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Buyse K, Goorts K, Peeters D, Dhondt E, Portzky G. Sexual harassment at work within Belgian Defence: a prevalence study. BMJ Mil Health 2023; 169:397-402. [PMID: 34417341 PMCID: PMC10579512 DOI: 10.1136/bmjmilitary-2021-001855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/13/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Sexual harassment (SH) at work can have an impact on the general health and well-being and on the productivity of the employee. To date, the Belgian Armed Forces do not have any accurate data about SH. Therefore, this study assessed the prevalence of SH within Belgian Defence. METHODS The prevalence of SH and staff mental well-being was investigated in a sample of 399 female soldiers. Using quantitative analysis, we measured the impact on mental well-being and the relation to demographic characteristics. Using a qualitative analysis in a subsample of eight female soldiers, we investigated barriers to reporting SH and the impact on professional performance and psychosocial well-being. RESULTS The prevalence of non-physical SH is 36.1% over the last 12 months and 64.4% over the course of a career. Physical SH has a prevalence of 16.1% and 43.4%, respectively. Rape prevalence was reported to be 1.4% over the past 12 months, 9% over the course of their career.One in three female soldiers suffer from reduced mental well-being, which was significantly associated with SH. In the interviews, female employees report an impact of SH on professional and personal performance. The willingness to report is low due to misunderstanding, disinformation and psychosocial insecurity. CONCLUSION High prevalence numbers were found suggesting an important impact on the professional performance and mental well-being of female military personnel. Organisational changes may create more willingness among victims to report incidents to the designated services.
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Affiliation(s)
- Kaatje Buyse
- Health and Wellbeing, Belgian Defence, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - K Goorts
- Health and Wellbeing, Belgian Defence, Brussels, Belgium
- Environment and Health, KU Leuven, Leuven, Belgium
| | - D Peeters
- Health and Wellbeing, Belgian Defence, Brussels, Belgium
| | - E Dhondt
- Health and Wellbeing, Belgian Defence, Brussels, Belgium
| | - G Portzky
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
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Rugo H, Loi S, Adams S, Schmid P, Schneeweiss A, Barrios C, Iwata H, Dieras V, Winer E, Kockx M, Peeters D, Chui S, Lin J, Nguyen Duc A, Viale G, Molinero L, Emens L. Performance of PD-L1 immunohistochemistry (IHC) assays in unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC): Post-hoc analysis of IMpassion130. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Girod M, Allerton F, Vangrinsven E, Tutunaru AC, de Marchin J, Gómez-Fernández-Blanco C, Ruiz-Nuño A, Wojnicz A, Farnir F, Gommeren K, Peeters D. CSF omeprazole concentration and albumin quotient following high dose intravenous omeprazole in dogs. Res Vet Sci 2019; 125:266-271. [PMID: 31326702 DOI: 10.1016/j.rvsc.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 06/09/2019] [Accepted: 07/10/2019] [Indexed: 10/26/2022]
Abstract
Clinical signs of syringomyelia and hydrocephalus occur secondary to cerebrospinal fluid (CSF) accumulation within the central nervous system. Omeprazole is recommended to treat these conditions despite little evidence of its capacity to decrease CSF production in the dog. Studies into new treatments are hampered by difficulties in measuring CSF production. The albumin quotient (QAlb), the ratio between CSF and serum albumin concentrations, may reflect CSF production and any decrease in CSF production should be associated with an increase in QAlb. The primary objective of this study was to determine CSF omeprazole concentration after administration of a high intravenous dose of omeprazole and to evaluate its impact on QAlb in the dog. The second aim was to validate QAlb as a surrogate marker of CSF production. Eighteen dogs were included in this prospective crossover placebo-controlled study. Each dog received omeprazole (10 mg/kg), acetazolamide (50 mg/kg) combined with furosemide (1 mg/kg) and saline. Blood and CSF samples were obtained on day 0 and then every 7 days, one hour after drug administration. Omeprazole concentrations (2.0 ± 0.4 μmol/L) reached in CSF after high dose omeprazole were lower than the concentrations previously described as decreasing CSF production in dogs. There was no significant increase in QAlb following administration of acetazolamide/furosemide, prohibiting validation of QAlb as a surrogate marker for CSF production. Several dogs presented transient mild side effects after injection of acetazolamide/furosemide. High dose omeprazole was well tolerated in all dogs.
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Affiliation(s)
- M Girod
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium.
| | - F Allerton
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - E Vangrinsven
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - A C Tutunaru
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - J de Marchin
- Labocit, Citadelle Hospital, Boulevard du 12ème de ligne, 1, 4000 Liège, Belgium
| | - C Gómez-Fernández-Blanco
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - A Ruiz-Nuño
- Servicio Farmacología Clínica, Hospital Universitario de la Princesa, planta 7ª, Diego de León, 62, 28006 Madrid, Spain
| | - A Wojnicz
- Servicio Farmacología Clínica, Hospital Universitario de la Princesa, planta 7ª, Diego de León, 62, 28006 Madrid, Spain
| | - F Farnir
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - K Gommeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
| | - D Peeters
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, avenue de Cureghem 3, B44, 4000 Liège, Belgium
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Ignatiadis M, Rothé F, Peeters D, Rouas G, Smeets D, Haan J, Lambrechts D, Campbell P, Piccart M, Voet T, Dirix L, Venet D, Sotiriou C. Abstract P1-01-10: Exome sequencing of circulating tumor cells in metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-01-10] [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
Aim: We interrogated whether Circulating Tumor Cells (CTCs) can complement metastatic biopsies for genomic analyses.
Patients and Methods: We compared single nucleotide variants (SNVs) and copy number aberrations (CNAs) identified using whole exome sequencing (WES) of DNA from frozen tumor tissue (primary/metastasis), amplified DNA from CTCs and normal DNA from 3 metastatic breast cancer (BC) patients (pts). All samples of the same patient were collected at the same timepoint. CTC isolation was performed using CellSearch and DEPArray systems followed by whole genome amplification (Ampli1 kit). WES was performed using the Illumina HiSeq2000 with 200X targeted coverage. Reads were aligned using bwa. SNVs had to be called by both Haplotype Caller (vs. reference genome) and Strelka (vs. paired normal). CNAs were determined by counting reads in 1MB windows and by comparing tumor/CTC samples with normal DNA. Pairwise concordance of CNAs profiles of different samples from the same patient was assessed using Spearman correlation (ρ). Significance of ρ differences between pts was obtained by Kruskal-Wallis test. Orthogonal validation for selected SNVs was performed.
Results: We studied 3 patients from the 3 major BC subtypes, patient (pt)1 with ER-/HER2+ BC (samples collected at diagnosis, initially metastatic disease), pt2 with triple-negative BC (samples collected 2 years from diagnosis) and pt3 with ER+/HER2- BC (samples collected 8 years from diagnosis).
We first compared tumor tissue and CTCs for SNVs. For pt1, of the 77 SNVs identified in the tumor, 51 were found on at least one of 12 CTCs samples. For pt2, of the 62 SNVs identified in the tumor, 19 were found on at least 1 of 11 CTCs samples. For pt3, of the 225 SNVs identified in the tumor, 48 were found on at least 1 of 3 CTCs samples. Interestingly, by increasing the number of CTCs analyzed, we increased the % of identified SNVs from synchronous tumor tissue. SNVs with high variant allele fraction (VAF) in tumor tissue were detected significantly more often in CTCs: 22% of the SNVs with VAFs <20% were found at least once, compared to 53% and 74% of SNVs with VAFs >20% and >40%, respectively (p=10-12, Fisher exact test).
Then, we compared tumor tissue and CTCs for CNAs. As time from diagnosis of metastatic disease to samples collection increased, we observed significantly higher heterogeneity within CTCs from the same patient (median ρ between CTCs was 86% for pt1, 84% for pt2 and 28% for pt3, p<0.01) and between CTCs and tumor tissue from the same patient (median ρ was 78% for pt1, 67% for pt2 and 21% for pt3, p<10-4). Interestingly, in pt3 one CTC was more similar to the metastasis than the other 2 (ρ of 53%, 21% and 21%). When a phylogenetic tree was constructed for pt3 by combining SNVs and CNAs data, three clones were identified: one clone with an AKT1 (E17K) and a TP53 (R248W) mutation and a 8p deletion, a second clone with the above profile plus an 8q amplification and a third clone with an AKT1 and an ESR1 (Y537N) mutation and 1p deletion. The metastasis was similar with the first clone.
Conclusions: These data suggest that tumor tissue and single CTC exome sequencing analyses provide complementary information to map tumor heterogeneity. Further validation for potential clinical applications is needed.
Citation Format: Ignatiadis M, Rothé F, Peeters D, Rouas G, Smeets D, Haan J, Lambrechts D, Campbell P, Piccart M, Voet T, Dirix L, Venet D, Sotiriou C. Exome sequencing of circulating tumor cells in metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-01-10.
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Affiliation(s)
- M Ignatiadis
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - F Rothé
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Peeters
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - G Rouas
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Smeets
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - J Haan
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Lambrechts
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - P Campbell
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - M Piccart
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - T Voet
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - L Dirix
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Venet
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - C Sotiriou
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
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Canonne A, Bolen G, Peeters D, Billen F, Clercx C. Long-term follow-up in dogs with idiopathic eosinophilic bronchopneumopathy treated with inhaled steroid therapy. J Small Anim Pract 2016; 57:537-542. [DOI: 10.1111/jsap.12529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 11/30/2022]
Affiliation(s)
- A.M. Canonne
- Department of Small Animal Clinical Sciences, Internal Medicine; Faculty of Veterinary Medicine, University of Liège; Liège 4000 Belgium
| | - G. Bolen
- Department of Small Animal Clinical Sciences, Diagnostic Imaging; Faculty of Veterinary Medicine, University of Liège; Liège 4000 Belgium
| | - D. Peeters
- Department of Small Animal Clinical Sciences, Internal Medicine; Faculty of Veterinary Medicine, University of Liège; Liège 4000 Belgium
| | - F. Billen
- Department of Small Animal Clinical Sciences, Internal Medicine; Faculty of Veterinary Medicine, University of Liège; Liège 4000 Belgium
| | - C. Clercx
- Department of Small Animal Clinical Sciences, Internal Medicine; Faculty of Veterinary Medicine, University of Liège; Liège 4000 Belgium
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Kroeze Y, Peeters D, Boulle F, van den Hove DLA, van Bokhoven H, Zhou H, Homberg JR. Long-term consequences of chronic fluoxetine exposure on the expression of myelination-related genes in the rat hippocampus. Transl Psychiatry 2016; 6:e779. [PMID: 27070407 PMCID: PMC4872416 DOI: 10.1038/tp.2016.60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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7
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Girod M, Allerton F, Gommeren K, Tutunaru A, de Marchin J, Van Soens I, Ramery E, Peeters D. Evaluation of the effect of oral omeprazole on canine cerebrospinal fluid production: A pilot study. Vet J 2016; 209:119-24. [DOI: 10.1016/j.tvjl.2015.10.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 10/18/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
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Brouwer A, van de Wiel M, Peeters B, van Dam PJ, Vermeulen P, Peeters M, Van Laere S, Peeters D, Dirix L. Abstract P3-04-01: Manual and digital detection of HER2 status of 2721 circulating tumour cells in patients with metastatic breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-04-01] [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:
In metastatic breast cancer (MBC), discordant expression levels of the human epidermal growth factor receptor 2 (HER2) have been noted between primary tumours (PT) and matched metastatic lesions (Meta). Therefore reassessment of this predictive marker at time of metastatic disease might help to optimize treatment. Circulating tumour cells (CTCs) offer the potential to provide a repeatedly accessible source of tumour cells for the real-time assessment of actual tumour characteristics.
Here we report on a retrospective study analysing over two and a half thousand CTCs in order to evaluate the inter-observer variability when using the semi-quantitative scale (0-3+) described by Riethdorf in 2010. Furthermore we designed a digital scoring system using 13 parameters selected by ImageJ. HER2 status in CTCs was compared to PT and/or Meta of patients with MBC.
Materials and methods:
65 patients starting first or second line systemic therapy for MBC and harbouring more than 5 CTC/7.5 mL blood were selected. HER2 status of 2721 CTCs was determined by immunofluorescence using the CellSearch system. HER2 status of the solid lesions was determined by IHC or FISH. Inter-observer variability was calculated using the Kendalls tau tests. 284 CTCs were analysed with the digital scoring system using ImageJ 'plot profile' and 'analyse particles'. Selected parameters comprise cell size, mean and maximum intensity of the cell and its surrounding, and both ratio's and differences of the aforementioned. Dissimilarity matrix was calculated using Pearson Correlation-Distance.
Results:
Of 2721 CTCs, 1485 cells (55%) were scored 0+ and 2263 cells (83%) were found to be HER2- (0+ or 1+) by both observers. 458 cells (17%) were scored HER2+ (2+ or 3+) by at least one of the observers, however only 175 (6%) by both observers. Inter-observer variability was 0.703, but when omitting the usually undebatable 0+ cells, this variability showed to be 0.278.
HER2 scoring of CTC by two observers. HER2- (0+/1+)HER2+ (2+/3+)HER2- (0+/1+)2263 (83%)131 (4.8%)HER2+ (2+/3+)152 (5.6%)175 (6.4%)
24 of 65 patients had at least 80% 0+ CTCs (≥96% HER2- cells). Of these patients, 5 were HER2+ based on their PT. Oppositely, 10 and 20 patients harboured at least 40% and 10% HER2+ CTCs respectively. From these 20 patients only 10 were diagnosed with HER2+ disease on PT or Meta and 1 was shifted form HER2- PT to HER2+ Meta.
The digital scoring system was able to identify four groups with different HER2 expression levels. When comparing the identified clusters with the manually scored cells the two moderately related clusters showed to contain almost only 2+ and 3+ CTCs. A very isolated cluster contained almost solely 0+ CTCs.
Discussion:
The manual scoring system showed to be feasible, however we noticed that there are some discrepancies regarding the scoring of 1+ to 3+ cells. The digital scoring is able to predict the outcome and can by itself cluster CTCs into 4 groups. It strongly distinguishes between the HER2+ and HER2- cells. HER2+ status can change during disease progression, both with gain and loss of HER2 positivity. This can be monitored using CTCs.
Citation Format: Brouwer A, van de Wiel M, Peeters B, van Dam P-J, Vermeulen P, Peeters M, Van Laere S, Peeters D, Dirix L. Manual and digital detection of HER2 status of 2721 circulating tumour cells in patients with metastatic breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-04-01.
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Affiliation(s)
- A Brouwer
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - M van de Wiel
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - B Peeters
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - P-J van Dam
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - P Vermeulen
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - M Peeters
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - S Van Laere
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - D Peeters
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - L Dirix
- Center for Oncological Research (CORE), University of Antwerp, Antwerp, Belgium; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
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Bidard FC, Peeters D, Fehm T, Nole F, Gisbert-Criado R, Mavroudis D, Grisanti S, Generali D, Garcia-Saenz JA, Stebbing J, Caldas C, Gazzaniga P, Manso L, Zamarchi R, Fernandez de Lascoiti A, de Mattos-Arruda L, Ignatiadis M, van Laere SJ, Meier-Stiegen F, Sandri MT, Vidal-Martinez J, Politaki E, Consoli F, Bottini A, Diaz-Rubio E, Krell J, Dawson SJ, Raimondi C, Rutten A, Janni W, Munzone E, Carañana V, Agelaki S, Almici C, Dirix L, Solomayer E, Zorzino L, Reis-Filho JS, Squifflet P, Pantel K, Beije N, Sleijfers S, Pierga JY, Michiels S. Abstract P2-08-08: Circulating tumor cells count-based nomograms to predict survival of metastatic breast cancer patients: Results from the European pooled analysis. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-08-08] [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: The European Pooled Analysis of CTC (EPAC) in metastatic breast cancer, based on 1,944 individual data from patients with various tumor types and clinical settings (Bidard et al, Lancet Oncol 2014), has established CTC count (CellSearch) at baseline and during therapy as a level of evidence 1 independent prognostic biomarker and demonstrated its superiority over serum blood markers. As part of the study pre-planned objectives, we sought to establish nomograms allowing accurate individual survival predictions.
Methods: Using individual data from 17 centers, we built simplified multivariate prognostic models taking into account the independent prognostic clinico-pathological (CP) characteristics including CTC count, dichotomized using the 5CTC/7.5ml threshold, at baseline and at 3-5 weeks after the start of a new treatment regimen, and derived nomograms for progression-free survival (PFS) and overall survival (OS) prediction at baseline and after 3-5 weeks of treatment. We report here the internal validation of these nomograms. Discrimination of the models was assessed using the c-index estimated by a jackknife procedure and the calibration was visually assessed through 10-fold crossvalidated calibration plots at 1,2,3 years for OS and 1,2 years for PFS.
Results: Multivariate models at baseline for PFS and OS were fitted on 1501 and 568 individual patient data with CTC count at baseline and CTC count at baseline and after 3-5 weeks, respectively. Models include tumor subtype, the number of previous chemotherapy lines (0/1/≥2), PS, age (<=50/>50-65/>65 years), metastasis-free intervals (0/>0-3/>3 years), metastatic sites (liver and CNS) and CTC count at baseline and eventually at 3-5 weeks of treatment. The C-index increased from 0.722 to 0.755 (increase in C-index:0.033, 95% CI [0.019;0.045]) when adding baseline CTC to the CP only model for OS (n=1501). For those patients with CTC values at 3-5 weeks (n=568), there was an additional increase in the C-index when adding CTC at 3-5 weeks to a model with already CP and baseline CTC from 0.731 to 0.743 (increase in C-index 0.013, 95% CI [-0.004;0.025]). The model with CP and baseline CTC counts showed a good calibration for OS at 1,2,3 years and the model with CP, baseline CTC and CTC count at 3-5 weeks a moderately good calibration. Similar results were obtained for PFS.
Conclusion: From the largest database with individual CTC data, we were able to build PFS and OS survival nomograms, with satisfactory discrimination and calibration. Our planned next step is to validate the nomogram in an additional cohort.
Citation Format: Bidard F-C, Peeters D, Fehm T, Nole F, Gisbert-Criado R, Mavroudis D, Grisanti S, Generali D, Garcia-Saenz JA, Stebbing J, Caldas C, Gazzaniga P, Manso L, Zamarchi R, Fernandez de Lascoiti A, de Mattos-Arruda L, Ignatiadis M, van Laere SJ, Meier-Stiegen F, Sandri M-T, Vidal-Martinez J, Politaki E, Consoli F, Bottini A, Diaz-Rubio E, Krell J, Dawson S-J, Raimondi C, Rutten A, Janni W, Munzone E, Carañana V, Agelaki S, Almici C, Dirix L, Solomayer E, Zorzino L, Reis-Filho JS, Squifflet P, Pantel K, Beije N, Sleijfers S, Pierga J-Y, Michiels S. Circulating tumor cells count-based nomograms to predict survival of metastatic breast cancer patients: Results from the European pooled analysis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-08.
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Affiliation(s)
- F-C Bidard
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - D Peeters
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - T Fehm
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - F Nole
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - R Gisbert-Criado
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - D Mavroudis
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - S Grisanti
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - D Generali
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - JA Garcia-Saenz
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - J Stebbing
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - C Caldas
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - P Gazzaniga
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - L Manso
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - R Zamarchi
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - A Fernandez de Lascoiti
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - L de Mattos-Arruda
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - M Ignatiadis
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - SJ van Laere
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - F Meier-Stiegen
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - M-T Sandri
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - J Vidal-Martinez
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - E Politaki
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - F Consoli
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - A Bottini
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - E Diaz-Rubio
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - J Krell
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - S-J Dawson
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - C Raimondi
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - A Rutten
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - W Janni
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - E Munzone
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - V Carañana
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - S Agelaki
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - C Almici
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - L Dirix
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - E Solomayer
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - L Zorzino
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - JS Reis-Filho
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - P Squifflet
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - K Pantel
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - N Beije
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - S Sleijfers
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - J-Y Pierga
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
| | - S Michiels
- Institut Curie, Paris, France; University of Antwerp, Antwerp, Belgium; Heinrich Heine University Düsseldorf, Düseeldorf, Germany; European Institute of Oncology, Milano, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Azienda Spedali Civili, Brescia, Italy; AZ Istituti Ospitalieri di Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College of Medicine, London, United Kingdom; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; Sapienza University, Roma, Italy; Hospital 12 de Octubre, Madrid, Spain; IOV-IRCCS, Padova, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University of Ulm, Ulm, Germany; Saarland University, Homburg, Germany; Memorial Sloan Kettering Cancer Center, New-York; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; International Drug Development Institute - IDDI, Louvain La Neuve, Belgi
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Peeters D, Brouwer A, Op de Beeck K, Van de Weyer G, Pauwels P, Peeters M, Vermeulen P, Van Laere S, Van Camp G, Dirix L. Whole exome sequencing of circulating and disseminated tumour cells in patients with metastatic breast cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv116.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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De Laere B, Peeters D, Salgado R, Vermeulen P, van Dam P, Dirix L, Van Laere S. Exploring the intra-patient PIK3CA mutational heterogeneity of circulating tumour cells by massive parallel sequencing in patients with metastatic hormone receptor-positive breast cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv117.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bignan G, Alexander R, Bischoff J, Connolly P, Cummings M, de Breucker S, Esser N, Fraiponts E, Gilissen R, Grasberger B, Janssens B, Lu T, Ludovici D, Meerpoel L, Meyer C, Parker M, Peeters D, Rocaboy C, Schubert C, Smans K. 430 Design and structure–activity relationships of highly potent and bioavailable imidazolinone FASN KR domain inhibitors. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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van der Doelen RHA, Deschamps W, D'Annibale C, Peeters D, Wevers RA, Zelena D, Homberg JR, Kozicz T. Early life adversity and serotonin transporter gene variation interact at the level of the adrenal gland to affect the adult hypothalamo-pituitary-adrenal axis. Transl Psychiatry 2014; 4:e409. [PMID: 25004389 PMCID: PMC4119224 DOI: 10.1038/tp.2014.57] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 05/06/2014] [Accepted: 05/22/2014] [Indexed: 01/17/2023] Open
Abstract
The short allelic variant of the serotonin transporter (5-HTT) promoter-linked polymorphic region (5-HTTLPR) has been associated with the etiology of major depression by interaction with early life stress (ELS). Furthermore, 5-HTTLPR has been associated with abnormal functioning of the stress-responsive hypothalamo-pituitary-adrenal (HPA) axis. Here, we examined if, and at what level, the HPA-axis is affected in an animal model for ELS × 5-HTTLPR interactions. Heterozygous and homozygous 5-HTT knockout rats and their wild-type littermates were exposed daily at postnatal days 2-14 to 3 h of maternal separation. When grown to adulthood, plasma levels of adrenocorticotropic hormone (ACTH), and the major rat glucocorticoid, corticosterone (CORT), were measured. Furthermore, the gene expression of key HPA-axis players at the level of the hypothalamus, pituitary and adrenal glands was assessed. No 5-HTT genotype × ELS interaction effects on gene expression were observed at the level of the hypothalamus or pituitary. However, we found significant 5-HTT genotype × ELS interaction effects for plasma CORT levels and adrenal mRNA levels of the ACTH receptor, such that 5-HTT deficiency was associated under control conditions with increased, but after ELS with decreased basal HPA-axis activity. With the use of an in vitro adrenal assay, naïve 5-HTT knockout rats were furthermore shown to display increased adrenal ACTH sensitivity. Therefore, we conclude that basal HPA-axis activity is affected by the interaction of 5-HTT genotype and ELS, and is programmed, within the axis itself, predominantly at the level of the adrenal gland. This study therefore emphasizes the importance of the adrenal gland for HPA-related psychiatric disorders.
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Affiliation(s)
- R H A van der Doelen
- Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Geert Grooteplein 21 (route 126), 6525 EZ Nijmegen, The Netherlands. E-mail:
| | - W Deschamps
- Department of Cellular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C D'Annibale
- Department of Cellular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D Peeters
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Cellular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R A Wevers
- Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D Zelena
- Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary
| | - J R Homberg
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T Kozicz
- Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Lavoué R, Geffré A, Braun JP, Peeters D, Granat F, Bourgès-Abella N, Trumel C. Breed-specific hematologic reference intervals in healthy adult Dogues de Bordeaux. Vet Clin Pathol 2014; 43:352-61. [PMID: 24798575 DOI: 10.1111/vcp.12151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is an increasing interest for breed-specific reference intervals in veterinary medicine. In a previous study, breed-specific biochemical reference intervals (RIs) have been established for Dogues de Bordeaux (DDBs). This breed is predisposed to familial juvenile glomerulonephropathy and hypothyroidism, and would benefit from hematologic RI. OBJECTIVE The purpose was de novo establishment of breed-specific hematologic RIs for the DDB in accordance with the International Federation of Clinical Chemistry and Clinical and Laboratory Standards Institute guidelines. METHODS One hundred and twenty DDBs from France and Belgium were recruited. CBCs were determined with the Sysmex XT-2000iV analyzer within 12 hours of blood collection. RIs were determined using the nonparametric method. Effects of sex, age, and face mask color were studied. RESULTS RIs were determined in 58 healthy dogs. DDBs had higher RIs for HGB, HCT, MCV, MCHC, and mean platelet volume, and lower RIs for reticulocytes counts, platelets by impedance (PLT-I) and optical count (PLT-O), and plateletcrit when compared with generic canine RIs. Age significantly affected RIs for HGB, HCT, MCHC, WBC, neutrophil, lymphocyte, and monocyte counts. CONCLUSION The generic canine RIs established in the same laboratory with analogous preanalytical and analytical variations did not differ significantly from breed-specific RIs, and thus have no significant impact on clinical decision making; however, breed-specific RIs are advised for some RBC and all platelet-related variables to avoid erroneous suspicion of polycythemia and thrombocytopenia when using general canine RIs for evaluation of DDB.
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Affiliation(s)
- R Lavoué
- Internal Medicine Unit , Institut National Polytechnique, Ecole Nationale Vétérinaire de Toulouse (INP-ENVT), Toulouse, France
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Etienne AL, Audigié F, Peeters D, Gabriel A, Busoni V. Ultrasonographic percutaneous anatomy of the atlanto-occipital region and indirect ultrasound-guided cisternal puncture in the dog and the cat. Anat Histol Embryol 2014; 44:92-8. [PMID: 24712312 DOI: 10.1111/ahe.12113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 02/20/2014] [Indexed: 11/29/2022]
Abstract
Cisternal puncture in dogs and cats is commonly carried out. This article describes the percutaneous ultrasound anatomy of the cisternal region in the dog and the cat and an indirect technique for ultrasound-guided cisternal puncture. Ultrasound images obtained ex vivo and in vivo were compared with anatomic sections and used to identify the landmarks for ultrasound-guided cisternal puncture. The ultrasound-guided procedure was established in cadavers and then applied in vivo in seven dogs and two cats. The anatomic landmarks for the ultrasound-guided puncture are the cisterna magna, the spinal cord, the two occipital condyles on transverse images, the external occipital crest and the dorsal arch of the first cervical vertebra on longitudinal images. Using these ultrasound anatomic landmarks, an indirect ultrasound-guided technique for cisternal puncture is applicable in the dog and the cat.
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Affiliation(s)
- A-L Etienne
- Diagnostic Imaging Section, Faculty of Veterinary Medicine, Liège University, Boulevard de Colonster, 20, Bât. B41, 4000, Liège, Belgium
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De Laere B, Peeters D, van Schooneveld E, Salgado R, Vermeulen P, Dirix L, Van Laere S. Abstract P1-04-04: Towards methodology of detecting PIK3CA mutations on single cell level by massive parallel sequencing. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-04-04] [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: The oncogene PIK3CA encodes the p110α catalytic subunit of phosphatidylinositol 3-kinase. Gain-of-function mutations occur in 20 – 40% of the diagnosed breast cancer cases and may predict response to PI3K/AKT/mTOR inhibitors. We have developed a methodology to determine the PIK3CA exon 9 and 20 mutational status on single cell level, allowing analysis of low-input patient material such as circulating tumor cells (CTC).
Methods: Single and groups of cultured breast cancer cells (BT20, MDA-MB-361 and MCF7) were isolated and recovered from spiked blood samples using the CellSearch and DEPArray platform respectively, and subjected to whole-genome amplification. Additionally, Formalin-fixed, paraffin-embedded (FFPE) tissue sections from 3 breast cancer patients were collected, of which two were mutant (MT) and one carried the wild-type (WT) genotype, as previously determined by external laboratories. Targeted PIK3CA PCR for exon 9 and 20 with unique multiplex identifiers (MIDs) allowed mixing of 32 samples and differentiation in the sequence data. Massive parallel sequencing was carried out using Titanium Amplicon chemistry (Lib-A) on a 454 GS Junior and data were analyzed using the amplicon variant analyzer (AVA) software.
Results: A throughput of 120.464 high-quality reads with a mean coverage depth of 987 reads (range 288 – 5979) allowed the reliable assessment of variants, which were concordant with NCBI SNP/COSMIC databases and external laboratories. In BT20, the variants and frequencies were the missense P539R (48,83%) and H1047R (45,36%) mutations. Missense E545K mutation was detected in MDA-MB-361 (33,33%) and MCF7 (70,83%). Above mentioned mutations were detected in 73,3% and 100% of analyzed single and groups of tumor cells, respectively. Inability to determine the mutational status in some single cells was due to loss of amplicon during purification. In the MT FFPE tissue sections, two variants were detected and were concordant with previously obtained results. The variants and frequencies detected were E542K (14,12%) and E545K (21,38%), and correlated well with the tumor cell content of the actual sample (40% and 50%, respectively). Additionally, variant analysis showed 2 different SNPs in exon 20, which are classified as the synonymous mutations T1025T and A995A. In the WT sample no PIK3CA mutations were detected, suggesting a 100% specificity on the obtained 454 data.
Conclusions: Our study delivers a semiautomated workflow using next-generation sequencing for the assessment of PIK3CA gain-of-function mutations on FFPE tissue sections and on single DEPArray purified cells from CellSearch pre-enriched whole blood samples. We are now implementing this workflow in the analysis of circulating tumor cells from patients with metastatic breast cancer. At the time of submitting, a cohort of 40 patients with luminal breast cancer was selected to assess the PIK3CA mutational status in the primary tumor, CTC and (if present) metastatic compartment.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-04-04.
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Affiliation(s)
- B De Laere
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
| | - D Peeters
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
| | - E van Schooneveld
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
| | - R Salgado
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
| | - P Vermeulen
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
| | - L Dirix
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
| | - S Van Laere
- Translational Cancer Research Unit, Oncology Center, GZA Hospitals Sint-Augustinus, Wilrijk, Antwerpen, Belgium; U Leuven, Leuven, Vlaams-Brabant, Belgium
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Bidard FC, Peeters D, Fehm T, Nole F, Gisbert-Criado R, Mavrudis D, Grisanti S, Generali D, Garcia-Saenz JA, Stebbing J, Caldas C, Gazzaniga P, Manso L, Zamarchi R, Antelo ML, de Mattos-Arruda L, Ignatiadis M, Lebofsky R, van Laere SJ, Meier-Stiegen F, Sandri MT, Vidal-Martinez J, Politaki E, Consoli F, Bottini A, Diaz-Rubio E, Krell J, Dawson SJ, Raimondi C, Rutten A, Janni W, Munzone E, Caranana V, Agelaki S, Almici C, Dirix L, Solomayer E, Zorzino L, Johannes H, Reis-Filho J, Pantel K, Pierga JY, Michiels S. Abstract PD6-5: Pooled analysis of circulating tumor cells in metastatic breast cancer: Findings from 1944 individual patients data. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-pd6-5] [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: Clinical validity of CTCs (CellSearch®) in metastatic breast cancer (MBC) patients has previously been assessed in studies with limited statistical power. We aimed to pool all European studies to obtain high-level evidence on the prognostic value of CTCs, to investigate their effects across different clinico-pathological characteristics and therapies and to further validate the MD Anderson/Institut Curie/Fox Chase CTC-based prognostic nomogram established in first-line treated MBC patients (Giordano et al, Clin Cancer Res 2013).
Material and methods: Methods were predefined in a written protocol. In December 2012, we searched for eligible studies that accrued patients in 2003-2012. We contacted all European laboratories using CellSearch®. We used likelihood ratio tests (LR) in Cox regression models stratified by study to assess the independent prognostic value of CTC when added to a clinicopathological (CP) model for progression-free (PFS) and overall survival (OS). Landmark analyses were used to assess the prognostic effect of early changes in CTC. The CTC-based nomogram (http://cancernomograms.com/CTCOnline.html) score was retrieved for every patient; we calculated C-indices, drew calibration plots and Kaplan-Meier curves according to quintiles of the nomogram score.
Results: We collected individual data of 1944 MBC patients, from 20 different studies (some unpublished), from 17 centers in 7 European countries. We observed 1507 PFS events and 929 deaths. Baseline CTC count was significantly associated with several patient characteristics, such as performance status (PS, p<10-4), synchronous metastasis (p<10- 2) tumor subtype (p<10-4), liver & bone metastases (p<10-4), CEA & CA15-3 levels (p<10-4). The CP model for OS included PS, MBC subtypes, number of previous lines of treatment, patient's age, metastasis-free interval, metastatic sites (p<0.01 for all). In a multivariate analysis containing the CP model parameters and CTC count at baseline, elevated CTC count (≥5) was a significant independent predictor of OS (n = 1444, HR = 2.7, 95%CI [2.2-3.2], LR p<10-4). Baseline serum markers added either no or marginal effect to the CP plus baseline CTC model for OS. In contrast, early changes in CTC status at week 3-5 significantly added prognostic information for OS to the model with CP factors and baseline CTC+ (n = 569, HR = 1.8 [2.2-3.2], LR p<0.001). In the population of interest (MBC treated by first line chemotherapy, n = 402 patients, 176 deaths), the CTC-based nomogram exhibited a good C-index for OS (0.69), was well calibrated and showed clear separation of the survival curves. Additional results, including subgroup analyses by tumor subtype and treatments will be presented at the meeting.
Conclusions: This pooled analysis is the largest study ever reported on CTC in MBC, with a previously unreached statistical power. It provides a clear level-of-evidence 1 on the independent prognostic value of CTCs before and during treatment in MBC. Also, the CTC-based prognostic nomogram is independently validated.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr PD6-5.
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Affiliation(s)
- F-C Bidard
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - D Peeters
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - T Fehm
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - F Nole
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - R Gisbert-Criado
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - D Mavrudis
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - S Grisanti
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - D Generali
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - JA Garcia-Saenz
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - J Stebbing
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - C Caldas
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - P Gazzaniga
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - L Manso
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - R Zamarchi
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - M-L Antelo
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - L de Mattos-Arruda
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - M Ignatiadis
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - R Lebofsky
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - SJ van Laere
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - F Meier-Stiegen
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - M-T Sandri
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - J Vidal-Martinez
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - E Politaki
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - F Consoli
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - A Bottini
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - E Diaz-Rubio
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - J Krell
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - S-J Dawson
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - C Raimondi
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - A Rutten
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - W Janni
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - E Munzone
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - V Caranana
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - S Agelaki
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - C Almici
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - L Dirix
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - E Solomayer
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - L Zorzino
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - H Johannes
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - J Reis-Filho
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - K Pantel
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - J-Y Pierga
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
| | - S Michiels
- Institut Curie, Paris, France; GZA Hospitals Sint-Augustinus, Antwerp, Belgium; University Medical Center, Duesseldorf, Germany; European Institute of Oncology, Milan, Italy; Hospital Arnau de Vilanova, Valencia, Spain; University Hospital of Heraklion, Heraklion, Greece; Public Hospitals of Brescia, Brescia, Italy; Hospital Institute of Cremona, Cremona, Italy; Hospital Clinico San Carlos, Madrid, Spain; Imperial College, London, United Kingdom; University of Cambridge, Cambridge, United Kingdom; Sapienza University of Rome, Rome, Italy; University Hospital 12 de Octubre, Madrid, Spain; Venetian Institute of Oncology, Padua, Italy; Hospital de Navarra, Pamplona, Spain; Val d'Hebron Institute of Oncology, Barcelona, Spain; Institut Jules Bordet, Brussels, Belgium; University Medical Center, Tuebingen, Germany; University Medical Center, Ulm, Germany; University of Saarland, Homburg, Germany; IDDI - International Drug Development Institute, Louvain-La-Neuve, Belgium; Memorial Sloan-Kettering Cancer Center, Ne
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Garigliany MM, Desmecht D, Bayrou C, Peeters D. No Serologic Evidence for Emerging Schmallenberg Virus Infection in Dogs (Canis domesticus). Vector Borne Zoonotic Dis 2013; 13:830-3. [DOI: 10.1089/vbz.2012.1251] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- M-M. Garigliany
- Department of Pathology, Faculty of Veterinary Medicine, University of Liège, Belgium
- These authors contributed equally to this study
| | - D. Desmecht
- Department of Pathology, Faculty of Veterinary Medicine, University of Liège, Belgium
- These authors contributed equally to this study
| | - C. Bayrou
- Department of Pathology, Faculty of Veterinary Medicine, University of Liège, Belgium
| | - D. Peeters
- Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Belgium
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Krafft E, Laurila HP, Peters IR, Bureau F, Peeters D, Day MJ, Rajamäki MM, Clercx C. Analysis of gene expression in canine idiopathic pulmonary fibrosis. Vet J 2013; 198:479-86. [PMID: 24120450 DOI: 10.1016/j.tvjl.2013.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 08/13/2013] [Accepted: 08/17/2013] [Indexed: 01/16/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF) in dogs is a rare disease of unknown aetiology, seen in terrier breeds, particularly the West Highland white terrier (WHWT). The aim of this study was to determine pulmonary gene expression in canine IPF in order to gain insights into the pathogenesis of the disease and to identify possible biomarkers. Microarray analyses were conducted to determine gene expression profiles in the lungs of dogs with IPF and control dogs of various breeds. More than 700 genes were identified as having greater than two-fold difference in expression between the two groups. The significant biological functions associated with these genes were related to cellular growth and proliferation, developmental processes, cellular movement, cell to cell signalling and interaction, and antigen presentation. Altered levels of expression were confirmed by quantitative reverse transcriptase PCR for genes encoding chemokine (C-C) ligand (CCL) 2 (+4.9 times), CCL7 (+6.8 times), interleukin 8 (+4.32 times), chemokine (C-X-C) ligand 14 (+3.4 times), fibroblast activation protein (+4.7 times) and the palate, lung and nasal associated protein (PLUNC, -25 times). Serum CCL2 concentrations were significantly higher in WHWTs with IPF (mean 628.1 pg/mL, interquartile range 460.3-652.7 pg/mL) than unaffected WHWTs (mean 344.0 pg/mL, interquartile range 254.5-415.5 pg/mL; P=0.001). The results support CCL2 as a candidate biomarker for IPF in dogs.
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Affiliation(s)
- E Krafft
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20, 4000 Liège, Belgium.
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Abstract
BACKGROUND Breed-specific reference intervals are of increasing interest in veterinary medicine. The health monitoring of the Dogue de Bordeaux, a breed predisposed to familial juvenile glomerulonephropathy and hypothyroidism, would benefit from specific reference intervals. OBJECTIVE The purpose of this study was to establish breed-specific biochemical reference intervals for the Dogue de Bordeaux in accordance with the International Federation of Clinical Chemistry and Clinical and Laboratory Standards Institute guidelines. METHODS One hundred and twenty Dogues de Bordeaux from France and Belgium were recruited. Complete urinalysis and chemistry panels, venous blood gas variables, total thyroxin and thyroid stimulating hormone, and fibrinogen and antithrombin were measured for each dog. Reference intervals were determined using the non-parametric method. Confounding variables such as sex, age and color of facial mask were analyzed. RESULTS Due to pre-defined criteria for exclusion, 62 healthy dogs were finally selected for the reference intervals determination. Using the instrument manufacturer's generic canine RI for most analytes did not have a significant impact on potential clinical decisions, except for total proteins, ALT, AST, total cholesterol, lipase and total thyroxin, for which possible clinically relevant differences were noted. CONCLUSION Specific reference intervals for biochemical analytes in the Dogue de Bordeaux were determined under controlled pre-analytical and analytical conditions, and according to international recommendations. The use of these breed-specific reference intervals is recommended when using the specified analytic instruments, especially for the 6 analytes for which the reference intervals differed considerably from those provided by manufacturers.
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Affiliation(s)
- R Lavoué
- Internal Medicine Unit, Toulouse, France
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Vanherberghen M, Bureau F, Peters IR, Day MJ, Lynch A, Fievez L, Billen F, Clercx C, Peeters D. Cytokine and transcription factor expression by Aspergillus fumigatus-stimulated peripheral blood mononuclear cells in dogs with sino-nasal aspergillosis. Vet Immunol Immunopathol 2013; 154:111-20. [PMID: 23759303 DOI: 10.1016/j.vetimm.2013.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 05/10/2013] [Accepted: 05/14/2013] [Indexed: 01/22/2023]
Abstract
The causal agent of sino-nasal aspergillosis is usually Aspergillus fumigatus, which is a saprophytic and ubiquitous fungus that causes a severe rhinosinusitis in apparent healthy dogs. Affected dogs do not have systemic immuno-suppression. It has been shown previously that dogs affected by this disease have local over-expression of interleukin (IL)-10 and Th1 cytokines in nasal mucosal tissue. The aim of the present study was to assess the response of peripheral blood mononuclear cells (PBMC) from affected and unaffected dogs to antigen-specific stimulation with heat-inactivated Aspergillus spp. conidia, by quantifying gene expression for specific Th1, Th2, Th17 and Treg cytokines and their related transcription factors. Quantification of IL-4 and IFN-γ protein in culture supernatant was performed by enzyme-linked immunosorbent assay (ELISA). PBMC from dogs with SNA produced adequate mRNA encoding IFN-γ and IFN-γ protein. The expression of IL-17A mRNA was significantly greater in PBMC of affected compared with unaffected dogs. The amount of IL-10 mRNA in PBMC from affected dogs decreased after antigen-specific challenge. These results suggest that the incapacity of affected dogs to clear these fungal infections is not related to a defect in Th1 immunity or to an overwhelming regulatory reaction, but rather to an uncontrolled pro-inflammatory reaction driven by Th17 cells.
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Affiliation(s)
- M Vanherberghen
- Companion Animal Clinical Sciences, University of Liège, Belgium.
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Mercier E, Peters IR, Billen F, Battaille G, Clercx C, Day MJ, Peeters D. Potential role of Alternaria and Cladosporium species in canine lymphoplasmacytic rhinitis. J Small Anim Pract 2013; 54:179-83. [PMID: 23496099 DOI: 10.1111/jsap.12049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the possible role of Alternaria and Cladosporium species in the pathogenesis of canine lymphoplasmacytic rhinitis by comparing the amount of specific fungal DNA in nasal mucosal biopsies between dogs without nasal neoplasia and those with lymphoplasmacytic rhinitis or nasal neoplasia. METHODS Quantitative real-time polymerase chain reaction (qPCR) assays detecting DNA from Alternaria and Cladosporium fungi were applied to nasal mucosal biopsies collected from dogs with lymphoplasmacytic rhinitis (n = 8), dogs with nasal neoplasia (n = 10) and control animals (n = 10). A copy number for each sample was calculated using a standard curve of known copy number and differences amongst groups were assessed using Kruskal-Wallis tests. RESULTS No significant difference was found between the groups. Low levels of Alternaria DNA (10-100 copies/PCR) were detected in one sample; very low levels of DNA (<10 copies/qPCR) were detected in 6 samples, and 21 samples were negative. Low levels of Cladosporium DNA were detected in 2 samples; very low levels of DNA in 18; and 8 were negative. CLINICAL SIGNIFICANCE Results of this study reveal that Alternaria and Cladosporium species are part of the canine nasal flora, and that these fungi are probably not involved in the pathogenesis of lymphoplasmacytic rhinitis.
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Affiliation(s)
- E Mercier
- Department of Veterinary Clinical Sciences, Division of Companion Animal Internal Medicine, Faculty of Veterinary Medicine, University of Liège, Sart Tilman, 4000, Liège, Belgium
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Krafft E, Heikkilä H, Jespers P, Peeters D, Day M, Rajamäki M, Mc Entee K, Clercx C. Serum and Bronchoalveolar Lavage Fluid Endothelin-1 Concentrations as Diagnostic Biomarkers of Canine Idiopathic Pulmonary Fibrosis. J Vet Intern Med 2011; 25:990-6. [DOI: 10.1111/j.1939-1676.2011.0766.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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van Schooneveld E, Wouters M, Van der Auwera I, Peeters D, Huget P, van Dam PA, Vermeulen PB, Van Laere SJ, Dirix LY. Detection of circulating miRNAs in serum from patients with breast cancer and their association with the presence of metastatic disease. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Peeters D, van Dam P, Van den Eynden G, Benoy I, Van Laere SJ, van Dam PA, Huget P, Pauwels P, Peeters M, Vermeulen PB, Dirix LY. Detection of circulating tumor cells in patients with advanced breast cancer according to the immunohistochemical subtype. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e21022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Peeters D, Van den Eynden G, Benoy I, Van der Auwera I, Trinh XB, Sas L, Van Laere S, van Dam P, Pauwels P, Peeters M, Vermeulen P, Dirix L. Abstract P3-02-10: Comparison of Circulating Tumour Cells in Peripheral and Central Venous Blood of Patients with Metastatic Breast Cancer: A Pilot Study. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-02-10] [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: Enumeration of circulating tumour cells (CTC), as performed by the CellSearch System (Veridex, Raritan, NJ, USA), has prognostic significance in patients with metastatic breast cancer (MBC). Questions remain on how these cells - if all - are capable to survive in the circulation and ultimately give rise to distant metastases. Experiments in mouse models have shown that CTC only appear transiently in the circulation after injection in the tail vein or left ventricle. Data on the discrete localisation of CTC in the blood stream and CTC kinetics in human breast cancer is still limited. The aim of this pilot study was to directly compare the amount of CTC measured in peripheral and central venous blood samples of patients with MBC in order to reveal possible differences. Methods: So far, we have included 18 patients with MBC presenting at our hospital with either primary metastatic (N=2) or progressive disease (N=16). Most patients suffered from diffuse metastatic involvement and were extensively pretreated. Clinically evident lung metastases were documented in 4/18 patients. Peripheral venous blood (PVB) - obtained from an antecubital vein - and central venous blood (CVB) samples - obtained from the subcutaneous port catheter - were drawn into CellSave Preservative tubes (Immunicon, Huntingdon Valley, PA) and processed in parallel using the CellSearch Circulating Tumor Cell Test (Veridex, Raritan, NJ, USA). With this test, CTC captured from 7.5 mL whole blood, are defined as EpCAM+, nuclear cells (DAPI+), expressing cytokeratins 8/18/19 and lacking CD45 expression.
Results: CTC were detected in both PVB and CVB samples of 16/18 patients. In 2 patients no CTC were detected, neither in PVB nor in CVB. In 16 patients with detectable CTC, the number of CTC was found to be significantly higher in CVB (median: 65; range: 3-4036) than in PVB (median: 45; range: 1-4013) samples (Wilcoxon Signed Ranks Test, P=0.001). When analyzing samples parewise, the number of CTC in CVB was higher than the number of CTC in PVB in 15/16 patients, although marginally in 4 of 15 patients (median ratio CVB/PVB: 1.8; range: 1.0-3.1). Only 1 patient showed a higher number of CTC in PVB (absolute value: 49 CTC/7.5 mL blood) as compared to CVB (absolute value: 41 CTC/7.5 mL blood).
Conclusions: In this study, a substantial decrease in the number of CTC was observed between CVB and PVB of patients with MBC. This difference might be relevant in the clinical setting as a quantitative cut off in the number of CTC is used to distinguish between patients with good and worse prognosis. As hand metastases are most uncommon, the lungs are suggested to function as the main sieve, even in the absence of clinically overt lung metastases. However, further research in larger patient populations and - where feasible - including radial arterial blood sampling, is required in order to confirm these results and to investigate human CTC kinetics in depth.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-02-10.
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Affiliation(s)
- D Peeters
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - G Van den Eynden
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - I Benoy
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - I Van der Auwera
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - XB Trinh
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - L Sas
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - S Van Laere
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - P van Dam
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - P Pauwels
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - M Peeters
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - P Vermeulen
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
| | - L. Dirix
- Laboratory of Pathology GZA Hospitals Sint-Augustinus/University of Antwerp, Belgium; University Hospital Antwerp/University of Antwerp, Belgium; AML, Antwerp, Belgium
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Leunens V, Migchels P, Peeters D, Zeegers-Huyskens TH. Infrared Investigation of the Interaction Between Diphenylketimine and Proton Donors. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bscb.19921010212] [Citation(s) in RCA: 3] [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: 11/08/2022]
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Leroy G, Peeters D, Rosoux-Clarisse F. L'Utilisation D'Orbitales Localisées Dans L'Étude Theorique des Molécules IV. Le Polyéthylène Dans Sa Conformation T. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bscb.19760850902] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lavoué R, van der Lugt J, Day M, Georges M, Busoni V, Merveille A, Poujade A, Peeters D. Progressive Juvenile Glomerulonephropathy in 16 Related French Mastiff (Bordeaux) Dogs. J Vet Intern Med 2010; 24:314-22. [DOI: 10.1111/j.1939-1676.2010.0474.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Elwood C, Devauchelle P, Elliott J, Freiche V, German AJ, Gualtieri M, Hall E, den Hertog E, Neiger R, Peeters D, Roura X, Savary-Bataille K. Emesis in dogs: a review. J Small Anim Pract 2010; 51:4-22. [PMID: 20137004 PMCID: PMC7167204 DOI: 10.1111/j.1748-5827.2009.00820.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2009] [Indexed: 11/26/2022]
Abstract
Emesis is a common presenting sign in small animal practice. It requires a rational approach to management that is based upon a sound understanding of pathophysiology combined with logical decision making. This review, which assesses the weight of available evidence, outlines the physiology of the vomiting reflex, causes of emesis, the consequences of emesis and the approach to clinical management of the vomiting dog. The applicability of diagnostic testing modalities and the merit of traditional approaches to management, such as dietary changes, are discussed. The role and usefulness of both traditional and novel anti-emetic drugs is examined, including in specific circumstances such as following cytotoxic drug treatment. The review also examines areas in which common clinical practice is not necessarily supported by objective evidence and, as such, highlights questions worthy of further clinical research.
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Affiliation(s)
- C Elwood
- Davies Veterinary Specialists, Manor Farm Business Park, Higham Gobion, Hitchin, Hertfordshire SG5 3HR
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Peeters D, Benoy I, Van den Eynden G, Van der Auwera I, Van Laere S, Trinh X, Limame R, Huget P, van Dam P, Vermeulen P, Dirix L. Prognostic Significance of Real-Time RT-PCR Detection of Disseminated Tumour Cells in Bone Marrow and Circulating Tumour Cells in Patients with Breast Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3019] [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: Despite optimal staging and treatment, up to 40% of stage I and II breast cancer (BC) patients will develop recurrent disease over time. These patients are believed to have disseminated tumour cells (DTC) at the time of diagnosis. Detection of minimal disease in bone marrow (BM) has been suggested to be a more direct approach to select metastasis-prone patients among this 'good prognosis group'. Peripheral blood (PB) sampling however is more convenient. The aim of this study was to evaluate whether the detection of DTC in either PB or BM predicts overall survival (OS). The initial analysis was published with a mean follow up time of 786 days (Benoy et al., BrJC 2006). We now report on these data after a mean follow up of nearly 5 years.Material and methods: PB and BM samples were collected from 148 patients with primary (M0, n=116) and metastatic (M+, n=32) BC before the initiation of any local or systemic treatment. PB of healthy volunteers and BM of patients with a nonmalignant breast lesion or a haematological malignancy served as control group. DTC were detected by measuring relative gene expression (RGE) for cytokeratin 19 (CK19) and mammaglobin (MAM), using a quantitative RT-PCR detection method. The 95 percentile of the RGE for CK19 and MAM of the control group was used as cutoff to determine elevation in BC patients. Kaplan-Meier analysis was used to predict OS.Results: Mean follow up time was 1518 days (+/- 719). Elevated CK19 expression was detected in 42 (28%) BM samples and in 22 (15%) PB samples. MAM expression was elevated in 20% (both PB and BM) of the patients with BC. There was a 68% (CK19) and 75% (MAM) concordance between PB and BM samples when classifying the results as either positive or negative. Patients with an elevated CK19 or MAM expression in BM had a worse OS than patients without elevated expression levels (p=0.002 (CK19) and p=0.001 (MAM)). For PB, no statistical significant difference in OS was observed between patients with or without elevated CK19 (p=0.227), but a strong trend for predicting OS was observed according to MAM status (p=0.054). Separate analyses of M0 and M+ patients revealed only a marked difference in OS according to BM CK19 in the M+ patient group. In M0 patients disease free survival (DFS) was not significantly predicted by CK19 and/or MAM status in BM alone (p=0.173 (CK19), p=0.219 (MAM)), but the presence of the double positive phenotype showed a trend for predicting DFS (p=0.059).Conclusions: DTC measured as elevated CK19 or MAM mRNA expression, could be detected in both PB and BM of patients with BC. Only the presence of DTC in BM was highly predictive for OS. However, with longer follow up differences in OS between patients with or without elevated CK19 and particularly MAM expression in PB also tend to become more significant. Furthermore, on the long term, double positivity for CK19/MAM in BM seems to predict DFS in patients with localized BC.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3019.
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Affiliation(s)
- D. Peeters
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - I. Benoy
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - G. Van den Eynden
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - I. Van der Auwera
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - S. Van Laere
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - X. Trinh
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - R. Limame
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - P. Huget
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - P. van Dam
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - P. Vermeulen
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
| | - L. Dirix
- 1Translational Cancer Research Group Antwerp, Oncology Center AZ Sint-Augustinus/University of Antwerp, Belgium
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Vanherberghen M, Day MJ, Delvaux F, Gabriel A, Clercx C, Peeters D. An immunohistochemical study of the inflammatory infiltrate associated with nasal carcinoma in dogs and cats. J Comp Pathol 2009; 141:17-26. [PMID: 19362315 DOI: 10.1016/j.jcpa.2009.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 01/24/2009] [Indexed: 01/07/2023]
Abstract
The aims of this study were to characterize the inflammatory infiltrate associated with nasal carcinoma in dogs and cats and to determine whether this differed between the two species or with different types of carcinoma. Sections from fixed tissue biopsy samples of intranasal carcinoma from 31 dogs and six cats were labelled immunohistochemically to detect expression of the T-lymphocyte marker CD3, class II molecules of the major histocompatibility complex (MHC II), the myelomonocytic antigen MAC387 and immunoglobulin (Ig) G, IgA and IgM within the cytoplasm of plasma cells. All canine carcinomas were heavily infiltrated by MAC387(+) neutrophils, with smaller numbers of MAC387(+) macrophages. T cells were particularly prominent in the infiltrate associated with transitional carcinoma, and in such tumours were frequently mixed with MHC II(+) cells having macrophage or dendritic cell morphology. IgG(+) and IgA(+) plasma cells were detected at the peripheral margins of all types of canine carcinoma. In contrast, feline intranasal carcinoma was invariably associated with a marked infiltration of CD3(+) T cells. The feline tumour infiltrates contained sparse neutrophils and macrophages and few IgG(+) and IgA(+) plasma cells. These findings suggest that qualitatively different immune responses are induced in response to specific types of canine intranasal carcinoma, and that the canine and feline immune response to these neoplasms is also distinct.
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Affiliation(s)
- M Vanherberghen
- Department of Small Animal Clinical Sciences, Section of Internal Medicine, University of Liège, Belgium
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Neirynck V, Willems A, Peeters D, Van Regenmortel N, De laet I, Schoonheydt K, Dits H, Malbrain M. Influence of continuous venovenous hemofiltration on transpulmonary thermodilution-derived parameters. Crit Care 2009. [PMCID: PMC4084160 DOI: 10.1186/cc7438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Billen F, Clercx C, Le Garérrès A, Massart L, Mignon B, Peeters D. Effect of sampling method and incubation temperature on fungal culture in canine sinonasal aspergillosis. J Small Anim Pract 2008; 50:67-72. [PMID: 19037883 DOI: 10.1111/j.1748-5827.2008.00672.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the most appropriate sampling procedure and the effect of incubation temperature on fungal culture in the diagnosis of canine sinonasal aspergillosis (SNA). METHODS Sixteen dogs with SNA and 20 dogs with non-fungal nasal disease entered a prospective study. Nasal secretions and mucosal biopsies were collected in all dogs. Fungal plaques were also sampled in dogs with SNA. Each specimen was taken in duplicate from each dog and incubated at room temperature and 37 degrees C. RESULTS In dogs with SNA, nasal secretions, mucosal biopsies and fungal plaques yielded fungal growth at room temperature in one, one and seven dogs, respectively, whereas fungal growth was obtained at 37 degrees C in three, 12 and 14 dogs, respectively. No specimen collected from any dog with non-fungal nasal disease yielded fungal growth at room temperature or at 37 degrees C. CLINICAL SIGNIFICANCE The diagnosis of canine SNA is more likely to be confirmed following culture of mucosal biopsies or fungal plaques than nasal secretions sampled blindly with swabs. Incubating cultures at 37 degrees C is more likely to provide a diagnostic outcome than when samples are cultured at room temperature. Fungal culture of nasal specimens has good specificity for the diagnosis of SNA in dogs.
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Affiliation(s)
- F Billen
- Department of Clinical Sciences, University of Liège, Boulevard de Colonster, Liège, Belgium
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Billen F, Peeters D, Peters IR, Helps CR, Huynen P, De Mol P, Massart L, Day MJ, Clercx C. Comparison of the value of measurement of serum galactomannan and Aspergillus-specific antibodies in the diagnosis of canine sino-nasal aspergillosis. Vet Microbiol 2008; 133:358-65. [PMID: 18768268 DOI: 10.1016/j.vetmic.2008.07.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [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: 05/20/2008] [Revised: 07/18/2008] [Accepted: 07/24/2008] [Indexed: 11/18/2022]
Abstract
Serology is currently used for the diagnosis of canine sino-nasal aspergillosis (SNA). However, the accuracy of serological testing using commercially available, standardized purified antigen preparations of Aspergillus (CAPurAspAg) has only been poorly documented. The aim of the present study was to assess the diagnostic value of an agar-gel double immunodiffusion (AGDD) test and an anti-Aspergillus IgG ELISA, using CAPurAspAg and the commercially available Platelia test for the detection of serum galactomannan. Sera from 17 dogs with SNA, 18 dogs with a nasal tumour (NT), 11 dogs with lymphoplasmacytic rhinitis (LPR) and 33 control dogs were tested with the 3 methods. AGDD result was positive in 76.5% of dogs with SNA, whereas all sera from dogs with non-fungal nasal disease and control dogs were negative. A positive IgG ELISA result was obtained in 88% of dogs with SNA and in 18% of dogs with LPR. All patients with NT and control dogs had a negative IgG ELISA result. The Platelia test was positive in 24% of dogs with SNA, 11% of dogs with NT, 9% of dogs with LPR and 24% of control dogs. The results of this study suggest that (1) the detection of serum Aspergillus-specific antibodies with AGDD or ELISA, using CAPurAspAg, provides excellent specificity and good sensitivity, (2) the specificity is higher for AGDD (100%) than for ELISA (96.8%) while sensitivity is higher for ELISA (88.2%) than for AGDD (76.5%) and (3) serum galactomannan quantification with the Plateliat test is unreliable for the diagnosis of canine SNA.
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Affiliation(s)
- F Billen
- Department of Veterinary Clinical Sciences, University of Liège, Boulevard de Colonster 20(B44), 4000 Liège, Belgium.
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Poncelet L, Coppens A, Peeters D, Bianchi E, Grant CK, Kadhim H. Detection of antigenic heterogeneity in feline coronavirus nucleocapsid in feline pyogranulomatous meningoencephalitis. Vet Pathol 2008; 45:140-53. [PMID: 18424826 DOI: 10.1354/vp.45-2-140] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [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]
Abstract
A new monoclonal antibody (mAb), CCV2-2, was compared with the widely used FIPV3-70 mAb, both directed against canine coronavirus (CCoV), as a diagnostic and research tool. Western blot showed that both anti-CCoV mAbs only reacted with a protein of 50 kD, a weight consistent with the feline coronavirus (FCoV) viral nucleocapsid. A competitive inhibition enzyme-linked immunosorbent assay showed that the 2 recognized epitopes are distinct. Preincubation of CCV2-2 mAb with FCoV antigen suppressed the immunostaining. Formalin-fixed, paraffin-embedded sections from brains of 15 cats with the dry form of feline infectious peritonitis (FIP) were examined by immunohistochemistry. Immunohistochemistry was performed with both anti-CCoV mAbs, either on consecutive or on the same sections. A myeloid-histiocytic marker, MAC 387, was also used to identify FIP virus-infected cells. In all regions where MAC 387-positive cells were present, positive staining with the CCV2-2 mAb was systematically detected, except at some levels in 1 cat. In contrast, none or only a few cells were positive for the FIPV3-70 mAb. Double immunostaining showed macrophages that were immunopositive for either CCV2-2 alone or alternatively for CCV2-2 and FIPV3-70 mAbs. This reveals the coexistence of 2 cohorts of phagocytes whose FIP viral contents differed by the presence or absence of the FIPV3-70-recognized epitope. These findings provide evidence for antigenic heterogeneity in coronavirus nucleocapsid protein in FIP lesions, a result that is in line with molecular observations. In addition, we provide for the first time morphologic depiction of viral variants distribution in these lesions.
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Affiliation(s)
- L Poncelet
- Anatomy/Embryology Department, CP 619, Faculty of Medicine, Free University of Brussels, Route de Lennik 808, Brussels, Belgium.
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Bolognin M, Kirschvink N, Leemans J, De Buscher V, Snaps F, Gustin P, Peeters D, Clercx C. Characterisation of the acute and reversible airway inflammation induced by cadmium chloride inhalation in healthy dogs and evaluation of the effects of salbutamol and prednisolone. Vet J 2007; 179:443-50. [PMID: 18037312 DOI: 10.1016/j.tvjl.2007.10.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 09/19/2007] [Accepted: 10/02/2007] [Indexed: 10/22/2022]
Abstract
The aims of this study were firstly to characterise a model of subclinical and reversible bronchial inflammation induced by cadmium chloride inhalation in healthy dogs and then to examine the effect of prednisolone or salbutamol treatment on the resulting bronchitis. The model characterisation and the effects of treatment were studied using clinical symptoms, haematology, thoracic radiography, bronchoscopy and bronchoalveolar lavage, barometric whole-body plethysmography and histamine broncho-provocation tests. In addition, the activity of matrix metalloproteinases (MMP)-2 and -9 were determined in serum and bronchoalveolar lavage fluid (BALF). Cadmium inhalation induced: (1) a transient bronchial inflammation, dominated by neutrophils; (2) a neutrophilia of the blood that persisted for up to 4 weeks; (3) a transient increased bronchial reactivity, and (4) a significant increase in MMP-9 activity in the BALF. Prednisolone treatment reduced the influx of inflammatory cells into the BALF, but not significantly, had no effect on pulmonary function, and did not reduce of airway hypersensitivity. Salbutamol had almost no effect on any of the parameters investigated.
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Affiliation(s)
- M Bolognin
- Department for Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium.
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Billen F, Peeters D, Dehard S, Day MJ, Clercx C. Distribution of leucocyte subsets in the canine pharyngeal tonsil. J Comp Pathol 2006; 135:63-73. [PMID: 16959260 DOI: 10.1016/j.jcpa.2006.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 04/15/2006] [Indexed: 10/24/2022]
Abstract
This report describes the distribution and nature of lymphoid tissue in the nasopharyngeal mucosa of six puppies (mean age+/-SD, 0.3+/-0.25 years) and eight adult dogs (mean age+/-SD, 8.8+/-2.67 years) without respiratory disease. A non-encapsulated area of organized mucosa-associated lymphoid tissue was observed in the caudal part of the posterior wall of the nasopharynx, distal to the openings of the auditory tubes. This structure was consistent with the pharyngeal tonsil and was microscopically more extensive in puppies than in adult dogs. Histochemistry and immunohistochemistry were used to characterize and enumerate the leucocyte subsets in this part of the nasopharynx. Mast cells were found immediately beneath the respiratory epithelium but were also scattered in the glandular and muscular tissue. IgA(+) plasma cells outnumbered IgG(+) and IgM(+) plasma cells, especially in the glandular tissue. All classes of plasma cells were present in significantly greater numbers in adults than in puppies. MHC class II(+) cells were mainly observed in areas containing diffuse and follicular aggregates of lymphoid cells. Both MHC class II(+) cells and CD1c(+) cells with a dendritic morphology were predominantly found immediately beneath or within the epithelium, and cells expressing these markers were more abundant in puppies than in adult dogs. The anti-L1 marker labelled low numbers of cells with a neutrophilic morphology, which were significantly more abundant in puppies than in adult dogs. The majority of lymphoid cells were CD3(+) T lymphocytes and these were particularly abundant in areas containing aggregates of lymphoid cells; CD4(+), CD8(+) and TCR alphabeta(+) cells had the same distribution as the CD3(+) cells. CD4(+) cells were more numerous than CD8(+) cells. The quantitative and qualitative data obtained will enable comparisons to be made with similar studies in dogs suffering from nasopharyngeal diseases, or when the local immune system needs to be investigated.
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Affiliation(s)
- F Billen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20 B44, 4000 Liège, Belgium, and (*)Division of Veterinary Pathology, Infection and Immunity, School of Clinical Veterinary Science, University of Bristol, Langford BS40 5DU, UK
| | - D Peeters
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20 B44, 4000 Liège, Belgium, and (*)Division of Veterinary Pathology, Infection and Immunity, School of Clinical Veterinary Science, University of Bristol, Langford BS40 5DU, UK
| | - S Dehard
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20 B44, 4000 Liège, Belgium, and (*)Division of Veterinary Pathology, Infection and Immunity, School of Clinical Veterinary Science, University of Bristol, Langford BS40 5DU, UK
| | - M J Day
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20 B44, 4000 Liège, Belgium, and (*)Division of Veterinary Pathology, Infection and Immunity, School of Clinical Veterinary Science, University of Bristol, Langford BS40 5DU, UK
| | - C Clercx
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Boulevard de Colonster 20 B44, 4000 Liège, Belgium, and (*)Division of Veterinary Pathology, Infection and Immunity, School of Clinical Veterinary Science, University of Bristol, Langford BS40 5DU, UK
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Abstract
A nine-month-old miniature doberman was referred for the evaluation of chronic icterus. History and clinical and histopathological findings were supportive of a diagnosis of drug-induced destructive cholangitis. The main histopathological findings were canalicular, centrilobular cholestasis and ductopenia with moderate inflammatory infiltrate. The dog had received three types of treatment for demodicosis before the onset of jaundice. Amoxicillin-clavulanate, amitraz, milbemycin oxime or an interaction between two of the three drugs may have been responsible for the destructive cholangitis.
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Affiliation(s)
- A Gabriel
- Department of Small Animal Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
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Gabriel A, Poncelet L, Van Ham L, Clercx C, Braund KG, Bhatti S, Detilleux J, Peeters D. Laryngeal paralysis-polyneuropathy complex in young related Pyrenean mountain dogs. J Small Anim Pract 2006; 47:144-9. [PMID: 16512846 DOI: 10.1111/j.1748-5827.2006.00058.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To characterise clinical, electrophysiological and histopathological findings. To analyse pedigree information in six young related Pyrenean mountain dogs with laryngeal paralysis-polyneuropathy complex (LP-PNC). METHODS A retrospective study of clinical records and pedigrees of six young related Pyrenean mountain dogs with LP-PNC was carried out. RESULTS All dogs were presented with laryngeal paralysis and concurrent megaoesophagus. Electrodiagnostic testing was performed in three dogs and showed electrophysiological abnormalities in the distal appendicular muscles. Histopathological findings of peripheral nerve samples were dominated by distal axonal degeneration. Clinical, electrophysiological and histopathological findings were supportive of a diagnosis of degenerative, sensorimotor LP-PNC, similar to that reported in young dalmatians and rottweilers. All dogs died or were euthanased by two years of age. An autosomal recessive mode of inheritance was suspected based on pedigree analysis. CLINICAL SIGNIFICANCE Congenital LP-PNC should be suspected in any young dog presenting with laryngeal dysfunction and other concurrent neurological abnormalities. The prognosis is usually poor.
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Affiliation(s)
- A Gabriel
- Department of Small Animal Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Bd Colonster 20, B44, 4000 Liège, Belgium
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Peeters D, Peters IR, Clercx C, Day MJ. Real-time RT-PCR quantification of mRNA encoding cytokines, CC chemokines and CCR3 in bronchial biopsies from dogs with eosinophilic bronchopneumopathy. Vet Immunol Immunopathol 2006; 110:65-77. [PMID: 16226318 DOI: 10.1016/j.vetimm.2005.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Revised: 09/05/2005] [Accepted: 09/08/2005] [Indexed: 10/25/2022]
Abstract
Idiopathic canine eosinophilic bronchopneumopathy (EBP) is a disease characterized by eosinophilic infiltration of the pulmonary interstitium and bronchial mucosa, a cause for which has not yet been discovered. A recent study, examining the relative proportion of various lymphocyte cell subsets within bronchoalveolar lavage fluid from dogs with EBP, has shown a selective increase in CD4(+) T-cells and a selective decrease in CD8(+) T-cells, suggesting that a similar Th2 immune response might occur in EBP. The aim of the present study was to determine the profile of cytokine, chemokine and CC chemokine receptor 3 (CCR3) messenger RNA (mRNA) expression in bronchial tissue from dogs with EBP. Real-time RT-PCR assays were used for the quantification of mRNA encoding for a panel of cytokines, CC chemokines and CCR3 in perendoscopic bronchial biopsies from eight dogs with EBP and seven age-matched control dogs. Messenger RNA transcribed from the housekeeping gene glyceraldehyde-3-phosphate dehydrogenase was used for normalisation of the threshold cycle in order to determine the relative copy numbers of the transcripts. No significant difference in the expression of any cytokine, MCP-1, -2, -4 and CCR3 was found between control and EBP dogs. The expression of transcript for MCP-3, eotaxin-2 and -3 was significantly greater in bronchial biopsies from dogs with EBP than in samples from control dogs while there was significantly less mRNA encoding RANTES in the mucosa of dogs with EBP. In conclusion, the cytokine mRNA expression profile in perendoscopic bronchial biopsies is similar in dogs with EBP and dogs without respiratory disease. Further studies on the quantification of mRNA encoding cytokines in isolated T lymphocytes from bronchoalveolar lavage fluid or bronchial biopsies are needed before any conclusion on the cytokine profile in canine EBP can be drawn. Eotaxin-2, -3 and MCP-3 appear to be implicated in the pathogenesis of the disease.
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Affiliation(s)
- D Peeters
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Sart-Tilman B44, 4000 Liège, Belgium.
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Peeters D, Day MJ, Clercx C. Distribution of leucocyte subsets in bronchial mucosa from dogs with eosinophilic bronchopneumopathy. J Comp Pathol 2005; 133:128-35. [PMID: 16026798 DOI: 10.1016/j.jcpa.2005.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Accepted: 02/15/2005] [Indexed: 11/29/2022]
Abstract
Immunohistochemistry was used to characterize the distribution of leucocyte subsets in the bronchial mucosa of 11 dogs with idiopathic eosinophilic bronchopneumopathy (EBP). Formalin-fixed tissues from all dogs were included in the study, but frozen tissue from only one dog was available. MHC class II(+) cells were found in moderate numbers in the lamina propria (LP). These cells were morphologically either dendritic-like cells or macrophages, but many macrophages did not express MHC class II. Such molecules were expressed by occasional fibroblasts. L1(+) cells, which formed a relatively small component of the LP inflammatory infiltrate, were morphologically either macrophages or polymorphonuclear cells (probably eosinophils). IgA(+) plasma cells were found in varying numbers in the LP, mostly in association with glandular tissue. IgG(+) plasma cells were less common, and IgM(+) plasma cells were present in low numbers. Many CD3(+) cells were present in the LP. In the single case from which frozen tissue was available, most of the lymphocytes were labelled with CD4 marker, while smaller numbers were CD8(+) T cells. Most of the lymphocytes in this case were positively labelled with T-cell receptor (TCR)-alphabeta marker. TCR-gammadelta(+) cells, although less common, were present in significant numbers throughout the LP. CDlc(+) dendritic cells were numerous in the epithelium and in the LP, immediately beneath the basement membrane. These findings, which were similar to those described in human asthma, are suggestive of a Th2 dominant immune response in canine EBP. As in human asthma, this provides a possible basis for new forms of treatment in canine EBP.
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Affiliation(s)
- D Peeters
- Department of Clinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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Robiette R, Defacqz N, Peeters D, Marchand-Brynaert J. A Novel Strategy Towards Aminophosphonic Derivatives Based on the Diels-Alder Cycloaddition: Experimental and Theoretical Approaches. Curr Org Synth 2005. [DOI: 10.2174/157017905774322668] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Peeters D, Peters IR, Farnir F, Clercx C, Day MJ. Real-time RT-PCR quantification of mRNA encoding cytokines and chemokines in histologically normal canine nasal, bronchial and pulmonary tissue. Vet Immunol Immunopathol 2005; 104:195-204. [PMID: 15734540 DOI: 10.1016/j.vetimm.2004.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2004] [Revised: 11/17/2004] [Accepted: 11/17/2004] [Indexed: 11/26/2022]
Abstract
Cytokines and chemokines are likely to be involved in the pathogenesis of inflammatory diseases of the canine respiratory tract. The roles and relative amounts of these molecules have not yet been defined in the respiratory mucosa of normal dogs or dogs with naturally acquired respiratory inflammation. In the present study, real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays were employed to quantify messenger RNA (mRNA) encoding the chemokines monocyte chemotactic protein (MCP)-2, eotaxin-2 and eotaxin-3, and the cytokines interleukin-4 (IL-4), IL-5, IL-6, IL-10, IL-12p40, IL-18, interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) in normal nasal, bronchial and pulmonary tissues from puppies (n = 4) and from adult dogs (n = 7). There was no significant difference in the expression of any transcript between puppies and adult dogs at any of the anatomical sites examined. The expression of mRNA encoding eotaxin-2 and eotaxin-3 increased significantly with progression from the nasal mucosa to pulmonary parenchyma but expression of MCP-2 mRNA did not show this trend. At all levels of the respiratory mucosa, the most abundant transcripts were those encoding IL-18 and TGF-beta. Transcripts encoding IL-6, IL-10, IL-12 and TNF-alpha were approximately ten-fold less abundant, and IL-4, IL-5 and IFN-gamma were the least abundant templates. There was significantly different amount of mRNA encoding IL-5, IL-18 and TNF-alpha between particular anatomical levels of the respiratory mucosa while the mRNA expression of the other cytokines was similar at all anatomical sites. The results of the present study will enable comparisons to be made with results obtained from similar samples obtained from dogs with nasal, bronchial or pulmonary diseases.
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Affiliation(s)
- D Peeters
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Sart-Tilman B44, 4000 Liège, Belgium
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Peeters D, Day MJ, Farnir F, Moore P, Clercx C. Distribution of leucocyte subsets in the canine respiratory tract. J Comp Pathol 2005; 132:261-72. [PMID: 15893984 DOI: 10.1016/j.jcpa.2004.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2004] [Accepted: 10/18/2004] [Indexed: 11/23/2022]
Abstract
Histochemistry and immunohistochemistry were used to characterize leucocyte subsets in the respiratory tract of 15 outbred dogs (five aged <6 months and 10 aged >1 year) that had no evidence of respiratory disease. No organized nose- or bronchus-associated lymphoid tissue was observed in any of the sections examined. IgA(+) plasma cells predominated in nasal mucosa and in all parts of the bronchial tree, with fewer IgG(+) and IgM(+) plasma cells. The numbers of IgA(+) and IgM(+) cells were significantly greater in the nasal mucosa than in any other part of the respiratory mucosa. There were significantly fewer IgA(+), IgG(+) and IgM(+) cells in all parts of the respiratory tract in the puppies than in the adults. The number and distribution of mast cells and cells expressing MHC class II, L1 or CD1c were recorded. Mast cells were mainly found in the subepithelial lamina propria of nasal and bronchial mucosa and in the alveolar interstitium, and cells expressing IgE had a similar distribution. Mast cells were also present within muscle layers of the bronchial tree. The numbers of mast cells and MHC class II(+) cells were significantly greater in the nasal mucosa than in any other part of the respiratory mucosa. In the nose, carina and primary and secondary bronchus, there were significantly more mast cells and MHC class II(+) cells in puppies than in adult dogs, whereas the numbers of L1(+) cells and CD1c(+) cells in most sites were significantly greater in older dogs. There were significantly more CD3(+) and CD8(+) cells in the nasal mucosa than in any part of the bronchial mucosa. In most parts of the respiratory mucosa, CD4(+), CD8(+) and TCR alphabeta(+) cells were present in significantly greater numbers in adults than in puppies. All parts of the respiratory tract had similar numbers of mucosal CD4(+) and CD8(+) T lymphocytes. TCR gammadelta(+) cells were absent or sparse in all samples. These data, obtained from dogs without respiratory disease, will enable comparisons to be made with dogs suffering from infectious or inflammatory nasal, bronchial and pulmonary diseases.
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Affiliation(s)
- D Peeters
- Department of Clinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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Abstract
In this study, histochemistry and immunohistochemistry were used to characterize the phenotype and distribution of leucocytes in the distal nasal mucosa of 15 dogs with nasal aspergillosis. The most consistent histopathological finding was a severe, predominantly lymphoplasmacytic, inflammatory infiltration of the lamina propria. Fungal hyphae were not observed to invade the mucosa but were found at the mucosal surface and within material collected from the nasal cavity. The main immunohistochemical findings were (1) a predominance of IgG(+) plasma cells over IgA(+) and IgM(+) plasma cells, (2) significant numbers of macrophages and dendritic cells expressing MHC class II molecules, (3) macrophages and neutrophils expressing L1 antigen and (4) a mixture of CD4(+) and CD8(+) T cells. These findings are consistent with a dominant Th1-regulated cell-mediated immune response. The nature of the inflammatory infiltrate and the lack of invasiveness of the mucosa by the fungus, together with the clinical course of the disease and the apparent immunocompetence of the affected dogs, suggest that canine nasal aspergillosis resembles the chronic erosive non-invasive fungal sinusitis described in human patients.
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Affiliation(s)
- D Peeters
- Department of Clinical Veterinary Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
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Abstract
A six-year-old, male dobermann was presented with a history of dyspnoea and bouts of coughing. Radiography and computed tomography of the thorax showed pleural effusion and a well-circumscribed, calcified mass of 10 cm in diameter, appearing to originate from the left first rib. Thoracocentesis revealed that the pleural fluid was chylous in nature. An incisional biopsy was performed, which gave a histological diagnosis of chondroma. Resolution of the chylothorax after en-bloc surgical removal of the tumour suggested that the rib tumour was the initiating cause of the chylothorax. Seventeen months later, rib neoplasia recurred without pleural effusion, and was removed successfully. To the authors' knowledge, rib chondroma, which is an unusual tumour in dogs, has not been previously documented as a cause of chylothorax.
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Affiliation(s)
- S Watine
- Small Animal Internal Medicine, Department of Clinical Sciences, College of Veterinary Medicine, University of Liège, 20 boulevard de Colonster B44, 4000 Liège, Belgium
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