1
|
Köbel M, Kang E, Weir A, Rambau PF, Lee C, Nelson GS, Ghatage P, Meagher NS, Riggan MJ, Alsop J, Anglesio MS, Beckmann MW, Bisinotto C, Boisen M, Boros J, Brand AH, Brooks‐Wilson A, Carney ME, Coulson P, Courtney‐Brooks M, Cushing‐Haugen KL, Cybulski C, Deen S, El‐Bahrawy MA, Elishaev E, Erber R, Fereday S, Fischer A, Gayther SA, Barquin‐Garcia A, Gentry‐Maharaj A, Gilks CB, Gronwald H, Grube M, Harnett PR, Harris HR, Hartkopf AD, Hartmann A, Hein A, Hendley J, Hernandez BY, Huang Y, Jakubowska A, Jimenez‐Linan M, Jones ME, Kennedy CJ, Kluz T, Koziak JM, Lesnock J, Lester J, Lubiński J, Longacre TA, Lycke M, Mateoiu C, McCauley BM, McGuire V, Ney B, Olawaiye A, Orsulic S, Osorio A, Paz‐Ares L, Ramón y Cajal T, Rothstein JH, Ruebner M, Schoemaker MJ, Shah M, Sharma R, Sherman ME, Shvetsov YB, Singh N, Steed H, Storr SJ, Talhouk A, Traficante N, Wang C, Whittemore AS, Widschwendter M, Wilkens LR, Winham SJ, Benitez J, Berchuck A, Bowtell DD, Candido dos Reis FJ, Campbell I, Cook LS, DeFazio A, Doherty JA, Fasching PA, Fortner RT, García MJ, Goodman MT, Goode EL, Gronwald J, Huntsman DG, Karlan BY, Kelemen LE, Kommoss S, Le ND, Martin SG, Menon U, Modugno F, Pharoah PDP, Schildkraut JM, Sieh W, Staebler A, Sundfeldt K, Swerdlow AJ, Ramus SJ, Brenton JD. p53 and ovarian carcinoma survival: an Ovarian Tumor Tissue Analysis consortium study. J Pathol Clin Res 2023; 9:208-222. [PMID: 36948887 PMCID: PMC10073933 DOI: 10.1002/cjp2.311] [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: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 03/24/2023]
Abstract
Our objective was to test whether p53 expression status is associated with survival for women diagnosed with the most common ovarian carcinoma histotypes (high-grade serous carcinoma [HGSC], endometrioid carcinoma [EC], and clear cell carcinoma [CCC]) using a large multi-institutional cohort from the Ovarian Tumor Tissue Analysis (OTTA) consortium. p53 expression was assessed on 6,678 cases represented on tissue microarrays from 25 participating OTTA study sites using a previously validated immunohistochemical (IHC) assay as a surrogate for the presence and functional effect of TP53 mutations. Three abnormal expression patterns (overexpression, complete absence, and cytoplasmic) and the normal (wild type) pattern were recorded. Survival analyses were performed by histotype. The frequency of abnormal p53 expression was 93.4% (4,630/4,957) in HGSC compared to 11.9% (116/973) in EC and 11.5% (86/748) in CCC. In HGSC, there were no differences in overall survival across the abnormal p53 expression patterns. However, in EC and CCC, abnormal p53 expression was associated with an increased risk of death for women diagnosed with EC in multivariate analysis compared to normal p53 as the reference (hazard ratio [HR] = 2.18, 95% confidence interval [CI] 1.36-3.47, p = 0.0011) and with CCC (HR = 1.57, 95% CI 1.11-2.22, p = 0.012). Abnormal p53 was also associated with shorter overall survival in The International Federation of Gynecology and Obstetrics stage I/II EC and CCC. Our study provides further evidence that functional groups of TP53 mutations assessed by abnormal surrogate p53 IHC patterns are not associated with survival in HGSC. In contrast, we validate that abnormal p53 IHC is a strong independent prognostic marker for EC and demonstrate for the first time an independent prognostic association of abnormal p53 IHC with overall survival in patients with CCC.
Collapse
Affiliation(s)
- Martin Köbel
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| | - Eun‐Young Kang
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| | - Ashley Weir
- School of Clinical MedicineUNSW Medicine and Health, University of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer Program, Lowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
| | - Peter F Rambau
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
- Pathology DepartmentCatholic University of Health and Allied Sciences‐BugandoMwanzaTanzania
| | - Cheng‐Han Lee
- Department of Pathology and Laboratory MedicineUniversity of AlbertaEdmontonABCanada
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Nicola S Meagher
- School of Clinical MedicineUNSW Medicine and Health, University of NSW SydneySydneyNew South WalesAustralia
- The Daffodil CentreThe University of Sydney, a Joint Venture with Cancer Council NSWSydneyNew South WalesAustralia
| | - Marjorie J Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic OncologyDuke University Medical CenterDurhamNCUSA
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Michael S Anglesio
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBCCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British Columbia, BC Cancer, and Vancouver General HospitalVancouverBCCanada
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Christiani Bisinotto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Michelle Boisen
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Jessica Boros
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Alison H Brand
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | | | - Michael E Carney
- Department of Obstetrics and Gynecology, John A. Burns School of MedicineUniversity of HawaiiHonoluluHIUSA
| | - Penny Coulson
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Madeleine Courtney‐Brooks
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Kara L Cushing‐Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattleWAUSA
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Suha Deen
- Department of HistopathologyNottingham University Hospitals NHS Trust, Queen's Medical CentreNottinghamUK
| | - Mona A El‐Bahrawy
- Department of Metabolism, Digestion and ReproductionImperial College London, Hammersmith HospitalLondonUK
| | - Esther Elishaev
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Sian Fereday
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - AOCS Group
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- QIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Anna Fischer
- Institute of Pathology and Neuropathology, Tuebingen University HospitalTuebingenGermany
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | | | - Aleksandra Gentry‐Maharaj
- MRC Clinical Trials UnitInstitute of Clinical Trials & Methodology, University College LondonLondonUK
| | - C Blake Gilks
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Helena Gronwald
- Department of Propaedeutics, Physical Diagnostics and Dental PhysiotherapyPomeranian Medical UniversitySzczecinPoland
| | - Marcel Grube
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Paul R Harnett
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
- Crown Princess Mary Cancer CentreWestmead HospitalSydneyNew South WalesAustralia
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Andreas D Hartkopf
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
- Department of Gynecology and ObstetricsUniversity Hospital of UlmUlmGermany
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Joy Hendley
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Brenda Y Hernandez
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Yajue Huang
- Department of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
- Independent Laboratory of Molecular Biology and Genetic DiagnosticsPomeranian Medical UniversitySzczecinPoland
| | | | - Michael E Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Catherine J Kennedy
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Tomasz Kluz
- Department of Gynecology and ObstetricsInstitute of Medical Sciences, Medical College of Rzeszow UniversityRzeszówPoland
| | | | - Jaime Lesnock
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCAUSA
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Teri A Longacre
- Department of PathologyStanford University School of MedicineStanfordCAUSA
| | - Maria Lycke
- Department of Obstetrics and GynecologyInstitute of Clinical Science, Sahlgrenska University Hospital, University of GothenburgGothenburgSweden
| | | | - Bryan M McCauley
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo ClinicRochesterMNUSA
| | - Valerie McGuire
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCAUSA
| | - Britta Ney
- Institute of Pathology and Neuropathology, Tuebingen University HospitalTuebingenGermany
| | - Alexander Olawaiye
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCAUSA
| | - Ana Osorio
- Genetics Service, Fundación Jiménez DíazMadridSpain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
| | - Luis Paz‐Ares
- H12O‐CNIO Lung Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO)MadridSpain
- Oncology DepartmentHospital Universitario 12 de OctubreMadridSpain
| | | | - Joseph H Rothstein
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNYUSA
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Minouk J Schoemaker
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic OncologyWestmead HospitalSydneyNew South WalesAustralia
| | - Mark E Sherman
- Department of Health Sciences Research, Mayo ClinicJacksonvilleFLUSA
| | - Yurii B Shvetsov
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Naveena Singh
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyUniversity of AlbertaEdmontonABCanada
- Section of Gynecologic Oncology Surgery, North Zone, Alberta Health ServicesEdmontonABCanada
| | - Sarah J Storr
- Nottingham Breast Cancer Research CentreBiodiscovery Institute, University of NottinghamNottinghamUK
| | - Aline Talhouk
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBCCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British Columbia, BC Cancer, and Vancouver General HospitalVancouverBCCanada
| | - Nadia Traficante
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo ClinicRochesterMNUSA
| | - Alice S Whittemore
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCAUSA
- Department of Biomedical Data ScienceStanford University School of MedicineStanfordCAUSA
| | | | - Lynne R Wilkens
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Stacey J Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo ClinicRochesterMNUSA
| | - Javier Benitez
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO)MadridSpain
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic OncologyDuke University Medical CenterDurhamNCUSA
| | - David D Bowtell
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Ian Campbell
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Linda S Cook
- Epidemiology, School of Public HealthUniversity of ColoradoAuroraCOUSA
- Community Health Sciences, University of CalgaryCalgaryABCanada
| | - Anna DeFazio
- The Daffodil CentreThe University of Sydney, a Joint Venture with Cancer Council NSWSydneyNew South WalesAustralia
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health SciencesUniversity of UtahSalt Lake CityUTUSA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)HeidelbergGermany
- Department of Research, Cancer Registry of NorwayOsloNorway
| | - María J García
- Computational Oncology Group, Structural Biology Programme, Spanish National Cancer Research Centre (CNIO)MadridSpain
| | - Marc T Goodman
- Cancer Prevention and Control Program, Cedars‐Sinai Cancer, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo ClinicRochesterMNUSA
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - David G Huntsman
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBCCanada
- Department of Molecular Oncology, BC Cancer Research CentreVancouverBCCanada
| | - Beth Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCAUSA
| | - Linda E Kelemen
- Division of Acute Disease Epidemiology, South Carolina Department of Health & Environmental ControlColumbiaSCUSA
| | - Stefan Kommoss
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Nhu D Le
- Cancer Control Research, BC Cancer AgencyVancouverBCCanada
| | - Stewart G Martin
- Nottingham Breast Cancer Research CentreBiodiscovery Institute, University of NottinghamNottinghamUK
| | - Usha Menon
- MRC Clinical Trials UnitInstitute of Clinical Trials & Methodology, University College LondonLondonUK
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Department of EpidemiologyUniversity of Pittsburgh School of Public HealthPittsburghPAUSA
- Women's Cancer Research CenterMagee‐Womens Research Institute and Hillman Cancer CenterPittsburghPAUSA
| | - Paul DP Pharoah
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
- Department of Computational Biomedicine, Cedars‐Sinai Medical CenterWest HollywoodCAUSA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaGAUSA
| | - Weiva Sieh
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNYUSA
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Annette Staebler
- Institute of Pathology and Neuropathology, Tuebingen University HospitalTuebingenGermany
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical ScienceSahlgrenska Center for Cancer Research, University of GothenburgGothenburgSweden
| | - Anthony J Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUK
| | - Susan J Ramus
- School of Clinical MedicineUNSW Medicine and Health, University of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer Program, Lowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of CambridgeCambridgeUK
| |
Collapse
|
2
|
Wang C, Block MS, Cunningham JM, Sherman ME, McCauley BM, Armasu SM, Vierkant RA, Traficante N, Talhouk A, Ramus SJ, Pejovic N, Köbel M, Jorgensen BD, Garsed DW, Fereday S, Doherty JA, Ariyaratne D, Anglesio MS, Widschwendter M, Pejovic T, Bosquet JG, Bowtell DD, Winham SJ, Goode EL. Methylation Signature Implicated in Immuno-Suppressive Activities in Tubo-Ovarian High-Grade Serous Carcinoma. Cancer Epidemiol Biomarkers Prev 2023; 32:542-549. [PMID: 36790339 PMCID: PMC10073286 DOI: 10.1158/1055-9965.epi-22-0941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/07/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Better understanding of prognostic factors in tubo-ovarian high-grade serous carcinoma (HGSC) is critical, as diagnosis confers an aggressive disease course. Variation in tumor DNA methylation shows promise predicting outcome, yet prior studies were largely platform-specific and unable to evaluate multiple molecular features. METHODS We analyzed genome-wide DNA methylation in 1,040 frozen HGSC, including 325 previously reported upon, seeking a multi-platform quantitative methylation signature that we evaluated in relation to clinical features, tumor characteristics, time to recurrence/death, extent of CD8+ tumor-infiltrating lymphocytes (TIL), gene expression molecular subtypes, and gene expression of the ATP-binding cassette transporter TAP1. RESULTS Methylation signature was associated with shorter time to recurrence, independent of clinical factors (N = 715 new set, hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.10-2.46; P = 0.015; N = 325 published set HR, 2.87; 95% CI, 2.17-3.81; P = 2.2 × 10-13) and remained prognostic after adjustment for gene expression molecular subtype and TAP1 expression (N = 599; HR, 2.22; 95% CI, 1.66-2.95; P = 4.1 × 10-8). Methylation signature was inversely related to CD8+ TIL levels (P = 2.4 × 10-7) and TAP1 expression (P = 0.0011) and was associated with gene expression molecular subtype (P = 5.9 × 10-4) in covariate-adjusted analysis. CONCLUSIONS Multi-center analysis identified a novel quantitative tumor methylation signature of HGSC applicable to numerous commercially available platforms indicative of shorter time to recurrence/death, adjusting for other factors. Along with immune cell composition analysis, these results suggest a role for DNA methylation in the immunosuppressive microenvironment. IMPACT This work aids in identification of targetable epigenome processes and stratification of patients for whom tailored treatment may be most beneficial.
Collapse
Affiliation(s)
- Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | | | - Julie M. Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mark E. Sherman
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Bryan M. McCauley
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Sebastian M. Armasu
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Robert A. Vierkant
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Australian Ovarian Cancer Study Group
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research and Department of Gynaecological Oncology, Westmead Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Aline Talhouk
- British Columbia’s Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Susan J. Ramus
- School of Clinical Medicine, Faculty of Medicine, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | | | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Brooke D. Jorgensen
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Dale W. Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Michael S. Anglesio
- British Columbia’s Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Martin Widschwendter
- European Translational Oncology Prevention and Screening (EUTOPS) Institute, Universität Innsbruck, Hall in Tirol, Austria
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Jesus Gonzalez Bosquet
- Department of Obstetrics and Gynecologic, Division of Gynecologic Oncology, University of Iowa, Iowa City, IA, USA
| | - David D. Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Ellen L. Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
3
|
Kang E, Weir A, Meagher NS, Farrington K, Nelson GS, Ghatage P, Lee C, Riggan MJ, Bolithon A, Popovic G, Leung B, Tang K, Lambie N, Millstein J, Alsop J, Anglesio MS, Ataseven B, Barlow E, Beckmann MW, Berger J, Bisinotto C, Bösmüller H, Boros J, Brand AH, Brooks‐Wilson A, Brucker SY, Carney ME, Casablanca Y, Cazorla‐Jiménez A, Cohen PA, Conrads TP, Cook LS, Coulson P, Courtney‐Brooks M, Cramer DW, Crowe P, Cunningham JM, Cybulski C, Darcy KM, El‐Bahrawy MA, Elishaev E, Erber R, Farrell R, Fereday S, Fischer A, García MJ, Gayther SA, Gentry‐Maharaj A, Gilks CB, Grube M, Harnett PR, Harrington SP, Harter P, Hartmann A, Hecht JL, Heikaus S, Hein A, Heitz F, Hendley J, Hernandez BY, Polo SH, Heublein S, Hirasawa A, Høgdall E, Høgdall CK, Horlings HM, Huntsman DG, Huzarski T, Jewell A, Jimenez‐Linan M, Jones ME, Kaufmann SH, Kennedy CJ, Khabele D, Kommoss FKF, Kruitwagen RFPM, Lambrechts D, Le ND, Lener M, Lester J, Leung Y, Linder A, Loverix L, Lubiński J, Madan R, Maxwell GL, Modugno F, Neuhausen SL, Olawaiye A, Olbrecht S, Orsulic S, Palacios J, Pearce CL, Pike MC, Quinn CM, Mohan GR, Rodríguez‐Antona C, Ruebner M, Ryan A, Salfinger SG, Sasamoto N, Schildkraut JM, Schoemaker MJ, Shah M, Sharma R, Shvetsov YB, Singh N, Sonke GS, Steele L, Stewart CJR, Sundfeldt K, Swerdlow AJ, Talhouk A, Tan A, Taylor SE, Terry KL, Tołoczko A, Traficante N, Van de Vijver KK, van der Aa MA, Van Gorp T, Van Nieuwenhuysen E, van‐Wagensveld L, Vergote I, Vierkant RA, Wang C, Wilkens LR, Winham SJ, Wu AH, Benitez J, Berchuck A, Candido dos Reis FJ, DeFazio A, Fasching PA, Goode EL, Goodman MT, Gronwald J, Karlan BY, Kommoss S, Menon U, Sinn H, Staebler A, Brenton JD, Bowtell DD, Pharoah PDP, Ramus SJ, Köbel M. CCNE1 and survival of patients with tubo-ovarian high-grade serous carcinoma: An Ovarian Tumor Tissue Analysis consortium study. Cancer 2023; 129:697-713. [PMID: 36572991 PMCID: PMC10107112 DOI: 10.1002/cncr.34582] [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: 06/17/2022] [Revised: 09/14/2022] [Accepted: 09/30/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cyclin E1 (CCNE1) is a potential predictive marker and therapeutic target in tubo-ovarian high-grade serous carcinoma (HGSC). Smaller studies have revealed unfavorable associations for CCNE1 amplification and CCNE1 overexpression with survival, but to date no large-scale, histotype-specific validation has been performed. The hypothesis was that high-level amplification of CCNE1 and CCNE1 overexpression, as well as a combination of the two, are linked to shorter overall survival in HGSC. METHODS Within the Ovarian Tumor Tissue Analysis consortium, amplification status and protein level in 3029 HGSC cases and mRNA expression in 2419 samples were investigated. RESULTS High-level amplification (>8 copies by chromogenic in situ hybridization) was found in 8.6% of HGSC and overexpression (>60% with at least 5% demonstrating strong intensity by immunohistochemistry) was found in 22.4%. CCNE1 high-level amplification and overexpression both were linked to shorter overall survival in multivariate survival analysis adjusted for age and stage, with hazard stratification by study (hazard ratio [HR], 1.26; 95% CI, 1.08-1.47, p = .034, and HR, 1.18; 95% CI, 1.05-1.32, p = .015, respectively). This was also true for cases with combined high-level amplification/overexpression (HR, 1.26; 95% CI, 1.09-1.47, p = .033). CCNE1 mRNA expression was not associated with overall survival (HR, 1.00 per 1-SD increase; 95% CI, 0.94-1.06; p = .58). CCNE1 high-level amplification is mutually exclusive with the presence of germline BRCA1/2 pathogenic variants and shows an inverse association to RB1 loss. CONCLUSION This study provides large-scale validation that CCNE1 high-level amplification is associated with shorter survival, supporting its utility as a prognostic biomarker in HGSC.
Collapse
Affiliation(s)
- Eun‐Young Kang
- Department of Pathology and Laboratory MedicineUniversity of CalgaryFoothills Medical CenterCalgaryAlbertaCanada
| | - Ashley Weir
- School of Clinical MedicineUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer ProgramLowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
| | - Nicola S. Meagher
- School of Clinical MedicineUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- The Daffodil CentreThe University of SydneyA Joint Venture With Cancer Council NSWSydneyNew South WalesAustralia
| | - Kyo Farrington
- Department of Pathology and Laboratory MedicineUniversity of CalgaryFoothills Medical CenterCalgaryAlbertaCanada
| | - Gregg S. Nelson
- Department of OncologyDivision of Gynecologic OncologyCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Prafull Ghatage
- Department of OncologyDivision of Gynecologic OncologyCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Cheng‐Han Lee
- Department of Pathology and Laboratory MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - Marjorie J. Riggan
- Department of Obstetrics and GynecologyDivision of Gynecologic OncologyDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Adelyn Bolithon
- Adult Cancer ProgramLowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
- School of Women's and Children's HealthFaculty of Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Gordana Popovic
- Stats CentralMark Wainwright Analytical CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Betty Leung
- Prince of Wales Clinical SchoolUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Katrina Tang
- Department of Anatomical PathologyPrince of Wales HospitalSydneyNew South WalesAustralia
| | - Neil Lambie
- Canterbury Health LaboratoriesChristchurchNew Zealand
| | - Joshua Millstein
- Division of BiostatisticsDepartment of Population and Public Health SciencesKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jennifer Alsop
- Department of OncologyCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Michael S. Anglesio
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British ColumbiaBC Cancerand Vancouver General HospitalVancouverBritish ColumbiaCanada
| | - Beyhan Ataseven
- Department of Gynecology and Gynecologic OncologyEvangelische Kliniken Essen‐Mitte (KEM)EssenGermany
- Department of Obstetrics and GynecologyLudwig Maximilian University MunichMunichGermany
| | - Ellen Barlow
- Gynaecological Cancer CentreRoyal Hospital for WomenSydneyNew South WalesAustralia
| | - Matthias W. Beckmann
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Jessica Berger
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Christiani Bisinotto
- Department of Gynecology and ObstetricsRibeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Hans Bösmüller
- Institute of Pathology and NeuropathologyTuebingen University HospitalTuebingenGermany
| | - Jessica Boros
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Alison H. Brand
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Angela Brooks‐Wilson
- Canada's Michael Smith Genome Sciences CentreBC CancerVancouverBritish ColumbiaCanada
| | - Sara Y. Brucker
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Michael E. Carney
- Department of Obstetrics and GynecologyJohn A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| | - Yovanni Casablanca
- Uniformed Services of the Health Sciences Gynecologic Cancer Center of ExcellenceBethesdaMarylandUSA
| | | | - Paul A. Cohen
- Department of Gynaecological OncologySt John of God Subiaco HospitalSubiacoWestern AustraliaAustralia
- Division of Obstetrics and GynaecologyMedical SchoolUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Thomas P. Conrads
- Women's Health Integrated Research CenterInova Health SystemFalls ChurchVirginiaUSA
| | - Linda S. Cook
- EpidemiologySchool of Public HealthUniversity of ColoradoAuroraColoradoUSA
- Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Penny Coulson
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Madeleine Courtney‐Brooks
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology CenterDepartment of Obstetrics and GynecologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Philip Crowe
- Prince of Wales Clinical SchoolUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- Department of SurgeryPrince of Wales Private HospitalRandwickNew South WalesAustralia
| | - Julie M. Cunningham
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Cezary Cybulski
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Kathleen M. Darcy
- Gynecologic Cancer Center of ExcellenceDepartment of Gynecologic Surgery and ObstetricsUniformed Services University of the Health SciencesWalter Reed National Military Medical CenterBethesdaMarylandUSA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA
| | - Mona A. El‐Bahrawy
- Department of Metabolism, Digestion and ReproductionImperial College LondonHammersmith HospitalLondonUK
| | - Esther Elishaev
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Ramona Erber
- Institute of PathologyComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Rhonda Farrell
- Prince of Wales Private HospitalRandwickNew South WalesAustralia
| | - Sian Fereday
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Anna Fischer
- Institute of Pathology and NeuropathologyTuebingen University HospitalTuebingenGermany
| | - María J. García
- Computational Oncology GroupStructural Biology ProgrammeSpanish National Cancer Research Centre (CNIO)MadridSpain
| | - Simon A. Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics CoreCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | | | - C. Blake Gilks
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - AOCS Group
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- QIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Marcel Grube
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Paul R. Harnett
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
- Crown Princess Mary Cancer CentreWestmead HospitalSydneyNew South WalesAustralia
| | - Shariska Petersen Harrington
- Division of Gynecologic OncologyDepartment of Obstetrics and GynecologyThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Philipp Harter
- Department of Gynecology and Gynecologic OncologyEvangelische Kliniken Essen‐Mitte (KEM)EssenGermany
- Department of Gynecology and Gynecological OncologyHSK, Dr. Horst‐Schmidt KlinikWiesbadenWiesbadenGermany
| | - Arndt Hartmann
- Institute of PathologyComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Jonathan L. Hecht
- Department of PathologyBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMassachusettsUSA
| | | | - Alexander Hein
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Florian Heitz
- Department of Gynecology and Gynecologic OncologyEvangelische Kliniken Essen‐Mitte (KEM)EssenGermany
- Department of Gynecology and Gynecological OncologyHSK, Dr. Horst‐Schmidt KlinikWiesbadenWiesbadenGermany
- Center for PathologyEvangelische Kliniken Essen‐MitteEssenGermany
| | - Joy Hendley
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | | | | | - Sabine Heublein
- Department of Obstetrics and GynecologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Akira Hirasawa
- Department of Clinical Genomic MedicineGraduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama UniversityOkayamaJapan
| | - Estrid Høgdall
- Department of PathologyHerlev HospitalUniversity of CopenhagenCopenhagenDenmark
| | - Claus K. Høgdall
- Department of GynaecologyRigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Hugo M. Horlings
- Division of Molecular PathologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - David G. Huntsman
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Molecular OncologyBC Cancer Research CentreVancouverBritish ColumbiaCanada
| | - Tomasz Huzarski
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
- Department of Genetics and PathologyUniversity of Zielona GoraZielona GoraPoland
| | - Andrea Jewell
- Division of Gynecologic OncologyDepartment of Obstetrics and GynecologyThe University of Kansas Medical CenterKansas CityKansasUSA
| | | | - Michael E. Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Scott H. Kaufmann
- Division of Oncology Research and Department of Molecular Pharmacology & Experimental TherapeuticsMayo ClinicRochesterMinnesotaUSA
| | - Catherine J. Kennedy
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Dineo Khabele
- Division of Gynecologic OncologyDepartment of Obstetrics and GynecologyWashington University in St. LouisSt. LouisMissouriUSA
| | | | - Roy F. P. M. Kruitwagen
- Department of Obstetrics and GynecologyMaastricht University Medical CentreMaastrichtThe Netherlands
- GROW – School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Diether Lambrechts
- Department of Human GeneticsLaboratory for Translational GeneticsKU LeuvenLeuvenBelgium
- VIB Center for Cancer BiologyVIBLeuvenBelgium
| | - Nhu D. Le
- Cancer Control ResearchBC Cancer AgencyVancouverBritish ColumbiaCanada
| | - Marcin Lener
- International Hereditary Cancer CenterDepartment of Genetics and PathologyPomeranian Medical University in SzczecinSzczecinPoland
| | - Jenny Lester
- David Geffen School of MedicineDepartment of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - Yee Leung
- Division of Obstetrics and GynaecologyFaculty of Health and Medical SciencesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
- Department of Gynaecological OncologyKing Edward Memorial HospitalSubiacoWestern AustraliaAustralia
- Australia New Zealand Gynaecological Oncology GroupCamperdownAustralia
| | - Anna Linder
- Department of Obstetrics and GynecologyInst of Clinical Science, Sahlgrenska Center for Cancer ResearchUniversity of GothenburgGothenburgSweden
| | - Liselore Loverix
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Jan Lubiński
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Rashna Madan
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | | | - Francesmary Modugno
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Department of EpidemiologyUniversity of Pittsburgh School of Public HealthPittsburghPennsylvaniaUSA
- Women's Cancer Research CenterMagee‐Womens Research Institute and Hillman Cancer CenterPittsburghPennsylvaniaUSA
| | - Susan L. Neuhausen
- Department of Population SciencesBeckman Research Institute of City of HopeDuarteCaliforniaUSA
| | - Alexander Olawaiye
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Siel Olbrecht
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Sandra Orsulic
- David Geffen School of MedicineDepartment of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - José Palacios
- Department of PathologyHospital Ramón y CajalInstituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)CIBERONCUniversidad de AlcaláMadridSpain
| | - Celeste Leigh Pearce
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Malcolm C. Pike
- Department of Epidemiology and BiostatisticsMemorial Sloan‐Kettering Cancer CenterNew YorkNew YorkUSA
- Department of Population Health and Public Health SciencesKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCaliforniaUSA
| | - Carmel M. Quinn
- The Health Precincts BiobankUNSW Biospecimen ServicesMark Wainwright Analytical CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Ganendra Raj Mohan
- Department of Gynaecological OncologySt John of God Subiaco HospitalSubiacoWestern AustraliaAustralia
- Department of Gynaecological OncologyKing Edward Memorial HospitalSubiacoWestern AustraliaAustralia
| | - Cristina Rodríguez‐Antona
- Hereditary Endocrine Cancer GroupSpanish National Cancer Research Center (CNIO)MadridSpain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
| | - Matthias Ruebner
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Andy Ryan
- MRC Clinical Trials UnitInstitute of Clinical Trials & MethodologyUniversity College LondonLondonUK
- Women's CancerInstitute for Women's HealthUniversity College LondonLondonUK
| | - Stuart G. Salfinger
- Department of Gynaecological OncologySt John of God Subiaco HospitalSubiacoWestern AustraliaAustralia
| | - Naoko Sasamoto
- Obstetrics and Gynecology Epidemiology CenterDepartment of Obstetrics and GynecologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Joellen M. Schildkraut
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
| | | | - Mitul Shah
- Department of OncologyCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic OncologyWestmead HospitalSydneyNew South WalesAustralia
| | | | - Naveena Singh
- Department of PathologyBarts Health National Health Service TrustLondonUK
| | - Gabe S. Sonke
- Department of Medical OncologyThe Netherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Linda Steele
- Department of Population SciencesBeckman Research Institute of City of HopeDuarteCaliforniaUSA
| | - Colin J. R. Stewart
- School for Women's and Infants' HealthUniversity of Western AustraliaPerthAustralia
| | - Karin Sundfeldt
- Department of Obstetrics and GynecologyInst of Clinical Science, Sahlgrenska Center for Cancer ResearchUniversity of GothenburgGothenburgSweden
| | - Anthony J. Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUK
| | - Aline Talhouk
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British ColumbiaBC Cancerand Vancouver General HospitalVancouverBritish ColumbiaCanada
| | - Adeline Tan
- Division of Obstetrics and GynaecologyFaculty of Health and Medical SciencesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
- Gynaepath WAClinipath (Sonic Healthcare)Osbourne ParkAustralia
| | - Sarah E. Taylor
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology CenterDepartment of Obstetrics and GynecologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Aleksandra Tołoczko
- Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Nadia Traficante
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Koen K. Van de Vijver
- Department of PathologyGhent University HospitalCancer Research Institute Ghent (CRIG)GhentBelgium
- Department of PathologyAntwerp University HospitalAntwerpBelgium
| | - Maaike A. van der Aa
- Department of ResearchNetherlands Comprehensive Cancer Organization (IKNL)UtrechtThe Netherlands
| | - Toon Van Gorp
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Els Van Nieuwenhuysen
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Lilian van‐Wagensveld
- Department of Obstetrics and GynecologyMaastricht University Medical CentreMaastrichtThe Netherlands
- GROW – School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
- Department of ResearchNetherlands Comprehensive Cancer Organization (IKNL)UtrechtThe Netherlands
| | - Ignace Vergote
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Robert A. Vierkant
- Department of Quantitative Health SciencesDivision of Clinical Trials and BiostatisticsMayo ClinicRochesterMinnesotaUSA
| | - Chen Wang
- Department of Quantitative Health SciencesDivision of Computational BiologyMayo ClinicRochesterMinnesotaUSA
| | | | - Stacey J. Winham
- Department of Quantitative Health SciencesDivision of Computational BiologyMayo ClinicRochesterMinnesotaUSA
| | - Anna H. Wu
- Department of Population Health and Public Health SciencesKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCaliforniaUSA
| | - Javier Benitez
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
- Human Genetics GroupSpanish National Cancer Research Centre (CNIO)MadridSpain
| | - Andrew Berchuck
- Department of Obstetrics and GynecologyDivision of Gynecologic OncologyDuke University Medical CenterDurhamNorth CarolinaUSA
| | | | - Anna DeFazio
- The Daffodil CentreThe University of SydneyA Joint Venture With Cancer Council NSWSydneyNew South WalesAustralia
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Peter A. Fasching
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Ellen L. Goode
- Department of Quantitative Health SciencesDivision of EpidemiologyMayo ClinicRochesterMinnesotaUSA
| | - Marc T. Goodman
- Cancer Prevention and Control ProgramCedars‐Sinai CancerCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Jacek Gronwald
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Beth Y. Karlan
- David Geffen School of MedicineDepartment of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - Stefan Kommoss
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Usha Menon
- MRC Clinical Trials UnitInstitute of Clinical Trials & MethodologyUniversity College LondonLondonUK
| | - Hans‐Peter Sinn
- Institute of PathologyHeidelberg University HospitalHeidelbergGermany
| | - Annette Staebler
- Institute of Pathology and NeuropathologyTuebingen University HospitalTuebingenGermany
| | - James D. Brenton
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUK
| | - David D. Bowtell
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Paul D. P. Pharoah
- Department of OncologyCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
- Department of Public Health and Primary CareCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Susan J. Ramus
- School of Clinical MedicineUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer ProgramLowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Martin Köbel
- Department of Pathology and Laboratory MedicineUniversity of CalgaryFoothills Medical CenterCalgaryAlbertaCanada
| |
Collapse
|
4
|
Gerstung M, Jolly C, Leshchiner I, Dentro SC, Gonzalez S, Rosebrock D, Mitchell TJ, Rubanova Y, Anur P, Yu K, Tarabichi M, Deshwar A, Wintersinger J, Kleinheinz K, Vázquez-García I, Haase K, Jerman L, Sengupta S, Macintyre G, Malikic S, Donmez N, Livitz DG, Cmero M, Demeulemeester J, Schumacher S, Fan Y, Yao X, Lee J, Schlesner M, Boutros PC, Bowtell DD, Zhu H, Getz G, Imielinski M, Beroukhim R, Sahinalp SC, Ji Y, Peifer M, Markowetz F, Mustonen V, Yuan K, Wang W, Morris QD, Spellman PT, Wedge DC, Van Loo P, Tarabichi M, Wintersinger J, Deshwar AG, Yu K, Gonzalez S, Rubanova Y, Macintyre G, Adams DJ, Anur P, Beroukhim R, Boutros PC, Bowtell DD, Campbell PJ, Cao S, Christie EL, Cmero M, Cun Y, Dawson KJ, Demeulemeester J, Donmez N, Drews RM, Eils R, Fan Y, Fittall M, Garsed DW, Getz G, Ha G, Imielinski M, Jerman L, Ji Y, Kleinheinz K, Lee J, Lee-Six H, Livitz DG, Malikic S, Markowetz F, Martincorena I, Mitchell TJ, Mustonen V, Oesper L, Peifer M, Peto M, Raphael BJ, Rosebrock D, Sahinalp SC, Salcedo A, Schlesner M, Schumacher S, Sengupta S, Shi R, Shin SJ, Spiro O, Pitkänen E, Pivot X, Piñeiro-Yáñez E, Planko L, Plass C, Polak P, Pons T, Popescu I, Potapova O, Prasad A, Stein LD, Preston SR, Prinz M, Pritchard AL, Prokopec SD, Provenzano E, Puente XS, Puig S, Puiggròs M, Pulido-Tamayo S, Pupo GM, Vázquez-García I, Purdie CA, Quinn MC, Rabionet R, Rader JS, Radlwimmer B, Radovic P, Raeder B, Raine KM, Ramakrishna M, Ramakrishnan K, Vembu S, Ramalingam S, Raphael BJ, Rathmell WK, Rausch T, Reifenberger G, Reimand J, Reis-Filho J, Reuter V, Reyes-Salazar I, Reyna MA, Wheeler DA, Reynolds SM, Rheinbay E, Riazalhosseini Y, Richardson AL, Richter J, Ringel M, Ringnér M, Rino Y, Rippe K, Roach J, Yang TP, Roberts LR, Roberts ND, Roberts SA, Robertson AG, Robertson AJ, Rodriguez JB, Rodriguez-Martin B, Rodríguez-González FG, Roehrl MHA, Rohde M, Yao X, Rokutan H, Romieu G, Rooman I, Roques T, Rosebrock D, Rosenberg M, Rosenstiel PC, Rosenwald A, Rowe EW, Royo R, Yuan K, Rozen SG, Rubanova Y, Rubin MA, Rubio-Perez C, Rudneva VA, Rusev BC, Ruzzenente A, Rätsch G, Sabarinathan R, Sabelnykova VY, Zhu H, Sadeghi S, Sahinalp SC, Saini N, Saito-Adachi M, Saksena G, Salcedo A, Salgado R, Salichos L, Sallari R, Saller C, Wang W, Salvia R, Sam M, Samra JS, Sanchez-Vega F, Sander C, Sanders G, Sarin R, Sarrafi I, Sasaki-Oku A, Sauer T, Morris QD, Sauter G, Saw RPM, Scardoni M, Scarlett CJ, Scarpa A, Scelo G, Schadendorf D, Schein JE, Schilhabel MB, Schlesner M, Spellman PT, Schlomm T, Schmidt HK, Schramm SJ, Schreiber S, Schultz N, Schumacher SE, Schwarz RF, Scolyer RA, Scott D, Scully R, Wedge DC, Seethala R, Segre AV, Selander I, Semple CA, Senbabaoglu Y, Sengupta S, Sereni E, Serra S, Sgroi DC, Shackleton M, Van Loo P, Shah NC, Shahabi S, Shang CA, Shang P, Shapira O, Shelton T, Shen C, Shen H, Shepherd R, Shi R, Spellman PT, Shi Y, Shiah YJ, Shibata T, Shih J, Shimizu E, Shimizu K, Shin SJ, Shiraishi Y, Shmaya T, Shmulevich I, Wedge DC, Shorser SI, Short C, Shrestha R, Shringarpure SS, Shriver C, Shuai S, Sidiropoulos N, Siebert R, Sieuwerts AM, Sieverling L, Van Loo P, Signoretti S, Sikora KO, Simbolo M, Simon R, Simons JV, Simpson JT, Simpson PT, Singer S, Sinnott-Armstrong N, Sipahimalani P, Aaltonen LA, Skelly TJ, Smid M, Smith J, Smith-McCune K, Socci ND, Sofia HJ, Soloway MG, Song L, Sood AK, Sothi S, Abascal F, Sotiriou C, Soulette CM, Span PN, Spellman PT, Sperandio N, Spillane AJ, Spiro O, Spring J, Staaf J, Stadler PF, Abeshouse A, Staib P, Stark SG, Stebbings L, Stefánsson ÓA, Stegle O, Stein LD, Stenhouse A, Stewart C, Stilgenbauer S, Stobbe MD, Aburatani H, Stratton MR, Stretch JR, Struck AJ, Stuart JM, Stunnenberg HG, Su H, Su X, Sun RX, Sungalee S, Susak H, Adams DJ, Suzuki A, Sweep F, Szczepanowski M, Sültmann H, Yugawa T, Tam A, Tamborero D, Tan BKT, Tan D, Tan P, Agrawal N, Tanaka H, Taniguchi H, Tanskanen TJ, Tarabichi M, Tarnuzzer R, Tarpey P, Taschuk ML, Tatsuno K, Tavaré S, Taylor DF, Ahn KS, Taylor-Weiner A, Teague JW, Teh BT, Tembe V, Temes J, Thai K, Thayer SP, Thiessen N, Thomas G, Thomas S, Ahn SM, Thompson A, Thompson AM, Thompson JFF, Thompson RH, Thorne H, Thorne LB, Thorogood A, Tiao G, Tijanic N, Timms LE, Aikata H, Tirabosco R, Tojo M, Tommasi S, Toon CW, Toprak UH, Torrents D, Tortora G, Tost J, Totoki Y, Townend D, Akbani R, Traficante N, Treilleux I, Trotta JR, Trümper LHP, Tsao M, Tsunoda T, Tubio JMC, Tucker O, Turkington R, Turner DJ, Akdemir KC, Tutt A, Ueno M, Ueno NT, Umbricht C, Umer HM, Underwood TJ, Urban L, Urushidate T, Ushiku T, Uusküla-Reimand L, Al-Ahmadie H, Valencia A, Van Den Berg DJ, Van Laere S, Van Loo P, Van Meir EG, Van den Eynden GG, Van der Kwast T, Vasudev N, Vazquez M, Vedururu R, Al-Sedairy ST, Veluvolu U, Vembu S, Verbeke LPC, Vermeulen P, Verrill C, Viari A, Vicente D, Vicentini C, VijayRaghavan K, Viksna J, Al-Shahrour F, Vilain RE, Villasante I, Vincent-Salomon A, Visakorpi T, Voet D, Vyas P, Vázquez-García I, Waddell NM, Waddell N, Wadelius C, Alawi M, Wadi L, Wagener R, Wala JA, Wang J, Wang J, Wang L, Wang Q, Wang W, Wang Y, Wang Z, Albert M, Waring PM, Warnatz HJ, Warrell J, Warren AY, Waszak SM, Wedge DC, Weichenhan D, Weinberger P, Weinstein JN, Weischenfeldt J, Aldape K, Weisenberger DJ, Welch I, Wendl MC, Werner J, Whalley JP, Wheeler DA, Whitaker HC, Wigle D, Wilkerson MD, Williams A, Alexandrov LB, Wilmott JS, Wilson GW, Wilson JM, Wilson RK, Winterhoff B, Wintersinger JA, Wiznerowicz M, Wolf S, Wong BH, Wong T, Ally A, Wong W, Woo Y, Wood S, Wouters BG, Wright AJ, Wright DW, Wright MH, Wu CL, Wu DY, Wu G, Alsop K, Wu J, Wu K, Wu Y, Wu Z, Xi L, Xia T, Xiang Q, Xiao X, Xing R, Xiong H, Alvarez EG, Xu Q, Xu Y, Xue H, Yachida S, Yakneen S, Yamaguchi R, Yamaguchi TN, Yamamoto M, Yamamoto S, Yamaue H, Amary F, Yang F, Yang H, Yang JY, Yang L, Yang L, Yang S, Yang TP, Yang Y, Yao X, Yaspo ML, Amin SB, Yates L, Yau C, Ye C, Ye K, Yellapantula VD, Yoon CJ, Yoon SS, Yousif F, Yu J, Yu K, Aminou B, Yu W, Yu Y, Yuan K, Yuan Y, Yuen D, Yung CK, Zaikova O, Zamora J, Zapatka M, Zenklusen JC, Ammerpohl O, Zenz T, Zeps N, Zhang CZ, Zhang F, Zhang H, Zhang H, Zhang H, Zhang J, Zhang J, Zhang J, Anderson MJ, Zhang X, Zhang X, Zhang Y, Zhang Z, Zhao Z, Zheng L, Zheng X, Zhou W, Zhou Y, Zhu B, Ang Y, Zhu H, Zhu J, Zhu S, Zou L, Zou X, deFazio A, van As N, van Deurzen CHM, van de Vijver MJ, van’t Veer L, Antonello D, von Mering C, Anur P, Aparicio S, Appelbaum EL, Arai Y, Aretz A, Arihiro K, Ariizumi SI, Armenia J, Arnould L, Asa S, Assenov Y, Atwal G, Aukema S, Auman JT, Aure MRR, Awadalla P, Aymerich M, Bader GD, Baez-Ortega A, Bailey MH, Bailey PJ, Balasundaram M, Balu S, Bandopadhayay P, Banks RE, Barbi S, Barbour AP, Barenboim J, Barnholtz-Sloan J, Barr H, Barrera E, Bartlett J, Bartolome J, Bassi C, Bathe OF, Baumhoer D, Bavi P, Baylin SB, Bazant W, Beardsmore D, Beck TA, Behjati S, Behren A, Niu B, Bell C, Beltran S, Benz C, Berchuck A, Bergmann AK, Bergstrom EN, Berman BP, Berney DM, Bernhart SH, Beroukhim R, Berrios M, Bersani S, Bertl J, Betancourt M, Bhandari V, Bhosle SG, Biankin AV, Bieg M, Bigner D, Binder H, Birney E, Birrer M, Biswas NK, Bjerkehagen B, Bodenheimer T, Boice L, Bonizzato G, De Bono JS, Boot A, Bootwalla MS, Borg A, Borkhardt A, Boroevich KA, Borozan I, Borst C, Bosenberg M, Bosio M, Boultwood J, Bourque G, Boutros PC, Bova GS, Bowen DT, Bowlby R, Bowtell DDL, Boyault S, Boyce R, Boyd J, Brazma A, Brennan P, Brewer DS, Brinkman AB, Bristow RG, Broaddus RR, Brock JE, Brock M, Broeks A, Brooks AN, Brooks D, Brors B, Brunak S, Bruxner TJC, Bruzos AL, Buchanan A, Buchhalter I, Buchholz C, Bullman S, Burke H, Burkhardt B, Burns KH, Busanovich J, Bustamante CD, Butler AP, Butte AJ, Byrne NJ, Børresen-Dale AL, Caesar-Johnson SJ, Cafferkey A, Cahill D, Calabrese C, Caldas C, Calvo F, Camacho N, Campbell PJ, Campo E, Cantù C, Cao S, Carey TE, Carlevaro-Fita J, Carlsen R, Cataldo I, Cazzola M, Cebon J, Cerfolio R, Chadwick DE, Chakravarty D, Chalmers D, Chan CWY, Chan K, Chan-Seng-Yue M, Chandan VS, Chang DK, Chanock SJ, Chantrill LA, Chateigner A, Chatterjee N, Chayama K, Chen HW, Chen J, Chen K, Chen Y, Chen Z, Cherniack AD, Chien J, Chiew YE, Chin SF, Cho J, Cho S, Choi JK, Choi W, Chomienne C, Chong Z, Choo SP, Chou A, Christ AN, Christie EL, Chuah E, Cibulskis C, Cibulskis K, Cingarlini S, Clapham P, Claviez A, Cleary S, Cloonan N, Cmero M, Collins CC, Connor AA, Cooke SL, Cooper CS, Cope L, Corbo V, Cordes MG, Cordner SM, Cortés-Ciriano I, Covington K, Cowin PA, Craft B, Craft D, Creighton CJ, Cun Y, Curley E, Cutcutache I, Czajka K, Czerniak B, Dagg RA, Danilova L, Davi MV, Davidson NR, Davies H, Davis IJ, Davis-Dusenbery BN, Dawson KJ, De La Vega FM, De Paoli-Iseppi R, Defreitas T, Tos APD, Delaneau O, Demchok JA, Demeulemeester J, Demidov GM, Demircioğlu D, Dennis NM, Denroche RE, Dentro SC, Desai N, Deshpande V, Deshwar AG, Desmedt C, Deu-Pons J, Dhalla N, Dhani NC, Dhingra P, Dhir R, DiBiase A, Diamanti K, Ding L, Ding S, Dinh HQ, Dirix L, Doddapaneni H, Donmez N, Dow MT, Drapkin R, Drechsel O, Drews RM, Serge S, Dudderidge T, Dueso-Barroso A, Dunford AJ, Dunn M, Dursi LJ, Duthie FR, Dutton-Regester K, Eagles J, Easton DF, Edmonds S, Edwards PA, Edwards SE, Eeles RA, Ehinger A, Eils J, Eils R, El-Naggar A, Eldridge M, Ellrott K, Erkek S, Escaramis G, Espiritu SMG, Estivill X, Etemadmoghadam D, Eyfjord JE, Faltas BM, Fan D, Fan Y, Faquin WC, Farcas C, Fassan M, Fatima A, Favero F, Fayzullaev N, Felau I, Fereday S, Ferguson ML, Ferretti V, Feuerbach L, Field MA, Fink JL, Finocchiaro G, Fisher C, Fittall MW, Fitzgerald A, Fitzgerald RC, Flanagan AM, Fleshner NE, Flicek P, Foekens JA, Fong KM, Fonseca NA, Foster CS, Fox NS, Fraser M, Frazer S, Frenkel-Morgenstern M, Friedman W, Frigola J, Fronick CC, Fujimoto A, Fujita M, Fukayama M, Fulton LA, Fulton RS, Furuta M, Futreal PA, Füllgrabe A, Gabriel SB, Gallinger S, Gambacorti-Passerini C, Gao J, Gao S, Garraway L, Garred Ø, Garrison E, Garsed DW, Gehlenborg N, Gelpi JLL, George J, Gerhard DS, Gerhauser C, Gershenwald JE, Gerstein M, Gerstung M, Getz G, Ghori M, Ghossein R, Giama NH, Gibbs RA, Gibson B, Gill AJ, Gill P, Giri DD, Glodzik D, Gnanapragasam VJ, Goebler ME, Goldman MJ, Gomez C, Gonzalez S, Gonzalez-Perez A, Gordenin DA, Gossage J, Gotoh K, Govindan R, Grabau D, Graham JS, Grant RC, Green AR, Green E, Greger L, Grehan N, Grimaldi S, Grimmond SM, Grossman RL, Grundhoff A, Gundem G, Guo Q, Gupta M, Gupta S, Gut IG, Gut M, Göke J, Ha G, Haake A, Haan D, Haas S, Haase K, Haber JE, Habermann N, Hach F, Haider S, Hama N, Hamdy FC, Hamilton A, Hamilton MP, Han L, Hanna GB, Hansmann M, Haradhvala NJ, Harismendy O, Harliwong I, Harmanci AO, Harrington E, Hasegawa T, Haussler D, Hawkins S, Hayami S, Hayashi S, Hayes DN, Hayes SJ, Hayward NK, Hazell S, He Y, Heath AP, Heath SC, Hedley D, Hegde AM, Heiman DI, Heinold MC, Heins Z, Heisler LE, Hellstrom-Lindberg E, Helmy M, Heo SG, Hepperla AJ, Heredia-Genestar JM, Herrmann C, Hersey P, Hess JM, Hilmarsdottir H, Hinton J, Hirano S, Hiraoka N, Hoadley KA, Hobolth A, Hodzic E, Hoell JI, Hoffmann S, Hofmann O, Holbrook A, Holik AZ, Hollingsworth MA, Holmes O, Holt RA, Hong C, Hong EP, Hong JH, Hooijer GK, Hornshøj H, Hosoda F, Hou Y, Hovestadt V, Howat W, Hoyle AP, Hruban RH, Hu J, Hu T, Hua X, Huang KL, Huang M, Huang MN, Huang V, Huang Y, Huber W, Hudson TJ, Hummel M, Hung JA, Huntsman D, Hupp TR, Huse J, Huska MR, Hutter B, Hutter CM, Hübschmann D, Iacobuzio-Donahue CA, Imbusch CD, Imielinski M, Imoto S, Isaacs WB, Isaev K, Ishikawa S, Iskar M, Islam SMA, Ittmann M, Ivkovic S, Izarzugaza JMG, Jacquemier J, Jakrot V, Jamieson NB, Jang GH, Jang SJ, Jayaseelan JC, Jayasinghe R, Jefferys SR, Jegalian K, Jennings JL, Jeon SH, Jerman L, Ji Y, Jiao W, Johansson PA, Johns AL, Johns J, Johnson R, Johnson TA, Jolly C, Joly Y, Jonasson JG, Jones CD, Jones DR, Jones DTW, Jones N, Jones SJM, Jonkers J, Ju YS, Juhl H, Jung J, Juul M, Juul RI, Juul S, Jäger N, Kabbe R, Kahles A, Kahraman A, Kaiser VB, Kakavand H, Kalimuthu S, von Kalle C, Kang KJ, Karaszi K, Karlan B, Karlić R, Karsch D, Kasaian K, Kassahn KS, Katai H, Kato M, Katoh H, Kawakami Y, Kay JD, Kazakoff SH, Kazanov MD, Keays M, Kebebew E, Kefford RF, Kellis M, Kench JG, Kennedy CJ, Kerssemakers JNA, Khoo D, Khoo V, Khuntikeo N, Khurana E, Kilpinen H, Kim HK, Kim HL, Kim HY, Kim H, Kim J, Kim J, Kim JK, Kim Y, King TA, Klapper W, Kleinheinz K, Klimczak LJ, Knappskog S, Kneba M, Knoppers BM, Koh Y, Komorowski J, Komura D, Komura M, Kong G, Kool M, Korbel JO, Korchina V, Korshunov A, Koscher M, Koster R, Kote-Jarai Z, Koures A, Kovacevic M, Kremeyer B, Kretzmer H, Kreuz M, Krishnamurthy S, Kube D, Kumar K, Kumar P, Kumar S, Kumar Y, Kundra R, Kübler K, Küppers R, Lagergren J, Lai PH, Laird PW, Lakhani SR, Lalansingh CM, Lalonde E, Lamaze FC, Lambert A, Lander E, Landgraf P, Landoni L, Langerød A, Lanzós A, Larsimont D, Larsson E, Lathrop M, Lau LMS, Lawerenz C, Lawlor RT, Lawrence MS, Lazar AJ, Lazic AM, Le X, Lee D, Lee D, Lee EA, Lee HJ, Lee JJK, Lee JY, Lee J, Lee MTM, Lee-Six H, Lehmann KV, Lehrach H, Lenze D, Leonard CR, Leongamornlert DA, Leshchiner I, Letourneau L, Letunic I, Levine DA, Lewis L, Ley T, Li C, Li CH, Li HI, Li J, Li L, Li S, Li S, Li X, Li X, Li X, Li Y, Liang H, Liang SB, Lichter P, Lin P, Lin Z, Linehan WM, Lingjærde OC, Liu D, Liu EM, Liu FFF, Liu F, Liu J, Liu X, Livingstone J, Livitz D, Livni N, Lochovsky L, Loeffler M, Long GV, Lopez-Guillermo A, Lou S, Louis DN, Lovat LB, Lu Y, Lu YJ, Lu Y, Luchini C, Lungu I, Luo X, Luxton HJ, Lynch AG, Lype L, López C, López-Otín C, Ma EZ, Ma Y, MacGrogan G, MacRae S, Macintyre G, Madsen T, Maejima K, Mafficini A, Maglinte DT, Maitra A, Majumder PP, Malcovati L, Malikic S, Malleo G, Mann GJ, Mantovani-Löffler L, Marchal K, Marchegiani G, Mardis ER, Margolin AA, Marin MG, Markowetz F, Markowski J, Marks J, Marques-Bonet T, Marra MA, Marsden L, Martens JWM, Martin S, Martin-Subero JI, Martincorena I, Martinez-Fundichely A, Maruvka YE, Mashl RJ, Massie CE, Matthew TJ, Matthews L, Mayer E, Mayes S, Mayo M, Mbabaali F, McCune K, McDermott U, McGillivray PD, McLellan MD, McPherson JD, McPherson JR, McPherson TA, Meier SR, Meng A, Meng S, Menzies A, Merrett ND, Merson S, Meyerson M, Meyerson W, Mieczkowski PA, Mihaiescu GL, Mijalkovic S, Mikkelsen T, Milella M, Mileshkin L, Miller CA, Miller DK, Miller JK, Mills GB, Milovanovic A, Minner S, Miotto M, Arnau GM, Mirabello L, Mitchell C, Mitchell TJ, Miyano S, Miyoshi N, Mizuno S, Molnár-Gábor F, Moore MJ, Moore RA, Morganella S, Morris QD, Morrison C, Mose LE, Moser CD, Muiños F, Mularoni L, Mungall AJ, Mungall K, Musgrove EA, Mustonen V, Mutch D, Muyas F, Muzny DM, Muñoz A, Myers J, Myklebost O, Möller P, Nagae G, Nagrial AM, Nahal-Bose HK, Nakagama H, Nakagawa H, Nakamura H, Nakamura T, Nakano K, Nandi T, Nangalia J, Nastic M, Navarro A, Navarro FCP, Neal DE, Nettekoven G, Newell F, Newhouse SJ, Newton Y, Ng AWT, Ng A, Nicholson J, Nicol D, Nie Y, Nielsen GP, Nielsen MM, Nik-Zainal S, Noble MS, Nones K, Northcott PA, Notta F, O’Connor BD, O’Donnell P, O’Donovan M, O’Meara S, O’Neill BP, O’Neill JR, Ocana D, Ochoa A, Oesper L, Ogden C, Ohdan H, Ohi K, Ohno-Machado L, Oien KA, Ojesina AI, Ojima H, Okusaka T, Omberg L, Ong CK, Ossowski S, Ott G, Ouellette BFF, P’ng C, Paczkowska M, Paiella S, Pairojkul C, Pajic M, Pan-Hammarström Q, Papaemmanuil E, Papatheodorou I, Paramasivam N, Park JW, Park JW, Park K, Park K, Park PJ, Parker JS, Parsons SL, Pass H, Pasternack D, Pastore A, Patch AM, Pauporté I, Pea A, Pearson JV, Pedamallu CS, Pedersen JS, Pederzoli P, Peifer M, Pennell NA, Perou CM, Perry MD, Petersen GM, Peto M, Petrelli N, Petryszak R, Pfister SM, Phillips M, Pich O, Pickett HA, Pihl TD, Pillay N, Pinder S, Pinese M, Pinho AV. Author Correction: The evolutionary history of 2,658 cancers. Nature 2023; 614:E42. [PMID: 36697833 PMCID: PMC9931577 DOI: 10.1038/s41586-022-05601-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Moritz Gerstung
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK. .,European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany. .,Wellcome Sanger Institute, Cambridge, UK.
| | - Clemency Jolly
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Ignaty Leshchiner
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Stefan C. Dentro
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.4991.50000 0004 1936 8948Big Data Institute, University of Oxford, Oxford, UK
| | - Santiago Gonzalez
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK
| | - Daniel Rosebrock
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Thomas J. Mitchell
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.5335.00000000121885934University of Cambridge, Cambridge, UK
| | - Yulia Rubanova
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Pavana Anur
- grid.5288.70000 0000 9758 5690Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR USA
| | - Kaixian Yu
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Maxime Tarabichi
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Amit Deshwar
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Jeff Wintersinger
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Kortine Kleinheinz
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Heidelberg University, Heidelberg, Germany
| | - Ignacio Vázquez-García
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.5335.00000000121885934University of Cambridge, Cambridge, UK
| | - Kerstin Haase
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Lara Jerman
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK ,grid.8954.00000 0001 0721 6013University of Ljubljana, Ljubljana, Slovenia
| | - Subhajit Sengupta
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, Evanston, IL USA
| | - Geoff Macintyre
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Salem Malikic
- grid.61971.380000 0004 1936 7494Simon Fraser University, Burnaby, British Columbia Canada ,grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada
| | - Nilgun Donmez
- grid.61971.380000 0004 1936 7494Simon Fraser University, Burnaby, British Columbia Canada ,grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada
| | - Dimitri G. Livitz
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Marek Cmero
- grid.1008.90000 0001 2179 088XUniversity of Melbourne, Melbourne, Victoria Australia ,grid.1042.70000 0004 0432 4889Walter and Eliza Hall Institute, Melbourne, Victoria Australia
| | - Jonas Demeulemeester
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.5596.f0000 0001 0668 7884University of Leuven, Leuven, Belgium
| | - Steven Schumacher
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Yu Fan
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Xiaotong Yao
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA ,grid.429884.b0000 0004 1791 0895New York Genome Center, New York, NY USA
| | - Juhee Lee
- grid.205975.c0000 0001 0740 6917University of California Santa Cruz, Santa Cruz, CA USA
| | - Matthias Schlesner
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul C. Boutros
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.419890.d0000 0004 0626 690XOntario Institute for Cancer Research, Toronto, Ontario Canada ,grid.19006.3e0000 0000 9632 6718University of California, Los Angeles, CA USA
| | - David D. Bowtell
- grid.1055.10000000403978434Peter MacCallum Cancer Centre, Melbourne, Victoria Australia
| | - Hongtu Zhu
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Gad Getz
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA USA ,grid.32224.350000 0004 0386 9924Department of Pathology, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Marcin Imielinski
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA ,grid.429884.b0000 0004 1791 0895New York Genome Center, New York, NY USA
| | - Rameen Beroukhim
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Dana-Farber Cancer Institute, Boston, MA USA
| | - S. Cenk Sahinalp
- grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada ,grid.411377.70000 0001 0790 959XIndiana University, Bloomington, IN USA
| | - Yuan Ji
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, Evanston, IL USA ,grid.170205.10000 0004 1936 7822The University of Chicago, Chicago, IL USA
| | - Martin Peifer
- grid.6190.e0000 0000 8580 3777University of Cologne, Cologne, Germany
| | - Florian Markowetz
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ville Mustonen
- grid.7737.40000 0004 0410 2071University of Helsinki, Helsinki, Finland
| | - Ke Yuan
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK ,grid.8756.c0000 0001 2193 314XUniversity of Glasgow, Glasgow, UK
| | - Wenyi Wang
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Quaid D. Morris
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | | | - Paul T. Spellman
- grid.5288.70000 0000 9758 5690Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR USA
| | - David C. Wedge
- grid.4991.50000 0004 1936 8948Big Data Institute, University of Oxford, Oxford, UK ,grid.454382.c0000 0004 7871 7212Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Peter Van Loo
- The Francis Crick Institute, London, UK. .,University of Leuven, Leuven, Belgium.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Weir A, Kang EY, Meagher NS, Nelson GS, Ghatage P, Lee CH, Riggan MJ, Gentry-Maharaj A, Ryan A, Singh N, Widschwendter M, Alsop J, Anglesio MS, Beckmann MW, Berger J, Bisinotto C, Boros J, Brand AH, Brenton JD, Brooks-Wilson A, Carney ME, Cunningham JM, Cushing-Haugen KL, Cybulski C, Elishaev E, Erber R, Fereday S, Fischer A, Paz-Ares L, Gayarre J, Gilks BC, Grube M, Harnett PR, Harris HR, Hartmann A, Hein A, Hendley J, Hernandez BY, Heublein S, Huang Y, Huzarski T, Jakubowska A, Jimenez-Linan M, Kennedy CJ, Kommoss FKF, Koziak JM, Kraemer B, Le ND, Lesnock J, Lester J, Lubiński J, Menkiszak J, Ney B, Olawaiye A, Orsulic S, Osorio A, Robles-Díaz L, Ruebner M, Shah M, Sharma R, Shvetsov YB, Steed H, Talhouk A, Taylor SE, Traficante N, Vierkant RA, Wang C, Wilkens LR, Winham SJ, Benitez J, Berchuck A, Bowtell DD, Candido Dos Reis FJ, Cook LS, DeFazio A, Doherty JA, Fasching PA, García MJ, Goode EL, Goodman MT, Gronwald J, Huntsman DG, Karlan BY, Kommoss S, Modugno F, Schildkraut JM, Sinn HP, Staebler A, Kelemen LE, Ford CE, Menon U, Pharoah PDP, Köbel M, Ramus SJ. Increased FOXJ1 protein expression is associated with improved overall survival in high-grade serous ovarian carcinoma: an Ovarian Tumor Tissue Analysis Consortium Study. Br J Cancer 2023; 128:137-147. [PMID: 36323878 DOI: 10.1038/s41416-022-02014-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 09/01/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Recently, we showed a >60% difference in 5-year survival for patients with tubo-ovarian high-grade serous carcinoma (HGSC) when stratified by a 101-gene mRNA expression prognostic signature. Given the varied patient outcomes, this study aimed to translate prognostic mRNA markers into protein expression assays by immunohistochemistry and validate their survival association in HGSC. METHODS Two prognostic genes, FOXJ1 and GMNN, were selected based on high-quality antibodies, correlation with protein expression and variation in immunohistochemical scores in a preliminary cohort (n = 134 and n = 80, respectively). Six thousand four hundred and thirty-four (FOXJ1) and 5470 (GMNN) formalin-fixed, paraffin-embedded ovarian neoplasms (4634 and 4185 HGSC, respectively) represented on tissue microarrays from the Ovarian Tumor Tissue Analysis consortium underwent immunohistochemical staining and scoring, then univariate and multivariate survival analysis. RESULTS Consistent with mRNA, FOXJ1 protein expression exhibited a linear, increasing association with improved overall survival in HGSC patients. Women with >50% expression had the most favourable outcomes (HR = 0.78, 95% CI 0.67-0.91, p < 0.0001). GMNN protein expression was not significantly associated with overall HSGC patient survival. However, HGSCs with >35% GMNN expression showed a trend for better outcomes, though this was not significant. CONCLUSION We provide foundational evidence for the prognostic value of FOXJ1 in HGSC, validating the prior mRNA-based prognostic association by immunohistochemistry.
Collapse
Affiliation(s)
- Ashley Weir
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Nicola S Meagher
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada
| | - Marjorie J Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Andy Ryan
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
- Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | | | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Michael S Anglesio
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jessica Berger
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christiani Bisinotto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jessica Boros
- Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Alison H Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - Michael E Carney
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Julie M Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Kara L Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Fischer
- Institute of Pathology and Neuropathology, Tuebingen University Hospital, Tuebingen, Germany
| | - Luis Paz-Ares
- H12O-CNIO Lung Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Javier Gayarre
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Blake C Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marcel Grube
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - Paul R Harnett
- The University of Sydney, Sydney, NSW, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Joy Hendley
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | | | - Sabine Heublein
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Yajue Huang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Tomasz Huzarski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Department of Genetics and Pathology, University of Zielona Gora, Zielona Gora, Poland
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Independent Laboratory of Molecular Biology and Genetic Diagnostics, Szczecin, Poland
| | | | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Felix K F Kommoss
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Bernhard Kraemer
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - Nhu D Le
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Jaime Lesnock
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Britta Ney
- Institute of Pathology and Neuropathology, Tuebingen University Hospital, Tuebingen, Germany
| | - Alexander Olawaiye
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, NSW, Australia
| | | | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
- Section of Gynecologic Oncology Surgery, North Zone, Alberta Health Services, Edmonton, AB, Canada
| | - Aline Talhouk
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
| | - Sarah E Taylor
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Robert A Vierkant
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | | | - Stacey J Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Javier Benitez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - David D Bowtell
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Linda S Cook
- Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Anna DeFazio
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - María J García
- Computational Oncology Group, Structural Biology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Marc T Goodman
- Cancer Prevention and Control Program, Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - David G Huntsman
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Beth Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Stefan Kommoss
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hans-Peter Sinn
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Annette Staebler
- Institute of Pathology and Neuropathology, Tuebingen University Hospital, Tuebingen, Germany
| | - Linda E Kelemen
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Caroline E Ford
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- School of Women's and Children's Health, Faculty of Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Susan J Ramus
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia.
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia.
| |
Collapse
|
6
|
Ho GY, Kyran EL, Bedo J, Wakefield MJ, Ennis DP, Mirza HB, Vandenberg CJ, Lieschke E, Farrell A, Hadla A, Lim R, Dall G, Vince JE, Chua NK, Kondrashova O, Upstill-Goddard R, Bailey UM, Dowson S, Roxburgh P, Glasspool RM, Bryson G, Biankin AV, Cooke SL, Ratnayake G, McNally O, Traficante N, DeFazio A, Weroha SJ, Bowtell DD, McNeish IA, Papenfuss AT, Scott CL, Barker HE. Epithelial-to-Mesenchymal Transition Supports Ovarian Carcinosarcoma Tumorigenesis and Confers Sensitivity to Microtubule Targeting with Eribulin. Cancer Res 2022; 82:4457-4473. [PMID: 36206301 PMCID: PMC9716257 DOI: 10.1158/0008-5472.can-21-4012] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/15/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023]
Abstract
Ovarian carcinosarcoma (OCS) is an aggressive and rare tumor type with limited treatment options. OCS is hypothesized to develop via the combination theory, with a single progenitor resulting in carcinomatous and sarcomatous components, or alternatively via the conversion theory, with the sarcomatous component developing from the carcinomatous component through epithelial-to-mesenchymal transition (EMT). In this study, we analyzed DNA variants from isolated carcinoma and sarcoma components to show that OCS from 18 women is monoclonal. RNA sequencing indicated that the carcinoma components were more mesenchymal when compared with pure epithelial ovarian carcinomas, supporting the conversion theory and suggesting that EMT is important in the formation of these tumors. Preclinical OCS models were used to test the efficacy of microtubule-targeting drugs, including eribulin, which has previously been shown to reverse EMT characteristics in breast cancers and induce differentiation in sarcomas. Vinorelbine and eribulin more effectively inhibited OCS growth than standard-of-care platinum-based chemotherapy, and treatment with eribulin reduced mesenchymal characteristics and N-MYC expression in OCS patient-derived xenografts. Eribulin treatment resulted in an accumulation of intracellular cholesterol in OCS cells, which triggered a downregulation of the mevalonate pathway and prevented further cholesterol biosynthesis. Finally, eribulin increased expression of genes related to immune activation and increased the intratumoral accumulation of CD8+ T cells, supporting exploration of immunotherapy combinations in the clinic. Together, these data indicate that EMT plays a key role in OCS tumorigenesis and support the conversion theory for OCS histogenesis. Targeting EMT using eribulin could help improve OCS patient outcomes. SIGNIFICANCE Genomic analyses and preclinical models of ovarian carcinosarcoma support the conversion theory for disease development and indicate that microtubule inhibitors could be used to suppress EMT and stimulate antitumor immunity.
Collapse
Affiliation(s)
- Gwo Yaw Ho
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
- The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Elizabeth L. Kyran
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
- Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - Justin Bedo
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- School of Computing and Information Systems, the University of Melbourne, Parkville, Victoria, Australia
| | - Matthew J. Wakefield
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Darren P. Ennis
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Hasan B. Mirza
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Cassandra J. Vandenberg
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth Lieschke
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Farrell
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Anthony Hadla
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Ratana Lim
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Genevieve Dall
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - James E. Vince
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| | - Ngee Kiat Chua
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Olga Kondrashova
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Rosanna Upstill-Goddard
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Ulla-Maja Bailey
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Suzanne Dowson
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
| | - Patricia Roxburgh
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Rosalind M. Glasspool
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Gareth Bryson
- Department of Pathology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Andrew V. Biankin
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
| | | | - Susanna L. Cooke
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
| | | | - Orla McNally
- The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Nadia Traficante
- Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, Australia
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia
| | - S. John Weroha
- Department of Oncology, Mayo Clinic, Rochester, Minnesota
| | - David D. Bowtell
- Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Iain A. McNeish
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, United Kingdom
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
| | - Anthony T. Papenfuss
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
- Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Clare L. Scott
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
- The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
- Sir Peter MacCallum Cancer Centre Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Holly E. Barker
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
7
|
Devlin MJ, Miller R, Laforets F, Kotantaki P, Garsed DW, Kristeleit R, Bowtell DD, McDermott J, Maniati E, Balkwill FR. The Tumor Microenvironment of Clear-Cell Ovarian Cancer. Cancer Immunol Res 2022; 10:1326-1339. [PMID: 36095166 PMCID: PMC9627265 DOI: 10.1158/2326-6066.cir-22-0407] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/01/2022] [Accepted: 09/02/2022] [Indexed: 01/07/2023]
Abstract
Some patients with advanced clear-cell ovarian cancer (CCOC) respond to immunotherapy; however, little is known about the tumor microenvironment (TME) of this relatively rare disease. Here, we describe a comprehensive quantitative and topographical analysis of biopsies from 45 patients, 9 with Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage I/II (early CCOC) and 36 with FIGO stage III/IV (advanced CCOC). We investigated 14 immune cell phenotype markers, PD-1 and ligands, and collagen structure and texture. We interrogated a microarray data set from a second cohort of 29 patients and compared the TMEs of ARID1A-wildtype (ARID1Awt) versus ARID1A-mutant (ARID1Amut) disease. We found significant variations in immune cell frequency and phenotype, checkpoint expression, and collagen matrix between the malignant cell area (MCA), leading edge (LE), and stroma. The MCA had the largest population of CD138+ plasma cells, the LE had more CD20+ B cells and T cells, whereas the stroma had more mast cells and αSMA+ fibroblasts. PD-L2 was expressed predominantly on malignant cells and was the dominant PD-1 ligand. Compared with early CCOC, advanced-stage disease had significantly more fibroblasts and a more complex collagen matrix, with microarray analysis indicating "TGFβ remodeling of the extracellular matrix" as the most significantly enriched pathway. Data showed significant differences in immune cell populations, collagen matrix, and cytokine expression between ARID1Awt and ARID1Amut CCOC, which may reflect different paths of tumorigenesis and the relationship to endometriosis. Increased infiltration of CD8+ T cells within the MCA and CD4+ T cells at the LE and stroma significantly associated with decreased overall survival.
Collapse
Affiliation(s)
- Michael-John Devlin
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
- Department of Medical Oncology, St Bartholomew's Hospital, London, United Kingdom
| | - Rowan Miller
- Department of Medical Oncology, St Bartholomew's Hospital, London, United Kingdom
- Department of Medical Oncology, University College London Hospital, London, United Kingdom
| | - Florian Laforets
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Panoraia Kotantaki
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Dale W. Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Rebecca Kristeleit
- Medical Oncology Department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Jacqueline McDermott
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Eleni Maniati
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Frances R. Balkwill
- Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
8
|
Aziz D, Portman N, Fernandez KJ, Lee C, Alexandrou S, Llop-Guevara A, Phan Z, Yong A, Wilkinson A, Sergio CM, Ferraro D, Etemadmoghadam D, Bowtell DD, Serra V, Waring P, Lim E, Caldon CE. Synergistic targeting of BRCA1 mutated breast cancers with PARP and CDK2 inhibition. NPJ Breast Cancer 2021; 7:111. [PMID: 34465787 PMCID: PMC8408175 DOI: 10.1038/s41523-021-00312-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/28/2021] [Indexed: 12/18/2022] Open
Abstract
Basal-like breast cancers (BLBC) are aggressive breast cancers that respond poorly to targeted therapies and chemotherapies. In order to define therapeutically targetable subsets of BLBC we examined two markers: cyclin E1 and BRCA1 loss. In high grade serous ovarian cancer (HGSOC) these markers are mutually exclusive, and define therapeutic subsets. We tested the same hypothesis for BLBC. Using a BLBC cohort enriched for BRCA1 loss, we identified convergence between BRCA1 loss and high cyclin E1 protein expression, in contrast to HGSOC in which CCNE1 amplification drives increased cyclin E1. In cell lines, BRCA1 loss was associated with stabilized cyclin E1 during the cell cycle, and BRCA1 siRNA led to increased cyclin E1 in association with reduced phospho-cyclin E1 T62. Mutation of cyclin E1 T62 to alanine increased cyclin E1 stability. We showed that tumors with high cyclin E1/BRCA1 mutation in the BLBC cohort also had decreased phospho-T62, supporting this hypothesis. Since cyclin E1/CDK2 protects cells from DNA damage and cyclin E1 is elevated in BRCA1 mutant cancers, we hypothesized that CDK2 inhibition would sensitize these cancers to PARP inhibition. CDK2 inhibition induced DNA damage and synergized with PARP inhibitors to reduce cell viability in cell lines with homologous recombination deficiency, including BRCA1 mutated cell lines. Treatment of BRCA1 mutant BLBC patient-derived xenograft models with combination PARP and CDK2 inhibition led to tumor regression and increased survival. We conclude that BRCA1 status and high cyclin E1 have potential as predictive biomarkers to dictate the therapeutic use of combination CDK inhibitors/PARP inhibitors in BLBC.
Collapse
Affiliation(s)
- Diar Aziz
- Centre for Translational Pathology, Department of Pathology and Department of Surgery, University of Melbourne, Parkville, VIC, Australia
- Peter MacCallum Cancer Institute, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC, Australia
- Pathology Department, College of Medicine, University of Mosul, Mosul, Iraq
| | - Neil Portman
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
- St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Kristine J Fernandez
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Christine Lee
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Sarah Alexandrou
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Alba Llop-Guevara
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Zoe Phan
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Aliza Yong
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Ashleigh Wilkinson
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - C Marcelo Sergio
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Danielle Ferraro
- Centre for Translational Pathology, Department of Pathology and Department of Surgery, University of Melbourne, Parkville, VIC, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC, Australia
| | - Dariush Etemadmoghadam
- Peter MacCallum Cancer Institute, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - David D Bowtell
- Peter MacCallum Cancer Institute, Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia
| | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Paul Waring
- Centre for Translational Pathology, Department of Pathology and Department of Surgery, University of Melbourne, Parkville, VIC, Australia
- Department of Surgery, University of Melbourne, Parkville, VIC, Australia
| | - Elgene Lim
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
- St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - C Elizabeth Caldon
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia.
- St. Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.
| |
Collapse
|
9
|
Song H, Dicks EM, Tyrer J, Intermaggio M, Chenevix-Trench G, Bowtell DD, Traficante N, Group A, Brenton J, Goranova T, Hosking K, Piskorz A, van Oudenhove E, Doherty J, Harris HR, Rossing MA, Duerst M, Dork T, Bogdanova NV, Modugno F, Moysich K, Odunsi K, Ness R, Karlan BY, Lester J, Jensen A, Krüger Kjaer S, Høgdall E, Campbell IG, Lázaro C, Pujara MA, Cunningham J, Vierkant R, Winham SJ, Hildebrandt M, Huff C, Li D, Wu X, Yu Y, Permuth JB, Levine DA, Schildkraut JM, Riggan MJ, Berchuck A, Webb PM, Group OS, Cybulski C, Gronwald J, Jakubowska A, Lubinski J, Alsop J, Harrington P, Chan I, Menon U, Pearce CL, Wu AH, de Fazio A, Kennedy CJ, Goode E, Ramus S, Gayther S, Pharoah P. Population-based targeted sequencing of 54 candidate genes identifies PALB2 as a susceptibility gene for high-grade serous ovarian cancer. J Med Genet 2021; 58:305-313. [PMID: 32546565 PMCID: PMC8086250 DOI: 10.1136/jmedgenet-2019-106739] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/13/2020] [Accepted: 05/12/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The known epithelial ovarian cancer (EOC) susceptibility genes account for less than 50% of the heritable risk of ovarian cancer suggesting that other susceptibility genes exist. The aim of this study was to evaluate the contribution to ovarian cancer susceptibility of rare deleterious germline variants in a set of candidate genes. METHODS We sequenced the coding region of 54 candidate genes in 6385 invasive EOC cases and 6115 controls of broad European ancestry. Genes with an increased frequency of putative deleterious variants in cases versus controls were further examined in an independent set of 14 135 EOC cases and 28 655 controls from the Ovarian Cancer Association Consortium and the UK Biobank. For each gene, we estimated the EOC risks and evaluated associations between germline variant status and clinical characteristics. RESULTS The ORs associated for high-grade serous ovarian cancer were 3.01 for PALB2 (95% CI 1.59 to 5.68; p=0.00068), 1.99 for POLK (95% CI 1.15 to 3.43; p=0.014) and 4.07 for SLX4 (95% CI 1.34 to 12.4; p=0.013). Deleterious mutations in FBXO10 were associated with a reduced risk of disease (OR 0.27, 95% CI 0.07 to 1.00, p=0.049). However, based on the Bayes false discovery probability, only the association for PALB2 in high-grade serous ovarian cancer is likely to represent a true positive. CONCLUSIONS We have found strong evidence that carriers of PALB2 deleterious mutations are at increased risk of high-grade serous ovarian cancer. Whether the magnitude of risk is sufficiently high to warrant the inclusion of PALB2 in cancer gene panels for ovarian cancer risk testing is unclear; much larger sample sizes will be needed to provide sufficiently precise estimates for clinical counselling.
Collapse
Affiliation(s)
- Honglin Song
- Department of Oncology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Ed M Dicks
- Department of Oncology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Jonathan Tyrer
- Department of Oncology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Maria Intermaggio
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Georgia Chenevix-Trench
- Cancer Genetics, Queensland Institute of Medical Research-QIMR, Herston, Queensland, Australia
| | - David D Bowtell
- Cancer Genomics and Genetics and Women's Cancer Programs, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Nadia Traficante
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Aocs Group
- QIMR Berghofer Department of Genetics and Computational Biology, Herston, Queensland, Australia
- Department of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - James Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Teodora Goranova
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Karen Hosking
- Department of Oncology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Anna Piskorz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Elke van Oudenhove
- Laura and Isaac Perlmutter Cancer Center, New York University, New York, New York, USA
| | - Jen Doherty
- Huntsman Institute, University of Utah, Salt Lake City, Utah, USA
| | - Holly R Harris
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Mary Anne Rossing
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Matthias Duerst
- Department of Gynaecology, Jena University Hospital, Friedrich Schiller University Jena, Jena, Thüringen, Germany
| | - Thilo Dork
- Gynaecology Research Unit, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Natalia V Bogdanova
- Department of Radiation Oncology, Hannover Medical School, Hannover, Niedersachsen, Germany
- Department of Gynaecology, NN Alexandrov National Cancer Centre, Minsk, Minsk, Belarus
| | - Francesmary Modugno
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kirsten Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Kunle Odunsi
- Department of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Roberta Ness
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Beth Y Karlan
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jenny Lester
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Kobenhavn, Denmark
| | - Susanne Krüger Kjaer
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Kobenhavn, Denmark
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Kobenhavn, Denmark
- Department of Pathology, Herlev Hospital, University of Copenhagen, Kobenhavn, Denmark
| | - Ian G Campbell
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Conxi Lázaro
- Hereditary Cancer Program, Catalan Institute of Oncology, Barcelona, Catalunya, Spain
| | - Miguel Angel Pujara
- Translational Research Laboratory, Catalan Institute of Oncology, Barcelona, Catalunya, Spain
| | - Julie Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Robert Vierkant
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Stacey J Winham
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle Hildebrandt
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Chad Huff
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Donghui Li
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xifeng Wu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yao Yu
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer B Permuth
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Douglas A Levine
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Gynecologic Oncology, Laura and Isaac Pearlmutter Cancer Center, New York University, New York, New York, USA
| | - Joellen M Schildkraut
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Marjorie J Riggan
- Department of Gynecologic Oncology, Duke University Hospital, Durham, North Carolina, USA
| | - Andrew Berchuck
- Department of Gynecologic Oncology, Duke University Hospital, Durham, North Carolina, USA
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Opal Study Group
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Zachodniopomorskie, Poland
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Zachodniopomorskie, Poland
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Zachodniopomorskie, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University in Szczecin, Szczecin, Zachodniopomorskie, Poland
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Zachodniopomorskie, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Patricia Harrington
- Department of Oncology, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Isaac Chan
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, London, UK
| | - Celeste L Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Anna de Fazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Ellen Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Susan Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - Simon Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Paul Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
10
|
Kalachand RD, Stordal B, Madden S, Chandler B, Cunningham J, Goode EL, Ruscito I, Braicu EI, Sehouli J, Ignatov A, Yu H, Katsaros D, Mills GB, Lu KH, Carey MS, Timms KM, Kupryjanczyk J, Rzepecka IK, Podgorska A, McAlpine JN, Swisher EM, Bernards SS, O'Riain C, O'Toole S, O'Leary JJ, Bowtell DD, Thomas DM, Prieske K, Joosse SA, Woelber L, Chaudhry P, Häfner N, Runnebaum IB, Hennessy BT. BRCA1 Promoter Methylation and Clinical Outcomes in Ovarian Cancer: An Individual Patient Data Meta-Analysis. J Natl Cancer Inst 2021; 112:1190-1203. [PMID: 32413141 DOI: 10.1093/jnci/djaa070] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/23/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND BRCA1 methylation has been associated with homologous recombination deficiency, a biomarker of platinum sensitivity. Studies evaluating BRCA1-methylated tubal and ovarian cancer (OC) do not consistently support improved survival following platinum chemotherapy. We examine the characteristics of BRCA1-methylated OC in a meta-analysis of individual participant data. METHODS Data of 2636 participants across 15 studies were analyzed. BRCA1-methylated tumors were defined according to their original study. Associations between BRCA1 methylation and clinicopathological characteristics were evaluated. The effects of methylation on overall survival (OS) and progression-free survival (PFS) were examined using mixed-effects models. All statistical tests were 2-sided. RESULTS 430 (16.3%) tumors were BRCA1-methylated. BRCA1 methylation was associated with younger age and advanced-stage, high-grade serous OC. There were no survival differences between BRCA1-methylated and non-BRCA1-methylated OC (median PFS = 20.0 vs 18.5 months, hazard ratio [HR] = 1.01, 95% CI = 0.87 to 1.16; P = .98; median OS = 46.6 vs 48.0 months, HR = 1.02, 95% CI = 0.87 to 1.18; P = .96). Where BRCA1/2 mutations were evaluated (n = 1248), BRCA1 methylation displayed no survival advantage over BRCA1/2-intact (BRCA1/2 wild-type non-BRCA1-methylated) OC. Studies used different methods to define BRCA1 methylation. Where BRCA1 methylation was determined using methylation-specific polymerase chain reaction and gel electrophoresis (n = 834), it was associated with improved survival (PFS: HR = 0.80, 95% CI = 0.66 to 0.97; P = .02; OS: HR = 0.80, 95% CI = 0.63 to 1.00; P = .05) on mixed-effects modeling. CONCLUSION BRCA1-methylated OC displays similar clinicopathological features to BRCA1-mutated OC but is not associated with survival. Heterogeneity within BRCA1 methylation assays influences associations. Refining these assays may better identify cases with silenced BRCA1 function and improved patient outcomes.
Collapse
Affiliation(s)
- Roshni D Kalachand
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Britta Stordal
- Department of Natural Sciences, Middlesex University, Hendon, London NW4 4BT, UK
| | - Stephen Madden
- Data Science Centre, Royal College of Surgeons in Ireland, Beaux Lane House, Dublin, Ireland
| | - Benjamin Chandler
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA
| | - Julie Cunningham
- Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ellen L Goode
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Ilary Ruscito
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.,Cell Therapy Unit and Laboratory of Tumor Immunology, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Elena I Braicu
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Jalid Sehouli
- Department of Gynecology, European Competence Center for Ovarian Cancer, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Atanas Ignatov
- Department of Gynecology and Obstetrics, University Medical Center, Regensburg, Germany
| | - Herbert Yu
- University of Hawaii Cancer Centre, Honolulu, HI, USA
| | - Dionyssios Katsaros
- AOU Citta della Salute and Department of Surgical Sciences, Gynecologic Oncology, University of Torino, Italy
| | - Gordon B Mills
- Department of Cell, Development and Cancer Biology Knight Cancer Institute, Oregon Health and Sciences University, Portland, OR, USA
| | - Karen H Lu
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark S Carey
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Jolanta Kupryjanczyk
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Iwona K Rzepecka
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Agnieszka Podgorska
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Jessica N McAlpine
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Ciaran O'Riain
- Department of Histopathology, Trinity College Dublin, Central Pathology Laboratory, St. James's Hospital, Dublin, Ireland
| | - Sharon O'Toole
- Department of Obstetrics and Gynaecology/Histopathology, Trinity College Dublin, Trinity Centre for Health Sciences, St. James's Hospital, Dublin, Ireland.,Emer Casey Research Laboratory, Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Central Pathology Laboratory, St. James's Hospital, Dublin, Ireland.,Emer Casey Research Laboratory, Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | | | - David M Thomas
- Genomic Cancer Medicine, Cancer Division, Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Darlinghurst, Australia
| | - Katharina Prieske
- Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon A Joosse
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linn Woelber
- Department of Gynecology and Gynecologic Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Parvesh Chaudhry
- Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Norman Häfner
- Department for Gynaecology and Reproductive Medicine, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany
| | - Ingo B Runnebaum
- Department for Gynaecology and Reproductive Medicine, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany
| | - Bryan T Hennessy
- Medical Oncology Group, Department of Molecular Medicine, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.,Department of Medical Oncology, Beaumont Hospital, Dublin, Ireland.,Our Lady of Lourdes Hospital, Drogheda, Ireland
| |
Collapse
|
11
|
Kassuhn W, Klein O, Darb-Esfahani S, Lammert H, Handzik S, Taube ET, Schmitt WD, Keunecke C, Horst D, Dreher F, George J, Bowtell DD, Dorigo O, Hummel M, Sehouli J, Blüthgen N, Kulbe H, Braicu EI. Classification of Molecular Subtypes of High-Grade Serous Ovarian Cancer by MALDI-Imaging. Cancers (Basel) 2021; 13:cancers13071512. [PMID: 33806030 PMCID: PMC8036744 DOI: 10.3390/cancers13071512] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary High-grade serous ovarian cancer (HGSOC) accounts for 70% of ovarian carcinomas with sobering survival rates. The mechanisms mediating treatment efficacy are still poorly understood with no adequate biomarkers of response to treatment and risk assessment. This variability of treatment response might be due to its molecular heterogeneity. Therefore, identification of biomarkers or molecular signatures to stratify patients and offer personalized treatment is of utmost priority. Currently, comprehensive gene expression profiling is time- and cost-extensive and limited by tissue heterogeneity. Thus, it has not been implemented into clinical practice. This study demonstrates for the first time a spatially resolved, time- and cost-effective approach to stratifying HGSOC patients by combining novel matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS) technology with machine-learning algorithms. Eventually, MALDI-derived predictive signatures for treatment efficacy, recurrent risk, or, as demonstrated here, molecular subtypes might be utilized for emerging clinical challenges to ultimately improve patient outcomes. Abstract Despite the correlation of clinical outcome and molecular subtypes of high-grade serous ovarian cancer (HGSOC), contemporary gene expression signatures have not been implemented in clinical practice to stratify patients for targeted therapy. Hence, we aimed to examine the potential of unsupervised matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS) to stratify patients who might benefit from targeted therapeutic strategies. Molecular subtyping of paraffin-embedded tissue samples from 279 HGSOC patients was performed by NanoString analysis (ground truth labeling). Next, we applied MALDI-IMS paired with machine-learning algorithms to identify distinct mass profiles on the same paraffin-embedded tissue sections and distinguish HGSOC subtypes by proteomic signature. Finally, we devised a novel approach to annotate spectra of stromal origin. We elucidated a MALDI-derived proteomic signature (135 peptides) able to classify HGSOC subtypes. Random forest classifiers achieved an area under the curve (AUC) of 0.983. Furthermore, we demonstrated that the exclusion of stroma-associated spectra provides tangible improvements to classification quality (AUC = 0.988). Moreover, novel MALDI-based stroma annotation achieved near-perfect classifications (AUC = 0.999). Here, we present a concept integrating MALDI-IMS with machine-learning algorithms to classify patients according to distinct molecular subtypes of HGSOC. This has great potential to assign patients for personalized treatment.
Collapse
Affiliation(s)
- Wanja Kassuhn
- Tumorbank Ovarian Cancer Network, ENGOT biobank, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (W.K.); (C.K.); (J.S.); (H.K.)
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizi Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - Oliver Klein
- BIH Center for Regenerative Therapies BCRT, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (O.K.); (S.H.)
| | - Silvia Darb-Esfahani
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
- Institute of Pathology Berlin-Spandau and Berlin-Buch, 13589 Berlin, Germany
| | - Hedwig Lammert
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
| | - Sylwia Handzik
- BIH Center for Regenerative Therapies BCRT, Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany; (O.K.); (S.H.)
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
| | - Eliane T. Taube
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
| | - Wolfgang D. Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
| | - Carlotta Keunecke
- Tumorbank Ovarian Cancer Network, ENGOT biobank, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (W.K.); (C.K.); (J.S.); (H.K.)
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizi Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - David Horst
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
| | - Felix Dreher
- Alacris Theranostics GmbH, 12489 Berlin, Germany;
| | - Joshy George
- The Jackson Laboratory for Genomic Medicine, Farmington, CT 06032, USA;
| | - David D. Bowtell
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, 3010 Parkville, Victoria, Australia;
| | - Oliver Dorigo
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford Women’s Cance Center, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Michael Hummel
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
| | - Jalid Sehouli
- Tumorbank Ovarian Cancer Network, ENGOT biobank, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (W.K.); (C.K.); (J.S.); (H.K.)
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizi Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - Nils Blüthgen
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (S.D.-E.); (H.L.); (E.T.T.); (W.D.S.); (D.H.); (M.H.); (N.B.)
- IRI Life Sciences, Humboldt University, 10115 Berlin, Germany
| | - Hagen Kulbe
- Tumorbank Ovarian Cancer Network, ENGOT biobank, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (W.K.); (C.K.); (J.S.); (H.K.)
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizi Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - Elena I. Braicu
- Tumorbank Ovarian Cancer Network, ENGOT biobank, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (W.K.); (C.K.); (J.S.); (H.K.)
- Department of Gynecology, European Competence Center for Ovarian Cancer, Charité-Universitätsmedizi Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Virchow Klinikum, 13353 Berlin, Germany
- Correspondence: ; Tel.: +49-030-450-664469
| |
Collapse
|
12
|
Yang X, Song H, Leslie G, Engel C, Hahnen E, Auber B, Horváth J, Kast K, Niederacher D, Turnbull C, Houlston R, Hanson H, Loveday C, Dolinsky JS, LaDuca H, Ramus SJ, Menon U, Rosenthal AN, Jacobs I, Gayther SA, Dicks E, Nevanlinna H, Aittomäki K, Pelttari LM, Ehrencrona H, Borg Å, Kvist A, Rivera B, Hansen TVO, Djursby M, Lee A, Dennis J, Bowtell DD, Traficante N, Diez O, Balmaña J, Gruber SB, Chenevix-Trench G, Investigators KC, Jensen A, Kjær SK, Høgdall E, Castéra L, Garber J, Janavicius R, Osorio A, Golmard L, Vega A, Couch FJ, Robson M, Gronwald J, Domchek SM, Culver JO, de la Hoya M, Easton DF, Foulkes WD, Tischkowitz M, Meindl A, Schmutzler RK, Pharoah PDP, Antoniou AC. Ovarian and Breast Cancer Risks Associated With Pathogenic Variants in RAD51C and RAD51D. J Natl Cancer Inst 2020; 112:1242-1250. [PMID: 32107557 PMCID: PMC7735771 DOI: 10.1093/jnci/djaa030] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/07/2020] [Accepted: 02/25/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The purpose of this study was to estimate precise age-specific tubo-ovarian carcinoma (TOC) and breast cancer (BC) risks for carriers of pathogenic variants in RAD51C and RAD51D. METHODS We analyzed data from 6178 families, 125 with pathogenic variants in RAD51C, and 6690 families, 60 with pathogenic variants in RAD51D. TOC and BC relative and cumulative risks were estimated using complex segregation analysis to model the cancer inheritance patterns in families while adjusting for the mode of ascertainment of each family. All statistical tests were two-sided. RESULTS Pathogenic variants in both RAD51C and RAD51D were associated with TOC (RAD51C: relative risk [RR] = 7.55, 95% confidence interval [CI] = 5.60 to 10.19; P = 5 × 10-40; RAD51D: RR = 7.60, 95% CI = 5.61 to 10.30; P = 5 × 10-39) and BC (RAD51C: RR = 1.99, 95% CI = 1.39 to 2.85; P = 1.55 × 10-4; RAD51D: RR = 1.83, 95% CI = 1.24 to 2.72; P = .002). For both RAD51C and RAD51D, there was a suggestion that the TOC relative risks increased with age until around age 60 years and decreased thereafter. The estimated cumulative risks of developing TOC to age 80 years were 11% (95% CI = 6% to 21%) for RAD51C and 13% (95% CI = 7% to 23%) for RAD51D pathogenic variant carriers. The estimated cumulative risks of developing BC to 80 years were 21% (95% CI = 15% to 29%) for RAD51C and 20% (95% CI = 14% to 28%) for RAD51D pathogenic variant carriers. Both TOC and BC risks for RAD51C and RAD51D pathogenic variant carriers varied by cancer family history and could be as high as 32-36% for TOC, for carriers with two first-degree relatives diagnosed with TOC, or 44-46% for BC, for carriers with two first-degree relatives diagnosed with BC. CONCLUSIONS These estimates will facilitate the genetic counseling of RAD51C and RAD51D pathogenic variant carriers and justify the incorporation of RAD51C and RAD51D into cancer risk prediction models.
Collapse
Affiliation(s)
- Xin Yang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Honglin Song
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Goska Leslie
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Eric Hahnen
- Faculty of Medicine and University Hospital Cologne, Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, University of Cologne, Cologne, Germany
| | - Bernd Auber
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Judit Horváth
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - Karin Kast
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dieter Niederacher
- Department of Gynecology and Obstetrics, Heinrich-Heine University Düsseldorf, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Richard Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Helen Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Chey Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | | | | | - Susan J Ramus
- School of Women’s and Children’s Health, Faculty of Medicine, University of NSW Sydney, Sydney, New South Wales, Australia
- Garvan Institute of Medical Research, The Kinghorn Cancer Centre, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Adam N Rosenthal
- Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Ian Jacobs
- Women’s Cancer, Institute for Women’s Health, University College London, London, UK
- University of New South Wales, Sydney, New South Wales, Australia
- University of Manchester, Manchester, UK
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Ed Dicks
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Liisa M Pelttari
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Hans Ehrencrona
- Department of Clinical Genetics and Pathology, Laboratory Medicine, Office for Medical Services, Region Skåne, Lund, Sweden
- Division of Clinical Genetics, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Åke Borg
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Anders Kvist
- Division of Oncology and Pathology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Barbara Rivera
- Gerald Bronfman Dept Oncology, Jewish General Hospital, McGill University and Lady Davis Institute, Montréal, QC, Canada
- Program in Molecular Mechanisms and Experimental Therapy in Oncology (Oncobell), IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Thomas V O Hansen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Genetics Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Malene Djursby
- Department of Clinical Genetics Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andrew Lee
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - David D Bowtell
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum, Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Nadia Traficante
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum, Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Orland Diez
- Oncogenetics Group, Vall dHebron Institute of Oncology, Barcelona, Spain
- Clinical and Molecular Genetics Area, University Hospital Vall dHebron, Barcelona, Spain
| | - Judith Balmaña
- Hereditary Cancer Genetics Group, Vall d’Hebron Institute of Oncology, Barcelona, Spain
- Department of Medical Oncology, University Hospital of Vall d’Hebron, Barcelona, Spain
| | - Stephen B Gruber
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjær
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Pathology, Molecular Unit, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Laurent Castéra
- Department of Cancer Biology and Genetics, Normandy Centre for Genomic and Personalized Medicine, François Baclesse Center, Inserm U1245, Caen, France
| | - Judy Garber
- Cancer Risk and Prevention Clinic, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ramunas Janavicius
- Department of Molecular and Regenerative Medicine, Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
- State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Ana Osorio
- Centro de Investigación en Red de Enfermedades Raras, Madrid, Spain
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Madrid, Spain
| | - Lisa Golmard
- Institut Curie, Paris Sciences Lettres Research University, Service de Génétique, Paris, France
| | - Ana Vega
- Centro de Investigación en Red de Enfermedades Raras, Madrid, Spain
- Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mark Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, Clinical Genetics Service, New York, NY, USA
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Susan M Domchek
- Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Julie O Culver
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Miguel de la Hoya
- Molecular Oncology Laboratory CIBERONC, Hospital Clinico San Carlos, IdISSC (Instituto de Investigación Sanitaria del Hospital Clínico San Carlos), Madrid, Spain
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - William D Foulkes
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, University of Cologne, Cologne, Germany
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marc Tischkowitz
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, University of Cologne, Cologne, Germany
- National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - Alfons Meindl
- Department of Gynecology and Obstetrics, University of Munich, Campus Großhadern, Munich, Germany
| | - Rita K Schmutzler
- Faculty of Medicine and University Hospital Cologne, Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Antonis C Antoniou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| |
Collapse
|
13
|
Talhouk A, George J, Wang C, Budden T, Tan TZ, Chiu DS, Kommoss S, Leong HS, Chen S, Intermaggio MP, Gilks B, Nazeran TM, Volchek M, Elatre W, Bentley RC, Senz J, Lum A, Chow V, Sudderuddin H, Mackenzie R, Leong SCY, Liu G, Johnson D, Chen B, Group A, Alsop J, Banerjee SN, Behrens S, Bodelon C, Brand AH, Brinton L, Carney ME, Chiew YE, Cushing-Haugen KL, Cybulski C, Ennis D, Fereday S, Fortner RT, García-Donas J, Gentry-Maharaj A, Glasspool R, Goranova T, Greene CS, Haluska P, Harris HR, Hendley J, Hernandez BY, Herpel E, Jimenez-Linan M, Karpinskyj C, Kaufmann SH, Keeney GL, Kennedy CJ, Köbel M, Koziak JM, Larson MC, Lester J, Lewsley LA, Lissowska J, Lubiński J, Luk H, Macintyre G, Mahner S, McNeish IA, Menkiszak J, Nevins N, Osorio A, Oszurek O, Palacios J, Hinsley S, Pearce CL, Pike MC, Piskorz AM, Ray-Coquard I, Rhenius V, Rodriguez-Antona C, Sharma R, Sherman ME, De Silva D, Singh N, Sinn P, Slamon D, Song H, Steed H, Stronach EA, Thompson PJ, Tołoczko A, Trabert B, Traficante N, Tseng CC, Widschwendter M, Wilkens LR, Winham SJ, Winterhoff B, Beeghly-Fadiel A, Benitez J, Berchuck A, Brenton JD, Brown R, Chang-Claude J, Chenevix-Trench G, deFazio A, Fasching PA, García MJ, Gayther SA, Goodman MT, Gronwald J, Henderson MJ, Karlan BY, Kelemen LE, Menon U, Orsulic S, Pharoah PDP, Wentzensen N, Wu AH, Schildkraut JM, Rossing MA, Konecny GE, Huntsman DG, Huang RYJ, Goode EL, Ramus SJ, Doherty JA, Bowtell DD, Anglesio MS. Development and Validation of the Gene Expression Predictor of High-grade Serous Ovarian Carcinoma Molecular SubTYPE (PrOTYPE). Clin Cancer Res 2020; 26:5411-5423. [PMID: 32554541 PMCID: PMC7572656 DOI: 10.1158/1078-0432.ccr-20-0103] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 03/31/2020] [Accepted: 06/11/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Gene expression-based molecular subtypes of high-grade serous tubo-ovarian cancer (HGSOC), demonstrated across multiple studies, may provide improved stratification for molecularly targeted trials. However, evaluation of clinical utility has been hindered by nonstandardized methods, which are not applicable in a clinical setting. We sought to generate a clinical grade minimal gene set assay for classification of individual tumor specimens into HGSOC subtypes and confirm previously reported subtype-associated features. EXPERIMENTAL DESIGN Adopting two independent approaches, we derived and internally validated algorithms for subtype prediction using published gene expression data from 1,650 tumors. We applied resulting models to NanoString data on 3,829 HGSOCs from the Ovarian Tumor Tissue Analysis consortium. We further developed, confirmed, and validated a reduced, minimal gene set predictor, with methods suitable for a single-patient setting. RESULTS Gene expression data were used to derive the predictor of high-grade serous ovarian carcinoma molecular subtype (PrOTYPE) assay. We established a de facto standard as a consensus of two parallel approaches. PrOTYPE subtypes are significantly associated with age, stage, residual disease, tumor-infiltrating lymphocytes, and outcome. The locked-down clinical grade PrOTYPE test includes a model with 55 genes that predicted gene expression subtype with >95% accuracy that was maintained in all analytic and biological validations. CONCLUSIONS We validated the PrOTYPE assay following the Institute of Medicine guidelines for the development of omics-based tests. This fully defined and locked-down clinical grade assay will enable trial design with molecular subtype stratification and allow for objective assessment of the predictive value of HGSOC molecular subtypes in precision medicine applications.See related commentary by McMullen et al., p. 5271.
Collapse
Affiliation(s)
- Aline Talhouk
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, British Columbia, Canada
| | - Joshy George
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut
| | - Chen Wang
- Mayo Clinic, Division of Biomedical Statistics and Informatics, Department of Health Science Research, Rochester, Minnesota
| | - Timothy Budden
- University of NSW Sydney, School of Women's and Children's Health, Faculty of Medicine, Sydney, New South Wales, Australia
- The University of Manchester, CRUK Manchester Institute, Manchester, United Kingdom
| | - Tuan Zea Tan
- National University of Singapore, Cancer Science Institute of Singapore, Center for Translational Medicine, Singapore, Singapore
| | - Derek S Chiu
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Stefan Kommoss
- Tuebingen University Hospital, Department of Women's Health, Tuebingen, Germany
| | - Huei San Leong
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Stephanie Chen
- Cedars-Sinai Medical Center, Center for Cancer Prevention and Translational Genomics, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Maria P Intermaggio
- University of NSW Sydney, School of Women's and Children's Health, Faculty of Medicine, Sydney, New South Wales, Australia
| | - Blake Gilks
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tayyebeh M Nazeran
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Mila Volchek
- Royal Women's Hospital, Anatomical Pathology, Parkville, Victoria, Australia
| | - Wafaa Elatre
- Department of Pathology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Rex C Bentley
- Department of Pathology, Duke University Hospital, Durham, North Carolina
| | - Janine Senz
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amy Lum
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Veronica Chow
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Hanwei Sudderuddin
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Robertson Mackenzie
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Samuel C Y Leong
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Geyi Liu
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Dustin Johnson
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Billy Chen
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
| | - Aocs Group
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, Queensland, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Susana N Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Gynaecology Unit, London, United Kingdom
| | - Sabine Behrens
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Clara Bodelon
- NCI, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Alison H Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Louise Brinton
- NCI, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Michael E Carney
- Department of Obstetrics and Gynecology, University of Hawaii, John A. Burns School of Medicine, Honolulu, Hawaii
| | - Yoke-Eng Chiew
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Kara L Cushing-Haugen
- Fred Hutchinson Cancer Research Center, Program in Epidemiology, Division of Public Health Sciences, Seattle, Washington
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Darren Ennis
- Imperial College London, Division of Cancer and Ovarian Cancer Action Research Centre, Department Surgery & Cancer, London, United Kingdom
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Sian Fereday
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Renée T Fortner
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Jesús García-Donas
- HM Hospitales Centro Integral Oncológico Clara Campal (HM CIOCC), Madrid, Spain
| | - Aleksandra Gentry-Maharaj
- University College London, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, United Kingdom
| | - Rosalind Glasspool
- Department of Medical Oncology, Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, United Kingdom
| | - Teodora Goranova
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Casey S Greene
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Paul Haluska
- Mayo Clinic, Department of Oncology, Rochester, Minnesota
| | - Holly R Harris
- Fred Hutchinson Cancer Research Center, Program in Epidemiology, Division of Public Health Sciences, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Joy Hendley
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Brenda Y Hernandez
- University of Hawaii Cancer Center, Cancer Epidemiology Program, Honolulu, Hawaii
| | - Esther Herpel
- Institute of Pathology and NCT Tissue Bank, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Chloe Karpinskyj
- University College London, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, United Kingdom
| | - Scott H Kaufmann
- Mayo Clinic, Department of Oncology, Rochester, Minnesota
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
| | - Gary L Keeney
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada
| | | | - Melissa C Larson
- Mayo Clinic, Division of Biomedical Statistics and Informatics, Department of Health Science Research, Rochester, Minnesota
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
- Cedars-Sinai Medical Center, Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Liz-Anne Lewsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Jolanta Lissowska
- M Sklodowska Curie National Research Institute of Oncology, Department of Cancer Epidemiology and Prevention, Warsaw, Poland
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Hugh Luk
- University of Hawaii Cancer Center, Cancer Epidemiology Program, Honolulu, Hawaii
| | - Geoff Macintyre
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Iain A McNeish
- Imperial College London, Division of Cancer and Ovarian Cancer Action Research Centre, Department Surgery & Cancer, London, United Kingdom
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Nikilyn Nevins
- Department of Gynaecological Oncology, Westmead Hospital and Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Ana Osorio
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid, Spain
| | - Oleg Oszurek
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - José Palacios
- Hospital Universitario Ramón y Cajal, Pathology Department. IRYCIS. CIBERONC. Universidad de Alcalá, Madrid, Spain
| | - Samantha Hinsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Celeste L Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Malcolm C Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Anna M Piskorz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | | | - Valerie Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Cristina Rodriguez-Antona
- Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, New South Wales, Australia
- University of Western Sydney at Westmead Hospital, Sydney, New South Wales, Australia
| | - Mark E Sherman
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Jacksonville, Florida
| | - Dilrini De Silva
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, United Kingdom
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dennis Slamon
- Division of Hematology and Oncology, Department of Medicine, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - Honglin Song
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Euan A Stronach
- Imperial College London, Division of Cancer and Ovarian Cancer Action Research Centre, Department Surgery & Cancer, London, United Kingdom
| | - Pamela J Thompson
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Los Angeles, California
| | - Aleksandra Tołoczko
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Britton Trabert
- NCI, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland
| | - Nadia Traficante
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Chiu-Chen Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Martin Widschwendter
- Department of Women's Cancer, Institute for Women's Health, University College London, London, United Kingdom
| | - Lynne R Wilkens
- University of Hawaii Cancer Center, Cancer Epidemiology Program, Honolulu, Hawaii
| | - Stacey J Winham
- Mayo Clinic, Division of Biomedical Statistics and Informatics, Department of Health Science Research, Rochester, Minnesota
| | - Boris Winterhoff
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, Minnesota
| | - Alicia Beeghly-Fadiel
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Javier Benitez
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid, Spain
| | - Andrew Berchuck
- Department of Gynecologic Oncology, Duke University Hospital, Durham, North Carolina
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Robert Brown
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Jenny Chang-Claude
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
- University Medical Center Hamburg-Eppendorf, Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Georgia Chenevix-Trench
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, Queensland, Australia
| | - Anna deFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Peter A Fasching
- Division of Hematology and Oncology, Department of Medicine, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, California
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - María J García
- Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Simon A Gayther
- Cedars-Sinai Medical Center, Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Los Angeles, California
| | - Marc T Goodman
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Los Angeles, California
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Michelle J Henderson
- Children's Cancer Institute, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Beth Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
- Cedars-Sinai Medical Center, Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Linda E Kelemen
- Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Usha Menon
- University College London, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, United Kingdom
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
- Cedars-Sinai Medical Center, Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | | - Anna H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mary Anne Rossing
- Fred Hutchinson Cancer Research Center, Program in Epidemiology, Division of Public Health Sciences, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Gottfried E Konecny
- Division of Hematology and Oncology, Department of Medicine, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, California
| | - David G Huntsman
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
| | - Ruby Yun-Ju Huang
- National University of Singapore, Cancer Science Institute of Singapore, Center for Translational Medicine, Singapore, Singapore
- National Taiwan University, School of Medicine, College of Medicine, Taipei City, Taiwan
| | - Ellen L Goode
- Division of Epidemiology, Department of Health Science Research, Mayo Clinic, Rochester, Minnesota.
| | - Susan J Ramus
- University of NSW Sydney, School of Women's and Children's Health, Faculty of Medicine, Sydney, New South Wales, Australia.
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Jennifer A Doherty
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.
| | - David D Bowtell
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael S Anglesio
- British Columbia's Gynecological Cancer Research Program (OVCARE), BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada.
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
14
|
Martins FC, Couturier DL, Paterson A, Karnezis AN, Chow C, Nazeran TM, Odunsi A, Gentry-Maharaj A, Vrvilo A, Hein A, Talhouk A, Osorio A, Hartkopf AD, Brooks-Wilson A, DeFazio A, Fischer A, Hartmann A, Hernandez BY, McCauley BM, Karpinskyj C, de Sousa CB, Høgdall C, Tiezzi DG, Herpel E, Taran FA, Modugno F, Keeney G, Nelson G, Steed H, Song H, Luk H, Benitez J, Alsop J, Koziak JM, Lester J, Rothstein JH, de Andrade JM, Lundvall L, Paz-Ares L, Robles-Díaz L, Wilkens LR, Garcia MJ, Intermaggio MP, Alcaraz ML, Brett MA, Beckmann MW, Jimenez-Linan M, Anglesio M, Carney ME, Schneider M, Traficante N, Pejovic N, Singh N, Le N, Sinn P, Ghatage P, Erber R, Edwards R, Vierkant R, Ness RB, Leung S, Orsulic S, Brucker SY, Kaufmann SH, Fereday S, Gayther S, Winham SJ, Kommoss S, Pejovic T, Longacre TA, McGuire V, Rhenius V, Sieh W, Shvetsov YB, Whittemore AS, Staebler A, Karlan BY, Rodriguez-Antona C, Bowtell DD, Goode EL, Høgdall E, Candido Dos Reis FJ, Gronwald J, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, Fasching PA, Crawford R, Deen S, Menon U, Huntsman DG, Köbel M, Ramus SJ, Pharoah PDP, Brenton JD. Clinical and pathological associations of PTEN expression in ovarian cancer: a multicentre study from the Ovarian Tumour Tissue Analysis Consortium. Br J Cancer 2020; 123:793-802. [PMID: 32555365 PMCID: PMC7463007 DOI: 10.1038/s41416-020-0900-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 03/14/2020] [Accepted: 04/29/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND PTEN loss is a putative driver in histotypes of ovarian cancer (high-grade serous (HGSOC), endometrioid (ENOC), clear cell (CCOC), mucinous (MOC), low-grade serous (LGSOC)). We aimed to characterise PTEN expression as a biomarker in epithelial ovarian cancer in a large population-based study. METHODS Tumours from 5400 patients from a multicentre observational, prospective cohort study of the Ovarian Tumour Tissue Analysis Consortium were used to evaluate associations between immunohistochemical PTEN patterns and overall survival time, age, stage, grade, residual tumour, CD8+ tumour-infiltrating lymphocytes (TIL) counts, expression of oestrogen receptor (ER), progesterone receptor (PR) and androgen receptor (AR) by means of Cox proportional hazard models and generalised Cochran-Mantel-Haenszel tests. RESULTS Downregulation of cytoplasmic PTEN expression was most frequent in ENOC (most frequently in younger patients; p value = 0.0001) and CCOC and was associated with longer overall survival in HGSOC (hazard ratio: 0.78, 95% CI: 0.65-0.94, p value = 0.022). PTEN expression was associated with ER, PR and AR expression (p values: 0.0008, 0.062 and 0.0002, respectively) in HGSOC and with lower CD8 counts in CCOC (p value < 0.0001). Heterogeneous expression of PTEN was more prevalent in advanced HGSOC (p value = 0.019) and associated with higher CD8 counts (p value = 0.0016). CONCLUSIONS PTEN loss is a frequent driver in ovarian carcinoma associating distinctly with expression of hormonal receptors and CD8+ TIL counts in HGSOC and CCOC histotypes.
Collapse
MESH Headings
- Adenocarcinoma, Clear Cell/enzymology
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Age Factors
- Biomarkers, Tumor/biosynthesis
- Biomarkers, Tumor/genetics
- Carcinoma, Ovarian Epithelial/enzymology
- Carcinoma, Ovarian Epithelial/genetics
- Carcinoma, Ovarian Epithelial/mortality
- Carcinoma, Ovarian Epithelial/pathology
- Cohort Studies
- Down-Regulation
- Female
- Gene Knockout Techniques
- Humans
- Middle Aged
- Neoplasm Staging
- Ovarian Neoplasms/enzymology
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- PTEN Phosphohydrolase/biosynthesis
- PTEN Phosphohydrolase/deficiency
- PTEN Phosphohydrolase/genetics
- Prospective Studies
- Receptors, Androgen/biosynthesis
- Receptors, Estrogen/biosynthesis
- Receptors, Progesterone/biosynthesis
- Tissue Array Analysis
- Tumor Suppressor Proteins/biosynthesis
- Tumor Suppressor Proteins/deficiency
Collapse
Affiliation(s)
- Filipe Correia Martins
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, England
- Experimental Medicine Initiative, University of Cambridge, Cambridge, England
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, England
| | - Dominique-Laurent Couturier
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, England
| | - Anna Paterson
- Department of Histopathology, Addenbrookes Hospital, Cambridge, England
| | - Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Christine Chow
- OVCARE, Vancouver Coastal Health Research Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Tayyebeh M Nazeran
- Department of Molecular Oncology and Department of Pathology and Laboratory Medicine, BC Cancer Research Centre, BC Cancer, Vancouver, BC, Canada
| | - Adekunle Odunsi
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Aleksandra Vrvilo
- Department of Ob/Gyn, Oregon Health & Science University, Portland, OR, USA
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Aline Talhouk
- Department of Molecular Oncology and Department of Pathology and Laboratory Medicine, BC Cancer Research Centre, BC Cancer, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, BC Cancer, Vancouver, BC, Canada
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas D Hartkopf
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Angela Brooks-Wilson
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Anna Fischer
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- MRC CTU, Institute of Clinical Trials and Methodology, University College London, London, England
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Claus Høgdall
- Department of Gynaecology, Rigshospitalet, University Hospital Copenhagen, Blegdamsvej 9, 2100, København, Denmark
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Esther Herpel
- NCT Tissue Bank, National Center for Tumour Diseases, Heidelberg, Germany
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Gary Keeney
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Honglin Song
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Cambridge, England
| | - Hugh Luk
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Javier Benitez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Jennifer Alsop
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Cambridge, England
| | | | - Jenny Lester
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Joseph H Rothstein
- Department of Population Health Science and Policy and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lene Lundvall
- Department of Gynaecology, Rigshospitalet, University Hospital Copenhagen, Blegdamsvej 9, 2100, København, Denmark
| | - Luis Paz-Ares
- Spanish National Cancer Research Center, CNIO Lung Cancer Clinical Research Unit, New York, NY, USA
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Maria J Garcia
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria P Intermaggio
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Marie-Lyne Alcaraz
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Cambridge, England
| | - Mary A Brett
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | - Michael Anglesio
- OVCARE, Vancouver Coastal Health Research Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology and Department of Pathology and Laboratory Medicine, BC Cancer Research Centre, BC Cancer, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Michael E Carney
- John A. Burns School of Medicine, Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, HI, USA
| | - Michael Schneider
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Nadia Traficante
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - Nadja Pejovic
- School of Medicine, St. Louis University, St. Louis, MO, 63103, USA
| | - Naveena Singh
- Department of Cellular Pathology, Barts Health National Health Service Trust, London, England
| | - Nhu Le
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Peter Sinn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ramona Erber
- Institute of Pathology, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Robert Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Roberta B Ness
- University of Texas School of Public Health, Houston, TX, USA
| | - Samuel Leung
- OVCARE, Vancouver Coastal Health Research Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Sandra Orsulic
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Scott H Kaufmann
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sian Fereday
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
- Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - Simon Gayther
- Cedars-Sinai Center for Bioinformatics and Functional Genomics, Los Angeles, CA, USA
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Tanja Pejovic
- Department of Ob/Gyn, Oregon Health & Science University, Portland, OR, USA
| | - Teri A Longacre
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Valerie Rhenius
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Cambridge, England
| | - Weiva Sieh
- Department of Population Health Science and Policy and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yurii B Shvetsov
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
- Department of Pathology, University of Melbourne, Melbourne, VIC, Australia
| | - Alice S Whittemore
- Department of Health Research and Policy and Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Annette Staebler
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Beth Y Karlan
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Cristina Rodriguez-Antona
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III Madrid, Madrid, Spain
| | - David D Bowtell
- Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Parkville, VIC, Australia
- The Garvan Institute, Sydney, NSW, Australia
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
- Cancer Genomics Program, Research Department, Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology, Biostatistics and Preventative Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, 90095, USA
| | - Robin Crawford
- Division of Oncology, Addenbrookes Hospital, Cambridge, England
| | - Suha Deen
- Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, England
| | - Usha Menon
- MRC CTU, Institute of Clinical Trials and Methodology, University College London, London, England
| | - David G Huntsman
- OVCARE, Vancouver Coastal Health Research Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology and Department of Pathology and Laboratory Medicine, BC Cancer Research Centre, BC Cancer, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, BC Cancer, Vancouver, BC, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Susan J Ramus
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
- The Garvan Institute, Sydney, NSW, Australia
| | - Paul D P Pharoah
- Department of Oncology, Strangeways Research Laboratory, University of Cambridge, Cambridge, England.
- Department of Public Health and Primary Care, Strangeways Research Laboratory, University of Cambridge, Worts Causeway, Cambridge, England.
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, England.
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, England.
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, England.
- Department of Oncology, Hutchison/MRC Research Centre, University of Cambridge, Cambridge, England.
| |
Collapse
|
15
|
Millstein J, Budden T, Goode EL, Anglesio MS, Talhouk A, Intermaggio MP, Leong HS, Chen S, Elatre W, Gilks B, Nazeran T, Volchek M, Bentley RC, Wang C, Chiu DS, Kommoss S, Leung SCY, Senz J, Lum A, Chow V, Sudderuddin H, Mackenzie R, George J, Fereday S, Hendley J, Traficante N, Steed H, Koziak JM, Köbel M, McNeish IA, Goranova T, Ennis D, Macintyre G, Silva De Silva D, Ramón Y Cajal T, García-Donas J, Hernando Polo S, Rodriguez GC, Cushing-Haugen KL, Harris HR, Greene CS, Zelaya RA, Behrens S, Fortner RT, Sinn P, Herpel E, Lester J, Lubiński J, Oszurek O, Tołoczko A, Cybulski C, Menkiszak J, Pearce CL, Pike MC, Tseng C, Alsop J, Rhenius V, Song H, Jimenez-Linan M, Piskorz AM, Gentry-Maharaj A, Karpinskyj C, Widschwendter M, Singh N, Kennedy CJ, Sharma R, Harnett PR, Gao B, Johnatty SE, Sayer R, Boros J, Winham SJ, Keeney GL, Kaufmann SH, Larson MC, Luk H, Hernandez BY, Thompson PJ, Wilkens LR, Carney ME, Trabert B, Lissowska J, Brinton L, Sherman ME, Bodelon C, Hinsley S, Lewsley LA, Glasspool R, Banerjee SN, Stronach EA, Haluska P, Ray-Coquard I, Mahner S, Winterhoff B, Slamon D, Levine DA, Kelemen LE, Benitez J, Chang-Claude J, Gronwald J, Wu AH, Menon U, Goodman MT, Schildkraut JM, Wentzensen N, Brown R, Berchuck A, Chenevix-Trench G, deFazio A, Gayther SA, García MJ, Henderson MJ, Rossing MA, Beeghly-Fadiel A, Fasching PA, Orsulic S, Karlan BY, Konecny GE, Huntsman DG, Bowtell DD, Brenton JD, Doherty JA, Pharoah PDP, Ramus SJ. Prognostic gene expression signature for high-grade serous ovarian cancer. Ann Oncol 2020; 31:1240-1250. [PMID: 32473302 PMCID: PMC7484370 DOI: 10.1016/j.annonc.2020.05.019] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Median overall survival (OS) for women with high-grade serous ovarian cancer (HGSOC) is ∼4 years, yet survival varies widely between patients. There are no well-established, gene expression signatures associated with prognosis. The aim of this study was to develop a robust prognostic signature for OS in patients with HGSOC. PATIENTS AND METHODS Expression of 513 genes, selected from a meta-analysis of 1455 tumours and other candidates, was measured using NanoString technology from formalin-fixed paraffin-embedded tumour tissue collected from 3769 women with HGSOC from multiple studies. Elastic net regularization for survival analysis was applied to develop a prognostic model for 5-year OS, trained on 2702 tumours from 15 studies and evaluated on an independent set of 1067 tumours from six studies. RESULTS Expression levels of 276 genes were associated with OS (false discovery rate < 0.05) in covariate-adjusted single-gene analyses. The top five genes were TAP1, ZFHX4, CXCL9, FBN1 and PTGER3 (P < 0.001). The best performing prognostic signature included 101 genes enriched in pathways with treatment implications. Each gain of one standard deviation in the gene expression score conferred a greater than twofold increase in risk of death [hazard ratio (HR) 2.35, 95% confidence interval (CI) 2.02-2.71; P < 0.001]. Median survival [HR (95% CI)] by gene expression score quintile was 9.5 (8.3 to -), 5.4 (4.6-7.0), 3.8 (3.3-4.6), 3.2 (2.9-3.7) and 2.3 (2.1-2.6) years. CONCLUSION The OTTA-SPOT (Ovarian Tumor Tissue Analysis consortium - Stratified Prognosis of Ovarian Tumours) gene expression signature may improve risk stratification in clinical trials by identifying patients who are least likely to achieve 5-year survival. The identified novel genes associated with the outcome may also yield opportunities for the development of targeted therapeutic approaches.
Collapse
Affiliation(s)
- J Millstein
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - T Budden
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, Australia; CRUK Manchester Institute, The University of Manchester, Manchester, UK
| | - E L Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, USA
| | - M S Anglesio
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - A Talhouk
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - M P Intermaggio
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, Australia
| | - H S Leong
- Peter MacCallum Cancer Center, Melbourne, Australia
| | - S Chen
- Center for Cancer Prevention and Translational Genomics, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - W Elatre
- Department of Pathology, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, USA
| | - B Gilks
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - T Nazeran
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - M Volchek
- Anatomical Pathology, Royal Women's Hospital, Parkville, Australia
| | - R C Bentley
- Department of Pathology, Duke University Hospital, Durham, USA
| | - C Wang
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, USA
| | - D S Chiu
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - S Kommoss
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - S C Y Leung
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - J Senz
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - A Lum
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - V Chow
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - H Sudderuddin
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - R Mackenzie
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada
| | - J George
- The Jackson Laboratory for Genomic Medicine, Farmington, USA
| | - S Fereday
- Peter MacCallum Cancer Center, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - J Hendley
- Peter MacCallum Cancer Center, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - N Traficante
- Peter MacCallum Cancer Center, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - H Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Canada
| | - J M Koziak
- Alberta Health Services-Cancer Care, Calgary, Canada
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Canada
| | - I A McNeish
- Division of Cancer and Ovarian Cancer Action Research Centre, Department Surgery & Cancer, Imperial College London, London, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - T Goranova
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - D Ennis
- Division of Cancer and Ovarian Cancer Action Research Centre, Department Surgery & Cancer, Imperial College London, London, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - D Silva De Silva
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - T Ramón Y Cajal
- Medical Oncology Service, Hospital Sant Pau, Barcelona, Spain
| | - J García-Donas
- HM Hospitales D Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - S Hernando Polo
- Medical Oncology Service, Hospital Universitario Funcacion Alcorcon, Alcorcón, Spain
| | - G C Rodriguez
- Division of Gynecologic Oncology, NorthShore University HealthSystem, University of Chicago, Evanston, USA
| | - K L Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - H R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA; Department of Epidemiology, University of Washington, Seattle, USA
| | - C S Greene
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - R A Zelaya
- Department of Genetics, Geisel School of Medicine at Dartmouth, Hanover, USA
| | - S Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Sinn
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - E Herpel
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases, University Hospital and German Cancer Research Center, Heidelberg, Germany
| | - J Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, USA; Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - O Oszurek
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - A Tołoczko
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - C Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - J Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - C L Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, USA; Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, USA
| | - M C Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, USA; Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - C Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - J Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - V Rhenius
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - H Song
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - M Jimenez-Linan
- Department of Pathology, Addenbrooke's Hospital NHS Trust, Cambridge, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - A Gentry-Maharaj
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - C Karpinskyj
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - M Widschwendter
- Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - N Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - C J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia
| | - R Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia; University of Western Sydney at Westmead Hospital, Sydney, Australia
| | - P R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network, Westmead Hospital, Sydney, Australia
| | - B Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network, Westmead Hospital, Sydney, Australia
| | - S E Johnatty
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - R Sayer
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia
| | - J Boros
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia
| | - S J Winham
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, USA
| | - G L Keeney
- Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, USA
| | - S H Kaufmann
- Department of Oncology, Mayo Clinic, Rochester, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, USA
| | - M C Larson
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, USA
| | - H Luk
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - B Y Hernandez
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - P J Thompson
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, USA
| | - L R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
| | - M E Carney
- John A. Burns School of Medicine, Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, USA
| | - B Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - J Lissowska
- Department of Cancer Epidemiology and Prevention, M Sklodowska Curie National Research Institute of Oncology, Warsaw, Poland
| | - L Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - M E Sherman
- Department of Health Sciences Research, Mayo Clinic College of Medicine, Jacksonville, USA
| | - C Bodelon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - S Hinsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - R Glasspool
- Department of Medical Oncology, Beatson West of Scotland Cancer Centre and University of Glasgow, Glasgow, UK
| | - S N Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, UK
| | - E A Stronach
- Division of Cancer and Ovarian Cancer Action Research Centre, Department Surgery & Cancer, Imperial College London, London, UK
| | - P Haluska
- Department of Oncology, Mayo Clinic, Rochester, USA
| | - I Ray-Coquard
- Centre Leon Berard and University Claude Bernard Lyon 1, Lyon, France
| | - S Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany
| | - B Winterhoff
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, Minneapolis, USA
| | - D Slamon
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, USA
| | - D A Levine
- Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA; Gynecologic Oncology, Laura and Isaac Pearlmutter Cancer Center, NYU Langone Medical Center, New York, USA
| | - L E Kelemen
- Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, USA
| | - J Benitez
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain; Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - J Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - A H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - U Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - M T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, USA
| | - J M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - N Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, USA
| | - R Brown
- Division of Cancer and Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Berchuck
- Department of Gynecologic Oncology, Duke University Hospital, Durham, USA
| | - G Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - A deFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, Australia
| | - S A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, USA
| | - M J García
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - M J Henderson
- Children's Cancer Institute, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, Australia
| | - M A Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA; Department of Epidemiology, University of Washington, Seattle, USA
| | - A Beeghly-Fadiel
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - P A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, USA; Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - S Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, USA; Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - B Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, USA; Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - G E Konecny
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, USA
| | - D G Huntsman
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada; Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, Canada
| | - D D Bowtell
- Peter MacCallum Cancer Center, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Australia
| | - J D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - J A Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, USA
| | - P D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK; Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - S J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, Australia; Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, Australia.
| |
Collapse
|
16
|
Mapagu C, Srirangan S, Au-Yeung G, Harnett PR, Bowtell DD, deFazio A. Abstract A48: Antiapoptotic gene expression and sensitivity to BH3-mimetics in chemoresistant, high-grade serous ovarian cancer cell lines. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.ovca19-a48] [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: The development of chemotherapy resistance is common in relapsed high-grade serous ovarian cancer (HGSOC). An understanding of mechanisms that are associated with the development of chemotherapy resistance in the clinical setting is needed to improve treatment outcomes. In this study, cell lines newly derived from patients with relapsed HGSOC were characterized at a molecular level to determine associations with response to commonly used chemotherapy drugs. RNA sequencing combined with high-throughput drug library screening was used to determine potential resistance mechanisms and identify drugs and combinations that may be effective in chemoresistant HGSOC.
Methods: Six ovarian cancer cell lines derived from ascites of relapsed HGSOC patients who had developed chemoresistant disease were characterized using multigene panel mutation testing, whole-genome DNA copy number analysis, and RNA sequencing. Drug responses to carboplatin and paclitaxel were determined using the CellTitre 96® AQueous One Solution Cell Proliferation Assay (Promega). For two of the resistant cell lines, high-throughput drug screens using three drug libraries—NCI-Approved Oncology Drug set (101 compounds), Kinase Inhibitor Library (210 compounds), and Targeted Agent Library (73 compounds)—were carried out to identify agents with activity in these resistant models. Apoptosis activation was measured using CellPlayer Caspase 3/7 assay (Essen Bioscience). Sensitivity to BH3-mimetics, ABT-737 and navitoclax (ABT-263), was tested in three of the cell lines and in one line, the effects of combining these agents with paclitaxel were assessed using CompuSyn.
Results: TP53 mutations were identified in all cell lines, consistent with high-grade serous histology, and all lines were relatively resistant to carboplatin. AOCS5 and AOCS15 were the most resistant to carboplatin and AOCS5 was also highly resistant to paclitaxel. Drug library screens carried out on both AOCS5 and AOCS15 showed differential sensitivity to a number of drug classes. While AOCS5 was found to be generally resistant to most drugs, it was sensitive to ABT-737. RNA-seq identified relative overexpression of antiapoptotic genes in AOCS5, in particular BCL2L1, BCL2, and BCL2L2, in comparison to the other five cell lines. AOCS5 was more sensitive to navitoclax and ABT-737 compared with cell lines that did not overexpress antiapoptotic genes. Combining BH3-mimetics and paclitaxel showed synergism in the highly paclitaxel-resistant cell line AOCS5.
Conclusion: Inhibition of apoptosis was identified as a potential mechanism of paclitaxel resistance, and overexpression of antiapoptotic genes may constitute a biomarker profile to predict sensitivity to BH3-mimetics in relapsed HGSOC.
Citation Format: Cristina Mapagu, Sivatharsny Srirangan, George Au-Yeung, Australian Ovarian Cancer Study, Paul R. Harnett, David D. Bowtell, Anna deFazio. Antiapoptotic gene expression and sensitivity to BH3-mimetics in chemoresistant, high-grade serous ovarian cancer cell lines [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research; 2019 Sep 13-16, 2019; Atlanta, GA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(13_Suppl):Abstract nr A48.
Collapse
Affiliation(s)
- Cristina Mapagu
- 1Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia,
| | - Sivatharsny Srirangan
- 1Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia,
| | | | - Paul R. Harnett
- 4Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | | | - Anna deFazio
- 1Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia,
| | | |
Collapse
|
17
|
Pavanello M, Dicks E, Song H, Ariff A, Bolithon A, Intermaggio MP, Pinese M, Moysich K, Odunsi KO, Goode E, Bowtell DD, Fasching P, Doherty JA, Modugno F, Kjær SK, Webb PM, Wu A, deFazio A, James P, Subramanian D, Campbell I, Gayther SA, Pharoah PD, Ramus SJ. Abstract B37: Germline mutations in new susceptibility genes for non-high-grade serous ovarian cancer. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.ovca19-b37] [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
Improving risk prediction and prevention strategies through identifying new susceptibility genes for non-high-grade serous ovarian cancer (non-HGS) would represent an important advance in reducing incidence and mortality. Epithelial ovarian cancer (EOC) has five main histotypes that have distinct pathologies, molecular changes, clinical characteristics, and tissues of origin. They are classified as high-grade serous (HGS), low-grade serous (LGS), clear-cell (CCC), endometrioid (END), and mucinous (MUC). A family history of breast or ovarian cancer is the strongest single risk factor for EOC. Germline mutations in the high-penetrance susceptibility genes BRCA1 and BRCA2 confer EOC risks of 44% and 17% by age 80, respectively. Only 40% of the excess familial risk is known, suggesting there are many other susceptibility genes yet unidentified. The non-HGS histotypes are poorly studied due to limited sample size within individual studies. Thus, families of cases with non-HGS tumors have few risk prediction options. Whole-exome sequencing (WES) analysis was performed on 251 non-HGS cases (56 LGS, 55 CCC, 117 END, 23 MUC). Cases were screened negative for BRCA1/2 mutations and selected for a family history of ovarian or breast cancer, or young onset (<45 years) of ovarian cancer. WES identified 1,278 genes with rare predicted truncating mutation in at least one case. Predicted truncating mutations in cases were compared to 171,584 controls from the Exome Aggregation Consortium (ExAC) and the Genome Aggregation Database (gnomAD). Gene-set enrichment analysis showed enrichment for genes involved in the DNA repair pathway (p=3.08 × 10−7). Twenty-five candidate genes (including 4 DNA repair genes) were selected for validation by targeted sequencing. Five genes important in HGS (BRIP1, FANCM, PALB2, RAD51C, RAD51D) as well as two additional candidates (XRCC2 and XRCC3) were also sequenced. Targeted sequencing was performed on 1,779 cases (669 END, 356 CCC, 327 LGS, 427 MUC) and 1,863 controls from studies in the Ovarian Cancer Association Consortium (OCAC). Library preparation and target enrichment was performed using the Fluidigm Juno System and Illumina sequencing was performed on a NovaSeq 6000 Sequencing System. A case-control analysis of predicted truncating variants in the 32 genes was performed. Using a minimum alternate allele frequency of 30%, we identified a higher frequency of mutations in non-HGS cases than controls in ERCC6 (p=0.034) and IL31RA (p=0.034). ERCC6 is involved in DNA repair and IL31RA is a cytokine receptor. Sanger sequencing validation of variants to confirm these results is ongoing. Several other genes showed suggestive higher frequencies of mutations in cases than controls. A larger case control analysis will be performed to confirm those findings. Identifying novel susceptibility genes for non-HGS may have clinical impact by reducing disease-associated mortality through improving risk prediction, identifying prevention strategies, and developing new targeted treatments.
Citation Format: Marina Pavanello, Ed Dicks, Honglin Song, Amir Ariff, Adelyn Bolithon, Maria P. Intermaggio, Mark Pinese, Kirsten Moysich, Kunle O. Odunsi, Ellen Goode, David D. Bowtell, Peter Fasching, Jennifer A. Doherty, Francesmary Modugno, Susanne K. Kjær, Penelope M. Webb, Anna Wu, Anna deFazio, Ovarian Cancer Association Consortium, Paul James, Deepak Subramanian, Ian Campbell, Simon A. Gayther, Paul D.P. Pharoah, Susan J. Ramus. Germline mutations in new susceptibility genes for non-high-grade serous ovarian cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research; 2019 Sep 13-16, 2019; Atlanta, GA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(13_Suppl):Abstract nr B37.
Collapse
Affiliation(s)
- Marina Pavanello
- 1School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia,
| | - Ed Dicks
- 2Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom,
| | - Honglin Song
- 2Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom,
| | - Amir Ariff
- 1School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia,
| | - Adelyn Bolithon
- 1School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia,
| | - Maria P. Intermaggio
- 1School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia,
| | - Mark Pinese
- 3Children’s Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia,
- 17The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia,
| | | | | | | | - David D. Bowtell
- 6Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,
- 18University of Melbourne, Parkville, VIC, Australia,
| | - Peter Fasching
- 7University of California at Los Angeles David Geffen School of Medicine, Los Angeles, CA,
- 19Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany,
| | | | - Francesmary Modugno
- 9Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA,
- 20Ovarian Cancer Center of Excellence, Womens Cancer Research Program, University of Pittsburgh School of Medicine, Pittsburgh, PA,
| | - Susanne K. Kjær
- 10Danish Cancer Society Research Center, Copenhagen, Denmark,
- 21Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Penelope M. Webb
- 11QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia,
| | - Anna Wu
- 12University of Southern California Keck School of Medicine, Los Angeles, CA,
| | - Anna deFazio
- 13Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia,
| | - Paul James
- 15Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,
| | | | - Ian Campbell
- 6Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,
| | - Simon A. Gayther
- 16Center for Cancer Prevention and Translational Genomics, Cedars Sinai Medical Center, Los Angeles, CA,
| | - Paul D.P. Pharoah
- 2Strangeways Research Laboratory, University of Cambridge, Cambridge, United Kingdom,
| | - Susan J. Ramus
- 1School of Women’s and Children’s Health, University of New South Wales, Sydney, NSW, Australia,
- 17The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia,
| | | |
Collapse
|
18
|
Millstein J, Budden T, Goode EL, Anglesio MS, Talhouk A, Huntsman DG, Bowtell DD, Brenton JD, Doherty JA, Pharoah PP, Ramus SJ. Abstract IA12: The Ovarian Tumour Tissue Analysis Consortium: Stratified Prognosis of Ovarian Tumors (OTTA-SPOT) signature for high-grade serous ovarian cancer. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.ovca19-ia12] [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: High-grade serous ovarian cancer (HGSOC) is the most common and aggressive epithelial ovarian cancer. HGSOC has poor survival, with five-year survival of less than 40%, as it is often diagnosed at a late stage. The median overall survival (OS) is approximately four years. Prognostic gene expression signatures for HGSOC have been inconsistent and have not been translated into clinical practice. The aim of this study was to develop a robust prognostic signature for HGSOC, in order to identify high-risk patients requiring alternative treatments.
Methods: A meta-analysis of 1,455 tumors was performed and 200 prognostic genes were selected for expression profiling. An additional 315 candidate genes were selected from the literature, drug-targetable pathways, and other hypotheses. NanoString expression analysis of the 513 genes was performed on formalin-fixed, paraffin-embedded (FFPE) tumor tissue from 3,769 women with HGSOC from the Ovarian Tumor Tissue Analysis (OTTA) Consortium. A prognostic model for 5-year survival was developed using regression-based and machine learning methods. The model was trained on 2,702 tumors and evaluated on an independent set of 1,067 tumors. A NanoString expression analysis was performed on 2,692 additional tumors, for a subset of 218 of the genes, including the prognostic signature.
Results: Expression of 276 genes was associated with OS (false discovery rate (FDR) < 0.05) in single-gene analyses adjusted for age, stage, and race. The top five genes were TAP1, ZFHX4, CXCL9, FBN1, and PTGER3 (p << 0.001). A 101-gene prognostic signature was established, where a gain of one standard deviation in the gene expression score conferred a greater than two-fold increase in risk of death (HR (hazard ratio) = 2.35 [2.02, 2.71]; p << 0.001). Median survival by quintile group was 9.5, 5.4, 3.8, 3.2, and 2.3 years. Sensitivity analyses, applying the signature to specific patient groups, showed that the prognostic power of the signature is not explained by residual disease, treatment, BRCA status, or CD8 score. The prognostic signature was enriched in pathways with treatment implications, such as PI3K, GPCR, and immune. This signature is suitable for use in FFPE tumor material and future cases can be assigned an HR from the gene expression score. The signature was developed in cases that did not receive neoadjuvant treatment (NACT); however, application to NACT cases was assessed in the second NanoString expression analysis.
Conclusion: The OTTA-SPOT (Ovarian Tumor Tissue Analysis consortium – Stratified Prognosis of Ovarian Tumors) gene expression signature may improve risk stratification in clinical trials by identifying patients who are least likely to achieve 5-year survival.
Citation Format: Joshua Millstein, Timothy Budden, Ellen L. Goode, Michael S. Anglesio, Aline Talhouk, OTTA consortium, David G. Huntsman, David D. Bowtell, James D. Brenton, Jennifer A. Doherty, Paul P.D. Pharoah, Susan J. Ramus. The Ovarian Tumour Tissue Analysis Consortium: Stratified Prognosis of Ovarian Tumors (OTTA-SPOT) signature for high-grade serous ovarian cancer [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research; 2019 Sep 13-16, 2019; Atlanta, GA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(13_Suppl):Abstract nr IA12.
Collapse
Affiliation(s)
- Joshua Millstein
- 1University of Southern California Keck School of Medicine, Los Angeles, CA,
| | - Timothy Budden
- 2University of NSW Sydney School of Women’s and Children’s Health, Sydney, NSW, Australia,
- 10The University of Manchester CRUK Manchester Institute, Manchester, United Kingdom,
| | | | - Michael S. Anglesio
- 4University of British Columbia, Vancouver, BC, Canada,
- 11BC Cancer Research Centre, Vancouver, BC, Canada,
- 12Vancouver General Hospital, Vancouver, BC, Canada,
| | - Aline Talhouk
- 4University of British Columbia, Vancouver, BC, Canada,
- 11BC Cancer Research Centre, Vancouver, BC, Canada,
- 12Vancouver General Hospital, Vancouver, BC, Canada,
| | - David G. Huntsman
- 4University of British Columbia, Vancouver, BC, Canada,
- 11BC Cancer Research Centre, Vancouver, BC, Canada,
- 12Vancouver General Hospital, Vancouver, BC, Canada,
| | - David D. Bowtell
- 5Peter MacCallum Cancer Centre, Melbourne, VIC, Australia,
- 13University of Melbourne, Parkville, VIC, Australia,
| | - James D. Brenton
- 6Cancer Research UK Cambridge Institute, Cambridge, United Kingdom,
| | | | | | - Susan J. Ramus
- 9University of NSW Sydney, Sydney, NSW, Australia,
- 14The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia,
- 15University of NSW Sydney Lowy Cancer Research Centre, Sydney, NSW, Australia
| | | |
Collapse
|
19
|
Jung M, Gao J, Cheung L, Bongers A, Somers K, Clifton M, Ramsay EE, Russell AJ, Valli E, Gifford AJ, George J, Kennedy CJ, Wakefield MJ, Topp M, Ho GY, Scott CL, Bowtell DD, deFazio A, Norris MD, Haber M, Henderson MJ. ABCC4/MRP4 contributes to the aggressiveness of Myc-associated epithelial ovarian cancer. Int J Cancer 2020; 147:2225-2238. [PMID: 32277480 DOI: 10.1002/ijc.33005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/15/2020] [Accepted: 03/20/2020] [Indexed: 12/24/2022]
Abstract
Epithelial ovarian cancer (EOC) is a complex disease comprising discrete histological and molecular subtypes, for which survival rates remain unacceptably low. Tailored approaches for this deadly heterogeneous disease are urgently needed. Efflux pumps belonging to the ATP-binding cassette (ABC) family of transporters are known for roles in both drug resistance and cancer biology and are also highly targetable. Here we have investigated the association of ABCC4/MRP4 expression to clinical outcome and its biological function in endometrioid and serous tumors, common histological subtypes of EOC. We found high expression of ABCC4/MRP4, previously shown to be directly regulated by c-Myc/N-Myc, was associated with poor prognosis in endometrioid EOC (P = .001) as well as in a subset of serous EOC with a "high-MYCN" profile (C5/proliferative; P = .019). Transient siRNA-mediated suppression of MRP4 in EOC cells led to reduced growth, migration and invasion, with the effects being most pronounced in endometrioid and C5-like serous cells compared to non-C5 serous EOC cells. Sustained knockdown of MRP4 also sensitized endometrioid cells to MRP4 substrate drugs. Furthermore, suppression of MRP4 decreased the growth of patient-derived EOC cells in vivo. Together, our findings provide the first evidence that MRP4 plays an important role in the biology of Myc-associated ovarian tumors and highlight this transporter as a potential therapeutic target for EOC.
Collapse
Affiliation(s)
- Moonsun Jung
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia.,School of Women's and Children's Health, UNSW Australia, Kensington, New South Wales, Australia
| | - Jixuan Gao
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Leanna Cheung
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Angelika Bongers
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Klaartje Somers
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia.,School of Women's and Children's Health, UNSW Australia, Kensington, New South Wales, Australia
| | - Molly Clifton
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Emma E Ramsay
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Amanda J Russell
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Emanuele Valli
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia
| | - Andrew J Gifford
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia.,Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Joshy George
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Catherine J Kennedy
- Department of Gynecological Oncology, Westmead Hospital and Centre for Cancer Research, The Westmead Millennium Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew J Wakefield
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Monique Topp
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Gwo-Yaw Ho
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | -
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Clare L Scott
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - David D Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Anna deFazio
- Department of Gynecological Oncology, Westmead Hospital and Centre for Cancer Research, The Westmead Millennium Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Murray D Norris
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia.,School of Women's and Children's Health, UNSW Australia, Kensington, New South Wales, Australia.,University of New South Wales Centre for Childhood Cancer Research, UNSW Australia, Kensington, New South Wales, Australia
| | - Michelle Haber
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia.,School of Women's and Children's Health, UNSW Australia, Kensington, New South Wales, Australia
| | - Michelle J Henderson
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, New South Wales, Australia.,School of Women's and Children's Health, UNSW Australia, Kensington, New South Wales, Australia
| |
Collapse
|
20
|
Gerstung M, Jolly C, Leshchiner I, Dentro SC, Gonzalez S, Rosebrock D, Mitchell TJ, Rubanova Y, Anur P, Yu K, Tarabichi M, Deshwar A, Wintersinger J, Kleinheinz K, Vázquez-García I, Haase K, Jerman L, Sengupta S, Macintyre G, Malikic S, Donmez N, Livitz DG, Cmero M, Demeulemeester J, Schumacher S, Fan Y, Yao X, Lee J, Schlesner M, Boutros PC, Bowtell DD, Zhu H, Getz G, Imielinski M, Beroukhim R, Sahinalp SC, Ji Y, Peifer M, Markowetz F, Mustonen V, Yuan K, Wang W, Morris QD, Spellman PT, Wedge DC, Van Loo P. The evolutionary history of 2,658 cancers. Nature 2020; 578:122-128. [PMID: 32025013 PMCID: PMC7054212 DOI: 10.1038/s41586-019-1907-7] [Citation(s) in RCA: 518] [Impact Index Per Article: 129.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/18/2019] [Indexed: 01/28/2023]
Abstract
Cancer develops through a process of somatic evolution1,2. Sequencing data from a single biopsy represent a snapshot of this process that can reveal the timing of specific genomic aberrations and the changing influence of mutational processes3. Here, by whole-genome sequencing analysis of 2,658 cancers as part of the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA)4, we reconstruct the life history and evolution of mutational processes and driver mutation sequences of 38 types of cancer. Early oncogenesis is characterized by mutations in a constrained set of driver genes, and specific copy number gains, such as trisomy 7 in glioblastoma and isochromosome 17q in medulloblastoma. The mutational spectrum changes significantly throughout tumour evolution in 40% of samples. A nearly fourfold diversification of driver genes and increased genomic instability are features of later stages. Copy number alterations often occur in mitotic crises, and lead to simultaneous gains of chromosomal segments. Timing analyses suggest that driver mutations often precede diagnosis by many years, if not decades. Together, these results determine the evolutionary trajectories of cancer, and highlight opportunities for early cancer detection.
Collapse
Affiliation(s)
- Moritz Gerstung
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany ,grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK
| | - Clemency Jolly
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Ignaty Leshchiner
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Stefan C. Dentro
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.4991.50000 0004 1936 8948Big Data Institute, University of Oxford, Oxford, UK
| | - Santiago Gonzalez
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK
| | - Daniel Rosebrock
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Thomas J. Mitchell
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.5335.00000000121885934University of Cambridge, Cambridge, UK
| | - Yulia Rubanova
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Pavana Anur
- grid.5288.70000 0000 9758 5690Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR USA
| | - Kaixian Yu
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Maxime Tarabichi
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Amit Deshwar
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Jeff Wintersinger
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | - Kortine Kleinheinz
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Heidelberg University, Heidelberg, Germany
| | - Ignacio Vázquez-García
- grid.10306.340000 0004 0606 5382Wellcome Sanger Institute, Cambridge, UK ,grid.5335.00000000121885934University of Cambridge, Cambridge, UK
| | - Kerstin Haase
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK
| | - Lara Jerman
- grid.225360.00000 0000 9709 7726European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, UK ,grid.8954.00000 0001 0721 6013University of Ljubljana, Ljubljana, Slovenia
| | - Subhajit Sengupta
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, Evanston, IL USA
| | - Geoff Macintyre
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Salem Malikic
- grid.61971.380000 0004 1936 7494Simon Fraser University, Burnaby, British Columbia Canada ,grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada
| | - Nilgun Donmez
- grid.61971.380000 0004 1936 7494Simon Fraser University, Burnaby, British Columbia Canada ,grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada
| | - Dimitri G. Livitz
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Marek Cmero
- grid.1008.90000 0001 2179 088XUniversity of Melbourne, Melbourne, Victoria Australia ,grid.1042.70000 0004 0432 4889Walter and Eliza Hall Institute, Melbourne, Victoria Australia
| | - Jonas Demeulemeester
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.5596.f0000 0001 0668 7884University of Leuven, Leuven, Belgium
| | - Steven Schumacher
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Yu Fan
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Xiaotong Yao
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA ,grid.429884.b0000 0004 1791 0895New York Genome Center, New York, NY USA
| | - Juhee Lee
- grid.205975.c0000 0001 0740 6917University of California Santa Cruz, Santa Cruz, CA USA
| | - Matthias Schlesner
- grid.7497.d0000 0004 0492 0584German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul C. Boutros
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.419890.d0000 0004 0626 690XOntario Institute for Cancer Research, Toronto, Ontario Canada ,grid.19006.3e0000 0000 9632 6718University of California, Los Angeles, CA USA
| | - David D. Bowtell
- grid.1055.10000000403978434Peter MacCallum Cancer Centre, Melbourne, Victoria Australia
| | - Hongtu Zhu
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Gad Getz
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.32224.350000 0004 0386 9924Center for Cancer Research, Massachusetts General Hospital, Charlestown, MA USA ,grid.32224.350000 0004 0386 9924Department of Pathology, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Marcin Imielinski
- grid.5386.8000000041936877XWeill Cornell Medicine, New York, NY USA ,grid.429884.b0000 0004 1791 0895New York Genome Center, New York, NY USA
| | - Rameen Beroukhim
- grid.66859.340000 0004 0546 1623Broad Institute of MIT and Harvard, Cambridge, MA USA ,grid.65499.370000 0001 2106 9910Dana-Farber Cancer Institute, Boston, MA USA
| | - S. Cenk Sahinalp
- grid.412541.70000 0001 0684 7796Vancouver Prostate Centre, Vancouver, British Columbia Canada ,grid.411377.70000 0001 0790 959XIndiana University, Bloomington, IN USA
| | - Yuan Ji
- grid.240372.00000 0004 0400 4439NorthShore University HealthSystem, Evanston, IL USA ,grid.170205.10000 0004 1936 7822The University of Chicago, Chicago, IL USA
| | - Martin Peifer
- grid.6190.e0000 0000 8580 3777University of Cologne, Cologne, Germany
| | - Florian Markowetz
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ville Mustonen
- grid.7737.40000 0004 0410 2071University of Helsinki, Helsinki, Finland
| | - Ke Yuan
- grid.5335.00000000121885934Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK ,grid.8756.c0000 0001 2193 314XUniversity of Glasgow, Glasgow, UK
| | - Wenyi Wang
- grid.240145.60000 0001 2291 4776The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Quaid D. Morris
- grid.17063.330000 0001 2157 2938University of Toronto, Toronto, Ontario Canada ,grid.494618.6Vector Institute, Toronto, Ontario Canada
| | | | - Paul T. Spellman
- grid.5288.70000 0000 9758 5690Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR USA
| | - David C. Wedge
- grid.4991.50000 0004 1936 8948Big Data Institute, University of Oxford, Oxford, UK ,grid.454382.c0000 0004 7871 7212Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Peter Van Loo
- grid.451388.30000 0004 1795 1830The Francis Crick Institute, London, UK ,grid.5596.f0000 0001 0668 7884University of Leuven, Leuven, Belgium
| | | |
Collapse
|
21
|
Garsed DW, Pandey A, Fereday S, Alsop K, Wouters MC, Saner F, Beach JA, Milne K, Kennedy CJ, Hendley J, Traficante N, Pearce CL, Pike MC, Ramus SJ, Köbel M, Nelson BH, Goode EL, deFazio A, Bowtell DD. Abstract 2722: The genomic landscape of high-grade serous ovarian cancer in long-term survivors. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-2722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose: The majority of patients with high-grade serous ovarian cancer (HGSC) develop progressive disease following primary treatment, with a five-year survival rate of ~30%. However, a subset of patients have an extraordinary response to treatment and ~15% survive more than ten years (long-term survivors). The Multidisciplinary Ovarian Cancer Outcomes Group (MOCOG) aims to uncover factors that influence long-term survival of HGSC patients. Here, we investigated the genomic and immunologic determinants of exceptional survival of this deadly disease.
Experimental Design: Patient characteristics and clinical histories were evaluated to identify patients diagnosed with advanced stage (Stage IIIC/IV) and histopathologically confirmed HGSC with greater than 10-year overall survival. Whole-genome sequencing (WGS) was performed on primary tumors (median 78x coverage) and germline samples (median 39x coverage) of 55 long-term survivors. Primary tumor samples were also characterised by RNA sequencing, DNA methylation profiling and immunohistochemistry.
Results: A total 38 (69%) of long-term surviving patients had residual disease following surgery, suggestive of highly chemo-sensitive disease. Most patients (41, 75%) were alive at last follow-up and 26 (47%) were progression-free. Somatic mutation burden was higher in primary tumors of long-term survivors relative to controls (316 unselected HGSC patients in The Cancer Genome Atlas). Genome-wide mutational signatures were predominantly Signature 3 (associated with homologous recombination deficiency), Signature 1 (age related) and Signatures 5, 8 and 16 (unknown etiology). Inactivation of the tumor suppressor RB1 by structural rearrangements or homozygous deletion was frequent in long-term survivors, with 33% of tumors showing associated loss of RB1 protein expression by immunohistochemistry compared to 13% of unselected HGSC controls (n=207; P = 0.001). Staining of adjacent tumor tissue revealed that RB1 loss was associated with increased numbers of PD-1+ tumor-infiltrating lymphocytes (P = 0.015) and MHC class I on tumor cells (P = 0.002). In an independent HGSC cohort (n=847), RB1 protein loss was associated with prolonged survival (HR: 0.75, P < 0.001) compared to patients with RB1 positive tumors. Furthermore, co-occurrence of germline mutations in BRCA1 or BRCA2 and RB1 loss was associated with a significantly longer overall survival compared to patients with retained RB1 protein expression and no germline BRCA mutation (HR: 0.44, P < 0.001).
Conclusions: This study delineates the full landscape of genomic alterations in HGSC of long-term survivors. Our findings indicate that specific mutations might be associated with enhanced host immune responses and long-term survival.
Citation Format: Dale W. Garsed, Ahwan Pandey, Sian Fereday, Kathryn Alsop, Maartje C. Wouters, Flurina Saner, Jessica A. Beach, Katy Milne, Catherine J. Kennedy, Joy Hendley, Nadia Traficante, Celeste L. Pearce, Malcolm C. Pike, Multidisciplinary Ovarian Cancer Outcomes Group, Susan J. Ramus, Martin Köbel, Brad H. Nelson, Ellen L. Goode, Anna deFazio, David D. Bowtell. The genomic landscape of high-grade serous ovarian cancer in long-term survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2722.
Collapse
Affiliation(s)
| | - Ahwan Pandey
- 1Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sian Fereday
- 1Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Kathryn Alsop
- 1Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Flurina Saner
- 1Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Katy Milne
- 2British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | | | - Joy Hendley
- 1Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | | | | | - Martin Köbel
- 7University of Calgary Foothill Medical Center, Calgary, Alberta, Canada
| | - Brad H. Nelson
- 2British Columbia Cancer Agency, Victoria, British Columbia, Canada
| | | | - Anna deFazio
- 3The Westmead Institute for Medical Research, Sydney, Australia
| | | | | |
Collapse
|
22
|
McEvoy CR, Xu H, Smith K, Etemadmoghadam D, San Leong H, Choong DY, Byrne DJ, Iravani A, Beck S, Mileshkin L, Tothill RW, Bowtell DD, Bates BM, Nastevski V, Browning J, Bell AH, Khoo C, Desai J, Fellowes AP, Fox SB, Prall OW. Profound MEK inhibitor response in a cutaneous melanoma harboring a GOLGA4-RAF1 fusion. J Clin Invest 2019; 129:1940-1945. [PMID: 30835257 PMCID: PMC6486352 DOI: 10.1172/jci123089] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 02/26/2019] [Indexed: 12/11/2022] Open
Abstract
BRAF and CRAF are critical components of the MAPK signaling pathway which is activated in many cancer types. In approximately 1% of melanomas, BRAF or CRAF are activated through structural arrangements. We describe here a metastatic melanoma with a GOLGA4-RAF1 fusion and pathogenic variants in CTNNB1 and CDKN2A. Anti-CTLA4/anti-PD1 combination immunotherapy failed to control tumor progression. In the absence of other actionable variants the patient was administered MEK inhibitor therapy on the basis of its potential action against RAF1 fusions. This resulted in a profound and clinically significant response. We demonstrated that GOLGA4-RAF1 expression was associated with ERK activation, elevated expression of the RAS/RAF downstream co-effector ETV5, and a high Ki67 index. These findings provide a rationale for the dramatic response to targeted therapy. This study shows that thorough molecular characterization of treatment-resistant cancers can identify therapeutic targets and personalize management, leading to improved patient outcomes.
Collapse
Affiliation(s)
- Christopher R. McEvoy
- Department of Pathology, and
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Huiling Xu
- Department of Pathology, and
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
- Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | | | | | | | | | | | - Amir Iravani
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sophie Beck
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Linda Mileshkin
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Richard W. Tothill
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
- Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - David D. Bowtell
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | | | | | | | | | - Chloe Khoo
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Jayesh Desai
- Department of Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
- Department of Surgery, St Vincent’s Hospital, Fitzroy, Australia
- Clinical School, Austin Health, Heidelberg, Australia
- Department of Surgery, Royal Melbourne Hospital, Parkville, Australia
| | - Andrew P. Fellowes
- Department of Pathology, and
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Stephen B. Fox
- Department of Pathology, and
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
- Clinical Pathology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | | |
Collapse
|
23
|
Jung M, Russell AJ, Kennedy C, Gifford AJ, Mallitt KA, Sivarajasingam S, Bowtell DD, DeFazio A, Haber M, Norris MD, Henderson MJ. Clinical Importance of Myc Family Oncogene Aberrations in Epithelial Ovarian Cancer. JNCI Cancer Spectr 2018; 2:pky047. [PMID: 31360864 PMCID: PMC6649713 DOI: 10.1093/jncics/pky047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/24/2018] [Accepted: 06/08/2018] [Indexed: 12/21/2022] Open
Abstract
Background The Myc oncogene family has been implicated in many human malignancies and is often associated with particularly aggressive disease, suggesting Myc as an attractive prognostic marker and therapeutic target. However, for epithelial ovarian cancer (EOC), there is little consensus on the incidence and clinical relevance of Myc aberrations. Here we comprehensively investigated alterations in gene copy number, expression, and activity for Myc and evaluated their clinical significance in EOC. Methods To address inconsistencies in the literature regarding the definition of copy number variations, we developed a novel approach using quantitative polymerase chain reaction (qPCR) coupled with a statistical algorithm to estimate objective thresholds for detecting Myc gain/amplification in large cohorts of serous (n = 150) and endometrioid (n = 80) EOC. MYC, MYCN, and MYCL1 mRNA expression and Myc activity score for each case were examined by qPCR. Kaplan–Meier and Cox-regression analyses were conducted to assess clinical significance of Myc aberrations. Results Using a large panel of cancer cell lines (n = 34), we validated the statistical algorithm for determining clear thresholds for Myc gain/amplification. MYC was the most predominantly amplified of the Myc oncogene family members, and high MYC mRNA expression levels were associated with amplification in EOC. However, there was no association between prognosis and increased copy number or gene expression of MYC/MYCN/MYCL1 or with a pan-Myc transcriptional activity score, in EOC, although MYC amplification was associated with late stage and high grade in endometrioid EOC. Conclusion A systematic and comprehensive analysis of Myc genes, transcripts, and activity levels using qPCR revealed that although such aberrations commonly occur in EOC, overall they have limited impact on outcome, suggesting that the biological relevance of Myc oncogene family members is limited to certain subsets of this disease.
Collapse
Affiliation(s)
- MoonSun Jung
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia
| | - Amanda J Russell
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia.,Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Catherine Kennedy
- Department of Gynecological Oncology, Westmead Hospital and Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Andrew J Gifford
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia.,Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, NSW, Australia
| | | | - Kylie-Ann Mallitt
- Centre for Big Data Research in Health/School of Women's and Children's Health, UNSW Australia, Kensington, NSW, Australia
| | - Siva Sivarajasingam
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia
| | - David D Bowtell
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia.,Department of Gynecological Oncology, Westmead Hospital and Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, NSW, Australia.,Peter MacCallum Cancer Centre, Melbourne, VIC, Australia (Australian Ovarian Cancer Study Group).,Centre for Big Data Research in Health/School of Women's and Children's Health, UNSW Australia, Kensington, NSW, Australia.,University of New South Wales Centre for Childhood Cancer Research, UNSW Australia, Kensington, NSW, Australia.,Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Anna DeFazio
- Department of Gynecological Oncology, Westmead Hospital and Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Haber
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia
| | - Murray D Norris
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia.,University of New South Wales Centre for Childhood Cancer Research, UNSW Australia, Kensington, NSW, Australia
| | - Michelle J Henderson
- Children's Cancer Institute Australia, Lowy Cancer Research Centre, UNSW Australia, Kensington, NSW, Australia
| |
Collapse
|
24
|
Coffman LG, Pearson AT, Frisbie LG, Freeman Z, Christie E, Bowtell DD, Buckanovich RJ. Ovarian Carcinoma-Associated Mesenchymal Stem Cells Arise from Tissue-Specific Normal Stroma. Stem Cells 2018; 37:257-269. [PMID: 30353617 PMCID: PMC6392140 DOI: 10.1002/stem.2932] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 02/02/2023]
Abstract
Carcinoma-associated mesenchymal stem cells (CA-MSCs) are critical stromal progenitor cells within the tumor microenvironment (TME). We previously demonstrated that CA-MSCs differentially express bone morphogenetic protein family members, promote tumor cell growth, increase cancer "stemness," and chemotherapy resistance. Here, we use RNA sequencing of normal omental MSCs and ovarian CA-MSCs to demonstrate global changes in CA-MSC gene expression. Using these expression profiles, we create a unique predictive algorithm to classify CA-MSCs. Our classifier accurately distinguishes normal omental, ovary, and bone marrow MSCs from ovarian cancer CA-MSCs. Suggesting broad applicability, the model correctly classifies pancreatic and endometrial cancer CA-MSCs and distinguishes cancer associated fibroblasts from CA-MSCs. Using this classifier, we definitively demonstrate ovarian CA-MSCs arise from tumor mediated reprograming of local tissue MSCs. Although cancer cells alone cannot induce a CA-MSC phenotype, the in vivo ovarian TME can reprogram omental or ovary MSCs to protumorigenic CA-MSCs (classifier score of >0.96). In vitro studies suggest that both tumor secreted factors and hypoxia are critical to induce the CA-MSC phenotype. Interestingly, although the breast cancer TME can reprogram bone marrow MSCs into CA-MSCs, the ovarian TME cannot, demonstrating for the first time that tumor mediated CA-MSC conversion is tissue and cancer type dependent. Together these findings (a) provide a critical tool to define CA-MSCs and (b) highlight cancer cell influence on distinct normal tissues providing powerful insights into the mechanisms underlying cancer specific metastatic niche formation. Stem Cells 2019;37:257-269.
Collapse
Affiliation(s)
- Lan G Coffman
- Division of Hematology Oncology, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alexander T Pearson
- Division of Hematology Oncology, Department of Internal Medicine, University of Chicago, Illinois, USA
| | - Leonard G Frisbie
- Division of Hematology Oncology, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Zachary Freeman
- Unit for Laboratory Animal Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Christie
- Research Division Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - David D Bowtell
- Research Division Peter MacCallum Cancer Centre, Parkville, Victoria, Australia
| | - Ronald J Buckanovich
- Division of Hematology Oncology, Department of Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
25
|
Rambau PF, Vierkant RA, Intermaggio MP, Kelemen LE, Goodman MT, Herpel E, Pharoah PD, Kommoss S, Jimenez‐Linan M, Karlan BY, Gentry‐Maharaj A, Menon U, Polo SH, Candido dos Reis FJ, Doherty JA, Gayther SA, Sharma R, Larson MC, Harnett PR, Hatfield E, de Andrade JM, Nelson GS, Steed H, Schildkraut JM, Carney ME, Høgdall E, Whittemore AS, Widschwendter M, Kennedy CJ, Wang F, Wang Q, Wang C, Armasu SM, Daley F, Coulson P, Jones ME, Anglesio MS, Chow C, de Fazio A, García‐Closas M, Brucker SY, Cybulski C, Harris HR, Hartkopf AD, Huzarski T, Jensen A, Lubiński J, Oszurek O, Benitez J, Mina F, Staebler A, Taran FA, Pasternak J, Talhouk A, Rossing MA, Hendley J, Edwards RP, Fereday S, Modugno F, Ness RB, Sieh W, El‐Bahrawy MA, Winham SJ, Lester J, Kjaer SK, Gronwald J, Sinn P, Fasching PA, Chang‐Claude J, Moysich KB, Bowtell DD, Hernandez BY, Luk H, Behrens S, Shah M, Jung A, Ghatage P, Alsop J, Alsop K, García‐Donas J, Thompson PJ, Swerdlow AJ, Karpinskyj C, Cazorla‐Jiménez A, García MJ, Deen S, Wilkens LR, Palacios J, Berchuck A, Koziak JM, Brenton JD, Cook LS, Goode EL, Huntsman DG, Ramus SJ, Köbel M. Association of p16 expression with prognosis varies across ovarian carcinoma histotypes: an Ovarian Tumor Tissue Analysis consortium study. J Pathol Clin Res 2018; 4:250-261. [PMID: 30062862 PMCID: PMC6174617 DOI: 10.1002/cjp2.109] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/29/2018] [Accepted: 07/16/2018] [Indexed: 12/24/2022]
Abstract
We aimed to validate the prognostic association of p16 expression in ovarian high-grade serous carcinomas (HGSC) and to explore it in other ovarian carcinoma histotypes. p16 protein expression was assessed by clinical-grade immunohistochemistry in 6525 ovarian carcinomas including 4334 HGSC using tissue microarrays from 24 studies participating in the Ovarian Tumor Tissue Analysis consortium. p16 expression patterns were interpreted as abnormal (either overexpression referred to as block expression or absence) or normal (heterogeneous). CDKN2A (which encodes p16) mRNA expression was also analyzed in a subset (n = 2280) mostly representing HGSC (n = 2010). Association of p16 expression with overall survival (OS) was determined within histotypes as was CDKN2A expression for HGSC only. p16 block expression was most frequent in HGSC (56%) but neither protein nor mRNA expression was associated with OS. However, relative to heterogeneous expression, block expression was associated with shorter OS in endometriosis-associated carcinomas, clear cell [hazard ratio (HR): 2.02, 95% confidence (CI) 1.47-2.77, p < 0.001] and endometrioid (HR: 1.88, 95% CI 1.30-2.75, p = 0.004), while absence was associated with shorter OS in low-grade serous carcinomas (HR: 2.95, 95% CI 1.61-5.38, p = 0.001). Absence was most frequent in mucinous carcinoma (50%), and was not associated with OS in this histotype. The prognostic value of p16 expression is histotype-specific and pattern dependent. We provide definitive evidence against an association of p16 expression with survival in ovarian HGSC as previously suggested. Block expression of p16 in clear cell and endometrioid carcinoma should be further validated as a prognostic marker, and absence in low-grade serous carcinoma justifies CDK4 inhibition.
Collapse
Affiliation(s)
- Peter F Rambau
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
- Pathology DepartmentCatholic University of Health and Allied Sciences‐BugandoMwanzaTanzania
| | - Robert A Vierkant
- Department of Health Sciences Research, Division of Biomedical Statistics and InformaticsMayo ClinicRochesterMNUSA
| | - Maria P Intermaggio
- School of Women's and Children's HealthFaculty of Medicine, University of NSW SydneySydneyNSWAustralia
| | - Linda E Kelemen
- Department of Public Health SciencesMedical University of South CarolinaCharlestonSCUSA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Esther Herpel
- National Center for Tumor Diseases, University of HeidelbergHeidelbergGermany
| | - Paul D Pharoah
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Stefan Kommoss
- Department of Women's HealthTübingen University HospitalTübingenGermany
| | | | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Aleksandra Gentry‐Maharaj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College LondonLondonUK
| | - Usha Menon
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College LondonLondonUK
| | | | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Jennifer Anne Doherty
- Department of Population Health SciencesHuntsman Cancer Institute, University of UtahSalt Lake CityUTUSA
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA
- Center for Cancer Prevention and Translational GenomicsSamuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
- Department of Biomedical SciencesCedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Raghwa Sharma
- Pathology West ICPMR WestmeadWestmead Hospital, The University of SydneySydneyNSWAustralia
- University of Western Sydney at Westmead HospitalWestmeadNSWAustralia
| | - Melissa C Larson
- Department of Health Sciences Research, Division of Biomedical Statistics and InformaticsMayo ClinicRochesterMNUSA
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of SydneySydneyNSWAustralia
- The Crown Princess Mary Cancer Centre Westmead, Sydney‐West Cancer Network, Westmead HospitalSydneyNSWAustralia
| | - Emma Hatfield
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic OncologyRoyal Alexandra HospitalEdmontonABCanada
| | | | - Micheal E Carney
- John A. Burns School of Medicine, Department of Obstetrics and GynecologyUniversity of HawaiiHonoluluHIUSA
| | - Estrid Høgdall
- Department of Virus, Lifestyle and GenesDanish Cancer Society Research CenterCopenhagenDenmark
- Molecular Unit, Department of PathologyHerlev Hospital, University of CopenhagenCopenhagenDenmark
| | - Alice S Whittemore
- Department of Health Research and Policy – EpidemiologyStanford University School of MedicineStanfordCAUSA
- Department of Biomedical Data ScienceStanford University School of MedicineStanfordCAUSA
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College LondonLondonUK
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of SydneySydneyNSWAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNSWAustralia
| | - Frances Wang
- Cancer Control and Population SciencesDuke Cancer InstituteDurhamNCUSA
- Department of Community and Family MedicineDuke University Medical CenterDurhamNCUSA
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Chen Wang
- Department of Health Sciences ResearchMayo ClinicRochesterMNUSA
| | - Sebastian M Armasu
- Department of Health Sciences Research, Division of Biomedical Statistics and InformaticsMayo ClinicRochesterMNUSA
| | - Frances Daley
- Division of Breast Cancer ResearchInstitute of Cancer ResearchLondonUK
- Division of BioscienceBrunel UniversityLondonUK
| | - Penny Coulson
- Division of Genetics and EpidemiologyInstitute of Cancer ResearchLondonUK
| | - Micheal E Jones
- Division of Genetics and EpidemiologyInstitute of Cancer ResearchLondonUK
| | - Micheal S Anglesio
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British ColumbiaVancouverBCCanada
| | - Anna de Fazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of SydneySydneyNSWAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNSWAustralia
| | - Montserrat García‐Closas
- Division of Genetics and EpidemiologyInstitute of Cancer ResearchLondonUK
- Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaMDUSA
| | - Sara Y Brucker
- Department of Gynecology and ObstetricsUniversity of TübingenTübingenGermany
| | - Cezary Cybulski
- Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of Environmental Medicine, Division of Nutritional EpidemiologyKarolinska InstitutetStockholmSweden
| | | | - Tomasz Huzarski
- Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Allan Jensen
- Department of Virus, Lifestyle and GenesDanish Cancer Society Research CenterCopenhagenDenmark
| | - Jan Lubiński
- Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Javier Benitez
- Human Cancer Genetics ProgrammeSpanish National Cancer Research Centre (CNIO)MadridSpain
- Biomedical Network on Rare Diseases (CIBERER)MadridSpain
| | - Fady Mina
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| | - Annette Staebler
- Institute of Pathology, Tübingen University HospitalTübingenGermany
| | | | - Jana Pasternak
- Department of Women's HealthTübingen University HospitalTübingenGermany
| | - Aline Talhouk
- British Columbia's Ovarian Cancer Research (OVCARE) ProgramVancouver General Hospital, BC Cancer Agency and University of British ColumbiaVancouverBCCanada
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Joy Hendley
- Department of Research, Cancer Genomics and GeneticsPeter MacCallum Cancer CenterMelbourneVICAustralia
| | - AOCS Group
- Peter MacCallum Cancer CenterMelbourneVICAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Robert P Edwards
- Ovarian Cancer Center of Excellence, Womens Cancer Research ProgramMagee‐Womens Research Institute and University of Pittsburgh Cancer InstitutePittsburghPAUSA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Sian Fereday
- Department of Research, Cancer Genomics and GeneticsPeter MacCallum Cancer CenterMelbourneVICAustralia
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Womens Cancer Research Center, Magee‐Womens Research Institute and Hillman Cancer CenterPittsburghPAUSA
| | - Roberta B Ness
- University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, Icahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Mona A El‐Bahrawy
- Department of Histopathology, Imperial College LondonHammersmith HospitalLondonUK
| | - Stacey J Winham
- Department of Health Sciences Research, Division of Biomedical Statistics and InformaticsMayo ClinicRochesterMNUSA
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Susanne K Kjaer
- Department of Virus, Lifestyle and GenesDanish Cancer Society Research CenterCopenhagenDenmark
- Department of Gynaecology, RigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Jacek Gronwald
- Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Peter Sinn
- Department of PathologyInstitute of Pathology, University Hospital HeidelbergHeidelbergGermany
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and OncologyUniversity of California at Los AngelesLos AngelesCAUSA
- Department of Gynecology and ObstetricsComprehensive Cancer Center ER‐EMN, University Hospital Erlangen, Friedrich‐Alexander‐University Erlangen‐NurembergErlangenGermany
| | - Jenny Chang‐Claude
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
- Cancer Epidemiology GroupUniversity Cancer Center Hamburg (UCCH), University Medical Center Hamburg‐EppendorfHamburgGermany
| | - Kirsten B Moysich
- Division of Cancer Prevention and ControlRoswell Park Cancer InstituteBuffaloNYUSA
| | - David D Bowtell
- Department of Research, Cancer Genomics and GeneticsPeter MacCallum Cancer CenterMelbourneVICAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVICAustralia
| | - Brenda Y Hernandez
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Hugh Luk
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Sabine Behrens
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Audrey Jung
- Division of Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Kathryn Alsop
- Department of Research, Cancer Genomics and GeneticsPeter MacCallum Cancer CenterMelbourneVICAustralia
| | - Jesús García‐Donas
- Medical Oncology ServiceHM Hospitales – Centro Integral Oncológico HM Clara CampalMadridSpain
| | - Pamela J Thompson
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Anthony J Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUK
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College LondonLondonUK
| | | | - María J García
- Human Cancer Genetics ProgrammeSpanish National Cancer Research Centre (CNIO)MadridSpain
- Biomedical Network on Rare Diseases (CIBERER)MadridSpain
| | - Susha Deen
- Department of HistopathologyQueen's Medical Centre, Nottingham University Hospitals NHS TrustNottinghamUK
| | - Lynne R Wilkens
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - José Palacios
- Pathology Department, IRYCIS, CIBERONCUniversidad de Alcalá, Hospital Universitario Ramón y CajalMadridSpain
| | - Andrew Berchuck
- Department of Obstetrics and GynecologyDuke University Medical CenterDurhamNCUSA
| | | | - James D Brenton
- Cancer Research UK Cambridge Institute, University of CambridgeCambridgeUK
| | - Linda S Cook
- University of New Mexico Health Sciences Center, University of New MexicoAlbuquerqueNMUSA
- Department of Cancer Epidemiology and Prevention ResearchAlberta Health ServicesCalgaryABCanada
| | - Ellen L Goode
- Department of Health Science Research, Division of EpidemiologyMayo ClinicRochesterMNUSA
| | - David G Huntsman
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
- British Columbia's Ovarian Cancer Research (OVCARE) ProgramVancouver General Hospital, BC Cancer Agency and University of British ColumbiaVancouverBCCanada
- Department of Molecular OncologyBC Cancer Agency Research CentreVancouverBCCanada
| | - Susan J Ramus
- School of Women's and Children's HealthFaculty of Medicine, University of NSW SydneySydneyNSWAustralia
- The Kinghorn Cancer Centre, Garvan Institute of Medical ResearchSydneyNSWAustralia
| | - Martin Köbel
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| |
Collapse
|
26
|
Kondrashova O, Topp M, Nesic K, Lieschke E, Ho GY, Harrell MI, Zapparoli GV, Hadley A, Holian R, Boehm E, Heong V, Sanij E, Pearson RB, Krais JJ, Johnson N, McNally O, Ananda S, Alsop K, Hutt KJ, Kaufmann SH, Lin KK, Harding TC, Traficante N, deFazio A, McNeish IA, Bowtell DD, Swisher EM, Dobrovic A, Wakefield MJ, Scott CL. Methylation of all BRCA1 copies predicts response to the PARP inhibitor rucaparib in ovarian carcinoma. Nat Commun 2018; 9:3970. [PMID: 30266954 PMCID: PMC6162272 DOI: 10.1038/s41467-018-05564-z] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/25/2018] [Indexed: 01/17/2023] Open
Abstract
Accurately identifying patients with high-grade serous ovarian carcinoma (HGSOC) who respond to poly(ADP-ribose) polymerase inhibitor (PARPi) therapy is of great clinical importance. Here we show that quantitative BRCA1 methylation analysis provides new insight into PARPi response in preclinical models and ovarian cancer patients. The response of 12 HGSOC patient-derived xenografts (PDX) to the PARPi rucaparib was assessed, with variable dose-dependent responses observed in chemo-naive BRCA1/2-mutated PDX, and no responses in PDX lacking DNA repair pathway defects. Among BRCA1-methylated PDX, silencing of all BRCA1 copies predicts rucaparib response, whilst heterozygous methylation is associated with resistance. Analysis of 21 BRCA1-methylated platinum-sensitive recurrent HGSOC (ARIEL2 Part 1 trial) confirmed that homozygous or hemizygous BRCA1 methylation predicts rucaparib clinical response, and that methylation loss can occur after exposure to chemotherapy. Accordingly, quantitative BRCA1 methylation analysis in a pre-treatment biopsy could allow identification of patients most likely to benefit, and facilitate tailoring of PARPi therapy.
Collapse
Affiliation(s)
- Olga Kondrashova
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Monique Topp
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medicine and Health Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Ksenija Nesic
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Elizabeth Lieschke
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
| | - Gwo-Yaw Ho
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
- Royal Women's Hospital, Parkville, VIC, 3052, Australia
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia
| | - Maria I Harrell
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98195, USA
| | - Giada V Zapparoli
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
- School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Alison Hadley
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Robert Holian
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- School of Medicine, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Emma Boehm
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- School of Medicine, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Valerie Heong
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC, 3010, Australia
- Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | - Elaine Sanij
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia
- Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Richard B Pearson
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Department of Biochemistry and Molecular Biology, University of Melbourne, Parkville, VIC, 3010, Australia
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, 3168, Australia
| | - John J Krais
- Fox Chase Cancer Centre, Philadelphia, PA, 19111, USA
| | - Neil Johnson
- Fox Chase Cancer Centre, Philadelphia, PA, 19111, USA
| | - Orla McNally
- Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | | | - Kathryn Alsop
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia
| | - Karla J Hutt
- Department of Medicine and Health Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Scott H Kaufmann
- Departments of Oncology and Molecular Pharmacology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | | | - Nadia Traficante
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia
- Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Anna deFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney Medical School, The University of Sydney and Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, 2145, Australia
| | - Iain A McNeish
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Kensington, London, SW7 2AZ, United Kingdom
| | - David D Bowtell
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia
- Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Elizabeth M Swisher
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, 98195, USA
| | - Alexander Dobrovic
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, 3084, Australia
- School of Cancer Medicine, La Trobe University, Bundoora, VIC, 3086, Australia
- Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Matthew J Wakefield
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia
- Melbourne Bioinformatics, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Clare L Scott
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia.
- Department of Medicine and Health Sciences, Monash University, Clayton, VIC, 3168, Australia.
- Research Division, Peter MacCallum Cancer Centre, Grattan Street, Parkville, VIC, 3010, Australia.
| |
Collapse
|
27
|
Kelemen LE, Brenton JD, Bowtell DD, Fridley BL. Abstract A14: TP53 missense mutations associate with different metabolic pathways. Clin Cancer Res 2018. [DOI: 10.1158/1557-3265.ovca17-a14] [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: Deleterious TP53 mutations are found in 99% of patients with high-grade serous ovarian cancer (HGSOC). TP53 missense mutations, found in two-thirds of HGSOC tumors, endow the mutant protein with new gain-of-function (GOF) activities leading to altered expression of genes involved in maintaining controlled cellular metabolism and the development of drug resistance. Identification of specific altered pathways could be exploited therapeutically. We investigated whether all missense mutations alter the same metabolic pathways.
Methods: We used publicly available data from The Cancer Genome Atlas (TCGA) and the Australia Ovarian Cancer Study (AOCS). TCGA and AOCS gene expression datasets were downloaded from the Curated Ovarian Data, a resource of uniformly prepared microarray data from 23 studies with curated and documented clinical metadata. We merged gene expression data from TCGA (Affymetrix HT_HG-U133A) and AOCS (Affymetrix HG-U133Plus2), subset to 12,211 features common to both datasets and included non-missing values of invasive HGSOC. TP53 mutations were downloaded from TCGA and obtained for AOCS and merged with the curated datasets. The final datasets consisted of 295 patients in TCGA (N=184 with missense mutations with putative GOF activity, and N=111 nonsense mutations with putative loss of function (LOF) activity and 21 wild-type) and 142 patients in AOCS (N=83 missense mutations with putative GOF activity, N=59 nonsense mutations with putative LOF activity and N=13 wild-type). Gene expression values were normalized in each dataset separately by subtracting the mean value of each gene and dividing by the standard deviation. Mutations were categorized according to missense vs nonsense mutation class and also according to specific mutations. We evaluated all gene sets in KEGG but focused a priori on the association of Oxidative Phosphorylation (OXPHOS), Fatty Acid Metabolism (FA), Glycolysis and Gluconeogenesis (GLY), and the P53 pathway with overall (OS) and progression-free survival (PFS) using Cox regression models stratified by mutation class and adjusted for age and stage.
Results: There were no significant differences between TP53 missense vs nonsense mutation class for gene set expressions for a priori pathways of interest in TCGA, and a nominal difference for the P53 gene set expression (P=0.07) in AOCS. Comparing TCGA, AOCS, and the combined datasets, differential gene set expressions by TP53 mutation class were observed in all three datasets at P<0.10 for the sulfur relay system, melanogenesis, peroxisome, and purine metabolism pathways. In AOCS among patients with missense, but not nonsense, mutations, FA gene set expression (P=0.06) was associated with PFS, and FA (P=0.03) and P53 (P=0.09) gene set expressions were associated with OS. No significant associations were observed in TCGA or after combining datasets. When categorized according to specific TP53 mutations, we observed significant differences in gene set expressions. Compared to nonsense mutations, TP53 mutations p.I195N or p.I195T were associated with differentially expressed genes in the GLY pathway (P=0.04) and TP53 mutations p.Y220C or p.Y220H (P=0.01) as well as p.R248G, p.R248Q or p.R248W (P=0.04) were associated with differentially expressed genes in the P53 pathway. Compared with survival among patients with nonsense mutations (median 43.4 months, range 0.3-116 months), patients with p.I195 mutations had OS of 47.7 months (range 3-64 months), patients with Y220 mutations had OS of 37.5 months (range 5-69 months) and patients with p.R248 mutations had OS of 33.6 months (range 0.8-59). Patients with the longest median OS of 84.1 months (range 1-180 months) had mutations p.R273C, p.R273C/R248Q combined, p.R273H, p.R273H/R248Q combined, p.R273L, or p.R273P.
Conclusions: Specific TP53 missense mutations are associated with different metabolic pathways and may lead to differences in survival.
Citation Format: Linda E. Kelemen, James D. Brenton, David D. Bowtell, Brooke L. Fridley. TP53 missense mutations associate with different metabolic pathways. [abstract]. In: Proceedings of the AACR Conference: Addressing Critical Questions in Ovarian Cancer Research and Treatment; Oct 1-4, 2017; Pittsburgh, PA. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(15_Suppl):Abstract nr A14.
Collapse
Affiliation(s)
| | - James D. Brenton
- 2Cancer Research UK Cambridge Research Institute, Cambridge, United Kingdom,
| | | | | |
Collapse
|
28
|
Rambau PF, Vierkant RA, Intermaggio MP, Kelemen LE, Goodman MT, Herpel E, Pharoah PD, Kommoss S, Jimenez-Linan M, Karlan BY, Gentry-Maharaj A, Menon U, Polo SH, Candido Dos Reis FJ, Doherty JA, Gayther SA, Sharma R, Larson MC, Harnett PR, Hatfield E, de Andrade JM, Nelson GS, Steed H, Schildkraut JM, Carney ME, Høgdall E, Whittemore AS, Widschwendter M, Kennedy CJ, Wang F, Wang Q, Wang C, Armasu SM, Daley F, Coulson P, Jones ME, Anglesio MS, Chow C, de Fazio A, García-Closas M, Brucker SY, Cybulski C, Harris HR, Hartkopf AD, Huzarski T, Jensen A, Lubiński J, Oszurek O, Benitez J, Mina F, Staebler A, Taran FA, Pasternak J, Talhouk A, Rossing MA, Hendley J, Edwards RP, Fereday S, Modugno F, Ness RB, Sieh W, El-Bahrawy MA, Winham SJ, Lester J, Kjaer SK, Gronwald J, Sinn P, Fasching PA, Chang-Claude J, Moysich KB, Bowtell DD, Hernandez BY, Luk H, Behrens S, Shah M, Jung A, Ghatage P, Alsop J, Alsop K, García-Donas J, Thompson PJ, Swerdlow AJ, Karpinskyj C, Cazorla-Jiménez A, García MJ, Deen S, Wilkens LR, Palacios J, Berchuck A, Koziak JM, Brenton JD, Cook LS, Goode EL, Huntsman DG, Ramus SJ, Köbel M. Association of p16 expression with prognosis varies across ovarian carcinoma histotypes: an Ovarian Tumor Tissue Analysis consortium study. J Pathol Clin Res 2018. [PMID: 30062862 DOI: 10.1002/cjp2.109] [] [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] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We aimed to validate the prognostic association of p16 expression in ovarian high-grade serous carcinomas (HGSC) and to explore it in other ovarian carcinoma histotypes. p16 protein expression was assessed by clinical-grade immunohistochemistry in 6525 ovarian carcinomas including 4334 HGSC using tissue microarrays from 24 studies participating in the Ovarian Tumor Tissue Analysis consortium. p16 expression patterns were interpreted as abnormal (either overexpression referred to as block expression or absence) or normal (heterogeneous). CDKN2A (which encodes p16) mRNA expression was also analyzed in a subset (n = 2280) mostly representing HGSC (n = 2010). Association of p16 expression with overall survival (OS) was determined within histotypes as was CDKN2A expression for HGSC only. p16 block expression was most frequent in HGSC (56%) but neither protein nor mRNA expression was associated with OS. However, relative to heterogeneous expression, block expression was associated with shorter OS in endometriosis-associated carcinomas, clear cell [hazard ratio (HR): 2.02, 95% confidence (CI) 1.47-2.77, p < 0.001] and endometrioid (HR: 1.88, 95% CI 1.30-2.75, p = 0.004), while absence was associated with shorter OS in low-grade serous carcinomas (HR: 2.95, 95% CI 1.61-5.38, p = 0.001). Absence was most frequent in mucinous carcinoma (50%), and was not associated with OS in this histotype. The prognostic value of p16 expression is histotype-specific and pattern dependent. We provide definitive evidence against an association of p16 expression with survival in ovarian HGSC as previously suggested. Block expression of p16 in clear cell and endometrioid carcinoma should be further validated as a prognostic marker, and absence in low-grade serous carcinoma justifies CDK4 inhibition.
Collapse
Affiliation(s)
- Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada.,Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Robert A Vierkant
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Maria P Intermaggio
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Esther Herpel
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - Paul D Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK.,Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | | | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Usha Menon
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Susanna Hernando Polo
- Medical Oncology Service, Hospital Universitario Funcación Alcorcón, Alcorcón, Spain
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jennifer Anne Doherty
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Center for Cancer Prevention and Translational Genomics, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, NSW, Australia.,University of Western Sydney at Westmead Hospital, Westmead, NSW, Australia
| | - Melissa C Larson
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network, Westmead Hospital, Sydney, NSW, Australia
| | - Emma Hatfield
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Joellen M Schildkraut
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Micheal E Carney
- John A. Burns School of Medicine, Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, HI, USA
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Alice S Whittemore
- Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Frances Wang
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA.,Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sebastian M Armasu
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Frances Daley
- Division of Breast Cancer Research, Institute of Cancer Research, London, UK.,Division of Bioscience, Brunel University, London, UK
| | - Penny Coulson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Micheal E Jones
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Micheal S Anglesio
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Anna de Fazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Montserrat García-Closas
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sara Y Brucker
- Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Andreas D Hartkopf
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Tomasz Huzarski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Fady Mina
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Annette Staebler
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Florin Andrei Taran
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Jana Pasternak
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Aline Talhouk
- British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Joy Hendley
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | -
- Peter MacCallum Cancer Center, Melbourne, VIC, Australia.,Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Robert P Edwards
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.,Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sian Fereday
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
| | - Roberta B Ness
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mona A El-Bahrawy
- Department of Histopathology, Imperial College London, Hammersmith Hospital, London, UK
| | - Stacey J Winham
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susanne K Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, USA.,Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - David D Bowtell
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Brenda Y Hernandez
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Hugh Luk
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Kathryn Alsop
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales - Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Pamela J Thompson
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK.,Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | | | - María J García
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Susha Deen
- Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - José Palacios
- Pathology Department, IRYCIS, CIBERONC, Universidad de Alcalá, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | | | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Linda S Cook
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM, USA.,Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Ellen L Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, BC Cancer Agency Research Centre, Vancouver, BC, Canada
| | - Susan J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia.,The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| |
Collapse
|
29
|
Rambau PF, Vierkant RA, Intermaggio MP, Kelemen LE, Goodman MT, Herpel E, Pharoah PD, Kommoss S, Jimenez-Linan M, Karlan BY, Gentry-Maharaj A, Menon U, Polo SH, Candido Dos Reis FJ, Doherty JA, Gayther SA, Sharma R, Larson MC, Harnett PR, Hatfield E, de Andrade JM, Nelson GS, Steed H, Schildkraut JM, Carney ME, Høgdall E, Whittemore AS, Widschwendter M, Kennedy CJ, Wang F, Wang Q, Wang C, Armasu SM, Daley F, Coulson P, Jones ME, Anglesio MS, Chow C, de Fazio A, García-Closas M, Brucker SY, Cybulski C, Harris HR, Hartkopf AD, Huzarski T, Jensen A, Lubiński J, Oszurek O, Benitez J, Mina F, Staebler A, Taran FA, Pasternak J, Talhouk A, Rossing MA, Hendley J, Edwards RP, Fereday S, Modugno F, Ness RB, Sieh W, El-Bahrawy MA, Winham SJ, Lester J, Kjaer SK, Gronwald J, Sinn P, Fasching PA, Chang-Claude J, Moysich KB, Bowtell DD, Hernandez BY, Luk H, Behrens S, Shah M, Jung A, Ghatage P, Alsop J, Alsop K, García-Donas J, Thompson PJ, Swerdlow AJ, Karpinskyj C, Cazorla-Jiménez A, García MJ, Deen S, Wilkens LR, Palacios J, Berchuck A, Koziak JM, Brenton JD, Cook LS, Goode EL, Huntsman DG, Ramus SJ, Köbel M. Association of p16 expression with prognosis varies across ovarian carcinoma histotypes: an Ovarian Tumor Tissue Analysis consortium study. J Pathol Clin Res 2018. [PMID: 30062862 DOI: 10.1002/cjp2.109]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We aimed to validate the prognostic association of p16 expression in ovarian high-grade serous carcinomas (HGSC) and to explore it in other ovarian carcinoma histotypes. p16 protein expression was assessed by clinical-grade immunohistochemistry in 6525 ovarian carcinomas including 4334 HGSC using tissue microarrays from 24 studies participating in the Ovarian Tumor Tissue Analysis consortium. p16 expression patterns were interpreted as abnormal (either overexpression referred to as block expression or absence) or normal (heterogeneous). CDKN2A (which encodes p16) mRNA expression was also analyzed in a subset (n = 2280) mostly representing HGSC (n = 2010). Association of p16 expression with overall survival (OS) was determined within histotypes as was CDKN2A expression for HGSC only. p16 block expression was most frequent in HGSC (56%) but neither protein nor mRNA expression was associated with OS. However, relative to heterogeneous expression, block expression was associated with shorter OS in endometriosis-associated carcinomas, clear cell [hazard ratio (HR): 2.02, 95% confidence (CI) 1.47-2.77, p < 0.001] and endometrioid (HR: 1.88, 95% CI 1.30-2.75, p = 0.004), while absence was associated with shorter OS in low-grade serous carcinomas (HR: 2.95, 95% CI 1.61-5.38, p = 0.001). Absence was most frequent in mucinous carcinoma (50%), and was not associated with OS in this histotype. The prognostic value of p16 expression is histotype-specific and pattern dependent. We provide definitive evidence against an association of p16 expression with survival in ovarian HGSC as previously suggested. Block expression of p16 in clear cell and endometrioid carcinoma should be further validated as a prognostic marker, and absence in low-grade serous carcinoma justifies CDK4 inhibition.
Collapse
Affiliation(s)
- Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada.,Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Robert A Vierkant
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Maria P Intermaggio
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Esther Herpel
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - Paul D Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK.,Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | | | - Beth Y Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Usha Menon
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Susanna Hernando Polo
- Medical Oncology Service, Hospital Universitario Funcación Alcorcón, Alcorcón, Spain
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jennifer Anne Doherty
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Simon A Gayther
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Center for Cancer Prevention and Translational Genomics, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, NSW, Australia.,University of Western Sydney at Westmead Hospital, Westmead, NSW, Australia
| | - Melissa C Larson
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network, Westmead Hospital, Sydney, NSW, Australia
| | - Emma Hatfield
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Joellen M Schildkraut
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Micheal E Carney
- John A. Burns School of Medicine, Department of Obstetrics and Gynecology, University of Hawaii, Honolulu, HI, USA
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Alice S Whittemore
- Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Frances Wang
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA.,Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Sebastian M Armasu
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Frances Daley
- Division of Breast Cancer Research, Institute of Cancer Research, London, UK.,Division of Bioscience, Brunel University, London, UK
| | - Penny Coulson
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Micheal E Jones
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Micheal S Anglesio
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada
| | - Anna de Fazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Montserrat García-Closas
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK.,Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sara Y Brucker
- Department of Gynecology and Obstetrics, University of Tübingen, Tübingen, Germany
| | - Cezary Cybulski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Andreas D Hartkopf
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Tomasz Huzarski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Allan Jensen
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Fady Mina
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Annette Staebler
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Florin Andrei Taran
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Jana Pasternak
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Aline Talhouk
- British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada
| | - Mary Anne Rossing
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Joy Hendley
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | -
- Peter MacCallum Cancer Center, Melbourne, VIC, Australia.,Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Robert P Edwards
- Ovarian Cancer Center of Excellence, Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.,Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sian Fereday
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
| | - Roberta B Ness
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mona A El-Bahrawy
- Department of Histopathology, Imperial College London, Hammersmith Hospital, London, UK
| | - Stacey J Winham
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Susanne K Kjaer
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Jacek Gronwald
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, CA, USA.,Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - David D Bowtell
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Brenda Y Hernandez
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Hugh Luk
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Kathryn Alsop
- Department of Research, Cancer Genomics and Genetics, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales - Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Pamela J Thompson
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK.,Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London, London, UK
| | | | - María J García
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Susha Deen
- Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lynne R Wilkens
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - José Palacios
- Pathology Department, IRYCIS, CIBERONC, Universidad de Alcalá, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | | | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Linda S Cook
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM, USA.,Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Ellen L Goode
- Department of Health Science Research, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia's Ovarian Cancer Research (OVCARE) Program, Vancouver General Hospital, BC Cancer Agency and University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, BC Cancer Agency Research Centre, Vancouver, BC, Canada
| | - Susan J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia.,The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| |
Collapse
|
30
|
Christie EL, Pattnaik S, Fereday S, Study AOC, Thorne H, Bild A, Bowtell DD. Abstract 3393: Characterizing recurrent high-grade serous ovarian cancer through whole-genome sequencing. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3393] [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
Acquired drug resistance is the major obstacle in controlling high-grade serous ovarian cancer (HGSC) and leads to poor overall survival. Comparatively little massively parallel sequencing data exist from HGSC patients with recurrent disease who have been extensively treated with chemotherapy or newer targeted agents, such as anti-angiogenics or PARP inhibitors (PARPi). We previously identified four mechanisms of acquired resistance from whole-genome sequencing (WGS) of 23 HGSC patients with recurrent disease; a resistance mechanism of any kind was only identified in half of the patients. Since 2012, we have collected tumor samples from 16 HGSC patients through our rapid-autopsy program. On average, we collect 17 tumor sites per patient during the autopsy, and to date we have performed WGS on 28 autopsy samples from 8 patients. These data are allowing us to understand HGSC at end-stage, by examining the complete catalog of resistance mechanisms within an individual patient and reconstructing the natural history of HGSC. One acquired resistance mechanism we identified in HGSC involves transcriptional fusion of the drug efflux pump ABCB1 to an upstream gene that causes its overexpression. ABCB1 encodes the multidrug resistance transporter MDR1, also known as P-glycoprotein. Through WGS and targeted RNA sequencing on end-stage tumor samples as well as recurrent ascites samples, we identified multiple fusion partners to ABCB1, with more than 15% of recurrent HGSC patients harboring ABCB1 transcriptional fusions. A number of HGSC patients carry multiple ABCB1 fusions, demonstrating convergent evolution within patients and the strong selective advantage of ABCB1 overexpression by gene fusion. Extending our analysis to recurrent and autopsy samples from breast and prostate cancer patients also identified ABCB1 transcriptional fusions as a resistance mechanism in these cancers. Our findings suggest that ABCB1 transcriptional fusions are a common mechanism of acquired chemotherapy resistance in ovarian, breast and prostate cancer patients, and that characterizing end-stage disease is particularly informative for understanding resistance mechanisms.
Citation Format: Elizabeth L. Christie, Swetansu Pattnaik, Sian Fereday, Australian Ovarian Cancer Study, Heather Thorne, Andrea Bild, David D. Bowtell. Characterizing recurrent high-grade serous ovarian cancer through whole-genome sequencing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3393.
Collapse
Affiliation(s)
| | | | - Sian Fereday
- 1Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | | | | | | |
Collapse
|
31
|
Jolly C, Gerstung M, Leshchiner I, Dentro SC, Gonzalez S, Mitchell TJ, Rubanova Y, Anur P, Rosebrock D, Yu K, Tarabichi M, Deshwar A, Wintersinger J, Kleinheinz K, Vásquez-García I, Haase K, Sengupta S, Macintyre G, Malikic S, Donmez N, Livitz DG, Cmero M, Demeulemeester J, Schumacher S, Fan Y, Yao X, Lee J, Schlesner M, Boutros PC, Bowtell DD, Zhu H, Getz G, Imielinski M, Beroukhim R, Sahinalp SC, Ji Y, Peifer M, Markowetz F, Mustonen V, Juan K, Wang W, Morris QD, Spellman PT, Wedge DC, Loo PV. Abstract 218: The evolutionary history of 2,658 cancers. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-218] [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
Cancer develops through a continuous process of somatic evolution. Whole genome sequencing provides a snapshot of the tumor genome at the point of sampling, however, the data can contain information that permits the reconstruction of a tumor's evolutionary past.
Here, we apply such life history analyses on an unprecedented scale, to a set of 2,658 tumors spanning 39 cancer types. We estimated the timing of large chromosomal gains during tumor evolution, by comparing the rates of doubled to non-doubled point mutations within gained regions. Although we find that such events typically occur in the second half of clonal evolution, we also observe distinctive and early chromosomal gains in some cancer types, such as gains of chromosomes 7, 19 and 20 in glioblastoma, and isochromosome 17q in medulloblastoma. By integrating these results with the qualitative timing of individual driver mutations, we obtained an overall ranking, from early to late, of frequent somatic events per cancer type, which both identified novel patterns of tumor evolution, and incorporated additional detail into known models, such as the progression of APC-KRAS-TP53 in colorectal cancer proposed by Vogelstein and Fearon.
To estimate how mutational processes acting on the tumor genome change over time, we classified mutations in each sample according to three broad time periods (early clonal, late clonal, and subclonal), and quantified the activity of mutational signatures in each period. Most mutational processes appear to remain remarkably constant, however, certain signatures show clear and consistent changes during clonal evolution. Particularly, mutational signatures associated with exposure to carcinogens, such as smoking and UV light, tend to decrease over time. In contrast, signatures associated with defective endogenous processes, such as APOBEC mutagenesis and defective double strand break repair, show an increase between early and late phases of tumor evolution.
Making use of clock-like mutational signatures, we converted mutational time estimates for large events, such as whole genome duplication (WGD), and the emergence of the most recent common ancestor (MRCA), into real time estimates, which allowed us to combine our analyses into overall timelines of cancer evolution, per tumor type. For example, the typical timeline of ovarian adenocarcinoma development shows that early tumor evolution is characterized by mutations in TP53, and widespread genome instability, with WGD events taking place on average 8 years prior to diagnosis. In later stages of evolution, signatures of defective repair processes increase, and the MRCA emerges on average 1 year before diagnosis.
Taken together, these data reveal the common and divergent evolutionary trajectories available to a cancer, which might be crucial in understanding specific tumor biology, and in providing new opportunities for early detection and cancer prevention.
Citation Format: Clemency Jolly, Moritz Gerstung, Ignaty Leshchiner, Stefan C. Dentro, Santiago Gonzalez, Thomas J. Mitchell, Yulia Rubanova, Pavana Anur, Daniel Rosebrock, Kaixian Yu, Maxime Tarabichi, Amit Deshwar, Jeff Wintersinger, Kortine Kleinheinz, Ignacio Vásquez-García, Kerstin Haase, Subhajit Sengupta, Geoff Macintyre, Salem Malikic, Nilgun Donmez, Dimitri G. Livitz, Mark Cmero, Jonas Demeulemeester, Steve Schumacher, Yu Fan, Xiaotong Yao, Juhee Lee, Matthias Schlesner, Paul C. Boutros, David D. Bowtell, Hongtu Zhu, Gad Getz, Marcin Imielinski, Rameen Beroukhim, S Cenk Sahinalp, Yuan Ji, Martin Peifer, Florian Markowetz, Ville Mustonen, Ke Juan, Wenyi Wang, Quaid D. Morris, Paul T. Spellman, David C. Wedge, Peter Van Loo, PCAWG Evolution and Heterogeneity Working Group. The evolutionary history of 2,658 cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 218.
Collapse
Affiliation(s)
| | - Moritz Gerstung
- 2European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, United Kingdom
| | | | | | - Santiago Gonzalez
- 2European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Cambridge, United Kingdom
| | | | | | - Pavana Anur
- 6Oregon Health and Science University, Portland, OR
| | | | - Kaixian Yu
- 7The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Amit Deshwar
- 5University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Kerstin Haase
- 1The Francis Crick Institute, London, United Kingdom
| | | | - Geoff Macintyre
- 10Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Salem Malikic
- 11Simon Fraser University, Vancouver, British Columbia, Canada
| | - Nilgun Donmez
- 11Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - Mark Cmero
- 12University of Melbourne, Melbourne, Australia
| | | | | | - Yu Fan
- 7The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Juhee Lee
- 14University of California Santa Cruz, Santa Cruz, CA
| | | | | | | | - Hongtu Zhu
- 7The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gad Getz
- 3Broad Institute of MIT and Harvard, Cambridge, MA
| | | | | | | | - Yuan Ji
- 9NorthShore University HealthSystem, Evanston, IL
| | | | - Florian Markowetz
- 10Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | | | - Ke Juan
- 10Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Wenyi Wang
- 7The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Peter Van Loo
- 1The Francis Crick Institute, London, United Kingdom
| | | |
Collapse
|
32
|
Curry E, Zeller C, Masrour N, Patten DK, Gallon J, Wilhelm-Benartzi CS, Ghaem-Maghami S, Bowtell DD, Brown R. Genes Predisposed to DNA Hypermethylation during Acquired Resistance to Chemotherapy Are Identified in Ovarian Tumors by Bivalent Chromatin Domains at Initial Diagnosis. Cancer Res 2018; 78:1383-1391. [PMID: 29339543 DOI: 10.1158/0008-5472.can-17-1650] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/12/2017] [Accepted: 01/10/2018] [Indexed: 11/16/2022]
Abstract
Bivalent chromatin domains containing both active H3K4me3 and repressive H3K27me3 histone marks define gene sets poised for expression or silencing in differentiating embryonic stem (ES) cells. In cancer cells, aberrantly poised genes may facilitate changes in transcriptional states after exposure to anticancer drugs. In this study, we used ChIP-seq to characterize genome-wide positioning of H3K4me3- and H3K27me3-associated chromatin in primary high-grade serous ovarian carcinomas and in normal ovarian surface and fallopian tube tissue. Gene sets with proximal bivalent marks defined in this manner were evaluated subsequently as signatures of systematic change in DNA methylation and gene expression, comparing pairs of tissue samples taken from patients at primary presentation and relapse following chemotherapy. We found that gene sets harboring bivalent chromatin domains at their promoters in tumor tissue, but not normal epithelia, overlapped with Polycomb-repressive complex target genes as well as transcriptionally silenced genes in normal ovarian and tubal stem cells. The bivalently marked genes we identified in tumors before chemotherapy displayed increased promoter CpG methylation and reduced gene expression at relapse after chemotherapy of ovarian cancer. Overall, our results support the hypothesis that preexisting histone modifications at genes in a poised chromatin state may lead to epigenetic silencing during acquired drug resistance.Significance: These results suggest epigenetic targets for intervention to prevent the emergence of cancer drug resistance. Cancer Res; 78(6); 1383-91. ©2018 AACR.
Collapse
Affiliation(s)
- Edward Curry
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Constanze Zeller
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Nahal Masrour
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Darren K Patten
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
| | - John Gallon
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
| | | | - Sadaf Ghaem-Maghami
- Department Surgery & Cancer, Imperial College London, London, United Kingdom
| | - David D Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Robert Brown
- Department Surgery & Cancer, Imperial College London, London, United Kingdom.
- Institute of Cancer Research, Sutton, United Kingdom
| |
Collapse
|
33
|
Block MS, Vierkant RA, Rambau PF, Winham SJ, Wagner P, Traficante N, Tołoczko A, Tiezzi DG, Taran FA, Sinn P, Sieh W, Sharma R, Rothstein JH, Ramón Y Cajal T, Paz-Ares L, Oszurek O, Orsulic S, Ness RB, Nelson G, Modugno F, Menkiszak J, McGuire V, McCauley BM, Mack M, Lubiński J, Longacre TA, Li Z, Lester J, Kennedy CJ, Kalli KR, Jung AY, Johnatty SE, Jimenez-Linan M, Jensen A, Intermaggio MP, Hung J, Herpel E, Hernandez BY, Hartkopf AD, Harnett PR, Ghatage P, García-Bueno JM, Gao B, Fereday S, Eilber U, Edwards RP, de Sousa CB, de Andrade JM, Chudecka-Głaz A, Chenevix-Trench G, Cazorla A, Brucker SY, Alsop J, Whittemore AS, Steed H, Staebler A, Moysich KB, Menon U, Koziak JM, Kommoss S, Kjaer SK, Kelemen LE, Karlan BY, Huntsman DG, Høgdall E, Gronwald J, Goodman MT, Gilks B, García MJ, Fasching PA, de Fazio A, Deen S, Chang-Claude J, Candido Dos Reis FJ, Campbell IG, Brenton JD, Bowtell DD, Benítez J, Pharoah PDP, Köbel M, Ramus SJ, Goode EL. MyD88 and TLR4 Expression in Epithelial Ovarian Cancer. Mayo Clin Proc 2018; 93:307-320. [PMID: 29502561 PMCID: PMC5870793 DOI: 10.1016/j.mayocp.2017.10.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/14/2017] [Accepted: 10/16/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate myeloid differentiation primary response gene 88 (MyD88) and Toll-like receptor 4 (TLR4) expression in relation to clinical features of epithelial ovarian cancer, histologic subtypes, and overall survival. PATIENTS AND METHODS We conducted centralized immunohistochemical staining, semi-quantitative scoring, and survival analysis in 5263 patients participating in the Ovarian Tumor Tissue Analysis consortium. Patients were diagnosed between January 1, 1978, and December 31, 2014, including 2865 high-grade serous ovarian carcinomas (HGSOCs), with more than 12,000 person-years of follow-up time. Tissue microarrays were stained for MyD88 and TLR4, and staining intensity was classified using a 2-tiered system for each marker (weak vs strong). RESULTS Expression of MyD88 and TLR4 was similar in all histotypes except clear cell ovarian cancer, which showed reduced expression compared with other histotypes (P<.001 for both). In HGSOC, strong MyD88 expression was modestly associated with shortened overall survival (hazard ratio [HR], 1.13; 95% CI, 1.01-1.26; P=.04) but was also associated with advanced stage (P<.001). The expression of TLR4 was not associated with survival. In low-grade serous ovarian cancer (LGSOC), strong expression of both MyD88 and TLR4 was associated with favorable survival (HR [95% CI], 0.49 [0.29-0.84] and 0.44 [0.21-0.89], respectively; P=.009 and P=.02, respectively). CONCLUSION Results are consistent with an association between strong MyD88 staining and advanced stage and poorer survival in HGSOC and demonstrate correlation between strong MyD88 and TLR4 staining and improved survival in LGSOC, highlighting the biological differences between the 2 serous histotypes.
Collapse
Affiliation(s)
| | | | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada; Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Nadia Traficante
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, the University of Sydney, Sydney, Australia; University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Luis Paz-Ares
- H12O-CNIO Lung Cancer Clinical Research Unit, Madrid, Spain; Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Sandra Orsulic
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Marie Mack
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Gynecologic Oncology, the Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Jenny Lester
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Catherine J Kennedy
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | | | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria P Intermaggio
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Jillian Hung
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany; Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | | | - Andreas D Hartkopf
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Paul R Harnett
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, the University of Sydney, Sydney, Australia
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Bo Gao
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, the University of Sydney, Sydney, Australia
| | - Sian Fereday
- Department of Cancer Genomics and Genetics, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Ursula Eilber
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Alicia Cazorla
- Pathology Department, Fundación Jiménez Díaz, Madrid, Spain
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Alice S Whittemore
- Department of Health Research and Policy and Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | | | - Stefan Kommoss
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC
| | - Beth Y Karlan
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine, Division of Hematology and Oncology, University of California at Los Angeles; University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Anna de Fazio
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Suha Deen
- Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK; Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - David D Bowtell
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia; Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Paul D P Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK; Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
| |
Collapse
|
34
|
Goode EL, Block MS, Kalli KR, Vierkant RA, Chen W, Fogarty ZC, Gentry-Maharaj A, Tołoczko A, Hein A, Bouligny AL, Jensen A, Osorio A, Hartkopf A, Ryan A, Chudecka-Głaz A, Magliocco AM, Hartmann A, Jung AY, Gao B, Hernandez BY, Fridley BL, McCauley BM, Kennedy CJ, Wang C, Karpinskyj C, de Sousa CB, Tiezzi DG, Wachter DL, Herpel E, Taran FA, Modugno F, Nelson G, Lubiński J, Menkiszak J, Alsop J, Lester J, García-Donas J, Nation J, Hung J, Palacios J, Rothstein JH, Kelley JL, de Andrade JM, Robles-Díaz L, Intermaggio MP, Widschwendter M, Beckmann MW, Ruebner M, Jimenez-Linan M, Singh N, Oszurek O, Harnett PR, Rambau PF, Sinn P, Wagner P, Ghatage P, Sharma R, Edwards RP, Ness RB, Orsulic S, Brucker SY, Johnatty SE, Longacre TA, Ursula E, McGuire V, Sieh W, Natanzon Y, Li Z, Whittemore AS, Anna D, Staebler A, Karlan BY, Gilks B, Bowtell DD, Høgdall E, Candido dos Reis FJ, Steed H, Campbell IG, Gronwald J, Benítez J, Koziak JM, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, García MJ, Fasching PA, Kommoss S, Deen S, Kjaer SK, Menon U, Brenton JD, Pharoah PDP, Chenevix-Trench G, Huntsman DG, Winham SJ, Köbel M, Ramus SJ. Dose-Response Association of CD8+ Tumor-Infiltrating Lymphocytes and Survival Time in High-Grade Serous Ovarian Cancer. JAMA Oncol 2017; 3:e173290. [PMID: 29049607 PMCID: PMC5744673 DOI: 10.1001/jamaoncol.2017.3290] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Importance Cytotoxic CD8+ tumor-infiltrating lymphocytes (TILs) participate in immune control of epithelial ovarian cancer; however, little is known about prognostic patterns of CD8+ TILs by histotype and in relation to other clinical factors. Objective To define the prognostic role of CD8+ TILs in epithelial ovarian cancer. Design, Setting, and Participants This was a multicenter observational, prospective survival cohort study of the Ovarian Tumor Tissue Analysis Consortium. More than 5500 patients, including 3196 with high-grade serous ovarian carcinomas (HGSOCs), were followed prospectively for over 24 650 person-years. Exposures Following immunohistochemical analysis, CD8+ TILs were identified within the epithelial components of tumor islets. Patients were grouped based on the estimated number of CD8+ TILs per high-powered field: negative (none), low (1-2), moderate (3-19), and high (≥20). CD8+ TILs in a subset of patients were also assessed in a quantitative, uncategorized manner, and the functional form of associations with survival was assessed using penalized B-splines. Main Outcomes and Measures Overall survival time. Results The final sample included 5577 women; mean age at diagnosis was 58.4 years (median, 58.2 years). Among the 5 major invasive histotypes, HGSOCs showed the most infiltration. CD8+ TILs in HGSOCs were significantly associated with longer overall survival; median survival was 2.8 years for patients with no CD8+ TILs and 3.0 years, 3.8 years, and 5.1 years for patients with low, moderate, or high levels of CD8+ TILs, respectively (P value for trend = 4.2 × 10−16). A survival benefit was also observed among women with endometrioid and mucinous carcinomas, but not for those with the other histotypes. Among HGSOCs, CD8+ TILs were favorable regardless of extent of residual disease following cytoreduction, known standard treatment, and germline BRCA1 pathogenic mutation, but were not prognostic for BRCA2 mutation carriers. Evaluation of uncategorized CD8+ TIL counts showed a near-log-linear functional form. Conclusions and Relevance This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and HGSOC survival. That the extent of infiltration is prognostic, not merely its presence or absence, suggests that understanding factors that drive infiltration will be the key to unraveling outcome heterogeneity in this cancer.
Collapse
Affiliation(s)
- Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wenqian Chen
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zachary C Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Aliecia L Bouligny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Health Sciences, Spelman College, Atlanta, GA, USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Hartkopf
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Andy Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL, USA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - David L Wachter
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Germany and Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jenny Lester
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Jill Nation
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Hung
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal. IRYCIS. Universidad de Alcalá, Madrid, Spain. CIBERONC
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria P Intermaggio
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | | | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
- Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Germany
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia
- University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sandra Orsulic
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Eilber Ursula
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yanina Natanzon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Alice S Whittemore
- Department of Health Research and Policy, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - deFazio Anna
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Beth Y Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia,Canada
| | - David D Bowtell
- Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia
- The Garvan Institute, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - Stefan Kommoss
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Suha Deen
- Department of Histopathology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK
- Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - Paul DP Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
- The Garvan Institute, Sydney, New South Wales, Australia
| |
Collapse
|
35
|
Goode EL, Block MS, Kalli KR, Vierkant RA, Chen W, Fogarty ZC, Gentry-Maharaj A, Tołoczko A, Hein A, Bouligny AL, Jensen A, Osorio A, Hartkopf A, Ryan A, Chudecka-Głaz A, Magliocco AM, Hartmann A, Jung AY, Gao B, Hernandez BY, Fridley BL, McCauley BM, Kennedy CJ, Wang C, Karpinskyj C, de Sousa CB, Tiezzi DG, Wachter DL, Herpel E, Taran FA, Modugno F, Nelson G, Lubiński J, Menkiszak J, Alsop J, Lester J, García-Donas J, Nation J, Hung J, Palacios J, Rothstein JH, Kelley JL, de Andrade JM, Robles-Díaz L, Intermaggio MP, Widschwendter M, Beckmann MW, Ruebner M, Jimenez-Linan M, Singh N, Oszurek O, Harnett PR, Rambau PF, Sinn P, Wagner P, Ghatage P, Sharma R, Edwards RP, Ness RB, Orsulic S, Brucker SY, Johnatty SE, Longacre TA, Ursula E, McGuire V, Sieh W, Natanzon Y, Li Z, Whittemore AS, Anna D, Staebler A, Karlan BY, Gilks B, Bowtell DD, Høgdall E, Candido dos Reis FJ, Steed H, Campbell IG, Gronwald J, Benítez J, Koziak JM, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, García MJ, Fasching PA, Kommoss S, Deen S, Kjaer SK, Menon U, Brenton JD, Pharoah PDP, Chenevix-Trench G, Huntsman DG, Winham SJ, Köbel M, Ramus SJ. Dose-Response Association of CD8+ Tumor-Infiltrating Lymphocytes and Survival Time in High-Grade Serous Ovarian Cancer. JAMA Oncol 2017. [PMID: 29049607 DOI: 10.1001/jamaoncol.2017.3290] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Cytotoxic CD8+ tumor-infiltrating lymphocytes (TILs) participate in immune control of epithelial ovarian cancer; however, little is known about prognostic patterns of CD8+ TILs by histotype and in relation to other clinical factors. Objective To define the prognostic role of CD8+ TILs in epithelial ovarian cancer. Design, Setting, and Participants This was a multicenter observational, prospective survival cohort study of the Ovarian Tumor Tissue Analysis Consortium. More than 5500 patients, including 3196 with high-grade serous ovarian carcinomas (HGSOCs), were followed prospectively for over 24 650 person-years. Exposures Following immunohistochemical analysis, CD8+ TILs were identified within the epithelial components of tumor islets. Patients were grouped based on the estimated number of CD8+ TILs per high-powered field: negative (none), low (1-2), moderate (3-19), and high (≥20). CD8+ TILs in a subset of patients were also assessed in a quantitative, uncategorized manner, and the functional form of associations with survival was assessed using penalized B-splines. Main Outcomes and Measures Overall survival time. Results The final sample included 5577 women; mean age at diagnosis was 58.4 years (median, 58.2 years). Among the 5 major invasive histotypes, HGSOCs showed the most infiltration. CD8+ TILs in HGSOCs were significantly associated with longer overall survival; median survival was 2.8 years for patients with no CD8+ TILs and 3.0 years, 3.8 years, and 5.1 years for patients with low, moderate, or high levels of CD8+ TILs, respectively (P value for trend = 4.2 × 10−16). A survival benefit was also observed among women with endometrioid and mucinous carcinomas, but not for those with the other histotypes. Among HGSOCs, CD8+ TILs were favorable regardless of extent of residual disease following cytoreduction, known standard treatment, and germline BRCA1 pathogenic mutation, but were not prognostic for BRCA2 mutation carriers. Evaluation of uncategorized CD8+ TIL counts showed a near-log-linear functional form. Conclusions and Relevance This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and HGSOC survival. That the extent of infiltration is prognostic, not merely its presence or absence, suggests that understanding factors that drive infiltration will be the key to unraveling outcome heterogeneity in this cancer.
Collapse
Affiliation(s)
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wenqian Chen
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zachary C Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Aliecia L Bouligny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Health Sciences, Spelman College, Atlanta, GA, USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Hartkopf
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Andy Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL, USA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - David L Wachter
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Germany and Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA,Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jenny Lester
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Jill Nation
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Hung
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal. IRYCIS. Universidad de Alcalá, Madrid, Spain. CIBERONC
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria P Intermaggio
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | | | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada,Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Germany
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia,University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sandra Orsulic
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Eilber Ursula
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yanina Natanzon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Alice S Whittemore
- Department of Health Research and Policy, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - deFazio Anna
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Beth Y Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia,Canada
| | - David D Bowtell
- Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia,Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia,The Garvan Institute, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia,Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia,Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany,University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany,David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - Stefan Kommoss
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Suha Deen
- Department of Histopathology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK,Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK,Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - Paul DP Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK,Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia,The Garvan Institute, Sydney, New South Wales, Australia
| |
Collapse
|
36
|
Goode EL, Block MS, Kalli KR, Vierkant RA, Chen W, Fogarty ZC, Gentry-Maharaj A, Tołoczko A, Hein A, Bouligny AL, Jensen A, Osorio A, Hartkopf A, Ryan A, Chudecka-Głaz A, Magliocco AM, Hartmann A, Jung AY, Gao B, Hernandez BY, Fridley BL, McCauley BM, Kennedy CJ, Wang C, Karpinskyj C, de Sousa CB, Tiezzi DG, Wachter DL, Herpel E, Taran FA, Modugno F, Nelson G, Lubiński J, Menkiszak J, Alsop J, Lester J, García-Donas J, Nation J, Hung J, Palacios J, Rothstein JH, Kelley JL, de Andrade JM, Robles-Díaz L, Intermaggio MP, Widschwendter M, Beckmann MW, Ruebner M, Jimenez-Linan M, Singh N, Oszurek O, Harnett PR, Rambau PF, Sinn P, Wagner P, Ghatage P, Sharma R, Edwards RP, Ness RB, Orsulic S, Brucker SY, Johnatty SE, Longacre TA, Ursula E, McGuire V, Sieh W, Natanzon Y, Li Z, Whittemore AS, Anna D, Staebler A, Karlan BY, Gilks B, Bowtell DD, Høgdall E, Candido dos Reis FJ, Steed H, Campbell IG, Gronwald J, Benítez J, Koziak JM, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, García MJ, Fasching PA, Kommoss S, Deen S, Kjaer SK, Menon U, Brenton JD, Pharoah PDP, Chenevix-Trench G, Huntsman DG, Winham SJ, Köbel M, Ramus SJ. Dose-Response Association of CD8+ Tumor-Infiltrating Lymphocytes and Survival Time in High-Grade Serous Ovarian Cancer. JAMA Oncol 2017. [PMID: 29049607 DOI: 10.1001/jamaoncol.2017.3290]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Cytotoxic CD8+ tumor-infiltrating lymphocytes (TILs) participate in immune control of epithelial ovarian cancer; however, little is known about prognostic patterns of CD8+ TILs by histotype and in relation to other clinical factors. Objective To define the prognostic role of CD8+ TILs in epithelial ovarian cancer. Design, Setting, and Participants This was a multicenter observational, prospective survival cohort study of the Ovarian Tumor Tissue Analysis Consortium. More than 5500 patients, including 3196 with high-grade serous ovarian carcinomas (HGSOCs), were followed prospectively for over 24 650 person-years. Exposures Following immunohistochemical analysis, CD8+ TILs were identified within the epithelial components of tumor islets. Patients were grouped based on the estimated number of CD8+ TILs per high-powered field: negative (none), low (1-2), moderate (3-19), and high (≥20). CD8+ TILs in a subset of patients were also assessed in a quantitative, uncategorized manner, and the functional form of associations with survival was assessed using penalized B-splines. Main Outcomes and Measures Overall survival time. Results The final sample included 5577 women; mean age at diagnosis was 58.4 years (median, 58.2 years). Among the 5 major invasive histotypes, HGSOCs showed the most infiltration. CD8+ TILs in HGSOCs were significantly associated with longer overall survival; median survival was 2.8 years for patients with no CD8+ TILs and 3.0 years, 3.8 years, and 5.1 years for patients with low, moderate, or high levels of CD8+ TILs, respectively (P value for trend = 4.2 × 10−16). A survival benefit was also observed among women with endometrioid and mucinous carcinomas, but not for those with the other histotypes. Among HGSOCs, CD8+ TILs were favorable regardless of extent of residual disease following cytoreduction, known standard treatment, and germline BRCA1 pathogenic mutation, but were not prognostic for BRCA2 mutation carriers. Evaluation of uncategorized CD8+ TIL counts showed a near-log-linear functional form. Conclusions and Relevance This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and HGSOC survival. That the extent of infiltration is prognostic, not merely its presence or absence, suggests that understanding factors that drive infiltration will be the key to unraveling outcome heterogeneity in this cancer.
Collapse
Affiliation(s)
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wenqian Chen
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zachary C Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Aliecia L Bouligny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Health Sciences, Spelman College, Atlanta, GA, USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Hartkopf
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Andy Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL, USA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - David L Wachter
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Germany and Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA,Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jenny Lester
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Jill Nation
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Hung
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal. IRYCIS. Universidad de Alcalá, Madrid, Spain. CIBERONC
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria P Intermaggio
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | | | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada,Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Germany
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia,University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sandra Orsulic
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Eilber Ursula
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yanina Natanzon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Alice S Whittemore
- Department of Health Research and Policy, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - deFazio Anna
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Beth Y Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia,Canada
| | - David D Bowtell
- Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia,Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia,The Garvan Institute, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia,Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia,Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany,University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany,David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - Stefan Kommoss
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Suha Deen
- Department of Histopathology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK,Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK,Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - Paul DP Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK,Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia,The Garvan Institute, Sydney, New South Wales, Australia
| |
Collapse
|
37
|
Wong SQ, Raleigh JM, Callahan J, Vergara IA, Ftouni S, Hatzimihalis A, Colebatch AJ, Li J, Semple T, Doig K, Mintoff C, Sinha D, Yeh P, Silva MJ, Alsop K, Thorne H, Bowtell DD, Gyorki DE, Arnau GM, Cullinane C, Kee D, Brady B, Kelleher F, Dawson MA, Papenfuss AT, Shackleton M, Hicks RJ, McArthur GA, Sandhu S, Dawson SJ. Circulating Tumor DNA Analysis and Functional Imaging Provide Complementary Approaches for Comprehensive Disease Monitoring in Metastatic Melanoma. JCO Precis Oncol 2017; 1:1-14. [DOI: 10.1200/po.16.00009] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose Circulating tumor DNA (ctDNA) allows noninvasive disease monitoring across a range of malignancies. In metastatic melanoma, the extent to which ctDNA reflects changes in metabolic disease burden assessed by 18F-labeled fluorodeoxyglucose positron emission tomography (FDG-PET) is unknown. We assessed the role of ctDNA analysis in combination with FDG-PET to monitor tumor burden and genomic heterogeneity throughout treatment. Patients and Methods We performed a comprehensive analysis of serial ctDNA and FDG-PET in 52 patients who received systemic therapy for metastatic melanoma. Next-generation sequencing and digital polymerase chain reaction were used to analyze plasma samples from the cohort. Results ctDNA levels were monitored across patients with mutant BRAF, NRAS, and BRAF/NRAS wild type disease. Mutant BRAF and NRAS ctDNA levels correlated closely with changes in metabolic disease burden throughout treatment. TERT promoter mutant ctDNA levels also paralleled changes in tumor burden, which provide an alternative marker for disease monitoring. Of note, subcutaneous and cerebral disease sites were not well represented in plasma. Early changes in ctDNA and metabolic disease burden were important indicators of treatment response. Patients with an early decrease in ctDNA post-treatment had improved progression-free survival compared with patients in whom ctDNA levels remained unchanged or increased over time (hazard ratio, 2.6; P = .05). ctDNA analysis contributed key molecular information through the identification of putative resistance mechanisms to targeted therapy. A detailed comparison of the genomic architecture of plasma and multiregional tumor biopsy specimens at autopsy revealed the ability of ctDNA to comprehensively capture genomic heterogeneity across multiple disease sites. Conclusion The findings highlight the powerful role of ctDNA in metastatic melanoma as a complementary modality to functional imaging that allows real-time monitoring of both tumor burden and genomic changes throughout therapy.
Collapse
Affiliation(s)
- Stephen Q. Wong
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Jeanette M. Raleigh
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Jason Callahan
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Ismael A. Vergara
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Sarah Ftouni
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Athena Hatzimihalis
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Andrew J. Colebatch
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Jason Li
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Timothy Semple
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Kenneth Doig
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Christopher Mintoff
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Devbarna Sinha
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Paul Yeh
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Maria Joao Silva
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Kathryn Alsop
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Heather Thorne
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - David D. Bowtell
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - David E. Gyorki
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Gisela Mir Arnau
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Carleen Cullinane
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Damien Kee
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Benjamin Brady
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Fergal Kelleher
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Mark A. Dawson
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Anthony T. Papenfuss
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Mark Shackleton
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Rodney J. Hicks
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Grant A. McArthur
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Shahneen Sandhu
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Sarah-Jane Dawson
- All authors: Peter MacCallum Cancer Centre; Kenneth Doig, Heather Thorne, David D. Bowtell, Carleen Cullinane, Mark A. Dawson, Anthony T. Papenfuss, Mark Shackleton, Rodney J. Hicks, Grant A. McArthur, Shahneen Sandhu, and Sarah-Jane Dawson, University of Melbourne; and Anthony T. Papenfuss, Walter Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| |
Collapse
|
38
|
Dicks E, Song H, Ramus SJ, Oudenhove EV, Tyrer JP, Intermaggio MP, Kar S, Harrington P, Bowtell DD, Group AOCSS, Cicek MS, Cunningham JM, Fridley BL, Alsop J, Jimenez-Linan M, Piskorz A, Goranova T, Kent E, Siddiqui N, Paul J, Crawford R, Poblete S, Lele S, Sucheston-Campbell L, Moysich KB, Sieh W, McGuire V, Lester J, Odunsi K, Whittemore AS, Bogdanova N, Dürst M, Hillemanns P, Karlan BY, Gentry-Maharaj A, Menon U, Tischkowitz M, Levine D, Brenton JD, Dörk T, Goode EL, Gayther SA, Pharoah DP. Germline whole exome sequencing and large-scale replication identifies FANCM as a likely high grade serous ovarian cancer susceptibility gene. Oncotarget 2017; 8:50930-50940. [PMID: 28881617 PMCID: PMC5584218 DOI: 10.18632/oncotarget.15871] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/26/2017] [Indexed: 01/04/2023] Open
Abstract
We analyzed whole exome sequencing data in germline DNA from 412 high grade serous ovarian cancer (HGSOC) cases from The Cancer Genome Atlas Project and identified 5,517 genes harboring a predicted deleterious germline coding mutation in at least one HGSOC case. Gene-set enrichment analysis showed enrichment for genes involved in DNA repair (p = 1.8×10-3). Twelve DNA repair genes - APEX1, APLF, ATX, EME1, FANCL, FANCM, MAD2L2, PARP2, PARP3, POLN, RAD54L and SMUG1 - were prioritized for targeted sequencing in up to 3,107 HGSOC cases, 1,491 cases of other epithelial ovarian cancer (EOC) subtypes and 3,368 unaffected controls of European origin. We estimated mutation prevalence for each gene and tested for associations with disease risk. Mutations were identified in both cases and controls in all genes except MAD2L2, where we found no evidence of mutations in controls. In FANCM we observed a higher mutation frequency in HGSOC cases compared to controls (29/3,107 cases, 0.96 percent; 13/3,368 controls, 0.38 percent; P=0.008) with little evidence for association with other subtypes (6/1,491, 0.40 percent; P=0.82). The relative risk of HGSOC associated with deleterious FANCM mutations was estimated to be 2.5 (95% CI 1.3 - 5.0; P=0.006). In summary, whole exome sequencing of EOC cases with large-scale replication in case-control studies has identified FANCM as a likely novel susceptibility gene for HGSOC, with mutations associated with a moderate increase in risk. These data may have clinical implications for risk prediction and prevention approaches for high-grade serous ovarian cancer in the future and a significant impact on reducing disease mortality.
Collapse
Affiliation(s)
- Ed Dicks
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Honglin Song
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Susan J. Ramus
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, Australia
| | - Elke Van Oudenhove
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Jonathan P. Tyrer
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Maria P. Intermaggio
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Siddhartha Kar
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Patricia Harrington
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - David D. Bowtell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Department of Biochemistry and Molecular Biology, University of Melbourne, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London, London, UK
| | - AOCS Study Group
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Westmead Millennium Institute, Westmead Hospital, Sydney, Australia
- The QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | - Brooke L. Fridley
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | | | - Anna Piskorz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Teodora Goranova
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Emma Kent
- MRC Clinical Trials Unit, University College London, London, UK
| | - Nadeem Siddiqui
- Cancer Research UK Clinical Trials Unit, Institute of Cancer Sciences, University of Glasgow, Glasgow, Scotland
| | - James Paul
- Dept Gynaecol Oncology, Glasgow Royal Infirmary, Glasgow, Scotland
| | - Robin Crawford
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Samantha Poblete
- Department of Gynecological Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Shashi Lele
- Department of Gynecological Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Lara Sucheston-Campbell
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Kirsten B. Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Weiva Sieh
- Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine, Stanford, California, USA
| | - Valerie McGuire
- Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine, Stanford, California, USA
| | - Jenny Lester
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Kunle Odunsi
- Department of Gynecological Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Alice S. Whittemore
- Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine, Stanford, California, USA
| | - Natalia Bogdanova
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
- Radiation Oncology Research Unit, Hannover Medical School, Hannover, Germany
- Mother and Child Hospital, Minsk, Belarus
| | - Matthias Dürst
- Department of Obstetrics and Gynaecology, Friedrich-Schiller University, Jena, Germany
| | - Peter Hillemanns
- Clinics of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Beth Y. Karlan
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Aleksandra Gentry-Maharaj
- Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK
| | - Usha Menon
- Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK
| | - Marc Tischkowitz
- Department of Medical Genetic, University of Cambridge, Cambridge, UK
| | - Douglas Levine
- Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - James D. Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | | | - Simon A. Gayther
- Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
- Center for Bioinformatics and Functional Genomics, Department Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - D.P. Paul Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| |
Collapse
|
39
|
Natanzon Y, Earp M, Cunningham JM, Kalli KR, Winham SJ, Armasu SM, Larson MC, Wang C, Bowtell DD, Garsed DW, Goode E. Abstract 3368: Omics data integration analysis in high grade serous ovarian cancer: results from three studies. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3368] [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
High grade serous ovarian cancer (HGSOC) is a complex disease in which initiation and progression have been associated with gene mutation, DNA methylation changes, genetic variation, and epigenetic processes. Variation in several susceptibility regions and cancer-typical global methylation patterns have been observed in HGSOC; however, this knowledge has not been compelling in understanding HGSOC intiation or progression. As ingetration of genomic, epigenomic, and transcriptomic data has increased mechanistic understanding in other cancers, we hypothesized that tumor methylation alone or in combination with germline genetic variation influences tumor gene expression in HGSOC. We examined three nested models using an Elastnic Net (ENET) penalized regression method while adjusting for somatic copy number (CNV): a) germline genotype and tumor DNA methylation (full model), b) genotype only, and c) DNA methylation only. We included 339 cases from The Cancer Genome Atlas (TCGA), 54 cases from Mayo Clinic, and 78 cases from the Australian Ovarian Cancer Study (AOCS). Genotyping and copy number calls on germline DNA, expression, methylation and copy number on somatic samples were collected and analyzed on different platforms separately at each study site. We excluded genes with low overall expression and thus analyzed a total of 11,922 genes available in three datasets ( Ensembl IDs, 500kb window up- and downstream). In general, combining genomic data in HGSOC did not reveal a role for germline genetic variation in altering gene expression. However, in methylation only models 79 genes were associated with differential expression in the TCGA cases (permutation multiple testing adjusted p-val <0.05), in the Mayo cases (unadjusted p-val <0.05) and AOCS cases (unadjusted p-val <0.05). A known tummor suppressor (FBXW7) was associated with differential expression in the three datasets at p-val <0.01. This work demonstrates the feasibility, utility, and statistical power of ENET gene-level analyses incoporating maximal genomic information.
Citation Format: Yanina Natanzon, Madalene Earp, Julie M. Cunningham, Kimberly R. Kalli, Stacey J. Winham, Sebastian M. Armasu, Melissa C. Larson, Chen Wang, David D. Bowtell, Dale W. Garsed, Ellen Goode. Omics data integration analysis in high grade serous ovarian cancer: results from three studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3368. doi:10.1158/1538-7445.AM2017-3368
Collapse
|
40
|
Mapagu C, Fereday S, Bowtell DD, Harnett PR, deFazio A. Abstract 2787: Identifying predictive markers of endocrine response in high-grade serous ovarian cancer using RNA sequencing. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2787] [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
Epithelial ovarian cancer is a complex disease and patients vary considerably in response to treatment. A subset of patients responds well to endocrine therapy, however hormone receptor positivity does not predict response and there are no biomarkers in clinical use to help select patients that would benefit from endocrine agents. We aimed to identify markers of endocrine response in high-grade serous ovarian cancer (HGSOC) by analysis of genes that are differentially expressed in tumors from patients that are endocrine responders compared with non-responders, combined with analysis of estrogen (E2) regulated genes that differ between E2 sensitive and E2 insensitive HGSOC cell lines.
Methods: Among women recruited to the Australian Ovarian Cancer Study, we identified 10 HGSOC patients treated with endocrine therapy (5 responders and 5 non-responders, based on GCIG CA125 response criteria) and performed RNAseq on cryopreserved tumor tissue. We also utilized paired E2 receptor (ER) positive HGSOC cell lines, derived from the same patient, with differential sensitivity to the growth effect of E2, PEO1 (E2 insensitive) and PEO4 (E2 sensitive). RNA was extracted following treatment with 0.1 nM E2 (or vehicle) for 24 hrs and gene expression changes in response to E2 were determined using RNAseq. Expression of selected ER responsive genes was validated using PCR array. Differential gene expression was determined using EdgeR. Pathway and Gene Ontology enrichment analysis of differentially expressed genes were performed using Metacore.
Results: Between endocrine responders and non-responders, 27 genes were significantly differentially expressed (False Discovery Rate (FDR)<0.05, absolute log2 Fold-Change (FC)≥1). In the paired HGSOC cell lines, significantly more genes were regulated by E2 in E2-sensitive PEO4, compared with E2-insensitive PEO1 (896 genes compared to 56 genes, respectively, FDR<0.05, absolute log2FC≥1). In response to E2, up-regulation of NRP1 in PEO1, up-regulation of LTBP1, MYC, PDZK1 and down-regulation of S100A6 and CYP1A1 in PEO4 were validated by PCR array profiling of ER-related genes. Genes regulated by E2 in cell lines and also differentially expressed between endocrine responders and non-responders included anoctamin 1 (ANO1) and NOTCH-Regulated Ankyrin Repeat Protein (NRARP). Both were up-regulated in endocrine responders and also up-regulated by E2 in PEO4.
Conclusion: The use of RNAseq in both tumors and cell line models was able to identify plausible sets of genes with prior evidence of association with endocrine sensitivity. In breast cancer, ANO1 has been associated with good prognosis following tamoxifen treatment, while NOTCH signaling, implicated in endocrine resistance, is negatively regulated by NRARP. Further validation is required to test the utility of these genes as predictive biomarkers that may aid in identifying HGSOC patients likely to respond to endocrine treatment.
Citation Format: Cristina Mapagu, Sian Fereday, Australian Ovarian Cancer Study Group, David D. Bowtell, Paul R. Harnett, Anna deFazio. Identifying predictive markers of endocrine response in high-grade serous ovarian cancer using RNA sequencing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2787. doi:10.1158/1538-7445.AM2017-2787
Collapse
Affiliation(s)
- Cristina Mapagu
- 1Westmead Institute for Cancer Research, University of Sydney, Sydney, Australia
| | - Sian Fereday
- 2Peter MacCallum Cancer Centre, East Melbourne, Australia
| | | | - Paul R. Harnett
- 3Crown Princess Mary Cancer Centre at Westmead Hospital, Westmead, Australia
| | - Anna deFazio
- 1Westmead Institute for Cancer Research, University of Sydney, Sydney, Australia
| | | |
Collapse
|
41
|
Dickson KA, Cole AJ, Gill AJ, Clarkson A, Gard GB, Chou A, Kennedy CJ, Henderson BR, Fereday S, Traficante N, Alsop K, Bowtell DD, deFazio A, Clifton-Bligh R, Marsh DJ. The RING finger domain E3 ubiquitin ligases BRCA1 and the RNF20/RNF40 complex in global loss of the chromatin mark histone H2B monoubiquitination (H2Bub1) in cell line models and primary high-grade serous ovarian cancer. Hum Mol Genet 2017; 25:5460-5471. [PMID: 27798111 DOI: 10.1093/hmg/ddw362] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/18/2016] [Indexed: 02/07/2023] Open
Abstract
Enzymatic factors driving cancer-associated chromatin remodelling are of increasing interest as the role of the cancer epigenome in gene expression and DNA repair processes becomes elucidated. Monoubiquitination of histone H2B at lysine 120 (H2Bub1) is a central histone modification that functions in histone cross-talk, transcriptional elongation, DNA repair, maintaining centromeric chromatin and replication-dependent histone mRNA 3'-end processing, as well as being required for the differentiation of stem cells. The loss of global H2Bub1 is seen in a number of aggressive malignancies and has been linked to tumour progression and/or a poorer prognosis in some cancers. Here, we analyse a large cohort of high-grade serous ovarian cancers (HGSOC) and show loss of global H2Bub1 in 77% (313 of 407) of tumours. Loss of H2Bub1 was seen at all stages (I-IV) of HGSOC, indicating it is a relatively early epigenomic event in this aggressive malignancy. Manipulation of key H2Bub1 E3 ubiquitin ligases, RNF20, RNF40 and BRCA1, in ovarian cancer cell line models modulated H2Bub1 levels, indicative of the role of these RING finger ligases in monoubiquitination of H2Bub1 in vitro. However, in primary HGSOC, loss of RNF20 protein expression was identified in just 6% of tumours (26 of 424) and did not correlate with global H2Bub1 loss. Similarly, germline mutation of BRCA1 did not show a correlation with the global H2Bub1 loss. We conclude that the regulation of tumour-associated H2Bub1 levels is complex. Aberrant expression of alternative histone-associated 'writer' or 'eraser' enzymes are likely responsible for the global loss of H2Bub1 seen in HGSOC.
Collapse
Affiliation(s)
- Kristie-Ann Dickson
- Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hosptial, University of Sydney, St Leonards, NSW, Australia
| | - Alexander J Cole
- Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hosptial, University of Sydney, St Leonards, NSW, Australia
| | - Anthony J Gill
- Department of Anatomical Pathology, Royal North Shore Hospital, University of Sydney, Sydney NSW, and Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Adele Clarkson
- Department of Anatomical Pathology, Royal North Shore Hospital, University of Sydney, Sydney NSW, and Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Gregory B Gard
- Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Angela Chou
- Department of Anatomical Pathology, SYDPATH, St Vincents Hospitals, Darlinghurst, NSW, Australia
| | - Catherine J Kennedy
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Beric R Henderson
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | | | - Sian Fereday
- Cancer Genomics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Nadia Traficante
- Cancer Genomics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Kathryn Alsop
- Cancer Genomics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David D Bowtell
- Cancer Genomics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia and.,The Kinghorn Cancer Centre and Garvan Institute, Darlinghurst, NSW, Australia
| | - Anna deFazio
- Department of Gynaecological Oncology, Westmead Hospital, Westmead, NSW, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW, Australia
| | - Roderick Clifton-Bligh
- Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hosptial, University of Sydney, St Leonards, NSW, Australia
| | - Deborah J Marsh
- Hormones and Cancer Group, Kolling Institute of Medical Research, Royal North Shore Hosptial, University of Sydney, St Leonards, NSW, Australia
| |
Collapse
|
42
|
Samimi G, Bernardini MQ, Brody LC, Caga-Anan CF, Campbell IG, Chenevix-Trench G, Couch FJ, Dean M, de Hullu JA, Domchek SM, Drapkin R, Spencer Feigelson H, Friedlander M, Gaudet MM, Harmsen MG, Hurley K, James PA, Kwon JS, Lacbawan F, Lheureux S, Mai PL, Mechanic LE, Minasian LM, Myers ER, Robson ME, Ramus SJ, Rezende LF, Shaw PA, Slavin TP, Swisher EM, Takenaka M, Bowtell DD, Sherman ME. Traceback: A Proposed Framework to Increase Identification and Genetic Counseling of BRCA1 and BRCA2 Mutation Carriers Through Family-Based Outreach. J Clin Oncol 2017; 35:2329-2337. [PMID: 28398847 DOI: 10.1200/jco.2016.70.3439] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In May 2016, the Division of Cancer Prevention and the Division of Cancer Control and Population Sciences, National Cancer Institute, convened a workshop to discuss a conceptual framework for identifying and genetically testing previously diagnosed but unreferred patients with ovarian cancer and other unrecognized BRCA1 or BRCA2 mutation carriers to improve the detection of families at risk for breast or ovarian cancer. The concept, designated Traceback, was prompted by the recognition that although BRCA1 and BRCA2 mutations are frequent in women with ovarian cancer, many such women have not been tested, especially if their diagnosis predated changes in testing guidelines. The failure to identify mutation carriers among probands represents a lost opportunity to prevent cancer in unsuspecting relatives through risk-reduction intervention in mutation carriers and to provide appropriate reassurances to noncarriers. The Traceback program could provide an important opportunity to reach families from racial, ethnic, and socioeconomic groups who historically have not sought or been offered genetic counseling and testing and thereby contribute to a reduction in health disparities in women with germline BRCA mutations. To achieve an interdisciplinary perspective, the workshop assembled international experts in genetics, medical and gynecologic oncology, clinical psychology, epidemiology, genomics, cost-effectiveness modeling, pathology, bioethics, and patient advocacy to identify factors to consider when undertaking a Traceback program. This report highlights the workshop deliberations with the goal of stimulating research and providing a framework for pilot studies to assess the feasibility and ethical and logistical considerations related to the development of best practices for implementation of Traceback studies.
Collapse
Affiliation(s)
- Goli Samimi
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Marcus Q Bernardini
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Lawrence C Brody
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Charlisse F Caga-Anan
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Ian G Campbell
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Georgia Chenevix-Trench
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Fergus J Couch
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Michael Dean
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Joanne A de Hullu
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Susan M Domchek
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Ronny Drapkin
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Heather Spencer Feigelson
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Michael Friedlander
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Mia M Gaudet
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Marline G Harmsen
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Karen Hurley
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Paul A James
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Janice S Kwon
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Felicitas Lacbawan
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Stephanie Lheureux
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Phuong L Mai
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Leah E Mechanic
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Lori M Minasian
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Evan R Myers
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Mark E Robson
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Susan J Ramus
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Lisa F Rezende
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Patricia A Shaw
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Thomas P Slavin
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Elizabeth M Swisher
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Masataka Takenaka
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - David D Bowtell
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| | - Mark E Sherman
- Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA
| |
Collapse
|
43
|
Savas P, Teo ZL, Lefevre C, Flensburg C, Caramia F, Alsop K, Mansour M, Francis PA, Thorne HA, Silva MJ, Kanu N, Dietzen M, Rowan A, Kschischo M, Fox S, Bowtell DD, Dawson SJ, Speed TP, Swanton C, Loi S. Correction: The Subclonal Architecture of Metastatic Breast Cancer: Results from a Prospective Community-Based Rapid Autopsy Program "CASCADE". PLoS Med 2017; 14:e1002302. [PMID: 28430777 PMCID: PMC5400239 DOI: 10.1371/journal.pmed.1002302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
[This corrects the article DOI: 10.1371/journal.pmed.1002204.].
Collapse
|
44
|
Savas P, Teo ZL, Lefevre C, Flensburg C, Caramia F, Alsop K, Mansour M, Francis PA, Thorne HA, Silva MJ, Kanu N, Dietzen M, Rowan A, Kschischo M, Fox S, Bowtell DD, Dawson SJ, Speed TP, Swanton C, Loi S. The Subclonal Architecture of Metastatic Breast Cancer: Results from a Prospective Community-Based Rapid Autopsy Program "CASCADE". PLoS Med 2016; 13:e1002204. [PMID: 28027312 PMCID: PMC5189956 DOI: 10.1371/journal.pmed.1002204] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 11/17/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Understanding the cancer genome is seen as a key step in improving outcomes for cancer patients. Genomic assays are emerging as a possible avenue to personalised medicine in breast cancer. However, evolution of the cancer genome during the natural history of breast cancer is largely unknown, as is the profile of disease at death. We sought to study in detail these aspects of advanced breast cancers that have resulted in lethal disease. METHODS AND FINDINGS Three patients with oestrogen-receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer and one patient with triple negative breast cancer underwent rapid autopsy as part of an institutional prospective community-based rapid autopsy program (CASCADE). Cases represented a range of management problems in breast cancer, including late relapse after early stage disease, de novo metastatic disease, discordant disease response, and disease refractory to treatment. Between 5 and 12 metastatic sites were collected at autopsy together with available primary tumours and longitudinal metastatic biopsies taken during life. Samples underwent paired tumour-normal whole exome sequencing and single nucleotide polymorphism (SNP) arrays. Subclonal architectures were inferred by jointly analysing all samples from each patient. Mutations were validated using high depth amplicon sequencing. Between cases, there were significant differences in mutational burden, driver mutations, mutational processes, and copy number variation. Within each case, we found dramatic heterogeneity in subclonal structure from primary to metastatic disease and between metastatic sites, such that no single lesion captured the breadth of disease. Metastatic cross-seeding was found in each case, and treatment drove subclonal diversification. Subclones displayed parallel evolution of treatment resistance in some cases and apparent augmentation of key oncogenic drivers as an alternative resistance mechanism. We also observed the role of mutational processes in subclonal evolution. Limitations of this study include the potential for bias introduced by joint analysis of formalin-fixed archival specimens with fresh specimens and the difficulties in resolving subclones with whole exome sequencing. Other alterations that could define subclones such as structural variants or epigenetic modifications were not assessed. CONCLUSIONS This study highlights various mechanisms that shape the genome of metastatic breast cancer and the value of studying advanced disease in detail. Treatment drives significant genomic heterogeneity in breast cancers which has implications for disease monitoring and treatment selection in the personalised medicine paradigm.
Collapse
Affiliation(s)
- Peter Savas
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Zhi Ling Teo
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Christophe Lefevre
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Christoffer Flensburg
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - Franco Caramia
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Kathryn Alsop
- Cancer Genomics Program, Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Mariam Mansour
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Prudence A. Francis
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Heather A. Thorne
- Cancer Genomics Program, Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- kConFab, Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Maria Joao Silva
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Nnennaya Kanu
- UCL Cancer Institute, CRUK Lung Cancer Centre of Excellence, London, United Kingdom
| | - Michelle Dietzen
- UCL Cancer Institute, CRUK Lung Cancer Centre of Excellence, London, United Kingdom
| | - Andrew Rowan
- The Francis Crick Institute, London, United Kingdom
| | - Maik Kschischo
- University of Applied Sciences Koblenz, RheinAhrCampus Remagen, Department of Mathematics and Technology, Remagen, Germany
| | - Stephen Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David D. Bowtell
- Cancer Genomics Program, Division of Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Victoria, Australia
| | - Sarah-Jane Dawson
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Victoria, Australia
| | - Terence P. Speed
- Bioinformatics Division, Walter & Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
- Department of Mathematics and Statistics, University of Melbourne, Parkville, Victoria, Australia
| | - Charles Swanton
- UCL Cancer Institute, CRUK Lung Cancer Centre of Excellence, London, United Kingdom
- The Francis Crick Institute, London, United Kingdom
| | - Sherene Loi
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Victoria, Australia
| |
Collapse
|
45
|
Pharoah PDP, Song H, Dicks E, Intermaggio MP, Harrington P, Baynes C, Alsop K, Bogdanova N, Cicek MS, Cunningham JM, Fridley BL, Gentry-Maharaj A, Hillemanns P, Lele S, Lester J, McGuire V, Moysich KB, Poblete S, Sieh W, Sucheston-Campbell L, Widschwendter M, Whittemore AS, Dörk T, Menon U, Odunsi K, Goode EL, Karlan BY, Bowtell DD, Gayther SA, Ramus SJ. PPM1D Mosaic Truncating Variants in Ovarian Cancer Cases May Be Treatment-Related Somatic Mutations. J Natl Cancer Inst 2016; 108:djv347. [PMID: 26823519 PMCID: PMC5072371 DOI: 10.1093/jnci/djv347] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 06/30/2015] [Accepted: 10/20/2015] [Indexed: 11/14/2022] Open
Abstract
Mosaic truncating mutations in the protein phosphatase, Mg(2+)/Mn(2+)-dependent, 1D (PPM1D) gene have recently been reported with a statistically significantly greater frequency in lymphocyte DNA from ovarian cancer case patients compared with unaffected control patients. Using massively parallel sequencing (MPS) we identified truncating PPM1D mutations in 12 of 3236 epithelial ovarian cancer (EOC) case patients (0.37%) but in only one of 3431 unaffected control patients (0.03%) (P = .001). All statistical tests were two-sided. A combination of Sanger sequencing, pyrosequencing, and MPS data suggested that 12 of the 13 mutations were mosaic. All mutations were identified in post-chemotherapy treatment blood samples from case patients (n = 1827) (average 1234 days post-treatment in carriers) rather than from cases collected pretreatment (less than 14 days after diagnosis, n = 1384) (P = .002). These data suggest that PPM1D variants in EOC cases are primarily somatic mosaic mutations caused by treatment and are not associated with germline predisposition to EOC.
Collapse
Affiliation(s)
- Paul D P Pharoah
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Honglin Song
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Ed Dicks
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Maria P Intermaggio
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Patricia Harrington
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Caroline Baynes
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Kathryn Alsop
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Natalia Bogdanova
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Mine S Cicek
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Julie M Cunningham
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Brooke L Fridley
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Aleksandra Gentry-Maharaj
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Peter Hillemanns
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Shashi Lele
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Jenny Lester
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Valerie McGuire
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Kirsten B Moysich
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Samantha Poblete
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Weiva Sieh
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Lara Sucheston-Campbell
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Martin Widschwendter
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Alice S Whittemore
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Thilo Dörk
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Usha Menon
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Kunle Odunsi
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Ellen L Goode
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Beth Y Karlan
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - David D Bowtell
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Simon A Gayther
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| | - Susan J Ramus
- Affiliations of authors:CR-UK Department of Oncology, University of Cambridge, Strangeways Research Laboratory , Cambridge, UK (PDPP, HS, ED, PH, CB); Department of Preventive Medicine, Keck School of Medicine , USC/NorrisComprehensive Cancer Center, University of Southern California , CA (MPI, SAG, SJR); Peter MacCallum Cancer Centre, East Melbourne , Victoria , Australia (KA, AOCSG, DDB); Westmead Millennium Institute, Westmead Hospital , Sydney , Australia (AOCSG); The QIMR Berghofer Medical Research Institute , Brisbane , Australia (AOCSG); Gynaecology Research Unit, Hannover Medical School , Hannover , Germany (NB, TD); Radiation Oncology Research Unit, Hannover Medical School , Hannover , Germany (NB); Mother and Child Hospital , Minsk , Belarus (NB); Department of Health Science Research, Division of Epidemiology, Mayo Clinic , Rochester, MN (MSC, JMC, ELG); Department of Biostatistics, University of Kansas Medical Center , KS (BLF); Gynaecological Cancer Research Centre, Women's Cancer, Institute for Women's Health, University College London , London, UK (AGM, MW, UM); Clinics of Obstetrics and Gynaecology, Hannover Medical School , Hannover , Germany (PH); Department of Gynecological Oncology, Roswell Park Cancer Institute , Buffalo, NY (SL, SP, KO); Women's Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center , Los Angeles, CA (JL, BYK); Department of Health Research and Policy - Epidemiology, Stanford University School of Medicine , Stanford, CA (VM, WS, ASW); Department of Cancer Prevention and Control, Roswell Park Cancer Institute , Buffalo, NY (KBM, LSC); Department of Obstetrics and Gynecology, Duke University Medical Center , Durham, NC (OCAC); Department of Biochemistry and Molecular Biology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Sir Peter MacCallum Department of Oncology, University of Melbourne , Melbourne, Victoria , Australia (DDB); Ovarian Cancer Action Research Centre, Department of Surgery and Cancer, Imperial College London , London, UK (DDB)
| |
Collapse
|
46
|
Karnezis AN, Wang Y, Ramos P, Hendricks WP, Oliva E, D'Angelo E, Prat J, Nucci MR, Nielsen TO, Chow C, Leung S, Kommoss F, Kommoss S, Silva A, Ronnett BM, Rabban JT, Bowtell DD, Weissman BE, Trent JM, Gilks CB, Huntsman DG. Dual loss of the SWI/SNF complex ATPases SMARCA4/BRG1 and SMARCA2/BRM is highly sensitive and specific for small cell carcinoma of the ovary, hypercalcaemic type. J Pathol 2015; 238:389-400. [PMID: 26356327 PMCID: PMC4832362 DOI: 10.1002/path.4633] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/28/2015] [Accepted: 09/03/2015] [Indexed: 12/21/2022]
Abstract
Small cell carcinoma of the ovary, hypercalcaemic type (SCCOHT) is a lethal and sometimes familial ovarian tumour of young women and children. We and others recently discovered that over 90% of SCCOHTs harbour inactivating mutations in the chromatin remodelling gene SMARCA4 with concomitant loss of its encoded protein SMARCA4 (BRG1), one of two mutually exclusive ATPases of the SWI/SNF chromatin remodelling complex. To determine the specificity of SMARCA4 loss for SCCOHT, we examined the expression of SMARCA4 by immunohistochemistry in more than 3000 primary gynaecological tumours. Among ovarian tumours, it was only absent in clear cell carcinoma (15 of 360, 4%). In the uterus, it was absent in endometrial stromal sarcomas (4 of 52, 8%) and high‐grade endometrioid carcinomas (2 of 338, 1%). Recent studies have shown that SMARCA2 (BRM), the other mutually exclusive ATPase of the SWI/SNF complex, is necessary for survival of tumour cells lacking SMARCA4. Therefore, we examined SMARCA2 expression and discovered that all SMARCA4‐negative SCCOHTs also lacked SMARCA2 protein by IHC, including the SCCOHT cell lines BIN67 and SCCOHT1. Among ovarian tumours, the SMARCA4/SMARCA2 dual loss phenotype appears completely specific for SCCOHT. SMARCA2 loss was not due to mutation but rather from an absence of mRNA expression, which was restored by treatment with the histone deacetylase inhibitor trichostatin A. Re‐expression of SMARCA4 or SMARCA2 inhibited the growth of BIN67 and SCCOHT1 cell lines. Our results indicate that SMARCA4 loss, either alone or with SMARCA2, is highly sensitive and specific for SCCOHT and that restoration of either SWI/SNF ATPase can inhibit the growth of SCCOHT cell lines. © 2015 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
Collapse
Affiliation(s)
- Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Pilar Ramos
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - William Pd Hendricks
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Esther Oliva
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Emanuela D'Angelo
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Jaime Prat
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Marisa R Nucci
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Torsten O Nielsen
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Centre, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Samuel Leung
- Genetic Pathology Evaluation Centre, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | | | - Stefan Kommoss
- Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Tuebingen, Germany
| | - Annacarolina Silva
- The James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Joseph T Rabban
- Department of Anatomic Pathology, University of California San Francisco, San Francisco, CA, USA
| | - David D Bowtell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Bernard E Weissman
- Department of Pathology and Laboratory Medicine, Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Jeffrey M Trent
- Division of Integrated Cancer Genomics, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Genetic Pathology Evaluation Centre, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| |
Collapse
|
47
|
Hernandez L, Kim MK, Noonan AM, Sagher E, Kohlhammer H, Wright G, Lyle LT, Steeg PS, Anver M, Bowtell DD, Annunziata CM. A dual role for Caspase8 and NF- κB interactions in regulating apoptosis and necroptosis of ovarian cancer, with correlation to patient survival. Cell Death Discov 2015; 1:15053. [PMID: 28179987 PMCID: PMC5198842 DOI: 10.1038/cddiscovery.2015.53] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/24/2015] [Accepted: 09/26/2015] [Indexed: 12/15/2022] Open
Abstract
Ovarian cancer is a deadly disease characterized by primary and acquired resistance to chemotherapy. We previously associated NF-κB signaling with poor survival in ovarian cancer, and functionally demonstrated this pathway as mediating proliferation, invasion and metastasis. We aimed to identify cooperating pathways in NF-κB-dependent ovarian cancer cells, using genome-wide RNA interference as a loss-of-function screen for key regulators of cell survival with IKKβ inhibition. Functional genomic screen for interactions with NF-κB in ovarian cancer showed that cells depleted of Caspase8 died better with IKKβ inhibition. Overall, low Caspase8 was associated with shorter overall survival in three independent gene expression data sets of ovarian cancers. Conversely, Caspase8 expression was markedly highest in ovarian cancer subtypes characterized by strong T-cell infiltration and better overall prognosis, suggesting that Caspase8 expression increased chemotherapy-induced cell death. We investigated the effects of Caspase8 depletion on apoptosis and necroptosis of TNFα-stimulated ovarian cancer cell lines. Inhibition of NF-κB in ovarian cancer cells switched the effects of TNFα signaling from proliferation to death. Although Caspase8-high cancer cells died by apoptosis, Caspase8 depletion downregulated NF-κB signaling, stabilized RIPK1 and promoted necroptotic cell death. Blockage of NF-κB signaling and depletion of cIAP with SMAC-mimetic further rendered these cells susceptible to killing by necroptosis. These findings have implications for anticancer strategies to improve outcome for women with low Caspase8-expressing ovarian cancer.
Collapse
Affiliation(s)
- L Hernandez
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - M K Kim
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - A M Noonan
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - E Sagher
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - H Kohlhammer
- Metabolism Branch, Center for Cancer Research, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - G Wright
- Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National
Cancer Institute, Bethesda, MD
20892-1906, USA
| | - L T Lyle
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - P S Steeg
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| | - M Anver
- Pathology/Histotechnology Laboratory, LASP, Leidos Biomedical Research, Inc.,
Frederick, MD
21702-1201, USA
| | - D D Bowtell
- Centre for Cancer Genomics and Predictive Medicine, Peter MacCallum Cancer
Centre, East Melbourne, Victoria, Australia
- The Department of Pathology, University of Melbourne, Parkville,
Victoria, Australia
| | - on behalf of the Australian Ovarian Cancer Study Group
57
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
- Metabolism Branch, Center for Cancer Research, National Cancer Institute,
Bethesda, MD
20892-1906, USA
- Biometric Research Branch, Division of Cancer Treatment and Diagnosis, National
Cancer Institute, Bethesda, MD
20892-1906, USA
- Pathology/Histotechnology Laboratory, LASP, Leidos Biomedical Research, Inc.,
Frederick, MD
21702-1201, USA
- Centre for Cancer Genomics and Predictive Medicine, Peter MacCallum Cancer
Centre, East Melbourne, Victoria, Australia
- The Department of Pathology, University of Melbourne, Parkville,
Victoria, Australia
| | - C M Annunziata
- Women’s Malignancies Branch, National Cancer Institute,
Bethesda, MD
20892-1906, USA
| |
Collapse
|
48
|
Chen A, Wong CSF, Liu MCP, House CM, Sceneay J, Bowtell DD, Thompson EW, Möller A. The ubiquitin ligase Siah is a novel regulator of Zeb1 in breast cancer. Oncotarget 2015; 6:862-73. [PMID: 25528765 PMCID: PMC4359261 DOI: 10.18632/oncotarget.2696] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 11/04/2014] [Indexed: 01/11/2023] Open
Abstract
Elucidating the mechanisms that underlie metastasis is of paramount importance to understanding tumor progression and to the development of novel therapeutics. Epithelial to Mesenchymal Transition (EMT) plays a vital role in tumor cell dissemination and is regulated by a core cassette of transcription factors. Despite recent advances, the molecular pathways that regulate the EMT program have not yet been fully delineated. We show that Siah ubiquitin ligases regulate Zeb1 protein, a key EMT transcription factor. The induction of EMT in breast cancer cells leads to the down-regulation of Siah, while the loss of Siah induces a mesenchymal phenotype, concurrent with an up-regulation of Zeb1. Overexpression of Siah in vitro mediates Zeb1 degradation, which can be blocked with a Siah peptide inhibitor. Thus, this work demonstrates that Siah is a novel regulator of EMT. This work is the first to identify a mechanism of post-translational regulation of the key Epithelial to Mesenchymal Transition transcription factor Zeb1.
Collapse
Affiliation(s)
- Anna Chen
- Cancer Genomics and Genetics Laboratory, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne 3002, Australia.,Department of Pathology, The University of Melbourne, Parkville 3010, Australia
| | - Christina S F Wong
- Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia
| | - Mira C P Liu
- Cancer Genomics and Genetics Laboratory, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne 3002, Australia
| | - Colin M House
- Cancer Genomics and Genetics Laboratory, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne 3002, Australia
| | - Jaclyn Sceneay
- Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia
| | - David D Bowtell
- Cancer Genomics and Genetics Laboratory, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne 3002, Australia.,Department of Pathology, The University of Melbourne, Parkville 3010, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville 3010, Australia.,Department of Biochemistry, The University of Melbourne, Parkville 3010, Australia
| | - Erik W Thompson
- The University of Melbourne Department of Surgery, St Vincent's Hospital, Fitzroy 3065, Australia.,St Vincent's Institute of Medical Research, Fitzroy 3065, Australia.,Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove 4000, Australia
| | - Andreas Möller
- Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston 4006, Australia
| |
Collapse
|
49
|
Bowtell DD, Böhm S, Ahmed AA, Aspuria PJ, Bast RC, Beral V, Berek JS, Birrer MJ, Blagden S, Bookman MA, Brenton JD, Chiappinelli KB, Martins FC, Coukos G, Drapkin R, Edmondson R, Fotopoulou C, Gabra H, Galon J, Gourley C, Heong V, Huntsman DG, Iwanicki M, Karlan BY, Kaye A, Lengyel E, Levine DA, Lu KH, McNeish IA, Menon U, Narod SA, Nelson BH, Nephew KP, Pharoah P, Powell DJ, Ramos P, Romero IL, Scott CL, Sood AK, Stronach EA, Balkwill FR. Rethinking ovarian cancer II: reducing mortality from high-grade serous ovarian cancer. Nat Rev Cancer 2015; 15:668-79. [PMID: 26493647 PMCID: PMC4892184 DOI: 10.1038/nrc4019] [Citation(s) in RCA: 752] [Impact Index Per Article: 83.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
High-grade serous ovarian cancer (HGSOC) accounts for 70-80% of ovarian cancer deaths, and overall survival has not changed significantly for several decades. In this Opinion article, we outline a set of research priorities that we believe will reduce incidence and improve outcomes for women with this disease. This 'roadmap' for HGSOC was determined after extensive discussions at an Ovarian Cancer Action meeting in January 2015.
Collapse
Affiliation(s)
- David D Bowtell
- Cancer Genomics and Genetics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria 8006, Australia; and the Kinghorn Cancer Centre, Garvan Institute for Medical Research, Darlinghurst, Sydney, 2010 New South Wales, Australia
| | - Steffen Böhm
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
| | - Ahmed A Ahmed
- Nuffield Department of Obstetrics and Gynaecology and the Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK
| | - Paul-Joseph Aspuria
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA
| | - Robert C Bast
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | - Valerie Beral
- University of Oxford, Headington, Oxford, OX3 7LF, UK
| | | | | | - Sarah Blagden
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | | | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | | | - Filipe Correia Martins
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - George Coukos
- University Hospital of Lausanne, Lausanne, Switzerland
| | - Ronny Drapkin
- University of Pennsylvania, Penn Ovarian Cancer Research Center, Philadelphia, Pennsylvania 19104, USA
| | | | - Christina Fotopoulou
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Hani Gabra
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Jérôme Galon
- Institut National de la Santé et de la Recherche Médicale, UMRS1138, Laboratory of Integrative Cancer Immunology, Cordeliers Research Center, Université Paris Descartes, Sorbonne Paris Cité, Sorbonne Universités, UPMC Univ Paris 06, 75006 Paris, France
| | - Charlie Gourley
- Cancer Research Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Valerie Heong
- Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - David G Huntsman
- University of British Columbia, Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Faculty of Medicine, Vancouver, British Columbia V6T 2B5, Canada
| | | | - Beth Y Karlan
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA
| | | | | | - Douglas A Levine
- Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Karen H Lu
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | | | - Usha Menon
- Women's Cancer, Institute for Women's Health, University College London, London WC1E 6BT, UK
| | - Steven A Narod
- Women's College Research Institute, Toronto, Ontario M5G 1N8, Canada
| | - Brad H Nelson
- British Columbia Cancer Agency, Victoria, British Columbia V8R 6V5, Canada
| | - Kenneth P Nephew
- Indiana University School of Medicine &Simon Cancer Center, Bloomington, IN 47405-4401, USA
| | - Paul Pharoah
- University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Daniel J Powell
- University of Pennsylvania, Philadelphia, PA 19104-5156, USA
| | - Pilar Ramos
- Translational Genomics Research Institute (Tgen), Phoenix, Arizona 85004, USA
| | | | - Clare L Scott
- Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - Anil K Sood
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | - Euan A Stronach
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Frances R Balkwill
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
| |
Collapse
|
50
|
Kilroy G, Carter LE, Newman S, Burk DH, Manuel J, Möller A, Bowtell DD, Mynatt RL, Ghosh S, Floyd ZE. The ubiquitin ligase Siah2 regulates obesity-induced adipose tissue inflammation. Obesity (Silver Spring) 2015; 23:2223-32. [PMID: 26380945 PMCID: PMC4633373 DOI: 10.1002/oby.21220] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/10/2015] [Accepted: 06/16/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Chronic, low-grade adipose tissue inflammation associated with adipocyte hypertrophy is an important link in the relationship between obesity and insulin resistance. Although ubiquitin ligases regulate inflammatory processes, the role of these enzymes in metabolically driven adipose tissue inflammation is relatively unexplored. Herein, the effect of the ubiquitin ligase Siah2 on obesity-related adipose tissue inflammation was examined. METHODS Wild-type and Siah2KO mice were fed a low- or high-fat diet for 16 weeks. Indirect calorimetry, body composition, and glucose and insulin tolerance were assayed along with glucose and insulin levels. Gene and protein expression, immunohistochemistry, adipocyte size distribution, and lipolysis were also analyzed. RESULTS Enlarged adipocytes in obese Siah2KO mice were not associated with obesity-induced insulin resistance. Proinflammatory gene expression, stress kinase signaling, fibrosis, and crown-like structures were reduced in the Siah2KO adipose tissue, and Siah2KO adipocytes were more responsive to insulin-dependent inhibition of lipolysis. Loss of Siah2 increased expression of PPARγ target genes involved in lipid metabolism and decreased expression of proinflammatory adipokines regulated by PPARγ. CONCLUSIONS Siah2 links adipocyte hypertrophy with adipocyte dysfunction and recruitment of proinflammatory immune cells to adipose tissue. Selective regulation of PPARγ activity is a Siah2-mediated mechanism contributing to obesity-induced adipose tissue inflammation.
Collapse
Affiliation(s)
- Gail Kilroy
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | | | - Susan Newman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - David H. Burk
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Justin Manuel
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Andreas Möller
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - David D. Bowtell
- Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | | | - Sujoy Ghosh
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Cardiovascular and Metabolic Disease Program and Center for Computational Biology, Duke-NUS Graduate Medical School, Singapore
| | - Z. Elizabeth Floyd
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Corresponding author: Elizabeth Floyd, PhD, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808, Phone: 225-763-2724, FAX: 225-763-0273,
| |
Collapse
|