC tumors revealed that combination of MV+PD1i+RT resulted in tumour growth inhibition and a switch of tumour macrophages from M2 to M1 accompanied by increase in infiltration of cytotoxic CD8+ Tcells and NK cells. Conclusions: Previous pre-clinical studies reported CCL5-CCR5 axis as a poor prognostic marker and a possible cause of immune-resistance in pancreatic cancer. Herein we have demonstrated in prospectively collected clinical trial blood samples that high circulating CCL5 is associated with poor prognosis in LAPC. CCR5 inhibitor in combination with RT+PD1i may overcome immune-resistance, and should be tested in clinical trials. Clinical trial information: 96169987 .
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Affiliation(s)
| | | | - Catrin Cox
- Centre for Trials Research, Cardiff, United Kingdom
| | | | | | | | | | | | | | - Rob Owens
- Oxford University Hospital NHS Trust, Oxford, United Kingdom
| | | | - Tim Maughan
- University of Oxford, Oxford, United Kingdom
| | - Chris Hurt
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
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Willenbrock F, Cox C, Wilhelm-Benartzi C, Abraham A, Owens R, Sabbagh A, Hurt C, Maughan T, O'Neill E, Mukherjee S. Abstract B40: High circulating CCL5 is associated with poor prognosis in locally advanced pancreatic cancer (LAPC): Biomarker analysis from the randomized phase II SCALOP trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.panca19-b40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: SCALOP recruited 114 patients with LAPC. Induction chemotherapy consisted of 3 cycles of gemcitabine and capecitabine (GEMCAP). Patients with nonprogression (n=74) were randomized to GEM or CAP based CRT (50.4Gy/28 fractions). Blood samples collected at baseline were analyzed for 35 angiogenic and immune biomarkers reported to be of prognostic/predictive value in pancreatic cancer.
Methods: IGF-1, TGF-b1, and b-NGF were analyzed using R & D DuoSet ELISA systems and the signal detected using a POLARstar Omega plate reader. The remaining biomarkers were assessed using R & D multiplexed magnetic Luminex assays and measured using a Luminex Magpix. Assays were performed in triplicate.
Statistical Analysis: Univariate Cox proportional hazard models were used as continuous variable to determine the association with overall survival (OS). Multiple comparisons were adjusted using the False Discovery Rate (FDR). Those found to be significant at the q value <0.2 were then further investigated for independence from existing clinical characteristics (i.e., CA19-9, WHO PS and age). Of those found to be independent, optimal thresholds delineating low to high values were found using the R “survivalROC” package based on time-dependent ROC curves from censored survival data and their corresponding area under the curve (AUC). The dichotomized biomarkers, split at the optimal threshold, were then associated with OS using univariate and multivariable Cox proportional hazard models.
Results: Biomarker data were available on 63/74 patients. 57% (36/63) were male, 56% (35/63) were age <65, 59% (37/63) had WHO PS 0 compared to 1, 51% (32/63) received gemcitabine, median CA19.9 was 233IU/L (IQR 75,801) and median tumor diameter was 3.8cm (IQR 3, 4.8). Of the 35 biomarkers tested, only CCL5, IL3, and IFN had significant associations with OS. CCL5 and IL3 were then found to be independent of existing clinical characteristics and were taken forward, where their optimal thresholds were found to be 1.27 micg/ml (sensitivity 64%; specificity 100%) and 57.75 pg/ml (sensitivity 83%; specificity 100%), respectively. CCL5, but not IL3, was found to be significantly associated with OS once dichotomized at its optimal threshold, with a median OS of 18.5 (95% CI: 11.76-21.32) vs. 11.3 (9.86-15.51) months, HR 1.37 (95% CI:1.04-3.65; p=0.037) in the Cox multivariable model. Moreover, biomarker signatures incorporating both CCL5 and IL3 (continuous variable) with age, PS and CA19.9 were prognostic: CCL5 signature:19.2 vs. 10.8 mo (HR 2.79, p=0.001) IL3 signature: 18.5 vs. 11.2 mo (HR 2.35, p=0.006) CCL5/IL3 signature: 18.7 vs. 11.2 mo, (HR 2.25, p=0.11).
Conclusion: High circulating CCL5 has a significantly worse prognosis. This is consistent with preclinical literature that demonstrates the role of CCL5 in tumor invasion/metastasis and induction of an immunosuppressive microenvironment through Treg infiltration. We are currently conducting in vivo experiments involving CCR5 antagonists and immunotherapy in orthotopic mouse models.
Citation Format: Frances Willenbrock, Catrin Cox, Charlotte Wilhelm-Benartzi, Aswin Abraham, Robert Owens, Ahmad Sabbagh, Chris Hurt, Tim Maughan, Eric O'Neill, Somnath Mukherjee. High circulating CCL5 is associated with poor prognosis in locally advanced pancreatic cancer (LAPC): Biomarker analysis from the randomized phase II SCALOP trial [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer: Advances in Science and Clinical Care; 2019 Sept 6-9; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2019;79(24 Suppl):Abstract nr B40.
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Affiliation(s)
| | - Catrin Cox
- 2Wales Cancer Trial Unit, Cardiff, United Kingdom,
| | | | | | - Robert Owens
- 4Oxford University Hospital NHS Trust, Oxford, United Kingdom,
| | | | - Chris Hurt
- 3Cross Cancer Institute, Edmonton, AB, Canada,
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Milne P, Wilhelm-Benartzi C, Grunwald MR, Bigley V, Dillon R, Freeman SD, Gallagher K, Publicover A, Pagan S, Marr H, Jones GL, Dickinson AM, Grech A, Burnett AK, Russell NH, Levis M, Knapper S, Collin M. Serum Flt3 ligand is a biomarker of progenitor cell mass and prognosis in acute myeloid leukemia. Blood Adv 2019; 3:3052-3061. [PMID: 31648336 PMCID: PMC6849950 DOI: 10.1182/bloodadvances.2019000197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/30/2019] [Indexed: 11/20/2022] Open
Abstract
Fms-like tyrosine kinase 3 (Flt3) is expressed on progenitor cells and acute myeloid leukemia (AML) blasts. Fms-like tyrosine kinase 3 ligand (Flt3L) is detectable during homeostasis and increases in hypoplasia due to genetic defects or treatment with cytoreductive agents. Conversely, Flt3+ AML is associated with depletion of Flt3L to undetectable levels. After induction chemotherapy, Flt3L is restored in patients entering complete remission (CR) but remains depressed in those with refractory disease. Weekly sampling reveals marked differences in the kinetics of Flt3L response during the first 6 weeks of treatment, proportionate to the clearance of blasts and cellularity of the bone marrow. In the UK NCRI AML17 trial, Flt3L was measured at day 26 in a subgroup of 140 patients with Flt3 mutation randomized to the tyrosine kinase inhibitor lestaurtinib or placebo. In these patients, attainment of CR was associated with higher Flt3L at day 26 (Mann-Whitney UP < .0001). Day 26 Flt3L was also associated with survival; Flt3L ≤291 pg/mL was associated with inferior event-free survival (EFS), and Flt3L >1185 pg/mL was associated with higher overall survival (OS; P = .0119). The separation of EFS and OS curves increased when minimal residual disease (MRD) status was combined with Flt3L measurement, and Flt3L retained a near-significant association with survival after adjusting for MRD in a proportional hazards model. Serial measurement of Flt3L in patients who had received a hematopoietic stem cell transplant for AML illustrates the potential value of monitoring Flt3L to identify relapse. Measurement of Flt3L is a noninvasive test with the potential to inform clinical decisions in patients with AML.
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Affiliation(s)
- Paul Milne
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Charlotte Wilhelm-Benartzi
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Venetia Bigley
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Richard Dillon
- Department of Medical and Molecular Genetics, King's College, Strand, London, United Kingdom
| | - Sylvie D Freeman
- Clinical Immunology Service, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, United Kingdom
| | - Kathleen Gallagher
- Immune Monitoring Laboratory, Massachusetts General Hospital Center for Cancer Research, Boston, MA
| | - Amy Publicover
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sarah Pagan
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Helen Marr
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Gail L Jones
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Anne M Dickinson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Angela Grech
- Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Alan K Burnett
- Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Nigel H Russell
- Department of Haematology, Nottingham University Hospital, Nottingham, United Kingdom; and
| | - Mark Levis
- Division of Hematological Malignancies, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, MD
| | - Steven Knapper
- Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Matthew Collin
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
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7
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Usman S, Kahrs BH, Wilhelm-Benartzi C, Hassan WA, Barton H, Salvesen KA, Eggebø TM, Lees C. Prediction of mode of delivery using the first ultrasound-based "intrapartum app". Am J Obstet Gynecol 2019; 221:163-166. [PMID: 30928568 DOI: 10.1016/j.ajog.2019.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 01/17/2019] [Revised: 02/10/2019] [Accepted: 03/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Sana Usman
- Department of Cancer and Surgery, Imperial College London, London, UK; Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Birgitte Heiberg Kahrs
- National Center for Fetal Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Charlotte Wilhelm-Benartzi
- Wales Cancer Trials Unit Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, South Glamorgan, UK
| | - Wassim A Hassan
- Fetal Medicine Unit, Colchester Hospital University NHS Foundation Trust, Colchester General Hospital Trust Offices, Colchester, Essex, UK
| | - Helen Barton
- Department of Cancer and Surgery, Imperial College London, London, UK; Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Kjell A Salvesen
- National Center for Fetal Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torbjorn Moe Eggebø
- National Center for Fetal Medicine, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christoph Lees
- Department of Cancer and Surgery, Imperial College London, London, UK; Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK; Department of Development & Regeneration, KU Leuven, Leuven, Belgium.
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Usman S, Barton H, Wilhelm-Benartzi C, Lees CC. Ultrasound is better tolerated than vaginal examination in and before labour. Aust N Z J Obstet Gynaecol 2019; 59:362-366. [PMID: 30024022 DOI: 10.1111/ajo.12864] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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: 03/21/2018] [Accepted: 06/19/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Intrapartum ultrasound has been proposed as a method of assessing labour progress but its acceptability has not been comprehensively assessed. AIMS We evaluated the acceptability of intrapartum ultrasound in women having vaginal examination (VE) and ultrasound (US) assessment (transabdominal (TA) and transperineal (TP)) prior to delivery, with and without regional analgesia (RA). MATERIALS AND METHODS Women at 24-42 weeks gestation were included in a prospective observational cohort study. The acceptability of digital VE and TP US were assessed pre- and post-examination using the modified validated Wijma Delivery Experience Questionnaire. Acceptability scores ranged 6-36 (6 being most and 36 being least positive) in six domains: positive-trust and relax, negative-harmful to baby, worrying, painful, intrusive. RESULTS Of 119 women recruited, 104 completed both pre- and post-assessment questionnaires. Eighty-nine per cent of women were nulliparous with median gestation 40 + 2 weeks (25-42+1 ). Thirty-two per cent had RA before assessment, 91% in total. The combined acceptability scores of both negative and positive experiences (6 = most acceptable, 36 = least acceptable) for VE and US pre-assessment were 15 and 7 respectively (P < 0.0001: Mann-Whitney U-test). VE was associated with less positive / more negative domain scoring post-assessment 12 and 6, respectively (P < 0.0001). Although RA made no difference to the perceived experience pre-VE (P = 0.9), post-VE, women with RAs considered VEs more acceptable than those without RA (P = 0.0022). CONCLUSION(S) This is the first study to comprehensively assess the acceptability of VE and intrapartum US. US assessment prior to delivery is more acceptable than VE. RA ameliorated the negative experience of the VE post-assessment.
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Affiliation(s)
- Sana Usman
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Helen Barton
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Charlotte Wilhelm-Benartzi
- Wales Cancer Trials Unit Centre for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, South Glamorgan, UK
| | - Christoph C Lees
- Department of Surgery and Cancer, Imperial College London, London, UK
- Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, UK
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Howell SJ, Waters S, Twelves C, Joffe J, Moon S, Bale C, Venkitaraman R, Bezecny P, Casbard A, Wilhelm-Benartzi C, Carucci M, Butler R, Alchami F, Jones R. Abstract PD1-07: Withdrawn. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd1-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
Citation Format: Howell SJ, Waters S, Twelves C, Joffe J, Moon S, Bale C, Venkitaraman R, Bezecny P, Casbard A, Wilhelm-Benartzi C, Carucci M, Butler R, Alchami F, Jones R. Withdrawn [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD1-07.
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Affiliation(s)
- SJ Howell
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - S Waters
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - C Twelves
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - J Joffe
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - S Moon
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - C Bale
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - R Venkitaraman
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - P Bezecny
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - A Casbard
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - C Wilhelm-Benartzi
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - M Carucci
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - R Butler
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - F Alchami
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
| | - R Jones
- University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom; Velindre Cancer Centre, Cardiff, United Kingdom; University of Leeds and Leeds Teaching Hospitals Trust, Leeds, United Kingdom; Calderdale & Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom; University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, United Kingdom; Betsi Cadwaladr University Health Board, Bangor, United Kingdom; The Ipswich Hospital NHS Trust, Ipswich, United Kingdom; Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom; Centre for Trials Research, Cardiff University, Cardiff, United Kingdom; All Wales Laboratory Genetics Service, University Hospital of Wales, Cardiff, United Kingdom; University Hospital of Wales, Cardiff, United Kingdom; Cardiff University, Cardiff, United Kingdom
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Amrania H, Woodley-Barker L, Goddard K, Rosales B, Shousha S, Thomas G, McFarlane T, Sroya M, Wilhelm-Benartzi C, Cocks K, Coombes RC, Phillips CC. Mid-infrared imaging in breast cancer tissue: an objective measure of grading breast cancer biopsies. Converg Sci Phys Oncol 2018. [DOI: 10.1088/2057-1739/aaabc3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Flanagan JM, Wilson A, Koo C, Masrour N, Gallon J, Loomis E, Flower K, Wilhelm-Benartzi C, Hergovich A, Cunnea P, Gabra H, Braicu EI, Sehouli J, Darb-Esfahani S, Vanderstichele A, Vergote I, Kreuzinger C, Castillo-Tong DC, Wisman GBA, Berns EM, Siddiqui N, Paul J, Brown R. Platinum-Based Chemotherapy Induces Methylation Changes in Blood DNA Associated with Overall Survival in Patients with Ovarian Cancer. Clin Cancer Res 2017; 23:2213-2222. [PMID: 27663594 DOI: 10.1158/1078-0432.ccr-16-1754] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/25/2016] [Accepted: 09/06/2016] [Indexed: 11/16/2022]
Abstract
Purpose: DNA damage repair can lead to epigenetic changes. DNA mismatch repair proteins bind to platinum DNA adducts and at sites of DNA damage can recruit the DNA methylating enzyme DNMT1, resulting in aberrant methylation. We hypothesised that DNA damage repair during platinum-based chemotherapy may cause aberrant DNA methylation in normal tissues of patients such as blood.Experimental Design: We used Illumina 450k methylation arrays and bisulphite pyrosequencing to investigate methylation at presentation and relapse in blood DNA from patients with ovarian cancer enrolled in the SCOTROC1 trial (n = 247) and in a cohort of ovarian tumor DNA samples collected at first relapse (n = 46). We used an ovarian cancer cell line model to investigate the role of the DNA mismatch repair gene MLH1 in platinum-induced methylation changes.Results: Specific CpG methylation changes in blood at relapse are observed following platinum-based chemotherapy and are associated with patient survival, independent of other clinical factors [hazard ratio, 3.7; 95% confidence interval, 1.8-7.6, P = 2.8 × 10-4]. Similar changes occur in ovarian tumors at relapse, also associated with patient survival (hazard ratio, 2.6; 95% confidence interval, 1.0-6.8, P = 0.048). Using an ovarian cancer cell line model, we demonstrate that functional mismatch repair increases the frequency of platinum-induced methylation.Conclusions: DNA methylation in blood at relapse following chemotherapy, and not at presentation, is informative regarding survival of patients with ovarian cancer. Functional DNA mismatch repair increases the frequency of DNA methylation changes induced by platinum. DNA methylation in blood following chemotherapy could provide a noninvasive means of monitoring patients' epigenetic responses to treatment without requiring a tumor biopsy. Clin Cancer Res; 23(9); 2213-22. ©2016 AACR.
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Affiliation(s)
- James M Flanagan
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Angela Wilson
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Chail Koo
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nahal Masrour
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - John Gallon
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Erick Loomis
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Kirsty Flower
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | | | - Paula Cunnea
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hani Gabra
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Elena Ioana Braicu
- Department of Gynecology, European Competence Center for Ovarian Cancer; Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Tumorbank Ovarian Cancer Network (TOC), Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, European Competence Center for Ovarian Cancer; Campus Virchow Klinikum, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Tumorbank Ovarian Cancer Network (TOC), Berlin, Germany
| | - Silvia Darb-Esfahani
- Tumorbank Ovarian Cancer Network (TOC), Berlin, Germany
- Institute of Pathology, Charitéplatz, Berlin, Germany
| | - Adriaan Vanderstichele
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ignace Vergote
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Universitaire Ziekenhuizen Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Caroline Kreuzinger
- Translational Gynecology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Dan Cacsire Castillo-Tong
- Translational Gynecology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - G Bea A Wisman
- Department of Gynecologic Oncology, Cancer Research Center Groningen, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Els Mjj Berns
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam, the Netherlands
| | - Nadeem Siddiqui
- Department of Gynaecological Oncology, Glasgow Royal Infirmary, Glasgow, UK
| | - James Paul
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, UK
| | - Robert Brown
- Department of Surgery and Cancer, Imperial College London, London, UK. E-mail:
- Section of Molecular Pathology, Institute for Cancer Research, Sutton, UK
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Patch AM, Christie EL, Etemadmoghadam D, Garsed DW, George J, Fereday S, Nones K, Cowin P, Alsop K, Bailey PJ, Kassahn KS, Newell F, Quinn MCJ, Kazakoff S, Quek K, Wilhelm-Benartzi C, Curry E, Leong HS, Hamilton A, Mileshkin L, Au-Yeung G, Kennedy C, Hung J, Chiew YE, Harnett P, Friedlander M, Quinn M, Pyman J, Cordner S, O'Brien P, Leditschke J, Young G, Strachan K, Waring P, Azar W, Mitchell C, Traficante N, Hendley J, Thorne H, Shackleton M, Miller DK, Arnau GM, Tothill RW, Holloway TP, Semple T, Harliwong I, Nourse C, Nourbakhsh E, Manning S, Idrisoglu S, Bruxner TJC, Christ AN, Poudel B, Holmes O, Anderson M, Leonard C, Lonie A, Hall N, Wood S, Taylor DF, Xu Q, Fink JL, Waddell N, Drapkin R, Stronach E, Gabra H, Brown R, Jewell A, Nagaraj SH, Markham E, Wilson PJ, Ellul J, McNally O, Doyle MA, Vedururu R, Stewart C, Lengyel E, Pearson JV, Waddell N, deFazio A, Grimmond SM, Bowtell DDL. Corrigendum: Whole-genome characterization of chemoresistant ovarian cancer. Nature 2015; 527:398. [PMID: 26503049 DOI: 10.1038/nature15716] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Eggebø TM, Wilhelm-Benartzi C, Hassan WA, Usman S, Salvesen KA, Lees CC. A model to predict vaginal delivery in nulliparous women based on maternal characteristics and intrapartum ultrasound. Am J Obstet Gynecol 2015; 213:362.e1-6. [PMID: 26008180 DOI: 10.1016/j.ajog.2015.05.044] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 12/15/2014] [Revised: 04/25/2015] [Accepted: 05/20/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Accurate prediction of whether a nulliparous woman will have a vaginal delivery would be a major advance in obstetrics. The objective of the study was to develop such a model based on maternal characteristics and the results of intrapartum ultrasound. STUDY DESIGN One hundred twenty-two nulliparous women in the first stage of labor were included in a prospective observational 2-centre study. Labor was classified as prolonged according to the respective countries' national guidelines. Fetal head position was assessed with transabdominal ultrasound and cervical dilatation by digital examination, and transperineal ultrasound was used to determine head-perineum distance and the presence of caput succedaneum. The subjects were divided into a testing set (n = 61) and a validation set (n = 61) and a risk score derived using multivariable logistic regression with vaginal birth as the outcome, which was dichotomized into no/cesarean delivery and yes/vaginal birth. Covariates included head-perineum distance, caput succedaneum, and occiput posterior position, which were dichotomized respectively into the following: ≤40 mm, >40 mm, <10 mm, ≥10 mm, and no, yes. Maternal age, gestational age, and maternal body mass index were included as continuous covariates. RESULTS Dichotomized score is significantly associated with vaginal delivery (P = .03). Women with a score above the median had greater than 10 times the odds of having a vaginal delivery as compared with those with a score below the median. The receiver-operating characteristic curve showed an area under the curve of 0.853 (95% confidence interval, 0.678-1.000). CONCLUSION A risk score based on maternal characteristics and intrapartum findings can predict vaginal delivery in nulliparous women in the first stage of labor.
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Affiliation(s)
- Tørbjorn Moe Eggebø
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway; National Center for Fetal Medicine, Trondheim University Hospital (St Olav's Hospital), Trondheim, Norway
| | - Charlotte Wilhelm-Benartzi
- ICTU-Cancer Clinical Trials Unit, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Wassim A Hassan
- Department of Fetal Medicine, Rosie Maternity Hospital, Addenbrooke's Hospital, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, United Kingdom
| | - Sana Usman
- Department of Cancer and Surgery, Imperial College London, Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare National Health Service Trust, London, United Kingdom
| | - Kjell A Salvesen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Christoph C Lees
- Department of Cancer and Surgery, Imperial College London, Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare National Health Service Trust, London, United Kingdom; Department of Development and Regeneration, KU Leuven, Belgium.
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SHENKER NATALIES, Flower KJ, Wilhelm-Benartzi C, Dai W, Bell E, El Bahrawy M, Weaver G, Flanagan JM, Brown R. Abstract 1063: Transcriptional implications of intragenic DNA methylation in the estrogen receptor alpha gene in breast cancer cells and tissues. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1063] [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
Introduction: DNA methylation variability regions (MVRs) across the estrogen receptor alpha (ESR1) gene have been identified in peripheral blood cells from breast cancer patients and healthy individuals. In contrast to promoter methylation, gene body methylation may be important in maintaining active transcription. This study aimed to assess MVRs in ESR1 in breast cancer cell lines, tumor biopsies and exfoliated epithelial cells from expressed breast milk (EBM) to determine their significance for ESR1 transcription.
Methods: DNA methylation levels in eight MVRs across ESR1 were assessed in pyrosequencing bisulphite-converted DNA from three oestrogen receptor (ER)-positive and three ER-negative breast cancer cell lines. DNA methylation and expression were assessed following treatment with the demethylating agent, decitabine (DAC, 1 μM), or DMSO (controls). ESR1 methylation levels were also assayed in DNA from 155 invasive ductal carcinoma biopsies provided by the Breast Cancer Campaign Tissue Bank, and validated with DNA methylation profiles from the TCGA breast tumors (n = 356 ER-pos, n = 109 ER-neg). DNA methylation was profiled in exfoliated breast epithelial cells from EBM using the Illumina 450K (n = 36) and pyrosequencing in a further 53 donor samples. ESR1 mRNA levels were measured by qRT-PCR.
Results: We show that ER-positive cell lines had unmethylated ESR1 promoter regions and highly methylated intragenic regions (median, 80.45%) while ER-negative cells had methylated promoters and lower intragenic methylation levels (median, 38.62%). DAC treatment increased ESR1 expression in ER-negative cells, but significantly reduced methylation and expression of ESR1 in ER-positive cells. The ESR1 promoter was unmethylated in breast tumor biopsies with high levels of intragenic methylation, independent of ER status. However, ESR1 methylation in the strongly ER-positive EBM DNA samples were very similar to ER-positive tumor cell lines.
Conclusion: Intragenic methylation levels correlated with ESR1 expression in vitro, but with markedly different methylation patterns between homogenous cell populations and heterogeneous tumour biopsies. DAC treatment inhibited ESR1 transcription in cells with an unmethylated ESR1 promoter along with reduced levels of intragenic DNA methylation. These findings emphasize the need for care when choosing tissue types for epigenetic research and interpreting results from heterogenous tissue.
Note: This abstract was not presented at the meeting.
Citation Format: NATALIE S. SHENKER, Kirsty J. Flower, Charlotte Wilhelm-Benartzi, Wei Dai, Emma Bell, Mona El Bahrawy, Gillian Weaver, James M. Flanagan, Robert Brown. Transcriptional implications of intragenic DNA methylation in the estrogen receptor alpha gene in breast cancer cells and tissues. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1063. doi:10.1158/1538-7445.AM2015-1063
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Affiliation(s)
| | | | | | - Wei Dai
- 1IMPERIAL COLLEGE LONDON, London, United Kingdom
| | - Emma Bell
- 1IMPERIAL COLLEGE LONDON, London, United Kingdom
| | | | - Gillian Weaver
- 2Queen Charlotte and Chelsea Hospital Milk Bank, London, United Kingdom
| | | | - Robert Brown
- 1IMPERIAL COLLEGE LONDON, London, United Kingdom
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Patch AM, Christie EL, Etemadmoghadam D, Garsed DW, George J, Fereday S, Nones K, Cowin P, Alsop K, Bailey PJ, Kassahn KS, Newell F, Quinn MCJ, Kazakoff S, Quek K, Wilhelm-Benartzi C, Curry E, Leong HS, Hamilton A, Mileshkin L, Au-Yeung G, Kennedy C, Hung J, Chiew YE, Harnett P, Friedlander M, Quinn M, Pyman J, Cordner S, O'Brien P, Leditschke J, Young G, Strachan K, Waring P, Azar W, Mitchell C, Traficante N, Hendley J, Thorne H, Shackleton M, Miller DK, Arnau GM, Tothill RW, Holloway TP, Semple T, Harliwong I, Nourse C, Nourbakhsh E, Manning S, Idrisoglu S, Bruxner TJC, Christ AN, Poudel B, Holmes O, Anderson M, Leonard C, Lonie A, Hall N, Wood S, Taylor DF, Xu Q, Fink JL, Waddell N, Drapkin R, Stronach E, Gabra H, Brown R, Jewell A, Nagaraj SH, Markham E, Wilson PJ, Ellul J, McNally O, Doyle MA, Vedururu R, Stewart C, Lengyel E, Pearson JV, Waddell N, deFazio A, Grimmond SM, Bowtell DDL. Whole-genome characterization of chemoresistant ovarian cancer. Nature 2015; 521:489-94. [PMID: 26017449 DOI: 10.1038/nature14410] [Citation(s) in RCA: 1050] [Impact Index Per Article: 116.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/16/2015] [Indexed: 12/12/2022]
Abstract
Patients with high-grade serous ovarian cancer (HGSC) have experienced little improvement in overall survival, and standard treatment has not advanced beyond platinum-based combination chemotherapy, during the past 30 years. To understand the drivers of clinical phenotypes better, here we use whole-genome sequencing of tumour and germline DNA samples from 92 patients with primary refractory, resistant, sensitive and matched acquired resistant disease. We show that gene breakage commonly inactivates the tumour suppressors RB1, NF1, RAD51B and PTEN in HGSC, and contributes to acquired chemotherapy resistance. CCNE1 amplification was common in primary resistant and refractory disease. We observed several molecular events associated with acquired resistance, including multiple independent reversions of germline BRCA1 or BRCA2 mutations in individual patients, loss of BRCA1 promoter methylation, an alteration in molecular subtype, and recurrent promoter fusion associated with overexpression of the drug efflux pump MDR1.
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics
- Cohort Studies
- Cyclin E/genetics
- Cystadenocarcinoma, Serous/drug therapy
- Cystadenocarcinoma, Serous/genetics
- DNA Methylation
- DNA Mutational Analysis
- DNA-Binding Proteins/genetics
- Drug Resistance, Neoplasm/drug effects
- Drug Resistance, Neoplasm/genetics
- Female
- Genes, BRCA1
- Genes, BRCA2
- Genes, Neurofibromatosis 1
- Genome, Human/genetics
- Germ-Line Mutation/genetics
- Humans
- Mutagenesis/genetics
- Oncogene Proteins/genetics
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/genetics
- PTEN Phosphohydrolase/genetics
- Promoter Regions, Genetic/genetics
- Retinoblastoma Protein/genetics
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Affiliation(s)
- Ann-Marie Patch
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | | | - Dariush Etemadmoghadam
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Department of Pathology, University of Melbourne, Parkville, Victoria 3052, Australia [3] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Dale W Garsed
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Joshy George
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06030, USA
| | - Sian Fereday
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Katia Nones
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Prue Cowin
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Kathryn Alsop
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Peter J Bailey
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] WolfsonWohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK
| | - Karin S Kassahn
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] Technology Advancement Unit, Genetics and Molecular Pathology, SA Pathology, Adelaide, South Australia 5000, Australia
| | - Felicity Newell
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Michael C J Quinn
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Stephen Kazakoff
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Kelly Quek
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Charlotte Wilhelm-Benartzi
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Ed Curry
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Huei San Leong
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Anne Hamilton
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Department of Medicine, University of Melbourne, Parkville, Victoria 3052, Australia [3] The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Linda Mileshkin
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - George Au-Yeung
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Catherine Kennedy
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Jillian Hung
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Yoke-Eng Chiew
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Paul Harnett
- Crown Princess Mary Cancer Centre and University of Sydney at Westmead Hospital, Westmead, Sydney, New South Wales 2145, Australia
| | - Michael Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales 2031, Australia
| | - Michael Quinn
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Jan Pyman
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Stephen Cordner
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Patricia O'Brien
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Jodie Leditschke
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Greg Young
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Kate Strachan
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Paul Waring
- Department of Pathology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Walid Azar
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Chris Mitchell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Joy Hendley
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Heather Thorne
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Mark Shackleton
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - David K Miller
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Gisela Mir Arnau
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Richard W Tothill
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | | | - Timothy Semple
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Ivon Harliwong
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Craig Nourse
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Ehsan Nourbakhsh
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Suzanne Manning
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Senel Idrisoglu
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Timothy J C Bruxner
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Angelika N Christ
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Barsha Poudel
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Oliver Holmes
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Matthew Anderson
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Conrad Leonard
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Andrew Lonie
- Victorian Life Sciences Computation Initiative, Carlton, Victoria 3053, Australia
| | - Nathan Hall
- La Trobe Institute for Molecular Science, Bundoora, Victoria 3083, Australia
| | - Scott Wood
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Darrin F Taylor
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Qinying Xu
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - J Lynn Fink
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Nick Waddell
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Ronny Drapkin
- Dana-Farber Cancer Institute, Boston, Massachusetts 02115-5450, USA
| | - Euan Stronach
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Hani Gabra
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Robert Brown
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | | | - Shivashankar H Nagaraj
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Emma Markham
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Peter J Wilson
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Jason Ellul
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Orla McNally
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Maria A Doyle
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | | | - Collin Stewart
- The University of Western Australia, Crawley, Western Australia 6009, Australia
| | | | - John V Pearson
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Nicola Waddell
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Anna deFazio
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Sean M Grimmond
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] WolfsonWohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK
| | - David D L Bowtell
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Department of Pathology, University of Melbourne, Parkville, Victoria 3052, Australia [3] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia [4] Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK [5] Department of Biochemistry and Molecular Biology, University of Melbourne, Parkville, Victoria 3052, Australia
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16
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Patch AM, Christie EL, Etemadmoghadam D, Garsed DW, George J, Fereday S, Nones K, Cowin P, Alsop K, Bailey PJ, Kassahn KS, Newell F, Quinn MCJ, Kazakoff S, Quek K, Wilhelm-Benartzi C, Curry E, Leong HS, Hamilton A, Mileshkin L, Au-Yeung G, Kennedy C, Hung J, Chiew YE, Harnett P, Friedlander M, Quinn M, Pyman J, Cordner S, O'Brien P, Leditschke J, Young G, Strachan K, Waring P, Azar W, Mitchell C, Traficante N, Hendley J, Thorne H, Shackleton M, Miller DK, Arnau GM, Tothill RW, Holloway TP, Semple T, Harliwong I, Nourse C, Nourbakhsh E, Manning S, Idrisoglu S, Bruxner TJC, Christ AN, Poudel B, Holmes O, Anderson M, Leonard C, Lonie A, Hall N, Wood S, Taylor DF, Xu Q, Fink JL, Waddell N, Drapkin R, Stronach E, Gabra H, Brown R, Jewell A, Nagaraj SH, Markham E, Wilson PJ, Ellul J, McNally O, Doyle MA, Vedururu R, Stewart C, Lengyel E, Pearson JV, Waddell N, deFazio A, Grimmond SM, Bowtell DDL. Whole-genome characterization of chemoresistant ovarian cancer. Nature 2015. [PMID: 26017449 DOI: 10.1038/nature14410] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Patients with high-grade serous ovarian cancer (HGSC) have experienced little improvement in overall survival, and standard treatment has not advanced beyond platinum-based combination chemotherapy, during the past 30 years. To understand the drivers of clinical phenotypes better, here we use whole-genome sequencing of tumour and germline DNA samples from 92 patients with primary refractory, resistant, sensitive and matched acquired resistant disease. We show that gene breakage commonly inactivates the tumour suppressors RB1, NF1, RAD51B and PTEN in HGSC, and contributes to acquired chemotherapy resistance. CCNE1 amplification was common in primary resistant and refractory disease. We observed several molecular events associated with acquired resistance, including multiple independent reversions of germline BRCA1 or BRCA2 mutations in individual patients, loss of BRCA1 promoter methylation, an alteration in molecular subtype, and recurrent promoter fusion associated with overexpression of the drug efflux pump MDR1.
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Affiliation(s)
- Ann-Marie Patch
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | | | - Dariush Etemadmoghadam
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Department of Pathology, University of Melbourne, Parkville, Victoria 3052, Australia [3] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Dale W Garsed
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Joshy George
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut 06030, USA
| | - Sian Fereday
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Katia Nones
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Prue Cowin
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Kathryn Alsop
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Peter J Bailey
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] WolfsonWohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK
| | - Karin S Kassahn
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] Technology Advancement Unit, Genetics and Molecular Pathology, SA Pathology, Adelaide, South Australia 5000, Australia
| | - Felicity Newell
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Michael C J Quinn
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Stephen Kazakoff
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Kelly Quek
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Charlotte Wilhelm-Benartzi
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Ed Curry
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Huei San Leong
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | | | - Anne Hamilton
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Department of Medicine, University of Melbourne, Parkville, Victoria 3052, Australia [3] The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Linda Mileshkin
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - George Au-Yeung
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Catherine Kennedy
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Jillian Hung
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Yoke-Eng Chiew
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Paul Harnett
- Crown Princess Mary Cancer Centre and University of Sydney at Westmead Hospital, Westmead, Sydney, New South Wales 2145, Australia
| | - Michael Friedlander
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales 2031, Australia
| | - Michael Quinn
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Jan Pyman
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Stephen Cordner
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Patricia O'Brien
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Jodie Leditschke
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Greg Young
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Kate Strachan
- Victorian Institute of Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Paul Waring
- Department of Pathology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Walid Azar
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Chris Mitchell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Joy Hendley
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Heather Thorne
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Mark Shackleton
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - David K Miller
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Gisela Mir Arnau
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Richard W Tothill
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia
| | | | - Timothy Semple
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Ivon Harliwong
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Craig Nourse
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Ehsan Nourbakhsh
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Suzanne Manning
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Senel Idrisoglu
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Timothy J C Bruxner
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Angelika N Christ
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Barsha Poudel
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Oliver Holmes
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Matthew Anderson
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Conrad Leonard
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Andrew Lonie
- Victorian Life Sciences Computation Initiative, Carlton, Victoria 3053, Australia
| | - Nathan Hall
- La Trobe Institute for Molecular Science, Bundoora, Victoria 3083, Australia
| | - Scott Wood
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Darrin F Taylor
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Qinying Xu
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - J Lynn Fink
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Nick Waddell
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Ronny Drapkin
- Dana-Farber Cancer Institute, Boston, Massachusetts 02115-5450, USA
| | - Euan Stronach
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Hani Gabra
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | - Robert Brown
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK
| | | | - Shivashankar H Nagaraj
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Emma Markham
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Peter J Wilson
- Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia
| | - Jason Ellul
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | - Orla McNally
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Maria A Doyle
- Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia
| | | | - Collin Stewart
- The University of Western Australia, Crawley, Western Australia 6009, Australia
| | | | - John V Pearson
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Nicola Waddell
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] QIMR Berghofer Medical Research Institute, Brisbane, Queensland 4006, Australia
| | - Anna deFazio
- Centre for Cancer Research, University of Sydney at Westmead Millennium Institute, and Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales 2145, Australia
| | - Sean M Grimmond
- 1] Queensland Centre for Medical Genomics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland 4067, Australia [2] WolfsonWohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1QH, UK
| | - David D L Bowtell
- 1] Peter MacCallum Cancer Centre, East Melbourne, Victoria 3002, Australia [2] Department of Pathology, University of Melbourne, Parkville, Victoria 3052, Australia [3] Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria 3052, Australia [4] Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London W12 0HS, UK [5] Department of Biochemistry and Molecular Biology, University of Melbourne, Parkville, Victoria 3052, Australia
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Brown R, Timms K, Paul J, Hughes E, El-Bahrawy M, Steel JH, Kalva S, Liu X, Wang Y, Rama NR, Wilhelm-Benartzi C, Gutin A, Lewsley LA, Siddiqui N, Patel N, Lanchbury JS, Gabra H, Stronach EA. Homologous recombination (HR) deficiency, tumor BRCA1/2 mutations (tmBRCA) and association with response and outcome following platinum monotherapy in high grade serous ovarian cancer (HGSOC). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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)
| | | | - James Paul
- University of Glasgow, Glasgow, United Kingdom
| | | | | | | | | | - Xinxue Liu
- Imperial College London, London, United Kingdom
| | | | - Nona R Rama
- Imperial College London, London, United Kingdom
| | | | | | - Liz-Anne Lewsley
- Scottish Gynaecological Cancer Trials Group (SGCTG), Glasgow, United Kingdom
| | | | - Naina Patel
- Imperial College London, London, United Kingdom
| | | | - Hani Gabra
- Ovarian Cancer Action Research Centre, London, United Kingdom
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Borley J, Wilhelm-Benartzi C, Yazbek J, Williamson R, Bharwani N, Stewart V, Carson I, Hird E, McIndoe A, Farthing A, Blagden S, Ghaem-Maghami S. Radiological predictors of cytoreductive outcomes in patients with advanced ovarian cancer. BJOG 2015; 122:843-849. [PMID: 25132394 DOI: 10.1111/1471-0528.12992] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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] [Accepted: 05/10/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess site of disease on preoperative computed tomography (CT) to predict surgical debulking in patients with ovarian cancer. DESIGN Two-phase retrospective cohort study. SETTING West London Gynaecological Cancer Centre, UK. POPULATION Women with stage 3 or 4, ovarian, fallopian or primary peritoneal cancer undergoing cytoreductive surgery. METHODS Preoperative CT images were reviewed by experienced radiologists to assess the presence or absence of disease at predetermined sites. Multivariable stepwise logistic regression models determined sites of disease which were significantly associated with surgical outcomes in the test (n = 111) and validation (n = 70) sets. MAIN OUTCOME MEASURES Sensitivity and specificity of CT in predicting surgical outcome. RESULTS Stepwise logistic regression identified that the presence of lung metastasis, pleural effusion, deposits on the large-bowel mesentery and small-bowel mesentery, and infrarenal para-aortic nodes were associated with debulking status. Logistic regression determined a surgical predictive score which was able to significantly predict suboptimal debulking (n = 94, P = 0.0001) with an area under the curve (AUC) of 0.749 (95% confidence interval [95% CI]: 0.652, 0.846) and a sensitivity of 69.2%, specificity of 71.4%, positive predictive value of 75.0% and negative predictive value of 65.2%. These results remained significant in a recent validation set. There was a significant difference in residual disease volume in the test and validation sets (P < 0.001) in keeping with improved optimal debulking rates. CONCLUSIONS The presence of disease at some sites on preoperative CT scan is significantly associated with suboptimal debulking and may be an indication for a change in surgical planning.
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Affiliation(s)
- J Borley
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | | - J Yazbek
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - R Williamson
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - N Bharwani
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - V Stewart
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
- Department of Radiology, Imperial College Healthcare NHS Trust, London, UK
| | - I Carson
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - E Hird
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - A McIndoe
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - A Farthing
- Department of Surgery and Cancer, Imperial College London, London, UK
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - S Blagden
- Department of Surgery and Cancer, Imperial College London, London, UK
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
| | - S Ghaem-Maghami
- Department of Surgery and Cancer, Imperial College London, London, UK
- West London Gynaecology Cancer Centre, Imperial College NHS Trust, London, UK
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Zeller C, Masrour N, Patel N, Dai W, Wilhelm-Benartzi C, Brown R. DNA Methylation Profiling Using Infinium Methylation Assay. Bio Protoc 2013. [DOI: 10.21769/bioprotoc.777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Borley J, Wilhelm-Benartzi C, Brown R, Ghaem-Maghami S. Does tumour biology determine surgical success in the treatment of epithelial ovarian cancer? A systematic literature review. Br J Cancer 2012; 107:1069-74. [PMID: 22935582 PMCID: PMC3461167 DOI: 10.1038/bjc.2012.376] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: Ovarian cancer is the most lethal gynaecological cancer. Progression-free and overall survival is significantly related to surgical success and residual disease volume. It is unclear whether this survival advantage is due to an intrinsic biological element of the tumour cells which enables successful surgery and improved prognosis, or alternatively the number of tumour sustaining cells remaining irrespective of differences in biology. Methods: A systematic review of the literature was performed identifying studies that have investigated the association between biomarkers and surgical outcomes. We attempted validation of these results using The Cancer Genome Atlas ovarian cancer data sets. Results: Thirty studies were identified of which sixteen determined protein expression, eight gene expression and one DNA methylation in association with surgical debulking. Individualised linear models adjusting for batch, stage and age identified only expression of the genes MTDH and insulin-like growth factor-1 receptor (IGF1R) to be significantly associated with debulking surgery (P<0.05, false discovery rate (FDR)<5%), although in the case of IGF1R this was in the opposite direction to previous findings. Conclusion: The majority of studies are limited by design, include heterogeneous samples and lack adjustment for major confounding factors. High quality detailed clinical annotations should be routinely collected in future to more accurately evaluate biomarkers of surgical outcome.
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Affiliation(s)
- J Borley
- Epigenetics Unit, Department of Surgery and Cancer, Imperial College London, 4th Floor IRDB, Hammersmith Hospital, London W12 0NN, UK
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Michaud DS, Izard J, Wilhelm-Benartzi C, Riboli E, Bueno-de-Mesquita B. Abstract LB-328: Plasma antibodies to oral pathogen and commensals and risk of pancreatic cancer in a large European prospective cohort study. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-lb-328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: A positive relationship between periodontal disease and pancreatic cancer risk has been observed in previous epidemiological studies. In a cohort study of health professional men, never smokers reporting a positive history of periodontal disease had a 2-fold higher risk of pancreatic cancer compared with those reporting no periodontal disease (RR = 2.09, 95% CI = 1.18-3.71). These findings suggest that oral bacteria may be able to disseminate to the pancreas or may be associated with risk indirectly. We examined the relationship between the presence of antibodies to 25 diverse strains of oral bacteria and pancreatic cancer risk in a prospective study. Methods: Antibodies to oral bacteria were measured in prediagnostic blood samples of 405 pancreatic cancer cases and 416 matched controls nested within the European Prospective Investigation on Cancer (EPIC), a large cohort study. Analyses were conducted using conditional logistic regression and additionally adjusted for smoking status and body mass index. Results: Individuals with high antibody levels to Porphyromonas gingivalis ATTC 53978 (>200 ng/ml), a pathogenic periodontal bacteria, had a two-fold higher risk of pancreatic cancer (OR = 2.14, 95% CI =1.05-4.36) compared with individuals with low levels of antibody (<200ng/ml). To explore the association with common oral bacteria, we performed a cluster analysis and obtained two clusters that aggregated individuals according to their antibody profiles. A substantially lower risk of pancreatic cancer was observed in the cluster with consistently elevated levels of antibodies, compared to a second cluster with overall lower levels (OR = 0.55, 95% CI = 0.36-0.83). Conclusions: In this study using prediagnostic bloods, we find support for a positive association between periodontal disease and pancreatic cancer. Additionally, our results further suggest that certain oral bacteria or an enhanced immune surveillance may provide some protection against pancreatic cancer. Our findings are consistent with dental research on periodontal disease etiology and treatment. Whether periodontal disease is causally related to pancreatic cancer or simply a marker of underlying immune response needs to be further elucidated.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-328. doi:1538-7445.AM2012-LB-328
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Affiliation(s)
| | | | | | - Elio Riboli
- 3Imperial College London, London, United Kingdom
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Filiberto AC, Maccani MA, Koestler D, Wilhelm-Benartzi C, Avissar-Whiting M, Banister CE, Gagne LA, Marsit CJ. Birthweight is associated with DNA promoter methylation of the glucocorticoid receptor in human placenta. Epigenetics 2011; 6:566-72. [PMID: 21521940 DOI: 10.4161/epi.6.5.15236] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Birthweight has been associated with a number of health outcomes throughout life. Crucial to proper infant growth and development is the placenta, and alterations to placental gene function may reflect differences in the intrauterine environment which functionally contribute to infant growth and may ultimately affect the child's health. To examine if epigenetic alteration to the glucocorticoid receptor (GR) gene was linked to infant growth, we analyzed 480 human placentas for differential methylation of the GR gene exon 1F and examined how this variation in methylation extent was associated with fetal growth. Multivariable linear regression revealed a significant association (p < 0.0001) between differential methylation of the GR gene and large for gestational age (LGA) status. Our work is one of the first to link infant growth as a measure of the intrauterine environment and epigenetic alterations to the GR and suggests that DNA methylation may be a critical determinant of placental function.
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Affiliation(s)
- Amanda C Filiberto
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, USA
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