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Wakkerman FC, Wu J, Putter H, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LCHW, Haverkort MAD, de Jong MA, Mens JWM, Wortman BG, Nout RA, Léon-Castillo A, Powell ME, Mileshkin LR, Katsaros D, Alfieri J, Leary A, Singh N, de Boer SM, Nijman HW, Smit VTHBM, Bosse T, Koelzer VH, Creutzberg CL, Horeweg N. Prognostic impact and causality of age on oncological outcomes in women with endometrial cancer: a multimethod analysis of the randomised PORTEC-1, PORTEC-2, and PORTEC-3 trials. Lancet Oncol 2024:S1470-2045(24)00142-6. [PMID: 38701815 DOI: 10.1016/s1470-2045(24)00142-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Numerous studies have shown that older women with endometrial cancer have a higher risk of recurrence and cancer-related death. However, it remains unclear whether older age is a causal prognostic factor, or whether other risk factors become increasingly common with age. We aimed to address this question with a unique multimethod study design using state-of-the-art statistical and causal inference techniques on datasets of three large, randomised trials. METHODS In this multimethod analysis, data from 1801 women participating in the randomised PORTEC-1, PORTEC-2, and PORTEC-3 trials were used for statistical analyses and causal inference. The cohort included 714 patients with intermediate-risk endometrial cancer, 427 patients with high-intermediate risk endometrial cancer, and 660 patients with high-risk endometrial cancer. Associations of age with clinicopathological and molecular features were analysed using non-parametric tests. Multivariable competing risk analyses were performed to determine the independent prognostic value of age. To analyse age as a causal prognostic variable, a deep learning causal inference model called AutoCI was used. FINDINGS Median follow-up as estimated using the reversed Kaplan-Meier method was 12·3 years (95% CI 11·9-12·6) for PORTEC-1, 10·5 years (10·2-10·7) for PORTEC-2, and 6·1 years (5·9-6·3) for PORTEC-3. Both overall recurrence and endometrial cancer-specific death significantly increased with age. Moreover, older women had a higher frequency of deep myometrial invasion, serous tumour histology, and p53-abnormal tumours. Age was an independent risk factor for both overall recurrence (hazard ratio [HR] 1·02 per year, 95% CI 1·01-1·04; p=0·0012) and endometrial cancer-specific death (HR 1·03 per year, 1·01-1·05; p=0·0012) and was identified as a significant causal variable. INTERPRETATION This study showed that advanced age was associated with more aggressive tumour features in women with endometrial cancer, and was independently and causally related to worse oncological outcomes. Therefore, our findings suggest that older women with endometrial cancer should not be excluded from diagnostic assessments, molecular testing, and adjuvant therapy based on their age alone. FUNDING None.
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Affiliation(s)
- Famke C Wakkerman
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Jiqing Wu
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hein Putter
- Department of Biostatistics, Leiden University Medical Center, Leiden, Netherlands
| | | | - Jan J Jobsen
- Department of Radiotherapy, Medisch Spectrum Twente, Enschede, Netherlands
| | | | | | - Marianne A de Jong
- Radiotherapy Institute Friesland, Radiation Oncology, Leeuwarden, Netherlands
| | - Jan Willem M Mens
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Bastiaan G Wortman
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Remi A Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - Melanie E Powell
- Department of Clinical Oncology, Barts Health NHS Trust, London, UK
| | - Linda R Mileshkin
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Dionyssios Katsaros
- Gynecology and Obstetrics, Departments of Surgical Sciences, City of Health and Science, University of Turin, Turin, Italy
| | - Joanne Alfieri
- Division of Radiation Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Alexandra Leary
- Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Naveena Singh
- Department of Pathology, Barts Health NHS Trust, London, UK
| | - Stephanie M de Boer
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Hans W Nijman
- Department of Gynaecologic Oncology, University Medical Center Groningen, Groningen, Netherlands
| | | | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
| | - Viktor H Koelzer
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Nanda Horeweg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands.
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Kenter GG, Greggi S, Vergote I, Katsaros D, Kobierski J, van Doorn H, Landoni F, van der Velden J, Reed N, Coens C, van Luijk I, Colombo N, Steen-Banasik EVD, Ottevanger N, Casado A. Randomized Phase III Study Comparing Neoadjuvant Chemotherapy Followed by Surgery Versus Chemoradiation in Stage IB2-IIB Cervical Cancer: EORTC-55994. J Clin Oncol 2023; 41:5035-5043. [PMID: 37656948 DOI: 10.1200/jco.22.02852] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 05/02/2023] [Accepted: 06/28/2023] [Indexed: 09/03/2023] Open
Abstract
PURPOSE This multicenter trial by the European Organisation for Research and Treatment of Cancer Gynecological Cancer Group was motivated by conflicting evidence on the value of neoadjuvant chemotherapy before surgery compared with concomitant chemoradiotherapy (CCRT) in stage IB2-IIB cervical carcinoma. METHODS Between May 2002 and January 2014, 626 patients with International Federation of Gynecology and Obstetrics stage IB2-IIb were randomly assigned between neoadjuvant chemotherapy followed by surgery (NACT-S; n = 314) and standard CCRT (n = 312). The primary end point was 5-year overall survival (OS) rate. Secondary end points were progression-free survival, OS, toxicity, and health-related quality of life (HRQOL). RESULTS After a median follow-up of 8.7 years, 198 patients (31.6%) died. Age, stage, and cell type were balanced in both arms. Protocol treatment was completed in 223 of 314 (71%) patients in NACT-S and 257 of 312(82%) in CCRT arms. Main reasons for incomplete protocol treatment were toxicity (30 of 314; 9.6%) and progressive disease (21 of 314; 6.7%) in the NACT-S arm and toxicity (23 of 312; 7.4%) and patient refusal (13 of 312; 4.2%) in the CCRT arm. Additional radiotherapy after completed NACT-S was given to 107 patients (48%), and additional surgery to 20 patients (8%) after completed CCRT. Short-term adverse events (AEs) ≥grade 3 occurred more frequently with NACT-S (41% v 23%), and long-term AEs ≥grade 3 more often with CCRT (21% v 15%). The 5-year OS was not significantly different between NACT-S (72%; 95% CI, 66 to 77) and CCRT (76%; 95% CI, 70 to 80). CONCLUSION This trial failed to demonstrate superiority in favor of the NACT-S arm but resulted in acceptable morbidity and HRQOL in both arms.
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Affiliation(s)
- Gemma G Kenter
- Center for Gynaecologic Oncology Amsterdam, Amsterdam University Medical Center, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Stefano Greggi
- Gynaecologic Oncology, Istituto Nazionale Tumori di Napoli IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Ignace Vergote
- Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Dionyssios Katsaros
- Department of Surgical Sciences, AOU Citta della Salute, Gynecologic Oncology, PO SANNA, University of Torino, Torino, Italy
| | - Juliusz Kobierski
- Department of Gynecology and Gynecologic Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Heleen van Doorn
- ErasmusMC Cancer Institute, University Medical Center, Rotterdam, the Netherlands
| | - Fabio Landoni
- Gynecologic Clinic Milano Bicocca University, Ospedale San Gerardo, Monza, Italy
| | | | - Nicholas Reed
- Medical Oncology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - Corneel Coens
- European Organization on Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | | | | | | | - Nelleke Ottevanger
- Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Antonio Casado
- Medical Oncology, University Hospital San Carlos, Madrid, Spain
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3
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Wang Z, Katsaros D, Wang J, Biglio N, Hernandez BY, Fei P, Lu L, Risch H, Yu H. Machine learning-based cluster analysis of immune cell subtypes and breast cancer survival. Sci Rep 2023; 13:18962. [PMID: 37923775 PMCID: PMC10624674 DOI: 10.1038/s41598-023-45932-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 10/25/2023] [Indexed: 11/06/2023] Open
Abstract
Host immunity involves various immune cells working in concert to achieve balanced immune response. Host immunity interacts with tumorigenic process impacting disease outcome. Clusters of different immune cells may reveal unique host immunity in relation to breast cancer progression. CIBERSORT algorithm was used to estimate relative abundances of 22 immune cell types in 3 datasets, METABRIC, TCGA, and our study. The cell type data in METABRIC were analyzed for cluster using unsupervised hierarchical clustering (UHC). The UHC results were employed to train machine learning models. Kaplan-Meier and Cox regression survival analyses were performed to assess cell clusters in association with relapse-free and overall survival. Differentially expressed genes by clusters were interrogated with IPA for molecular signatures. UHC analysis identified two distinct immune cell clusters, clusters A (83.2%) and B (16.8%). Memory B cells, plasma cells, CD8 positive T cells, resting memory CD4 T cells, activated NK cells, monocytes, M1 macrophages, and resting mast cells were more abundant in clusters A than B, whereas regulatory T cells and M0 and M2 macrophages were more in clusters B than A. Patients in cluster A had favorable survival. Similar survival associations were also observed in other independent studies. IPA analysis showed that pathogen-induced cytokine storm signaling pathway, phagosome formation, and T cell receptor signaling were related to the cell type clusters. Our finding suggests that different immune cell clusters may indicate distinct immune responses to tumor growth, suggesting their potential for disease management.
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Affiliation(s)
- Zhanwei Wang
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino, Turin, Italy
| | - Junlong Wang
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
- Department of Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Nicholetta Biglio
- Division of Obstetrics and Gynecology, Department of Surgical Sciences, University of Torino School of Medicine, Mauriziano Hospital, Turin, Italy
| | - Brenda Y Hernandez
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Peiwen Fei
- Cancer Biology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Harvey Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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Borella F, Fucina S, Mangherini L, Cosma S, Carosso AR, Cusato J, Cassoni P, Bertero L, Katsaros D, Benedetto C. Hormone Receptors and Epithelial Ovarian Cancer: Recent Advances in Biology and Treatment Options. Biomedicines 2023; 11:2157. [PMID: 37626654 PMCID: PMC10452581 DOI: 10.3390/biomedicines11082157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/03/2023] [Accepted: 07/22/2023] [Indexed: 08/27/2023] Open
Abstract
Epithelial ovarian cancer (EOC) is a significant cause of cancer-related mortality in women. Despite advances in diagnosis and treatment, EOC remains a challenging disease to manage, and the 5-year survival rate is still poor. The role of hormone receptors (HRs) in EOC carcinogenesis and prognosis has been actively explored; however, the role of hormone therapy (HT) in the treatment of these tumors is not well established. Most available data on HT mainly come from retrospective series and small early clinical trials. Several of these studies suggest that HT may have a role in adjuvant, maintenance therapy, or in the case of recurrent disease, especially for some subtypes of EOC (e.g., low-grade serous EOC). Furthermore, HT has recently been combined with targeted therapies, but most studies evaluating these combinations are still ongoing. The main aim of this review is to provide an overview of the progress made in the last decade to characterize the biological and prognostic role of HRs for EOC and the developments in their therapeutic targeting through HT.
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Affiliation(s)
- Fulvio Borella
- Gynecology and Obstetrics 1U, Departments of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy; (S.F.); (S.C.); (A.R.C.); (D.K.); (C.B.)
| | - Stefano Fucina
- Gynecology and Obstetrics 1U, Departments of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy; (S.F.); (S.C.); (A.R.C.); (D.K.); (C.B.)
| | - Luca Mangherini
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (L.M.); (P.C.); (L.B.)
| | - Stefano Cosma
- Gynecology and Obstetrics 1U, Departments of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy; (S.F.); (S.C.); (A.R.C.); (D.K.); (C.B.)
| | - Andrea Roberto Carosso
- Gynecology and Obstetrics 1U, Departments of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy; (S.F.); (S.C.); (A.R.C.); (D.K.); (C.B.)
| | - Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, 10149 Turin, Italy;
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (L.M.); (P.C.); (L.B.)
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy; (L.M.); (P.C.); (L.B.)
| | - Dionyssios Katsaros
- Gynecology and Obstetrics 1U, Departments of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy; (S.F.); (S.C.); (A.R.C.); (D.K.); (C.B.)
| | - Chiara Benedetto
- Gynecology and Obstetrics 1U, Departments of Surgical Sciences, City of Health and Science, University of Turin, 10126 Turin, Italy; (S.F.); (S.C.); (A.R.C.); (D.K.); (C.B.)
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Velle A, Pesenti C, Grassi T, Beltrame L, Martini P, Jaconi M, Agostinis F, Calura E, Katsaros D, Borella F, Fruscio R, D'Incalci M, Marchini S, Romualdi C. A comprehensive investigation of histotype-specific microRNA and their variants in Stage I epithelial ovarian cancers. Int J Cancer 2023; 152:1989-2001. [PMID: 36541726 DOI: 10.1002/ijc.34408] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/24/2022]
Abstract
isomiRs, the sequence-variants of microRNA, are known to be tissue and cell type specific but their physiological role is largely unknown. In our study, we explored for the first time the expression of isomiRs across different Stage I epithelial ovarian cancer (EOC) histological subtypes, in order to shed new light on their biological role in tumor growth and progression. In a multicentric retrospective cohort of tumor biopsies (n = 215) we sequenced small RNAs finding 971 expressed miRNAs, 64% of which are isomiRs. Among them, 42 isomiRs showed a clear histotype specific pattern, confirming our previously identified miRNA markers (miR192/194 and miR30a-3p/5p for mucinous and clear cell subtypes, respectively) and uncovering new biomarkers for all the five subtypes. Using integrative models, we found that the 38% of these miRNA expression alterations is the result of copy number variations while the 17% of differential transcriptional activities. Our work represents the first attempt to characterize isomiRs expression in Stage I EOC within and across subtypes and to contextualize their alterations in the framework of the large genomic heterogeneity of this tumor.
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Affiliation(s)
- Angelo Velle
- Department of Biology, University of Padova, Padova, Italy
| | - Chiara Pesenti
- Department of Oncology, Mario Negri Institute for Pharmacological Research, Milan, Italy.,Medical Genetics Unit, ASST Santi Paolo e Carlo, Milan, Italy
| | - Tommaso Grassi
- Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Luca Beltrame
- IRCCS Humanitas Research Hospital, Molecular Pharmacology Lab, Rozzano, Italy
| | - Paolo Martini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Marta Jaconi
- Department of Pathology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | | | - Enrica Calura
- Department of Biology, University of Padova, Padova, Italy
| | - Dionyssios Katsaros
- Azienda Ospedaliero-Universitaria Città della Salute, Presidio S Anna and Department of Surgical Science, Gynecology, University of Torino, Torino, Italy
| | - Fulvio Borella
- Gynaecology and Obstetrics 1, Department of Surgical Sciences, St Anna Hospital and University of Torino, Turin, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Maurizio D'Incalci
- Cancer Pharmacology, IRCCS Humanitas Research Hospital, Italy.,Department of Biomedical Sciences, Humanitas University, Italy
| | - Sergio Marchini
- IRCCS Humanitas Research Hospital, Molecular Pharmacology Lab, Rozzano, Italy
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Wang Z, Katsaros D, Wang J, Biglio N, Hernandez BY, Fei P, Lu L, Risch H, Yu H. Abstract 3020: Machine learning-based cluster analysis of immune cell subtypes and breast cancer survival. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Background: Host immunity involves various immune cells working in concert to achieve balanced immune response. Host immunity interacts with tumorigenic process impacting disease outcome. Clusters of different immune cells may indicate specific host-tumor interplay. Identifying the clusters may reveal unique host immunity in response to tumor growth.
Methods: CIBERSORT was used to estimate relative abundances of 22 immune cell types in 3 datasets, METABRIC, TCGA, and our study. The cell type data in METABRIC were analyzed for cluster using unsupervised hierarchical clustering (UHC). The UHC results were employed to train machine learning models, random forest (RF), deep neural network (DNN), stepAIC, and elastic net. Kaplan-Meier and Cox regression survival analyses were performed to assess cell clusters in association with relapse-free and overall survival. Differentially expressed genes (DEGs) by immune cell clusters were interrogated with IPA for molecular signatures.
Results: UHC analysis identified two distinct immune cell clusters, clusters A (83.2%) and B (16.8%). Memory B cells, plasma cells, CD8 positive T cells, resting memory CD4 T cells, activated NK cells, monocytes, M1 macrophages, and resting mast cells were more abundant in clusters A than B, whereas regulatory T cells and M0 and M2 macrophages were more in clusters B than A. Patients in cluster A had favorable survival compared to those in cluster B. Similar survival associations were also observed in TCGA and our study when using a RF model trained with the UHC results. The survival associations were independent from clinicopathological variables. IPA analysis showed that pathogen-induced cytokine storm signaling pathway, phagosome formation, and T cell receptor signaling were related to the cell type clusters.
Conclusions: Our finding suggests that different immune cell clusters may indicate distinct immune responses to tumor growth, suggesting their potential for disease management.
Citation Format: Zhanwei Wang, Dionyssios Katsaros, Junlong Wang, Nicholetta Biglio, Brenda Y. Hernandez, Peiwen Fei, Lingeng Lu, Harvey Risch, Herbert Yu. Machine learning-based cluster analysis of immune cell subtypes and breast cancer survival [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3020.
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Affiliation(s)
- Zhanwei Wang
- 1University of Hawai'i Cancer Center, Honolulu, HI
| | | | - Junlong Wang
- 1University of Hawai'i Cancer Center, Honolulu, HI
| | - Nicholetta Biglio
- 3University of Torino School of Medicine, Mauriziano Hospital, Turin, Italy
| | | | - Peiwen Fei
- 1University of Hawai'i Cancer Center, Honolulu, HI
| | - Lingeng Lu
- 4Yale School of Public Health, New Haven, CT
| | | | - Herbert Yu
- 1University of Hawai'i Cancer Center, Honolulu, HI
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Fremond S, Andani S, Wolf JB, Ørtoft G, Høgdall E, Dijkstra J, Jobsen JJ, Jürgenliemk-Schulz IM, Lutgens LCHW, Powell ME, Singh N, Mileshkin LR, Mackay HJ, Leary A, Katsaros D, Nijman HW, de Boer SM, Nout RA, Smit VT, Creutzberg CL, Horeweg N, Koelzer VH, Bosse T. Abstract 5695: Deep learning risk prediction model of distant recurrence from H&E endometrial cancer slides. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-5695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Accurate risk prediction of distant recurrence (DR) is crucial for personalized adjuvant systemic therapy of endometrial cancer (EC) stage I-III patients, as DR is associated with a 5-year overall survival of 10-20%. Risk stratification and treatment recommendation are currently based on histopathological and molecular markers, which is challenging due to high inter-observer variability and testing costs respectively. Deep Learning (DL) models can predict prognosis by identifying relevant visual features from H&E whole slide images (WSIs) at different resolutions without prior assumptions. Here, we developed and tested the first interpretable state-of-the-art DL model for WSI-based risk prediction of DR of stage I-III EC (DeREC) from the randomized PORTEC-1/-2/-3 trials and three clinical cohorts with long-term follow-up data. We used one representative H&E WSI each from 1761 EC patients, excluding those who received adjuvant chemotherapy as it lowers the risk of DR. We randomly sampled 20% as a held-out internal test set (N=353 with 62 events; 8.45 year median follow-up) and performed a 5-fold cross-validation on the training set (N=1408). WSIs were partitioned into 360 micron patches at 40x magnification. DeREC combined self-supervised representation learning of patches using a multi-resolution vision transformer and a WSI-level graph attention-based time-to-event prediction model. The model performance of correctly ranking patients by predicted risk scores and true time to DR was measured with the concordance-index and compared with a Cox’ Proportional Hazards (CPH) model fitted on histopathological variables (histotype, grade, lymphovascular space invasion, stage). Discriminative quality of the predicted risk groups was investigated with Kaplan-Meier analysis and the log-rank test. Most predictive patches by predicted risk groups were reviewed by an expert gynecopathologist for identification of prognostic morphological features. DeREC achieved a concordance-index of 0.764 [95%CI 0.754-0.773] on 5-fold cross validation and 0.757 on the test set, as compared to 0.704 [95%CI 0.662-0.746] with CPH. Predicted risk groups around quartiles 1 and 3 accurately stratified patients between low (N=89), intermediate (N=175), high (N=89) risk of DR (p<0.0001). Among the predicted low-risk group only 3 (3.37%) patients relapsed whereas intermediate and high-risk groups counted 27 (15.43%) and 32 (35.96%) events respectively. DeREC is the first DL model accurately distinguishing EC patients at high risk of DR from those at low risk using one H&E WSI, which would aid decisions on adjuvant treatment. DeREC outperformed standard statistical prediction methods using histopathological variables, indicating that it identified prognostic visual features which can be further investigated. Future development includes the integration of clinicopathological and molecular information.
Citation Format: Sarah Fremond, Sonali Andani, Jurriaan Barkey Wolf, Gitte Ørtoft, Estrid Høgdall, Jouke Dijkstra, Jan J. Jobsen, Ina M. Jürgenliemk-Schulz, Ludy CHW Lutgens, Melanie E. Powell, Naveena Singh, Linda R. Mileshkin, Helen J. Mackay, Alexandra Leary, Dionyssios Katsaros, Hans W. Nijman, Stephanie M. de Boer, Remi A. Nout, Vincent T.H.B.M Smit, Carien L. Creutzberg, Nanda Horeweg, Viktor H. Koelzer, Tjalling Bosse. Deep learning risk prediction model of distant recurrence from H&E endometrial cancer slides. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 5695.
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Affiliation(s)
- Sarah Fremond
- 1Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Sonali Andani
- 2ETH Zurich, University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Gitte Ørtoft
- 3Copenhagen University Hospital, Copenhagen, Denmark
| | - Estrid Høgdall
- 4Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jouke Dijkstra
- 1Leiden University Medical Center (LUMC), Leiden, Netherlands
| | | | | | | | | | - Naveena Singh
- 9Vancouver General Hospital, Vancouver, British Columbia, Canada
| | | | - Helen J. Mackay
- 11Odette Cancer Center Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | | | | | - Hans W. Nijman
- 14University Medical Center Groningen, Groningen, Netherlands
| | | | - Remi A. Nout
- 15Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | - Nanda Horeweg
- 1Leiden University Medical Center (LUMC), Leiden, Netherlands
| | - Viktor H. Koelzer
- 16University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tjalling Bosse
- 1Leiden University Medical Center (LUMC), Leiden, Netherlands
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Vergote I, Gonzalez-Martin A, Lorusso D, Gourley C, Mirza MR, Kurtz JE, Okamoto A, Moore K, Kridelka F, McNeish I, Reuss A, Votan B, du Bois A, Mahner S, Ray-Coquard I, Kohn EC, Berek JS, Tan DSP, Colombo N, Zang R, Concin N, O'Donnell D, Rauh-Hain A, Herrington CS, Marth C, Poveda A, Fujiwara K, Stuart GCE, Oza AM, Bookman MA, Mahner S, Reuss A, du Bois A, Grimm C, Marth C, Berger R, Concin N, Chang TC, Ochiai K, Gebski V, Davis A, Beale P, Vergote I, Kridelka F, Denys H, Vandecaveye V, Cancido dos Reis FJ, Del Pilar Estevez Diz M, Stuart G, MacKay H, Carey M, Cibula D, Dundr (path) P, Dorigo O, Berek J, O'Donnell D, Saadeh A, Boere I, Lok C, Coronado P, Ottevanger N, Tan DSP, Ng J, Gonzalez Martin A, Oaknin A, Poveda A, Perez Fidalgo A, Rauh-Hain A, Lu K, López-Zavala C, Gómez-García EM, Ray-Coquard I, Paoletti X, Kurtz JE, Joly F, Votan B, Bookman M, Moore K, Arend R, Fujiwara K, Fujiwara H, Hasegawa K, Bruchim I, Tsoref D, Oda K, Okamoto A, Enomoto T, Michel D, Kim HS, Lee JY, Mukhopadhyay A, Katsaros D, Colombo N, Pignata S, Lorusso D, Scambia G, Kohn E, Lee JM, McNeish I, Nicum S, Farrelly L, Sehouli J, Keller M, Braicu E, Bjørge L, Mirza MR, Auranen A, Welch S, Oza AM, Heinzelmann V, Gourley C, Roxburgh P, Herrington CS, Glasspool R, Zang R, Zhu J. Clinical research in ovarian cancer: consensus recommendations from the Gynecologic Cancer InterGroup. Lancet Oncol 2022; 23:e374-e384. [PMID: 35901833 PMCID: PMC9465953 DOI: 10.1016/s1470-2045(22)00139-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/13/2022]
Abstract
The Gynecologic Cancer InterGroup (GCIG) sixth Ovarian Cancer Conference on Clinical Research was held virtually in October, 2021, following published consensus guidelines. The goal of the consensus meeting was to achieve harmonisation on the design elements of upcoming trials in ovarian cancer, to select important questions for future study, and to identify unmet needs. All 33 GCIG member groups participated in the development, refinement, and adoption of 20 statements within four topic groups on clinical research in ovarian cancer including first line treatment, recurrent disease, disease subgroups, and future trials. Unanimous consensus was obtained for 14 of 20 statements, with greater than 90% concordance in the remaining six statements. The high acceptance rate following active deliberation among the GCIG groups confirmed that a consensus process could be applied in a virtual setting. Together with detailed categorisation of unmet needs, these consensus statements will promote the harmonisation of international clinical research in ovarian cancer.
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Pesenti C, Beltrame L, Velle A, Fruscio R, Jaconi M, Borella F, Cribiù FM, Calura E, Venturini LV, Lenoci D, Agostinis F, Katsaros D, Panini N, Bianchi T, Landoni F, Miozzo M, D'Incalci M, Brenton JD, Romualdi C, Marchini S. Copy number alterations in stage I epithelial ovarian cancer highlight three genomic patterns associated with prognosis. Eur J Cancer 2022; 171:85-95. [PMID: 35714451 DOI: 10.1016/j.ejca.2022.05.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/13/2022] [Accepted: 05/03/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Stage I epithelial ovarian cancer (EOC) encompasses five histologically different subtypes of tumors confined to the ovaries with a generally favorable prognosis. Despite the intrinsic heterogeneity, all stage I EOCs are treated with complete resection and adjuvant therapy in most of the cases. Owing to the lack of robust prognostic markers, this often leads to overtreatment. Therefore, a better molecular characterization of stage I EOCs could improve the assessment of the risk of relapse and the refinement of optimal treatment options. MATERIALS AND METHODS 205 stage I EOCs tumor biopsies with a median follow-up of eight years were gathered from two independent Italian tumor tissue collections, and the genome distribution of somatic copy number alterations (SCNAs) was investigated by shallow whole genome sequencing (sWGS) approach. RESULTS Despite the variability in SCNAs distribution both across and within the histotypes, we were able to define three common genomic instability patterns, namely stable, unstable, and highly unstable. These patterns were based on the percentage of the genome affected by SCNAs and on their length. The genomic instability pattern was strongly predictive of patients' prognosis also with multivariate models including currently used clinico-pathological variables. CONCLUSIONS The results obtained in this study support the idea that novel molecular markers, in this case genomic instability patterns, can anticipate the behavior of stage I EOC regardless of tumor subtype and provide valuable prognostic information. Thus, it might be propitious to extend the study of these genomic instability patterns to improve rational management of this disease.
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Affiliation(s)
- Chiara Pesenti
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Angelo Velle
- Department of Biology, University of Padova, Padova, Italy
| | - Robert Fruscio
- Department of Obstetrics and Gynaecology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Marta Jaconi
- Department of Pathology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fulvio Borella
- Gynecology and Obstetrics 1, Department of Surgical Sciences, San Anna Hospital, University of Torino, Torino, Italy
| | - Fulvia Milena Cribiù
- Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Enrica Calura
- Department of Biology, University of Padova, Padova, Italy
| | - Lara Veronica Venturini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Deborah Lenoci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Dionyssios Katsaros
- AOU City of Health, Dept of Surgical Sciences, Gynecology, St Anna Hospital and University of Torino, Torino, Italy
| | - Nicolò Panini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Tommaso Bianchi
- Department of Obstetrics and Gynaecology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Fabio Landoni
- Department of Obstetrics and Gynaecology, Università Degli Studi Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Monica Miozzo
- Department of Health Sciences, Medical Genetics, Università Degli Studi di Milano, Milano, Italy; Research Laboratories Coordination Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Maurizio D'Incalci
- Laboratory of Cancer Pharmacology, IRCCS Humanitas Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
| | - James D Brenton
- Cancer Research UK Cambridge Research Institute, University of Cambridge, Cambridge, UK
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Wang J, Katsaros D, Biglia N, Fu Y, Benedetto C, Loo L, Wang Z, Yu H. LncRNA ZNF582-AS1 Expression and Methylation in Breast Cancer and Its Biological and Clinical Implications. Cancers (Basel) 2022; 14:2788. [PMID: 35681777 PMCID: PMC9179509 DOI: 10.3390/cancers14112788] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 04/20/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Long non-coding RNAs (lncRNAs) play an important role in cellular activities and functions, but our understanding of their involvement in cancer is limited. Methods: TCGA data on RNA expression and DNA methylation were analyzed for lncRNAs' association with breast cancer survival, using the Cox proportional hazard regression model. Fresh tumor samples and clinical information from 361 breast cancer patients in our study were used to confirm the TCGA finding on ZNF582-AS1. A RT-qPCR method was developed to measure ZNF582-AS1 expression. Survival associations with ZNF582-AS1 were verified with a meta-analysis. In silico predictions of molecular targets and cellular functions of ZNF582-AS1 were performed based on its molecular signatures and nucleotide sequences. Results:ZNF582-AS1 expression was lower in breast tumors than adjacent normal tissues. Low ZNF582-AS1 was associated with high-grade or ER-negative tumors. Patients with high ZNF582-AS1 had a lower risk of relapse and death. These survival associations were confirmed in a meta-analysis and remained significant after adjustment for tumor grade, disease stage, patient age, and hormone receptor status. Correlation analysis indicated the possible suppression of ZNF582-AS1 expression by promoter methylation. Bioinformatics interrogation of molecular signatures suggested that ZNF582-AS1 could suppress tumor cell proliferation via downregulating the HER2-mediated signaling pathway. Analysis of online data also suggested that HIF-1-related transcription factors could suppress ZNF582-AS1 expression, and the lncRNA might bind to hsa-miR-940, a known oncogenic miRNA in breast cancer. Conclusions: ZNF582-AS1 may play a role in suppressing breast cancer progression. Elucidating the lncRNA's function and regulation may improve our understanding of the disease.
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Affiliation(s)
- Junlong Wang
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
- Department of Molecular Biosciences & Bioengineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino School of Medicine, 10124 Turin, Italy; (D.K.); (C.B.)
| | - Nicoletta Biglia
- Department of Surgical Sciences, Division of Obstetrics and Gynecology, University of Torino School of Medicine, Mauriziano Hospital, 10124 Turin, Italy;
| | - Yuanyuan Fu
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
- Department of Molecular Biosciences & Bioengineering, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - Chiara Benedetto
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino School of Medicine, 10124 Turin, Italy; (D.K.); (C.B.)
| | - Lenora Loo
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
| | - Zhanwei Wang
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
| | - Herbert Yu
- University of Hawaii Cancer Center, Honolulu, HI 96813, USA; (J.W.); (Y.F.); (L.L.); (Z.W.)
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11
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Wortman BG, Post CCB, Powell ME, Khaw P, Fyles A, D'Amico R, Haie-Meder C, Jürgenliemk-Schulz IM, McCormack M, Do V, Katsaros D, Bessette P, Baron MH, Nout RA, Whitmarsh K, Mileshkin L, Lutgens LCHW, Kitchener HC, Brooks S, Nijman HW, Astreinidou E, Putter H, Creutzberg CL, de Boer SM. Radiation Therapy Techniques and Treatment-Related Toxicity in the PORTEC-3 Trial: Comparison of 3-Dimensional Conformal Radiation Therapy Versus Intensity-Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2021; 112:390-399. [PMID: 34610387 DOI: 10.1016/j.ijrobp.2021.09.042] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE Radiation therapy techniques have developed from 3-dimensional conformal radiation therapy (3DCRT) to intensity modulated radiation therapy (IMRT), with better sparing of the surrounding normal tissues. The current analysis aimed to investigate whether IMRT, compared to 3DCRT, resulted in fewer adverse events (AEs) and patient-reported symptoms in the randomized PORTEC-3 trial for high-risk endometrial cancer. METHODS AND MATERIALS Data on AEs and patient-reported quality of life (QoL) of the PORTEC-3 trial were available for analysis. Physician-reported AEs were graded using Common Terminology Criteria for Adverse Events v3.0. QoL was assessed by the European Organisation for Research and Treatment of Cancer QLQC30, CX24, and OV28 questionnaires. Data were compared between 3DCRT and IMRT. A P value of ≤ .01 was considered statistically significant due to the risk of multiple testing. For QoL, combined scores 1 to 2 ("not at all" and "a little") versus 3 to 4 ("quite a bit" and "very much") were compared between the techniques. RESULTS Of 658 evaluable patients, 559 received 3DCRT and 99 IMRT. Median follow-up was 74.6 months. During treatment no significant differences were observed, with a trend for more grade ≥3 AEs, mostly hematologic and gastrointestinal, after 3DCRT (37.7% vs 26.3%, P = .03). During follow-up, 15.4% (vs 4%) had grade ≥2 diarrhea, and 26.1% (vs 13.1%) had grade ≥2 hematologic AEs after 3DCRT (vs IMRT) (both P < .01). Among 574 (87%) patients evaluable for QoL, 494 received 3DCRT and 80 IMRT. During treatment, 37.5% (vs 28.6%) reported diarrhea after 3DCRT (vs IMRT) (P = .125); 22.1% (versus 10.0%) bowel urgency (P = 0039), and 18.2% and 8.6% abdominal cramps (P = .058). Other QoL scores showed no differences. CONCLUSIONS IMRT resulted in fewer grade ≥3 AEs during treatment and significantly lower rates of grade ≥2 diarrhea and hematologic AEs during follow-up. Trends toward fewer patient-reported bowel urgency and abdominal cramps were observed after IMRT compared to 3DCRT.
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Affiliation(s)
- Bastiaan G Wortman
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Cathalijne C B Post
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melanie E Powell
- Department of Clinical Oncology, Barts Health NHS Trust, London, United Kingdom
| | - Pearly Khaw
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Anthony Fyles
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Romerai D'Amico
- Department of Radiotherapy, Azienda Socio Sanitaria Territoriale, Lecco, Italy
| | | | | | - Mary McCormack
- Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Viet Do
- Radiation Oncology, Liverpool & Macarthur Cancer Therapy Center, NSW, Australia
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecologic Oncology, Città della Salute and Sant'Anna Hospital, University of Turin, Turin, Italy
| | - Paul Bessette
- Gynecologic Oncology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie Hélène Baron
- Department of Radiotherapy, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Remi A Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Linda Mileshkin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - Henry C Kitchener
- Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Susan Brooks
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand
| | - Hans W Nijman
- Department of Gynecologic Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Eleftheria Astreinidou
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Stephanie M de Boer
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
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12
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Di Liello R, Arenare L, Raspagliesi F, Scambia G, Pisano C, Colombo N, Frezzini S, Tognon G, Artioli G, Gadducci A, Lauria R, Ferrero A, Cinieri S, De Censi A, Breda E, Scollo P, De Giorgi U, Lissoni AA, Katsaros D, Lorusso D, Salutari V, Cecere SC, Lapresa M, Nardin M, Bogani G, Distefano M, Greggi S, Gargiulo P, Schettino C, Gallo C, Daniele G, Califano D, Perrone F, Pignata S, Piccirillo MC. Thromboembolic events and antithrombotic prophylaxis in advanced ovarian cancer patients treated with bevacizumab: secondary analysis of the phase IV MITO-16A/MaNGO-OV2A trial. Int J Gynecol Cancer 2021; 31:1348-1355. [PMID: 34462317 DOI: 10.1136/ijgc-2021-002786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/16/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION The use of routine antithrombotic prophylaxis is not recommended for advanced cancer patients receiving chemotherapy. The effect of bevacizumab-containing therapy on the risk of thromboembolic events remains controversial in ovarian cancer patients. We report on the incidence of thromboembolic events and the prevalence of antithrombotic therapy in patients enrolled in the single arm, phase IV, MITO-16A/MaNGO-OV2A trial. METHODS In this trial, potential prognostic factors for patients with previously untreated ovarian cancer receiving a combination of platinum-based chemotherapy and bevacizumab were explored and the final analysis has already been reported. In this secondary analysis, the occurrence of thromboembolic events and the use of antithrombotic therapy were described according to the clinical characteristics of the patients. The prognostic role of thromboembolic events for progression-free and overall survival were also evaluated. RESULTS From October 2012 to November 2014, 398 eligible patients were enrolled. 76 patients (19.1%) were receiving some type of anticoagulant or anti-aggregant treatment at baseline. Overall, 24 thromboembolic events were reported (cumulative incidence of 6.0%). The occurrence of thromboembolic events was not associated with baseline patient characteristics and was not modified by the use of antithrombotic prophylaxis (HR 0.60, 95% CI 0.18 to 2.0). Occurrence of thromboembolic events was not associated with progression-free survival (HR 1.34, 95% CI 0.83 to 2.15) or overall survival (HR 0.78, 95% CI 0.37 to 1.61). CONCLUSIONS In our study, a 6.0% rate of thromboembolic events was reported during treatment with bevacizumab plus chemotherapy. Thromboembolic events were not associated with the clinical characteristics of the patients or with the use of antithrombotic prophylaxis, nor did they significantly affect the long-term prognosis. TRIAL REGISTRATION NUMBER NCT01706120.
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Affiliation(s)
- Raimondo Di Liello
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Laura Arenare
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Francesco Raspagliesi
- Dipartimento di Chirurgia, SC Chirurgia Ginecologica, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Giovanni Scambia
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Ginecologia Oncologica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carmela Pisano
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Napoli, Italy
| | - Nicoletta Colombo
- Istituto Europeo di Oncologia IRCCS, and Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Simona Frezzini
- Oncologia Medica II e Radiologia, Istituto Oncologico Veneto IRCCS, and Università di Padova, Padova, Italy
| | - Germana Tognon
- Divisione di Ostetricia e Ginecologia, ASST Spedali Civili di Brescia, Università di Brescia, Brescia, Italy
| | - Grazia Artioli
- Oncologia Medica, ULSS2 Marca Trevigiana, Treviso, Italy
| | - Angiolo Gadducci
- Dipartimento di Medicina Clinica e Sperimentale, UO Ginecologia e Ostetricia, Università di Pisa, Pisa, Italy
| | - Rossella Lauria
- Oncologia Medica, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Napoli, Italy
| | - Annamaria Ferrero
- Divisione Universitaria di Ginecologia e Ostetricia, AO Ordine Mauriziano, Torino, Italy
| | - Saverio Cinieri
- Oncologia Medica, Ospedale Senatore Antonio Perrino, Brindisi, Italy
| | | | - Enrico Breda
- Dipartimento di Oncologia, Ospedale S. Giovanni Calibita Fatebenefratelli, Roma, Italy
| | - Paolo Scollo
- UO Ostetricia e Ginecologia, Dipartimento Materno-Infantile, Ospedale Cannizzaro, Catania, Italy
| | - Ugo De Giorgi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Meldola, Italy
| | | | - Dionyssios Katsaros
- AOU Città della Salute, Dipartimento di Scienze Chirurgiche, Ginecologia Oncologica, Ospedale Ostetrico Ginecologico S Anna, Torino, Italy
| | - Domenica Lorusso
- Divisione di Ginecologia Medica, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Vanda Salutari
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Ginecologia Oncologica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Sabrina Chiara Cecere
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Napoli, Italy
| | - Mariateresa Lapresa
- Divisione di Ginecologia Medica, Istituto Europeo di Oncologia IRCCS, Milano, Italy
| | - Margherita Nardin
- Oncologia Medica II e Radiologia, Istituto Oncologico Veneto IRCCS, and Università di Padova, Padova, Italy
| | - Giorgio Bogani
- Dipartimento di Chirurgia, SC Chirurgia Ginecologica, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Mariagrazia Distefano
- Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Ginecologia Oncologica, Fondazione Policlinico Universitario Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefano Greggi
- SC Ginecologia Oncologica, Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Napoli, Campania, Italy
| | - Piera Gargiulo
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Clorinda Schettino
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Ciro Gallo
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Gennaro Daniele
- Direzione Scientifica, Fondazione Policlinico Universitario A Gemelli IRCCS, Roma, Italy
| | - Daniela Califano
- Bersagli Molecolari del Microambiente, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Francesco Perrone
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Sandro Pignata
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Napoli, Italy
| | - Maria Carmela Piccirillo
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
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Wortman B, Post C, Powell M, Khaw P, Fyles A, D’Amico R, Haie-Meder C, Jurgenliemk-Schulz I, McCormack M, Do V, Katsaros D, Bessette P, Baron M, Nout R, Whitmarsh K, Mileshkin L, Lutgens L, Kitchener H, Brooks S, Nijman H, Astreinidou E, Putter H, Creutzberg C, de Boer S. OC-0298 Toxicity and patient-reported symptoms after 3D-conformal or intensity-modulated pelvic radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06845-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Daniele G, Raspagliesi F, Scambia G, Pisano C, Colombo N, Frezzini S, Tognon G, Artioli G, Gadducci A, Lauria R, Ferrero A, Cinieri S, De Censi A, Breda E, Scollo P, De Giorgi U, Lissoni AA, Katsaros D, Lorusso D, Salutari V, Cecere SC, Zaccarelli E, Nardin M, Bogani G, Distefano M, Greggi S, Piccirillo MC, Fossati R, Giannone G, Arenare L, Gallo C, Perrone F, Pignata S. Bevacizumab, carboplatin, and paclitaxel in the first line treatment of advanced ovarian cancer patients: the phase IV MITO-16A/MaNGO-OV2A study. Int J Gynecol Cancer 2021; 31:875-882. [PMID: 33931498 DOI: 10.1136/ijgc-2021-002434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore the clinical and biological prognostic factors for advanced ovarian cancer patients receiving first-line treatment with carboplatin, paclitaxel, and bevacizumab. METHODS A multicenter, phase IV, single arm trial was performed. Patients with advanced (FIGO (International Federation of Gynecology and Obstetrics) stage IIIB-IV) or recurrent, previously untreated, ovarian cancer received carboplatin (AUC (area under the curve) 5), paclitaxel (175 mg/m2) plus bevacizumab (15 mg/kg) on day 1 for six 3-weekly cycles followed by bevacizumab single agent (15 mg/kg) until progression or unacceptable toxicity up to a maximum of 22 total cycles. Here we report the final analysis on the role of clinical prognostic factors. The study had 80% power with a two-tailed 0.01 α error to detect a 0.60 hazard ratio with a factor expressed in at least 20% of the population. Both progression-free and overall survival were used as endpoints. RESULTS From October 2012 to November 2014, 398 eligible patients were treated. After a median follow-up of 32.3 months (IQR 24.1-40.4), median progression-free survival was 20.8 months (95% CI 19.1 to 22.0) and median overall survival was 41.1 months (95% CI 39.1 to 43.5). Clinical factors significantly predicting progression-free and overall survival were performance status, stage, and residual disease after primary surgery. Neither baseline blood pressure/antihypertensive treatment nor the development of hypertension during bevacizumab were prognostic. There were two deaths possibly related to treatment, but no unexpected safety signal was reported. CONCLUSIONS Efficacy and safety of bevacizumab in combination with carboplatin and paclitaxel and as maintenance were comparable to previous data. Hypertension, either at baseline or developed during treatment, was not prognostic. Performance status, stage, and residual disease after primary surgery remain the most important clinical prognostic factors. TRIAL REGISTRATION NUMBER EudraCT 2012-003043-29; NCT01706120.
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Affiliation(s)
- Gennaro Daniele
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy.,Direzione Scientifica, Policlinico Universitario Agostino Gemelli, Roma, Italy
| | | | - Giovanni Scambia
- Dipartimento Scienze della Salute della Donna e del Bambino, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carmela Pisano
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Nicoletta Colombo
- Istituto Europeo di Oncologia IRCCS, and Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Simona Frezzini
- Oncologia Medica 2, Istituto Oncologico Veneto IRCCS, Padova, Italy
| | - Germana Tognon
- Divisione di Ostetricia e Ginecologia, ASST Spedali Civili di Brescia, Università degli Studi di Brescia, Brescia, Italy
| | - Grazia Artioli
- Oncologia ed Ematologia, U.L.S.S. 13, Mirano (VE), Italy.,Oncologia Medica, ULSS2 Marca Trevigiana, Treviso, Italy
| | - Angiolo Gadducci
- Dipartimento di Medicina Clinica e Sperimentale, UO Ginecologia e Ostetricia, Università degli Studi di Pisa Facolta di Medicina e Chirurgia, Pisa, Italy
| | - Rossella Lauria
- Oncologia Medica, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II Scuola di Medicina e Chirurgia, Napoli, Italy
| | - Annamaria Ferrero
- Divisione Universitaria di Ginecologia e Ostetricia, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy
| | - Saverio Cinieri
- Divisione di Oncologia Medica, Ospedale Antonio Perrino, Brindisi, Italy
| | | | - Enrico Breda
- Dipartimento di oncologia, Ospedale San Giovanni Calibita Fatebenefratelli, Roma, Italy
| | - Paolo Scollo
- Divisione di Ostetricia e Ginecologia, Azienda Ospedaliera Cannizzaro, Catania, Italy
| | - Ugo De Giorgi
- Oncologia Medica, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (FC), Italy
| | | | - Dionyssios Katsaros
- Dipartimento di Scienze Chirurgiche, Ginecologia Oncologica, Ospedale Sant'Anna, Università di Torino, Torino, Italy
| | - Domenica Lorusso
- Chirurgia Ginecologica, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.,Dipartimento Scienze della Salute della Donna e del Bambino, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Vanda Salutari
- Dipartimento Scienze della Salute della Donna e del Bambino, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Sabrina Chiara Cecere
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Eleonora Zaccarelli
- Istituto Europeo di Oncologia IRCCS, and Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Margherita Nardin
- Radiologia, Istituto Oncologico Veneto IRCCS, Università di Padova, Padova, Italy
| | - Giorgio Bogani
- Chirurgia Ginecologica, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Mariagrazia Distefano
- Dipartimento Scienze della Salute della Donna e del Bambino, Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefano Greggi
- Ginecologia Oncologica, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Maria Carmela Piccirillo
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Roldano Fossati
- Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Gaia Giannone
- Dipartimento di Oncologia, Università degli Studi di Torino e Istituto di Candiolo, FPO - IRCCS, Torino, Italy
| | - Laura Arenare
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Ciro Gallo
- Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
| | - Francesco Perrone
- Unità Sperimentazioni Cliniche, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - Sandro Pignata
- Oncologia Clinica Sperimentale Uro-Ginecologica, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
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15
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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.
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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
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16
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Giannone G, Scotto G, Katsaros D, De Giorgi U, Farolfi A, Borella F, Cosma S, Ferrero A, Mangiacotti S, Villa M, Tuninetti V, Ghisoni E, Turinetto M, Mittica G, Gemmiti S, Zavallone L, Aglietta M, Pasini B, Di Maio M, Valabrega G. Hypersensitivity to platinum salts according to BRCA status in ovarian cancer: A retrospective analysis of clinical outcomes and systematic review of literature. Gynecol Oncol 2021; 162:80-87. [PMID: 33896588 DOI: 10.1016/j.ygyno.2021.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/13/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hypersensitivity reactions (HSRs) to platinum are an important issue in the treatment of patients (pts) with ovarian cancer (OC). Germline BRCA mutations have been proposed as a risk factor. We aimed at evaluating the incidence and severity of HSRs to platinum in OC pts. with known BRCA status. PATIENTS AND METHODS We retrospectively analyzed 432 pts. from 5 Italian Centers. In addition, we performed a systematic review and meta-analysis of published series. RESULTS Four hundred nine pts. received at least one prior platinum-based treatment line: 314 were BRCA wild type (77%) and 95 were BRCA mutated (23%). There was no statistical difference in exposure to platinum. Incidence of any grade HSRs was higher among BRCA mutated pts. [9% vs 18%, p = 0.019] and the time-to-HSRs curves show that the risk increases with the duration of platinum exposure, in BRCA mutated pts. more than in BRCA wild type. A multivariable analysis showed that harboring a germline BRCA mutation was related to a higher incidence of HSRs (HR: 1.84, 95% CI 1.00-3.99, p = 0.05) while having received pegylated liposomal doxorubicin (PLD) was related to a lower incidence of HSRs (HR: 0.03 95% CI 0.004-0.22, p = 0.001). The systematic review confirmed the higher incidence of HSRs in BRCA mutated pts., though heterogeneity among series was significant. CONCLUSIONS In OC pts. with BRCA mutations, there is a significantly higher incidence of HSRs to carboplatin, not justified by longer drug exposure. On the other hand, PLD exerted a protective role in our series.
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Affiliation(s)
- G Giannone
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy.
| | - G Scotto
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - D Katsaros
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - U De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - A Farolfi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - F Borella
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - S Cosma
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - A Ferrero
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
| | | | - M Villa
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Turin, Italy
| | - V Tuninetti
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - E Ghisoni
- Department of Oncology, Lausanne University Hospital, Switzerland; Ludwig Institute for Cancer Research, Lausanne, Switzerland
| | - M Turinetto
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - G Mittica
- Unit of Oncology, ASL Verbano Cusio Ossola (VCO), Omegna (VB), Italy
| | - S Gemmiti
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S. Anna, University of Turin, Turin, Italy
| | - L Zavallone
- Department of Medical Oncology, Infermi Hospital, Biella, Italy
| | - M Aglietta
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
| | - B Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Di Maio
- Department of Oncology, A.O. Ordine Mauriziano Hospital, University of Turin, Turin, Italy
| | - G Valabrega
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo (TO), Italy; Department of Oncology, University of Turin, Turin, Italy
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17
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Fu Y, Katsaros D, Biglia N, Wang Z, Pagano I, Tius M, Tiirikainen M, Rosser C, Yang H, Yu H. Vitamin D receptor upregulates lncRNA TOPORS-AS1 which inhibits the Wnt/β-catenin pathway and associates with favorable prognosis of ovarian cancer. Sci Rep 2021; 11:7484. [PMID: 33820921 PMCID: PMC8021562 DOI: 10.1038/s41598-021-86923-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 09/04/2020] [Accepted: 03/17/2021] [Indexed: 12/16/2022] Open
Abstract
Long non-coding RNAs (lncRNAs) have important biological functions, but their involvement in ovarian cancer remains elusive. We analyzed high-throughput data to identify lncRNAs associated with ovarian cancer outcomes. Our search led to the discovery of lncRNA TOPORS Antisense RNA 1 (TOPORS-AS1). Patients with high TOPORS-AS1 expression had favorable overall survival compared to low expression. This association was replicated in our study and confirmed by meta-analysis. In vitro experiments demonstrated that overexpressing TOPORS-AS1 in ovarian cancer cells suppressed cell proliferation and inhibited aggressive cell behaviors, including migration, invasion, and colony formation. Analysis of tumor cell transcriptomes indicated TOPORS-AS1′s influence on the Wnt/β-catenin signaling. Additional experiments revealed that TOPORS-AS1 increased the phosphorylation of β-catenin and suppressed the expression of CTNNB1, disrupting the Wnt/β-catenin pathway. Our experiments further discovered that vitamin D receptor (VDR) upregulated TOPORS-AS1 expression and that inhibition of β-catenin by TOPORS-AS1 required a RNA binding protein, hnRNPA2B1 (heterogeneous nuclear ribonucleoprotein A2B1). Taken together, these findings suggest that TOPORS-AS1 may behave like a tumor suppressor in ovarian cancer through interrupting the Wnt/β-catenin signaling and that VDR upregulates the expression of TOPORS-AS1. Assessing TOPORS-AS1 expression in ovarian cancer may help predict disease prognosis and develop treatment strategy
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Affiliation(s)
- Yuanyuan Fu
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.,Department of Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città Della Salute, University of Torino, Turin, Italy
| | - Nicoletta Biglia
- Division of Obstetrics and Gynecology, Department of Surgical Sciences, University of Torino School of Medicine, Mauriziano Hospital, Turin, Italy
| | - Zhanwei Wang
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Ian Pagano
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Marcus Tius
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Maarit Tiirikainen
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Charles Rosser
- Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Haining Yang
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Herbert Yu
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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18
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Post C, De Boer S, Powell M, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger P, Ledermann J, Khaw P, D'Amico R, Fyles A, Baron M, Kitchener H, Nijman H, Lutgens L, Brooks S, Jürgenliemk-Schulz I, Feeney A, Nout R, Verhoeven-Adema K, Smit V, Putter H, Creutzberg C. OC-0369: Long-Term Quality of Life after (chemo)radiotherapy for high-risk Endometrial Cancer in PORTEC-3. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00393-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Post CCB, de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger NPB, Ledermann JA, Khaw P, D'Amico R, Fyles A, Baron MH, Kitchener HC, Nijman HW, Lutgens LCHW, Brooks S, Jürgenliemk-Schulz IM, Feeney A, Goss G, Fossati R, Ghatage P, Leary A, Do V, Lissoni AA, McCormack M, Nout RA, Verhoeven-Adema KW, Smit VTHBM, Putter H, Creutzberg CL. Long-Term Toxicity and Health-Related Quality of Life After Adjuvant Chemoradiation Therapy or Radiation Therapy Alone for High-Risk Endometrial Cancer in the Randomized PORTEC-3 Trial. Int J Radiat Oncol Biol Phys 2020; 109:975-986. [PMID: 33129910 DOI: 10.1016/j.ijrobp.2020.10.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/16/2020] [Accepted: 10/23/2020] [Indexed: 01/31/2023]
Abstract
PURPOSE The survival results of the PORTEC-3 trial showed a significant improvement in both overall and failure-free survival with chemoradiation therapy versus pelvic radiation therapy alone. The present analysis was performed to compare long-term adverse events (AE) and health-related quality of life (HRQOL). METHODS AND MATERIALS In the study, 660 women with high-risk endometrial cancer were randomly assigned to receive chemoradiation therapy (2 concurrent cycles of cisplatin followed by 4 cycles of carboplatin/paclitaxel) or radiation therapy alone. Toxicity was graded using Common Terminology Criteria for Adverse Events, version 3.0. HRQOL was measured using EORTC QLQ-C30 and CX24/OV28 subscales and compared with normative data. An as-treated analysis was performed. RESULTS Median follow-up was 74.6 months; 574 (87%) patients were evaluable for HRQOL. At 5 years, grade ≥2 AE were scored for 78 (38%) patients who had received chemoradiation therapy versus 46 (24%) who had received radiation therapy alone (P = .008). Grade 3 AE did not differ significantly between the groups (8% vs 5%, P = .18) at 5 years, and only one new late grade 4 toxicity had been reported. At 3 and 5 years, sensory neuropathy toxicity grade ≥2 persisted after chemoradiation therapy in 6% (vs 0% after radiation therapy, P < .001) and more patients reported significant tingling or numbness at HRQOL (27% vs 8%, P < .001 at 3 years; 24% vs 9%, P = .002 at 5 years). Up to 3 years, more patients who had chemoradiation therapy reported limb weakness (21% vs 5%, P < .001) and lower physical (79 vs 87, P < .001) and role functioning (78 vs 88, P < .001) scores. Both treatment groups reported similar long-term global health/quality of life scores, which were better than those of the normative population. CONCLUSIONS This study shows a long-lasting, clinically relevant, negative impact of chemoradiation therapy on toxicity and HRQOL, most importantly persistent peripheral sensory neuropathy. Physical and role functioning impairments were seen until 3 years. These long-term data are essential for patient information and shared decision-making regarding adjuvant chemotherapy for high-risk endometrial cancer.
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Affiliation(s)
- Cathalijne C B Post
- Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Stephanie M de Boer
- Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melanie E Powell
- Clinical Oncology, Barts Health NHS Trust, London, United Kingdom
| | - Linda Mileshkin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Dionyssios Katsaros
- Surgical Sciences and Gynecology, Città della Salute and S Anna Hospital, Torino, Italy
| | - Paul Bessette
- Gynaecologic Oncology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | | | | | - Jonathan A Ledermann
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, United Kingdom
| | - Pearly Khaw
- Radiation Oncology, Peter MacCallum Cancer Center, Melbourne, Australia
| | - Romerai D'Amico
- Radiotherapy, Azienda Socio Sanitaria Territoriale, Lecco, Italy
| | - Anthony Fyles
- Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Marie Hélène Baron
- Radiotherapy, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Henry C Kitchener
- Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Hans W Nijman
- Gynecologic Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Susan Brooks
- Radiation Oncology, Auckland City Hospital, Auckland, New Zealand
| | | | - Amanda Feeney
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, United Kingdom
| | - Geraldine Goss
- Medical Oncology, Box Hill Hospital, Melbourne, Australia
| | - Roldano Fossati
- Medical Oncology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Prafull Ghatage
- Gynecologic Oncology, Calgary-Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - Alexandra Leary
- Cancer Medicine and Gynecological Tumor Translational Research Lab, Gustave Roussy Cancer Center, INSERM U981, Université Paris Saclay, Villejuif, France
| | - Viet Do
- Radiation Oncology, Liverpool & Macarthur Cancer Therapy Centre, NSW, Australia
| | | | - Mary McCormack
- Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Remi A Nout
- Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karen W Verhoeven-Adema
- Central Data Management and Trial Coordination, Comprehensive Cancer Center Netherlands, Rotterdam, The Netherlands
| | | | - Hein Putter
- Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - Carien L Creutzberg
- Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
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20
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D'Ambrosio C, Erriquez J, Arigoni M, Capellero S, Mittica G, Ghisoni E, Borella F, Katsaros D, Privitera S, Ribotta M, Maldi E, Nardo GD, Berrino E, Venesio T, Ponzone R, Vaira M, Hall D, Jimenez-Linan M, Paterson A, Valabrega G, Calogero R, Brenton J, Di Renzo M, Olivero M. Abstract 1677: Assays of conventional chemotherapeutics and targeted drugs for ovarian cancer using patient derived models. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-1677] [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
Patients with advanced ovarian cancers have experienced little improvement in overall survival with standard treatments. We used patient derived models to accelerate the discovery of treatment options. We developed a platform of Patient Derived Xenografts (PDX), by implanting and propagating patient's tumor samples collected at surgery in severely immunocompromised mice. From each PDX line we derived short term cultures of PDX Derived Tumor Cells (PDTCs). We envisioned that the weakness of PDXs and PDTCs, i.e. lack of human stromal and immune cells, might be instrumental to link tumor biomarkers to treatments. We have successfully propagated 49 PDX lines from metastatic EOC, which were fully characterized as far as histology, immunohistochemistry of epithelial and tissue specific markers and presence of TP53 and BRCA1/2 mutations. On PDTCs cultures we first assessed sensitivity to Carboplatin, currently used as first-line drug in ovarian cancer treatment. Of PDX lines derived from naïve metastatic HGS-EOC copy number variations and whole exome sequencing analyses were carried out, in order to identify putative and actionable cancer genes. Thus, on PDTCs we assayed also approved or experimental targeted drugs as monotherapy or in combinations. In one PDX line we identified a possibly loss-of-function mutation (W624R) of the PIK3R1 gene (encoding the p85alpha regulatory subunit of PI3K) with an allele frequency of 0.9, which could result in activation of the PI3K pathway. Several PI3K inhibitors were assayed on PDTCs of this PDX line harboring the PIK3R1W624R. Buparlisib (a Pan Class I PI3Ki) showed the ability to block proliferation of the PDTCs and the growth of the relevant PDXs in vivo.
Altogether these data show that Patient Derived models are invaluable tools to unveil actionable pathways for the treatment of advanced/metastatic HGS-EOC.
Citation Format: Concetta D'Ambrosio, Jessica Erriquez, Maddalena Arigoni, Sonia Capellero, Gloria Mittica, Eleonora Ghisoni, Fulvio Borella, Dionyssios Katsaros, Silvana Privitera, Marisa Ribotta, Elena Maldi, Giovanna Di Nardo, Enrico Berrino, Tiziana Venesio, Riccardo Ponzone, Marco Vaira, Douglas Hall, Mercedes Jimenez-Linan, Anna Paterson, Giorgio Valabrega, Raffaele Calogero, James Brenton, Mariaflavia Di Renzo, Martina Olivero. Assays of conventional chemotherapeutics and targeted drugs for ovarian cancer using patient derived models [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1677.
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Affiliation(s)
| | | | | | | | | | | | - Fulvio Borella
- 4Citta della Salute e della Scienza di Torino, Torino, Italy
| | | | | | - Marisa Ribotta
- 4Citta della Salute e della Scienza di Torino, Torino, Italy
| | - Elena Maldi
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo, Italy
| | | | | | | | | | - Marco Vaira
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo, Italy
| | - Douglas Hall
- 6University of Cambridge, Cambridge, CB2 0RE, United Kingdom
| | | | - Anna Paterson
- 7Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE UK, United Kingdom
| | | | | | - James Brenton
- 7Cancer Research UK Cambridge Institute, Cambridge, CB2 0RE UK, United Kingdom
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21
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Cosma S, Borella F, Carosso A, Sciarrone A, Cusato J, Corcione S, Mengozzi G, Preti M, Katsaros D, Di Perri G, Benedetto C. The "scar" of a pandemic: Cumulative incidence of COVID-19 during the first trimester of pregnancy. J Med Virol 2020; 93:537-540. [PMID: 32633869 PMCID: PMC7361535 DOI: 10.1002/jmv.26267] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 07/01/2020] [Accepted: 07/02/2020] [Indexed: 01/01/2023]
Abstract
Congenitally‐ or perinatally‐acquired viral infections can be harmful to the fetus but data are limited about prevalence and outcomes of coronavirus disease 2019 (COVID‐19) disease during the first trimester of pregnancy. We report epidemiologic data from a study investigating a cohort of women who became pregnant just before or during the COVID‐19 pandemic. We recruited 138 consecutive pregnant women attending for first trimester screening (11‐13 weeks of gestation) at Sant'Anna Hospital, Turin, Piedmont, Italy, during the plateau and the falling phase of the COVID‐19 epidemic curve. Patients were tested for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) immunoglobulin M/immunoglobulin G antibody levels and SARS‐CoV‐2 detection in sera and nasopharyngeal swab samples. COVID‐19 cumulative incidence during the first trimester was of 10.1% with high prevalence of asymptomatic patients (42.8%). Similar to the course of the disease in non pregnant adults, 80% to 90% of infections were not severe.The prevalence of reported symptoms was four‐fold higher in SARS‐CoV‐2 positive patients (57%) than in those negative (13%) (P < .001), suggesting that direct self‐testing should open doors to confirmatory testing for COVID‐19. Our findings support the need for COVID‐19 screening in early pregnancy in epidemic areas to plan materno‐fetal health surveillance programs. 1‐ In a COVID‐19 endemic area, we found a cumulative incidence during the first trimester of pregnancy of 10.1% 2‐ Among positive patients, 42.8% were asymptomatic 3‐ In the COVID‐19 endemic area, a screening test for SARS‐CoV‐2 should be offered to all pregnant women in the first trimester.
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Affiliation(s)
- Stefano Cosma
- Gynecology and Obstetrics 1, Department of Surgical Sciences, School of Health and Science, University of Turin, Turin, Italy
| | - Fulvio Borella
- Gynecology and Obstetrics 1, Department of Surgical Sciences, School of Health and Science, University of Turin, Turin, Italy
| | - Andrea Carosso
- Gynecology and Obstetrics 1, Department of Surgical Sciences, School of Health and Science, University of Turin, Turin, Italy
| | - Andrea Sciarrone
- Obstetrics-Gynecological Ultrasound and Prenatal Diagnosis Unit, Department of Obstetrics and Gynecology, School of Health and Science, Turin, Italy
| | - Jessica Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Silvia Corcione
- Division of Infectious Diseases, Department of Medical Sciences, School of Health and Science, University of Turin, Turin, Italy.,Division of Geographic Medicine and Infectious Diseases, Tufts School of Medicine, Boston, Massachusetts
| | - Giulio Mengozzi
- Department of Public Health and Pediatric Sciences, Diagnostic Hemostasis Laboratories, School of Health and Science, Turin, Italy
| | - Mario Preti
- Gynecology and Obstetrics 1, Department of Surgical Sciences, School of Health and Science, University of Turin, Turin, Italy
| | - Dionyssios Katsaros
- Gynecology and Obstetrics 1, Department of Surgical Sciences, School of Health and Science, University of Turin, Turin, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, Amedeo di Savoia Hospital, University of Turin, Turin, Italy
| | - Chiara Benedetto
- Gynecology and Obstetrics 1, Department of Surgical Sciences, School of Health and Science, University of Turin, Turin, Italy
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22
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Giannone G, Scotto G, De Giorgi U, Farolfi A, Katsaros D, Borella F, Ferrero A, Villa M, Tuninetti V, Ghisoni E, Turinetto M, Zavallone L, Aglietta M, Pasini B, Di Maio M, Valabrega G. Hypersensitivity to platinum salts according to BRCA status in ovarian cancer: Retrospective analysis of clinical outcomes. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6053 Background: Hypersensitivity reactions (HSRs) to platinum salts are an important issue in the treatment of ovarian cancer (OC) patients (pts). Few data suggest that, along with number of previous cycles, germline BRCA mutations could be a risk factor. We aimed at evaluating the incidence and severity of HSRs to platinum salts in a large group of OC pts with known BRCA status and correlated them with drug exposure time. Methods: Between March 2003 and September 2019, 432 pts with a diagnosis of OC and a known BRCA status, were recorded in our 5 Institutions and retrospectively analyzed. The following data were collected: histology, BRCA status, type of surgery and first line therapy, number of total lines and cycles received, line and cycle of HSR onset, symptoms, history of other allergies and if desensitization was attempted. We graded the severity of HSRs according to CTCAE v5.0. We calculated the total duration of exposure to platinum salts, summing up the duration of all platinum lines received by the pts. Results: Four hundred nine of 432 (94.7%) pts were treated with at least one platinum-based line of therapy and were eligible for the analysis. Among them, 314 pts were BRCA wild type (BRCAwt) (76.8%) and 95 were BRCA mutated (BRCAmut) (23.2%). There was no statistical difference in number of prior lines of therapy [median 1 (2-6) for BRCA wt and 2 (1-6) for BRCAmut pts (p = 0.194)] and duration of exposure to platinum [median 126 (42 – 893) and 197 (42 – 896) days for BRCAwt and BRCAmut pts, respectively (p = 0.145)]. Incidence of any grade HSRs was 29 / 314 (9.2%) among BRCAwt pts vs. 17/ 95 (17.9%) among BRCAmut pts (Odds ratio [OR] 0.47, 95% CI 0.24 – 0.89, p= 0.019). All recorded HSRs to platinum salts were related to carboplatin. We observed a numerically higher incidence of Grade 3-4 HSRs in BRCAmut pts (5.1% in BRCAwt vs. 10.5% in BRCAmut cohort, OR 0.46, 95% CI 0.20 – 1.04, p = 0.057). The risk to develop HSRs increases with duration of exposure to platinum, particularly in BRCAmut pts. The cumulative incidence of any grade HSRs was 20.6% vs. 23.3% after 12 months and 38.4% vs. 59.7% after 18 months in BRCAwt and BRCAmut pts, respectively (Hazard Ratio [HR] 1.72, 95% CI 0.94 – 3.12, p = 0.073). The cumulative incidence of severe HSRs was 10.9% vs. 15.7% after 12 months and 26.5% vs. 41.0% after 18 months in BRCAwt and BRCAmut pts, respectively (HR 1.88, 95% CI 0.85 – 4.16, p = 0.11). Conclusions: In BRCAmut OC pts, there is a significantly higher incidence of HSRs to carboplatin, that seems not justified by longer drug exposure only.
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Affiliation(s)
- Gaia Giannone
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Giulia Scotto
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Department of Medical Oncology,Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Dionyssios Katsaros
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, Torino, Italy
| | - Fulvio Borella
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, Torino, Italy
| | - Annamaria Ferrero
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Torin, Italy
| | - Michela Villa
- Academic Department Gynaecology and Obstetrics, University of Turin, A.O. Ordine Mauriziano, Torin, Italy
| | | | | | | | - Laura Zavallone
- Department Medical Oncology, Infermi Hospital, Biella, Italy
| | | | - Barbara Pasini
- Department of Medical Science, University of Turin, Torino, Italy
| | - Massimo Di Maio
- Department of Oncology, A.O. Ordine Mauriziano Hospital, University of Turin, Turin, Italy
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23
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Mittica G, Goia M, Gambino A, Scotto G, Fonte M, Senetta R, Aglietta M, Borella F, Sapino A, Katsaros D, Maggiorotto F, Ghisoni E, Giannone G, Tuninetti V, Genta S, Eusebi C, Momi M, Cassoni P, Valabrega G. Validation of Androgen Receptor loss as a risk factor for the development of brain metastases from ovarian cancers. J Ovarian Res 2020; 13:53. [PMID: 32366278 PMCID: PMC7199337 DOI: 10.1186/s13048-020-00655-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background Central nervous system (CNS) spreading from epithelial ovarian carcinoma (EOC) is an uncommon but increasing phenomenon. We previously reported in a small series of 11 patients a correlation between Androgen Receptor (AR) loss and localization to CNS. Aims of this study were: to confirm a predictive role of AR loss in an independent validation cohort; to evaluate if AR status impacts on EOC survival. Results We collected an additional 29 cases and 19 controls as validation cohort. In this independent cohort at univariate analysis, cases exhibited lower expression of AR, considered both as continuous (p < 0.001) and as discrete variable (10% cut-off: p < 0.003; Immunoreactive score: p < 0.001). AR negative EOC showed an odds ratio (OR) = 8.33 for CNS dissemination compared with AR positive EOC. Kaplan-Meier curves of the combined dataset, combining data of new validation cohort with the previously published cohort, showed that AR < 10% significantly correlates with worse outcomes (p = 0.005 for Progression Free Survival (PFS) and p = 0.002 for brain PFS (bPFS) respectively). Comparison of AR expression between primary tissue and paired brain metastases in the combined dataset did not show any statistically significant difference. Conclusions We confirmed AR loss as predictive role for CNS involvement from EOC in an independent cohort of cases and controls. Early assessment of AR status could improve clinical management and patients’ prognosis.
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Affiliation(s)
- Gloria Mittica
- Unit of Oncology, ASL Verbano Cusio Ossola (VCO), Domodossola, Italy
| | - Margherita Goia
- Unit of Pathology, Città della Salute e della Scienza, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Angela Gambino
- Department Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Giulia Scotto
- Department of Oncology, University of Torino, Turin, Italy. .,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy.
| | - Mattia Fonte
- Department of Oncology, University of Torino, Turin, Italy
| | - Rebecca Senetta
- Unit of Pathology, Città della Salute e della Scienza, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Massimo Aglietta
- Department of Oncology, University of Torino, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology, AOU, Città della Salute e della Scienza, Turin, Italy
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU, Città della Salute e della Scienza, Turin, Italy
| | | | - Eleonora Ghisoni
- Department of Oncology, University of Torino, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - Gaia Giannone
- Department of Oncology, University of Torino, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - Valentina Tuninetti
- Department of Oncology, University of Torino, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - Sofia Genta
- Department of Oncology, University of Torino, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
| | - Chiara Eusebi
- Department Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Marina Momi
- Department Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Paola Cassoni
- Unit of Pathology, Città della Salute e della Scienza, Turin, Italy.,Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giorgio Valabrega
- Department of Oncology, University of Torino, Turin, Italy.,Candiolo Cancer Institute, FPO - IRCCS, Candiolo, TO, Italy
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24
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Arisio R, Borella F, Porpiglia M, Durando A, Bellino R, Bau MG, DE Sanctis C, Danese S, Benedetto C, Katsaros D. Axillary Dissection vs. no Axillary Dissection in Breast Cancer Patients With Positive Sentinel Lymph Node: A Single Institution Experience. In Vivo 2020; 33:1941-1947. [PMID: 31662523 DOI: 10.21873/invivo.11689] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 07/14/2019] [Revised: 07/28/2019] [Accepted: 08/01/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Axillary surgery of breast cancer patients is undergoing a paradigm shift, as axillary lymph node dissection's (ALND) usefulness is being questioned in the treatment of patients with tumor-positive sentinel lymph node biopsy (SLNB). The aim of this study was to investigate the overall survival (OS) and relapse-free survival (RFS) of patients with positive SLNB treated with ALND or not. PATIENTS AND METHODS We investigated 617 consecutive patients with cN0 operable breast cancer with positive SLNB undergoing mastectomy or conservative surgery. A total of 406 patients underwent ALND and 211 were managed expectantly. RESULTS No significant difference in OS and RFS was found between the two groups. The incidence of loco-regional recurrence in the SLNB-only group and the ALND group was low and not significant. CONCLUSION The type of breast cancer surgery and the omission of ALND does not improve OS or RSF rate in cases with metastatic SLN.
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Affiliation(s)
- Riccardo Arisio
- Department of Surgical Sciences, Sant'Anna Hospital, Turin, Italy
| | - Fulvio Borella
- Gynecology and Obstetrics 1, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Mauro Porpiglia
- Gynecology and Obstetrics 1, Department of Surgical Sciences, University of Turin, Turin, Italy.,Breast Unit, Sant'Anna Hospital, Turin, Italy
| | - Antonio Durando
- Breast Unit, Sant'Anna Hospital, Turin, Italy.,Gynecology and Obstetrics 2, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Roberto Bellino
- Breast Unit, Sant'Anna Hospital, Turin, Italy.,Gynecology and Obstetrics 2, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Maria Grazia Bau
- Breast Unit, Sant'Anna Hospital, Turin, Italy.,Gynecology and Obstetrics 3, Sant'Anna Hospital, Turin, Italy
| | - Corrado DE Sanctis
- Breast Unit, Sant'Anna Hospital, Turin, Italy.,Gynecology and Obstetrics 3, Sant'Anna Hospital, Turin, Italy
| | - Saverio Danese
- Breast Unit, Sant'Anna Hospital, Turin, Italy.,Gynecology and Obstetrics 4, Sant'Anna Hospital, Turin, Italy
| | - Chiara Benedetto
- Gynecology and Obstetrics 1, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Dionyssios Katsaros
- Gynecology and Obstetrics 1, Department of Surgical Sciences, University of Turin, Turin, Italy .,Breast Unit, Sant'Anna Hospital, Turin, Italy
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25
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D’Ambrosio C, Erriquez J, Arigoni M, Capellero S, Mittica G, Ghisoni E, Borella F, Katsaros D, Privitera S, Ribotta M, Maldi E, Di Nardo G, Berrino E, Venesio T, Ponzone R, Vaira M, Hall D, Jimenez-Linan M, Paterson AL, Calogero RA, Brenton JD, Valabrega G, Di Renzo MF, Olivero M. PIK3R1W624R Is an Actionable Mutation in High Grade Serous Ovarian Carcinoma. Cells 2020; 9:E442. [PMID: 32075097 PMCID: PMC7072782 DOI: 10.3390/cells9020442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/07/2019] [Revised: 02/04/2020] [Accepted: 02/13/2020] [Indexed: 12/17/2022] Open
Abstract
Identifying cancer drivers and actionable mutations is critical for precision oncology. In epithelial ovarian cancer (EOC) the majority of mutations lack biological or clinical validation. We fully characterized 43 lines of Patient-Derived Xenografts (PDXs) and performed copy number analysis and whole exome sequencing of 12 lines derived from naïve, high grade EOCs. Pyrosequencing allowed quantifying mutations in the source tumours. Drug response was assayed on PDX Derived Tumour Cells (PDTCs) and in vivo on PDXs. We identified a PIK3R1W624R variant in PDXs from a high grade serous EOC. Allele frequencies of PIK3R1W624R in all the passaged PDXs and in samples of the source tumour suggested that it was truncal and thus possibly a driver mutation. After inconclusive results in silico analyses, PDTCs and PDXs allowed the showing actionability of PIK3R1W624R and addiction of PIK3R1W624R carrying cells to inhibitors of the PI3K/AKT/mTOR pathway. It is noteworthy that PIK3R1 encodes the p85α regulatory subunit of PI3K, that is very rarely mutated in EOC. The PIK3R1W624R mutation is located in the cSH2 domain of the p85α that has never been involved in oncogenesis. These data show that patient-derived models are irreplaceable in their role of unveiling unpredicted driver and actionable variants in advanced ovarian cancer.
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Affiliation(s)
- Concetta D’Ambrosio
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
- Department of Oncology, University of Torino, Candiolo, 10060 Torino, Italy
| | - Jessica Erriquez
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Maddalena Arigoni
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (M.A.); (R.A.C.)
| | - Sonia Capellero
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
- Department of Oncology, University of Torino, Candiolo, 10060 Torino, Italy
| | - Gloria Mittica
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Eleonora Ghisoni
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Fulvio Borella
- Città della Salute e della Scienza, 10126 Torino, Italy; (F.B.); (D.K.); (S.P.); (M.R.)
| | - Dionyssios Katsaros
- Città della Salute e della Scienza, 10126 Torino, Italy; (F.B.); (D.K.); (S.P.); (M.R.)
| | - Silvana Privitera
- Città della Salute e della Scienza, 10126 Torino, Italy; (F.B.); (D.K.); (S.P.); (M.R.)
| | - Marisa Ribotta
- Città della Salute e della Scienza, 10126 Torino, Italy; (F.B.); (D.K.); (S.P.); (M.R.)
| | - Elena Maldi
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Giovanna Di Nardo
- Department of Life Sciences and Systems Biology, University of Torino, 10125 Torino, Italy;
| | - Enrico Berrino
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy
| | - Tiziana Venesio
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Riccardo Ponzone
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Marco Vaira
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
| | - Douglas Hall
- University of Cambridge, Cambridge CB2 0XZ, UK; (D.H.); (M.J.-L.); (A.L.P.); (J.D.B.)
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | | | - Anna L. Paterson
- University of Cambridge, Cambridge CB2 0XZ, UK; (D.H.); (M.J.-L.); (A.L.P.); (J.D.B.)
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - Raffaele A. Calogero
- Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy; (M.A.); (R.A.C.)
| | - James D. Brenton
- University of Cambridge, Cambridge CB2 0XZ, UK; (D.H.); (M.J.-L.); (A.L.P.); (J.D.B.)
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - Giorgio Valabrega
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
- Department of Oncology, University of Torino, Candiolo, 10060 Torino, Italy
| | - Maria Flavia Di Renzo
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
- Department of Oncology, University of Torino, Candiolo, 10060 Torino, Italy
| | - Martina Olivero
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, 10060 Torino, Italy; (C.D.); (J.E.); (S.C.); (G.M.); (E.G.); (E.M.); (E.B.); (T.V.); (R.P.); (M.V.); (G.V.); (M.O.)
- Department of Oncology, University of Torino, Candiolo, 10060 Torino, Italy
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Calura E, Ciciani M, Sambugaro A, Paracchini L, Benvenuto G, Milite S, Martini P, Beltrame L, Zane F, Fruscio R, Delle Marchette M, Borella F, Tognon G, Ravaggi A, Katsaros D, Bignotti E, Odicino F, D’Incalci M, Marchini S, Romualdi C. Transcriptional Characterization of Stage I Epithelial Ovarian Cancer: A Multicentric Study. Cells 2019; 8:cells8121554. [PMID: 31805750 PMCID: PMC6952972 DOI: 10.3390/cells8121554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/19/2019] [Accepted: 11/26/2019] [Indexed: 02/07/2023] Open
Abstract
Stage I epithelial ovarian cancer (EOC) represents about 10% of all EOCs. It is characterized by a complex histopathological and molecular heterogeneity, and it is composed of five main histological subtypes (mucinous, endometrioid, clear cell and high, and low grade serous), which have peculiar genetic, molecular, and clinical characteristics. As it occurs less frequently than advanced-stage EOC, its molecular features have not been thoroughly investigated. In this study, using in silico approaches and gene expression data, on a multicentric cohort composed of 208 snap-frozen tumor biopsies, we explored the subtype-specific molecular alterations that regulate tumor aggressiveness in stage I EOC. We found that single genes rather than pathways are responsible for histotype specificities and that a cAMP-PKA-CREB1 signaling axis seems to play a central role in histotype differentiation. Moreover, our results indicate that immune response seems to be, at least in part, involved in histotype differences, as a higher immune-reactive behavior of serous and mucinous samples was observed with respect to other histotypes.
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Affiliation(s)
- Enrica Calura
- Department of Biology, University of Padova, 35121 Padua, Italy; (E.C.); (A.S.); (G.B.); (S.M.); (P.M.); (C.R.)
| | - Matteo Ciciani
- Department of Cellular, Computational and Integrative Biology—CIBIO, University of Trento, 38123 Povo Trento, Italy;
| | - Andrea Sambugaro
- Department of Biology, University of Padova, 35121 Padua, Italy; (E.C.); (A.S.); (G.B.); (S.M.); (P.M.); (C.R.)
| | - Lara Paracchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy; (L.P.); (L.B.); (S.M.)
| | - Giuseppe Benvenuto
- Department of Biology, University of Padova, 35121 Padua, Italy; (E.C.); (A.S.); (G.B.); (S.M.); (P.M.); (C.R.)
| | - Salvatore Milite
- Department of Biology, University of Padova, 35121 Padua, Italy; (E.C.); (A.S.); (G.B.); (S.M.); (P.M.); (C.R.)
| | - Paolo Martini
- Department of Biology, University of Padova, 35121 Padua, Italy; (E.C.); (A.S.); (G.B.); (S.M.); (P.M.); (C.R.)
| | - Luca Beltrame
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy; (L.P.); (L.B.); (S.M.)
| | - Flaminia Zane
- Unit of Biological Adaptation and Ageing UMR8256, Institute of Biology Paris-Seine, Sorbonne University, 75005 Paris, France;
| | - Robert Fruscio
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, 20900 Monza, Italy; (R.F.); (M.D.M.)
| | - Martina Delle Marchette
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, 20900 Monza, Italy; (R.F.); (M.D.M.)
| | - Fulvio Borella
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, 10126 Torino, Italy; (F.B.); (D.K.)
| | - Germana Tognon
- Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (G.T.); (E.B.); (F.O.)
| | - Antonella Ravaggi
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST-Spedali Civili of Brescia, 25123 Brescia, Italy;
- Department of Clinical and Experimental Sciences, Division of Obstetrics and Gynecology, University of Brescia, 25123 Brescia, Italy
| | - Dionyssios Katsaros
- Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, 10126 Torino, Italy; (F.B.); (D.K.)
| | - Eliana Bignotti
- Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (G.T.); (E.B.); (F.O.)
- Angelo Nocivelli Institute of Molecular Medicine, University of Brescia and ASST-Spedali Civili of Brescia, 25123 Brescia, Italy;
| | - Franco Odicino
- Division of Obstetrics and Gynecology, ASST Spedali Civili di Brescia, 25123 Brescia, Italy; (G.T.); (E.B.); (F.O.)
| | - Maurizio D’Incalci
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy; (L.P.); (L.B.); (S.M.)
- Correspondence:
| | - Sergio Marchini
- Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milano, Italy; (L.P.); (L.B.); (S.M.)
| | - Chiara Romualdi
- Department of Biology, University of Padova, 35121 Padua, Italy; (E.C.); (A.S.); (G.B.); (S.M.); (P.M.); (C.R.)
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Olivero M, Erriquez J, Arigoni M, Capellero S, D'Ambrosio C, Mittica G, Borella F, Katsaros D, Privitera S, Berrino E, Venesio T, Valabrega G, Calogero R, Renzo MFD. Abstract GMM-023: PATIENT DERIVED XENOGRAFTS (PDXS) AND PDX DERIVED TUMOR CELLS (PDTC) ALLOW THE IDENTIFICATION OF ACTIONABLE CANCER GENES AND TREATMENT OPTIONS FOR PLATINUM REFRACTORY/RESISTANT OVARIAN CARCINOMAS. Clin Cancer Res 2019. [DOI: 10.1158/1557-3265.ovcasymp18-gmm-023] [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
Patients with advanced ovarian cancers have experienced little improvement in overall survival with standard treatments even after the incorporation of anti-angiogenic therapies. Besides anti-PARP inhibitors, matching individual critical genomic alterations with the best available drugs has not advanced as in other cancers, likely because a handful of cancer-related genes are mutated at high frequency, while many more are found mutated at much lower frequencies. This so called “mutation tail” is not only long but also mostly unexplored.
We used Patient Derived Xenografts (PDXs) to identify actionable cancer genes and PDX Derived Tumor Cells (PDTCs) to accelerate the discovery of treatment options. We envisioned that the alleged weakness of PDX models, i.e. lack of human stromal and immune cells, might be instrumental to identify mutations in cancer and to test approved or experimental targeted drugs as monotherapy or in different combinations to link biomarkers to treatments.
Forty-nine PDX lines from metastatic epithelial ovarian carcinomas have been propagated and fully characterized as far as histology, immunohistochemistry of epithelial and high-grade serous-specific markers and presence of TP53 and BRCA1/2 mutations.
Copy number variations (CNV) analysis and Whole Exome Sequencing (WES) were carried out PDX lines derived from naïve metastatic high-grade epithelial ovarian carcinomas, which came out to be refractory/resistant to platinum drugs. We studied non-synonymous mutations with allele frequencies ≥0.1. Only mutations in cancer genes listed in databases were further analyzed. SNPdb allowed ruling out polymorphisms. SIFT and PROVEAN softwares predicted deleterious or damaging effects onto the protein sequences. DGIdb helped selecting actionable genes.
We identified in one PDX line, a possibly loss-of-function mutation of the PIK3R1 gene (encoding the p85alpha regulatory subunit of PI3K) had an allele frequency=0.9 in early and late passages. Moreover, in two micro-dissected FFPE samples of the source tumor this mutation had an allele frequency nearly identical to that of the mutated TP53. Hence, PIK3R1W624R could be a trunk mutation in the PDX line and possibly in the human counterpart.
Treatment options were assayed ex-vivo, on short-term cultures of PDTCs of the PIK3R1W624R PDX line. Buparlisib, a pan-class I PI3K inhibitor, showed the ability to block proliferation of PDTCs and the growth in vivo of PDXs in regression preclinical trial. These data proofed-the-concept that a PDX-based pipeline is able to unveil actionable pathways for the treatment of advanced/metastatic ovarian cancer.
Citation Format: Martina Olivero, Jessica Erriquez, Maddalena Arigoni, Sonia Capellero, Concetta D'Ambrosio, Gloria Mittica, Fulvio Borella, Dionyssios Katsaros, Silvana Privitera, Enrico Berrino, Tiziana Venesio, Giorgio Valabrega, Raffaele Calogero and Maria Flavia Di Renzo. PATIENT DERIVED XENOGRAFTS (PDXS) AND PDX DERIVED TUMOR CELLS (PDTC) ALLOW THE IDENTIFICATION OF ACTIONABLE CANCER GENES AND TREATMENT OPTIONS FOR PLATINUM REFRACTORY/RESISTANT OVARIAN CARCINOMAS [abstract]. In: Proceedings of the 12th Biennial Ovarian Cancer Research Symposium; Sep 13-15, 2018; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2019;25(22 Suppl):Abstract nr GMM-023.
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Affiliation(s)
- Martina Olivero
- 1Department of Oncology, University of Torino, Torino, Italy,
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | | | | | - Sonia Capellero
- 1Department of Oncology, University of Torino, Torino, Italy,
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | - Concetta D'Ambrosio
- 1Department of Oncology, University of Torino, Torino, Italy,
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | - Gloria Mittica
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | - Fulvio Borella
- 4AOU Citta' della Salute, S.Anna Hospital, Torino, Italy
| | | | | | - Enrico Berrino
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | - Tiziana Venesio
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | - Giorgio Valabrega
- 1Department of Oncology, University of Torino, Torino, Italy,
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
| | | | - Maria Flavia Di Renzo
- 1Department of Oncology, University of Torino, Torino, Italy,
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino) Italy,
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de Boer S, Powell M, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger P, Ledermann J, Khaw P, Colombo A, Fyles A, Baron M, Jurgenliemk-Schulz I, Kitchener H, Nijman H, Kruitwagen R, Smit V, Nout R, Putter H, Creutzberg C. Patterns of Recurrence and Survival in the Randomized Portec-3 Trial of Chemoradiotherapy for High-Risk Endometrial Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger PB, Ledermann JA, Khaw P, D'Amico R, Fyles A, Baron MH, Jürgenliemk-Schulz IM, Kitchener HC, Nijman HW, Wilson G, Brooks S, Gribaudo S, Provencher D, Hanzen C, Kruitwagen RF, Smit VTHBM, Singh N, Do V, Lissoni A, Nout RA, Feeney A, Verhoeven-Adema KW, Putter H, Creutzberg CL. Adjuvant chemoradiotherapy versus radiotherapy alone in women with high-risk endometrial cancer (PORTEC-3): patterns of recurrence and post-hoc survival analysis of a randomised phase 3 trial. Lancet Oncol 2019; 20:1273-1285. [PMID: 31345626 PMCID: PMC6722042 DOI: 10.1016/s1470-2045(19)30395-x] [Citation(s) in RCA: 256] [Impact Index Per Article: 51.2] [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: 03/22/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND The PORTEC-3 trial investigated the benefit of combined adjuvant chemotherapy and radiotherapy versus pelvic radiotherapy alone for women with high-risk endometrial cancer. We updated the analysis to investigate patterns of recurrence and did a post-hoc survival analysis. METHODS In the multicentre randomised phase 3 PORTEC-3 trial, women with high-risk endometrial cancer were eligible if they had International Federation of Gynaecology and Obstetrics (FIGO) 2009 stage I, endometrioid grade 3 cancer with deep myometrial invasion or lymphovascular space invasion, or both; stage II or III disease; or stage I-III disease with serous or clear cell histology; were aged 18 years and older; and had a WHO performance status of 0-2. Participants were randomly assigned (1:1) to receive radiotherapy alone (48·6 Gy in 1·8 Gy fractions given on 5 days per week) or chemoradiotherapy (two cycles of cisplatin 50 mg/m2 given intravenously during radiotherapy, followed by four cycles of carboplatin AUC5 and paclitaxel 175 mg/m2 given intravenously), by use of a biased coin minimisation procedure with stratification for participating centre, lymphadenectomy, stage, and histological type. The co-primary endpoints were overall survival and failure-free survival. Secondary endpoints of vaginal, pelvic, and distant recurrence were analysed according to the first site of recurrence. Survival endpoints were analysed by intention-to-treat, and adjusted for stratification factors. Competing risk methods were used for failure-free survival and recurrence. We did a post-hoc analysis to analyse patterns of recurrence with 1 additional year of follow-up. The study was closed on Dec 20, 2013; follow-up is ongoing. This study is registered with ISRCTN, number ISRCTN14387080, and ClinicalTrials.gov, number NCT00411138. FINDINGS Between Nov 23, 2006, and Dec 20, 2013, 686 women were enrolled, of whom 660 were eligible and evaluable (330 in the chemoradiotherapy group, and 330 in the radiotherapy-alone group). At a median follow-up of 72·6 months (IQR 59·9-85·6), 5-year overall survival was 81·4% (95% CI 77·2-85·8) with chemoradiotherapy versus 76·1% (71·6-80·9) with radiotherapy alone (adjusted hazard ratio [HR] 0·70 [95% CI 0·51-0·97], p=0·034), and 5-year failure-free survival was 76·5% (95% CI 71·5-80·7) versus 69·1% (63·8-73·8; HR 0·70 [0·52-0·94], p=0·016). Distant metastases were the first site of recurrence in most patients with a relapse, occurring in 78 of 330 women (5-year probability 21·4%; 95% CI 17·3-26·3) in the chemoradiotherapy group versus 98 of 330 (5-year probability 29·1%; 24·4-34·3) in the radiotherapy-alone group (HR 0·74 [95% CI 0·55-0·99]; p=0·047). Isolated vaginal recurrence was the first site of recurrence in one patient (0·3%; 95% CI 0·0-2·1) in both groups (HR 0·99 [95% CI 0·06-15·90]; p=0·99), and isolated pelvic recurrence was the first site of recurrence in three women (0·9% [95% CI 0·3-2·8]) in the chemoradiotherapy group versus four (0·9% [95% CI 0·3-2·8]) in the radiotherapy-alone group (HR 0·75 [95% CI 0·17-3·33]; p=0·71). At 5 years, only one grade 4 adverse event (ileus or obstruction) was reported (in the chemoradiotherapy group). At 5 years, reported grade 3 adverse events did not differ significantly between the two groups, occurring in 16 (8%) of 201 women in the chemoradiotherapy group versus ten (5%) of 187 in the radiotherapy-alone group (p=0·24). The most common grade 3 adverse event was hypertension (in four [2%] women in both groups). At 5 years, grade 2 or worse adverse events were reported in 76 (38%) of 201 women in the chemoradiotherapy group versus 43 (23%) of 187 in the radiotherapy-alone group (p=0·002). Sensory neuropathy persisted more often after chemoradiotherapy than after radiotherapy alone, with 5-year rates of grade 2 or worse neuropathy of 6% (13 of 201 women) versus 0% (0 of 187). No treatment-related deaths were reported. INTERPRETATION This updated analysis shows significantly improved overall survival and failure-free survival with chemoradiotherapy versus radiotherapy alone. This treatment schedule should be discussed and recommended, especially for women with stage III or serous cancers, or both, as part of shared decision making between doctors and patients. Follow-up is ongoing to evaluate long-term survival. FUNDING Dutch Cancer Society, Cancer Research UK, National Health and Medical Research Council, Project Grant, Cancer Australia Grant, Italian Medicines Agency, and the Canadian Cancer Society Research Institute.
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Affiliation(s)
- Stephanie M de Boer
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands,Correspondence to: Dr Stephanie de Boer, Department of Radiation Oncology, K1-P, Leiden University Medical Center, 2300 RC Leiden, Netherlands
| | - Melanie E Powell
- Department of Clinical Oncology, Barts Health NHS Trust, London, UK
| | - Linda Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecologic Oncology, Città della Salute and S Anna Hospital, University of Turin, Turin, Italy
| | - Paul Bessette
- Canadian Cancer Trials Group, Department of Obstetrics and Gynaecology, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | | | - Jonathan A Ledermann
- Cancer Research UK, London, UK,UCL Cancer Trials Centre, UCL Cancer Institute, London, UK
| | - Pearly Khaw
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Romerai D'Amico
- Division of Radiation Oncology, ASST-Lecco, Ospedale AManzoni, Lecco, Italy
| | - Anthony Fyles
- Canadian Cancer Trials Group, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Marie-Helene Baron
- Department of Radiotherapy, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | | | - Henry C Kitchener
- Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | - Hans W Nijman
- Department of Gynaecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Godfrey Wilson
- Department of Pathology, Central Manchester Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
| | - Susan Brooks
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand
| | - Sergio Gribaudo
- Department of Oncology – Radiotherapy, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Diane Provencher
- Department of Gynaecologic Oncology, Hôpital Notre-Dame de Montreal, Montreal, QC, Canada
| | - Chantal Hanzen
- Department of Radiation Oncology, Centre Henri Becquerel, Rouen, France
| | - Roy F Kruitwagen
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, Netherlands,GROW - School for Oncology and Developmental Biology, Maastricht, Netherlands
| | | | - Naveena Singh
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - Viet Do
- Department of Radiation Oncology, Liverpool Cancer Therapy Centre, Liverpool, NSW, Australia
| | - Andrea Lissoni
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
| | - Remi A Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Amanda Feeney
- Cancer Research UK, London, UK,UCL Cancer Trials Centre, UCL Cancer Institute, London, UK
| | | | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
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30
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Borella F, Lucchino F, Bertero L, Ribotta M, Castellano I, Carosso A, Cosma S, Katsaros D, Benedetto C. Clinico-pathological features of gynecological myopericytoma: a challenging diagnosis in an exceptional location. Virchows Arch 2019; 475:763-770. [PMID: 31410559 DOI: 10.1007/s00428-019-02645-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/29/2019] [Accepted: 05/31/2019] [Indexed: 02/01/2023]
Abstract
Myopericytomas (MPC) are rare mesenchymal tumors, originating from the perivascular myoid cells. They predominantly occur in the skin and superficial soft tissues of the extremities, while visceral involvement is rare. Histological features and clinical course are usually benign. To the best of our knowledge, MPC is still an uncharacterized tumor entity of the female internal genital tract. We describe three MPC cases involving the female internal genital tract: (1) a uterine wall MPC arising in a 49-year-old woman with progressive pelvic/abdominal pain; (2) a cervix MPC of a 49-year-old woman who presented with metrorrhagia, and (3) a MPC presenting as a simple ovarian cyst in a 26-year-old woman with pain located in the left iliac fossa. All patients were surgically treated, and recurrence occurred in two cases. The histological and immunohistochemical findings, supporting the diagnosis of MPC, are presented; in particular, one case showed characteristics pointing towards an uncertain biological behavior/low-grade malignancy. A literature search was conducted to identify previous reports of gynecological MPC and for possible alternative diagnoses. Leiomyoma, epithelioid leiomyoma, angioleiomyoma, perivascular epithelioid cell tumor, solitary fibrous tumor, and low-grade endometrial stromal sarcoma should be considered in the differential diagnosis. Awareness of possible occurrence of this rare neoplasm in the female genital tract is important to reach a correct diagnosis in the spectrum of mesenchymal tumors. Considering the risk of recurrence, we recommend careful evaluation of surgical margins and complete surgical removal whenever possible.
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Affiliation(s)
- Fulvio Borella
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Fabiola Lucchino
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy.
| | - Marisa Ribotta
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Isabella Castellano
- Pathology Unit, Department of Medical Sciences, University of Turin, Via Santena 7, 10126, Turin, Italy
| | - Andrea Carosso
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Stefano Cosma
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Dionyssios Katsaros
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
| | - Chiara Benedetto
- Obstetrics and Gynaecology Unit, Department of Surgical Sciences, University of Turin, Via Ventimiglia 3, Turin, 10126, Italy
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Obata Y, Katsaros D, Biglia N, Shen Y, Fu Y, Wang Z, Yu H. Abstract 3545: High expression of miR-30a is associated with favorable breast cancer survival. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3545] [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: MicroRNAs (miRNAs) are single-stranded, small non-coding RNAs, consisting of about 20 nucleotides and studies have shown that miRNAs may play important roles in the development and progression of cancer. Members of the miR-30 family, including miR-30a, are reported to play different roles as oncogenes or tumor suppressor genes depending on the type of cancer in several studies. We studied miR-30a expression in breast cancer in relation to disease features and patient survival.
Methods: We measured miR-30a expression in tumor samples of 509 breast cancer patients by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Using the study-specific tertile distribution as cut-off, miR-30a expression data were grouped into low, medium, and high three categories. Hazards ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the association between miR-30a expression and breast cancer survival using the Cox proportional hazards regression model, and the analysis was adjusted for age at surgery, tumor grade, disease stage, and hormone receptor status. Overall survival (OS) was defined as the time interval from the date of surgery to the date of death or last follow-up. Disease-free survival (DFS) was the time interval from surgery to recurrence or last follow-up. We also retrieved breast cancer provisional data in The Cancer Genome Atlas (TCGA) using the web-based tool cBioPortal (http://www.cbioportal.org/index.do) and analyzed the association between miR-30a and breast cancer survival.
Results: Patients with estrogen receptor (ER)-positive tumors had higher expression of miR-30a compared to those with ER-negative tumors (p = 0.0080). Patients with progesterone receptor (PR)-positive tumors also had higher miR-30a expression than those with PR-negative tumors (p = 0.0038). Survival analysis showed that patients with high expression of miR-30a had 58% reduction in risk of relapse (HR = 0.42, 95% CI = 0.21-0.83, p = 0.013) compared to those with low expression. This association remained significant (HR = 0.43, 95% CI = 0.21-0.89, p = 0.023) after adjustment for age at surgery, disease stage, tumor grade, and hormone receptor status. A significant association between miR-30a and overall survival was also observed in the TCGA data (HR = 0.60, 95% CI = 0.41-0.88, p = 0.0088).
Conclusions: Our results suggest that high expression of miR-30a may reduce the risk of breast cancer relapse and miR-30a may act as a tumor suppressor in breast cancer.
Citation Format: Yuki Obata, Dionyssios Katsaros, Nicoletta Biglia, Yi Shen, Yuanyuan Fu, Zhanwei Wang, Herbert Yu. High expression of miR-30a is associated with favorable breast cancer survival [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 3545.
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Affiliation(s)
| | | | - Nicoletta Biglia
- 3University of Torino School of Medicine, Mauriziano Hospital, Turin, Italy
| | - Yi Shen
- 4University of Hawaii Cancer Center, Honolulu, HI
| | - Yuanyuan Fu
- 4University of Hawaii Cancer Center, Honolulu, HI
| | - Zhanwei Wang
- 4University of Hawaii Cancer Center, Honolulu, HI
| | - Herbert Yu
- 4University of Hawaii Cancer Center, Honolulu, HI
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Wang Z, Katsaros D, Biglia N, Shen Y, Fu Y, Tiirikainen M, Yu H. Low expression of WWC1, a tumor suppressor gene, is associated with aggressive breast cancer and poor survival outcome. FEBS Open Bio 2019; 9:1270-1280. [PMID: 31102318 PMCID: PMC6609559 DOI: 10.1002/2211-5463.12659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/28/2019] [Accepted: 05/16/2019] [Indexed: 12/23/2022] Open
Abstract
The WW and C2 domain containing 1 (WWC1) gene encodes a protein named WWC1 (or KIBRA), which is involved in the Hippo signaling pathway. WWC1 is often lost in triple-negative breast cancer and has been shown to suppress tumor metastasis. In this study, 470 breast cancer patients were recruited and WWC1 expression in the tumor samples was measured with quantitative reverse transcriptase PCR. Associations of WWC1 expression with breast cancer survival were analyzed using the Cox proportional hazards regression model and Kaplan-Meier survival analysis. The relationship between WWC1 expression and methylation was evaluated in a dataset from The Cancer Genome Atlas. Using our microarray data on gene expression and the Ingenuity Pathway Analysis, we predicted the WWC1-associated signaling pathways in breast cancer. Our results showed that low expression of WWC1 was significantly associated with advanced-stage diseases, high-grade tumors, and estrogen receptor- or progesterone receptor-negative status. Compared to those with high expression, patients with low WWC1 had higher risk of breast cancer relapse [hazard ratio (HR) = 2.06, 95% confidence interval (CI): 1.26-3.37] and higher risk of death (HR = 2.76, 95% CI: 1.51-5.03). The association with relapse-free survival remained significant after adjustment for disease stage, tumor grade, and hormone receptor status and was replicated in a public dataset. Analysis of high-throughput gene expression data indicated that WWC1 was involved in the Hippo signaling pathway. Online data also suggested that DNA methylation was inversely associated with WWC1 expression. The study confirmed that low WWC1 expression was associated with aggressive breast cancer and poor survival outcomes.
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Affiliation(s)
- Zhanwei Wang
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Turin, Italy
| | - Nicoletta Biglia
- Department of Surgical Science, Division of Obstetrics and Gynecology, Mauriziano Hospital, University of Torino School of Medicine, Turin, Italy
| | - Yi Shen
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Yuanyuan Fu
- University of Hawaii Cancer Center, Honolulu, HI, USA.,Department of Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | | | - Herbert Yu
- University of Hawaii Cancer Center, Honolulu, HI, USA
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Kenter G, Greggi S, Vergote I, Katsaros D, Kobierski J, Massuger L, van Doorn HC, Landoni F, Van Der Velden J, Reed NS, Coens C, van Luijk I, Ottevanger PB, Casado A. Results from neoadjuvant chemotherapy followed by surgery compared to chemoradiation for stage Ib2-IIb cervical cancer, EORTC 55994. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.5503] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5503 Background: Conflicting evidence on the value of neoadjuvant chemotherapy followed by surgery compared to concomitant chemoradiation in Stage IB2-IIB cervical carcinoma led to this multinational multicenter trial. As the trial is approaching completion of its follow-up, preliminary results are presented. Methods: Between May 2002 and June 2014 a total of 620 patients with FIGO stage Ib2-IIb were randomized between neoadjuvant chemotherapy followed by surgery (NACTS, arm 1, N=311) with standard concomitant chemoradiotherapy (CCRT, arm 2, N=309) . In arm 1, radical hysterectomy was required within 6 weeks after completion of cisplatin-based chemotherapy with a cumulative minimum of 225mg/m2, in arm 2, radiation consisted of 45-50 Gy plus boost concurrent with weekly cisplatin chemotherapy (40 mg/m2 per week). Primary endpoint was 5-yrs overall survival (OS). Results: Median follow-up time was 8.2 years ( 95% CI = 7.8 yrs – 8.6 yrs)) and similar between both arms. A total of 191 deaths (31%) occurred. Age, stage and histological cell type were balanced in both arms. Protocol treatment was completed in 459 (74%) patients (71% for NACTS; 82% for CCRT). In arm 1 238 (76%) patients underwent surgery. Main reasons for not having surgery as per protocol, were toxicity (25/74, 34%), progressive disease (18/74, 24%) and insufficient response to NACT (12/74, 16%). Additional radiotherapy was given to 113 patients (36.3%) in arm 1; additional surgery performed in 9 patients (2.9%) in arm 2. Short term severe adverse events (≥G3) occurred more frequently in arm 1 than in arm 2 (35% vs 21%, p < 0.001). The 5 year OS was 72% in arm 1 and 76% in arm 2 (not statistically significant, difference = 4.0% (95%CI: -4% - 12%); HR 0.87, 95%CI: 0.65-0.15, p=0.332). Conclusions: These preliminary results revealed no difference in 5-year OS between NACTS and CCRT, indicating that quality of life and long term toxicity are important to decide optimal treatment. The final results will be available by April 2019, including long-term toxicity and treatment effect across prognostic factors. Clinical trial information: NCT00039338.
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Affiliation(s)
- Gemma Kenter
- Center Gynaecological Cancer Amsterdam, Amsterdam, Netherlands
| | | | - Ignace Vergote
- BGOG and University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Dionyssios Katsaros
- Dept Surgical Sciences, Gynecologic Oncology, Città della Salute, S.Anna Hospital, Torino, Italy
| | | | - Leon Massuger
- Radboud University Medical Center, Nijmegen, Netherlands
| | - H. C. van Doorn
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Daniel Den Hoed/Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Fabio Landoni
- MaNGO and Division of Gynecologic Oncology, European Institute of Oncology, Milan, Italy
| | | | | | - Corneel Coens
- European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | - Iske van Luijk
- MC Haaglanden Bronovo, Gynaecology, The Hague, Netherlands
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de Boer SM, Wortman BG, Bosse T, Powell ME, Singh N, Hollema H, Wilson G, Chowdhury MN, Mileshkin L, Pyman J, Katsaros D, Carinelli S, Fyles A, McLachlin CM, Haie-Meder C, Duvillard P, Nout RA, Verhoeven-Adema KW, Putter H, Creutzberg CL, Smit VTHBM. Clinical consequences of upfront pathology review in the randomised PORTEC-3 trial for high-risk endometrial cancer. Ann Oncol 2019; 29:424-430. [PMID: 29190319 PMCID: PMC5834053 DOI: 10.1093/annonc/mdx753] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background In the PORTEC-3 trial, women with high-risk endometrial cancer (HR-EC) were randomised to receive pelvic radiotherapy (RT) with or without concurrent and adjuvant chemotherapy (two cycles of cisplatin 50 mg/m2 in weeks 1 and 4 of RT, followed by four cycles of carboplatin AUC5 and paclitaxel 175 mg/m2). Pathology review was required before patient enrolment. The aim of this analysis was to evaluate the role of central pathology review before randomisation. Patients and methods A total of 1295 cases underwent pathology review to confirm HR-EC in the Netherlands (n = 395) and the UK (n = 900), and for 1226/1295 (95%) matching review and original reports were available. In total, 329 of these patients were enrolled in the PORTEC-3 trial: 145 in the Netherlands and 184 in the UK, comprising 48% of the total PORTEC-3 cohort of 686 participants. Areas of discrepancies were evaluated, and inter-observer agreement between original and review opinion was evaluated by calculating the kappa value (κ). Results In the 1226 pathology reviews, 6356 selected items were evaluable for both original and review pathology. In 43% of cases at least one pathology item changed after review. For 102 patients (8%), this discrepancy led to ineligibility for the PORTEC-3 trial, most frequently due to differences in the assessment of histological type (34%), endocervical stromal involvement (27%) and histological grade (19%). Lowest inter-observer agreement was found for histological type (κ = 0.72), lymph-vascular space invasion (κ = 0.72) and histological grade (κ = 0.70). Conclusion Central pathology review by expert gynaeco-pathologists changed histological type, grade or other items in 43% of women with HR-EC, leading to ineligibility for the PORTEC-3 trial in 8%. Upfront pathology review is essential to ensure enrolment of the target trial-population, and to avoid over- or undertreatment, especially when treatment modalities with substantial toxicity are involved. This study is registered with ISRCTN (ISRCTN14387080, www.controlled-trials.com) and with ClinicalTrials.gov (NCT00411138).
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Affiliation(s)
- S M de Boer
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
| | - B G Wortman
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands; Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - T Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - M E Powell
- Department of Clinical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London
| | - N Singh
- Department of Cellular Pathology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - H Hollema
- Department of Pathology, University Medical Center Groningen, Groningen, The Netherlands
| | - G Wilson
- Department of Pathology, Central Manchester Hospitals NHS Foundation Trust, Manchester Royal Infirmary, Manchester, UK
| | - M N Chowdhury
- Department of Cellular Pathology, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - L Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Pyman
- Department of Anatomical Pathology, Royal Women's Hospital, Parkville, Australia
| | - D Katsaros
- Department of Surgical Sciences, Az O-Universitaria Città della Salute di Torino, Torino, Italy
| | - S Carinelli
- Division of Pathology and Laboratory Medicine, European Institute of Pathology, Milan, Italy
| | - A Fyles
- CCTG, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - C M McLachlin
- Department of Pathology and Laboratory Medicine, Western University, London, Canada
| | - C Haie-Meder
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - P Duvillard
- Department of Pathology, Institut Gustave Roussy, Villejuif, France
| | - R A Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - K W Verhoeven-Adema
- Central Trials Office, Comprehensive Cancer Center The Netherlands, Leiden, The Netherlands
| | - H Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
| | - C L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - V T H B M Smit
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
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Wang Z, Katsaros D, Biglia N, Shen Y, Loo L, Yu X, Lin H, Fu Y, Chu WM, Fei P, Ni Y, Jia W, Deng X, Qian B, Yu H. ERα upregulates the expression of long non-coding RNA LINC00472 which suppresses the phosphorylation of NF-κB in breast cancer. Breast Cancer Res Treat 2019; 175:353-368. [PMID: 30830488 DOI: 10.1007/s10549-018-05108-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/16/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE Low expression of long intergenic non-coding RNA LINC00472 in breast cancer is associated with aggressive tumors and unfavorable disease outcomes in multiple clinical datasets, but the reasons for these associations were unknown. METHODS To study the mechanisms underlying the lncRNA's connection to breast cancer, we investigated the molecular targets and regulation of LINC00472 in breast cancer cells, and analyzed relevant molecular features in relation to patient survival. Gene expression profiles of breast cancer cells overexpressing LINC00472 were analyzed for its regulatory pathways and downstream targets. Effects of LINC00472 overexpression on cell behaviors were evaluated in vitro and in vivo. Meta-analysis was performed using online datasets and our own study. RESULTS Analysis of LINC00472 transcriptome revealed ERα upregulation of LINC00472 expression, and an ERα-binding site in the LINC00472 promoter was identified. Evaluation of LINC00472 overexpression also indicated a possible link between LINC00472 and NF-κB. Cell experiments confirmed that LINC00472 suppressed the phosphorylation of p65 and IκBα through binding to IKKβ, inhibiting its phosphorylation. High LINC00472 expression inhibited tumor growth both in vitro and in vivo and suppressed aggressive tumor cell behaviors in vitro. Suppressing LINC00472 expression in ER-positive tumor cells increased cell aggressive behaviors. Tamoxifen treatment of ER-positive cells inhibited ERα and LINC00472 expression and increased p65 and IκBα phosphorylation. Meta-analysis showed that LINC00472 expression were higher in ER-positive than ER-negative tumors and that high expression was associated with better disease outcomes in ER-positive patients. CONCLUSIONS The study demonstrates that ERα upregulates LINC00472 which suppresses the phosphorylation of NF-κB, and suggests that endocrine treatment may lower LINC00472 and increase NF-κB activities, leading to tumor progression and disease recurrence.
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Affiliation(s)
- Zhanwei Wang
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino, Turin, Italy
| | - Nicoletta Biglia
- Division of Obstetrics and Gynecology, Department of Surgical Sciences, University of Torino School of Medicine, Mauriziano Hospital, Turin, Italy
| | - Yi Shen
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Lenora Loo
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Xiao Yu
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China
| | - Hongyan Lin
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China
| | - Yuanyuan Fu
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.,Department of Molecular Biosciences & Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Wen-Ming Chu
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Peiwen Fei
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Yan Ni
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Wei Jia
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Xiaobei Deng
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China
| | - Biyun Qian
- Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Faculty of Public Health, Shanghai Jiao Tong University School of Medicine, 227 South Chongqing Road, Shanghai, 200025, China.
| | - Herbert Yu
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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Olivero M, Erriquez J, Arigoni M, Capellero S, D'Ambrosio C, Mittica G, Borella F, Katsaros D, Privitera S, Berrino E, Venesio T, Valabrega G, Calogero R, Renzo MFD. Abstract 3102: Identification of actionable cancer genes and treatment options for metastatic ovarian carcinomas using patient-derived xenografts and PDX-derived tumor cells. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3102] [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
Patients with advanced ovarian cancers have experienced little improvement in overall survival with standard treatments even after the incorporation of anti-angiogenic therapies. Besides anti-PARP inhibitors, matching individual critical genomic alterations with the best available drugs has not advanced as in other cancers, likely because a handful of cancer-related genes are mutated at high frequency, while many more are found mutated at much lower frequencies. This so called “mutation tail” is not only long but also mostly unexplored.
We used Patient Derived Xenografts (PDXs) to identify actionable cancer genes and PDX Derived Tumor Cells (PDTCs) to accelerate the discovery of treatment options. We envisioned that the alleged weakness of PDX models, i.e. lack of human stromal and immune cells, might be instrumental to identify mutations in cancer and to test approved or experimental targeted drugs as monotherapy or in different combinations to link biomarkers to treatments.
Fourty-nine PDX lines from metastatic epithelial ovarian carcinomas have been propagated and fully characterized as far as histology, immunohistochemistry of epithelial and high-grade serous-specific markers and presence of TP53 and BRCA1/2 mutations.
Copy number variations (CNV) analysis and Whole Exome Sequencing (WES) were carried out of 12 PDX lines derived from naïve metastatic high-grade serous epithelial ovarian carcinomas. We studied non-synonymous mutations with allele frequencies ≥0.1. Only mutations in cancer genes listed in databases were further analyzed. SNPdb allowed ruling out polymorphisms. SIFT and PROVEAN softwares predicted deleterious or damaging effects onto the protein sequences. DGIdb helped selecting actionable genes.
We identified mutations in 1-4 cancer genes in 8/12 PDX lines. In one PDX line, a possibly loss-of-function mutation of the PIK3R1 gene (encoding the p85alpha regulatory subunit of PI3K) had an allele frequency=0.9 in early and late passages. Moreover, in two micro-dissected FFPE samples of the source tumor this mutation had an allele frequency nearly identical to that of the mutated TP53. Hence, PIK3R1W624R could be a trunk mutation in the PDX line and possibly in the human counterpart.
Treatment options were assayed ex-vivo, on short-term cultures of PDTCs of the PIK3R1W624R PDX line. Buparlisib, a pan-class I PI3K inhibitor, showed the ability to block proliferation of PDTCs and the growth in vivo of PDXs in regression preclinical trial. These data proofed-the-concept that a PDX-based pipeline is able to unveil actionable pathways for the treatment of advanced/metastatic ovarian cancer.
Citation Format: Martina Olivero, Jessica Erriquez, Maddalena Arigoni, Sonia Capellero, Concetta D'Ambrosio, Gloria Mittica, Fulvio Borella, Dionyssios Katsaros, Silvana Privitera, Enrico Berrino, Tiziana Venesio, Giorgio Valabrega, Raffaele Calogero, Maria Flavia Di Renzo. Identification of actionable cancer genes and treatment options for metastatic ovarian carcinomas using patient-derived xenografts and PDX-derived tumor cells [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 3102.
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Affiliation(s)
- Martina Olivero
- 1Candiolo Cancer Institute FPO-IRCCS, Univ. of Torino, Candiolo (Torino), Italy
| | | | | | - Sonia Capellero
- 1Candiolo Cancer Institute FPO-IRCCS, Univ. of Torino, Candiolo (Torino), Italy
| | - Concetta D'Ambrosio
- 1Candiolo Cancer Institute FPO-IRCCS, Univ. of Torino, Candiolo (Torino), Italy
| | - Gloria Mittica
- 1Candiolo Cancer Institute FPO-IRCCS, Univ. of Torino, Candiolo (Torino), Italy
| | - Fulvio Borella
- 4AOU Città della Salute, S.Anna Hospital, University of Torino, Torino, Italy
| | - Dionyssios Katsaros
- 4AOU Città della Salute, S.Anna Hospital, University of Torino, Torino, Italy
| | - Silvana Privitera
- 4AOU Città della Salute, S.Anna Hospital, University of Torino, Torino, Italy
| | - Enrico Berrino
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino), Italy
| | - Tiziana Venesio
- 2Candiolo Cancer Institute FPO-IRCCS, Candiolo (Torino), Italy
| | - Giorgio Valabrega
- 1Candiolo Cancer Institute FPO-IRCCS, Univ. of Torino, Candiolo (Torino), Italy
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Ghisoni E, Katsaros D, Maggiorotto F, Aglietta M, Vaira M, De Simone M, Mittica G, Giannone G, Robella M, Genta S, Lucchino F, Marocco F, Borella F, Valabrega G, Ponzone R. A predictive score for optimal cytoreduction at interval debulking surgery in epithelial ovarian cancer: a two- centers experience. J Ovarian Res 2018; 11:42. [PMID: 29843747 PMCID: PMC5975698 DOI: 10.1186/s13048-018-0415-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 02/21/2018] [Accepted: 05/16/2018] [Indexed: 02/05/2023] Open
Abstract
Background Optimal cytoreduction (macroscopic Residual Tumor, RT = 0) is the best survival predictor factor in epithelial ovarian cancer (EOC). It doesn’t exist a consolidated criteria to predict optimal surgical resection at interval debulking surgery (IDS). The aim of this study is to develop a predictive model of complete cytoreduction at IDS. Methods We, retrospectively, analyzed 93 out of 432 patients, with advanced EOC, underwent neoadjuvant chemotherapy (NACT) and IDS from January 2010 to December 2016 in two referral cancer centers. The correlation between clinical-pathological variables and residual disease at IDS has been investigated with univariate and multivariate analysis. A predictive score of cytoreduction (PSC) has been created by combining all significant variables. The performance of each single variable and PSC has been reported and the correlation of all significant variables with progression free survival (PFS) has been assessed. Results At IDS, 65 patients (69,8%) had complete cytoreduction with no residual disease (R = 0). Three criteria independently predicted R > 0: age ≥ 60 years (p = 0.014), CA-125 before NACT > 550 UI/dl (p = 0.044), and Peritoneal Cancer Index (PCI) > 16 (p < 0.001). A PSC ≥ 3 has been associated with a better accuracy (85,8%), limiting the number of incomplete surgeries to 16,5%. Moreover, a PCI > 16, a PSC ≥ 3 and the presence of R > 0 after IDS were all significantly associated with shorter PFS (p < 0.001, p < 0.001 and p = 0.004 respectively). Conclusions Our PSC predicts, in a large number of patients, complete cytoreduction at IDS, limiting the rate of futile extensive surgeries in case of presence of residual tumor (R > 0). The PSC should be prospectively validated in a larger series of EOC patients undergoing NACT-IDS.
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Affiliation(s)
- Eleonora Ghisoni
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Oncology, University of Torino, Turin, Italy
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU, Città della Salute e della Scienza, Turin, Italy
| | - Furio Maggiorotto
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - Massimo Aglietta
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Oncology, University of Torino, Turin, Italy
| | - Marco Vaira
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - Michele De Simone
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - Gloria Mittica
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Oncology, University of Torino, Turin, Italy
| | - Gaia Giannone
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Oncology, University of Torino, Turin, Italy
| | - Manuela Robella
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - Sofia Genta
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy.,Department of Oncology, University of Torino, Turin, Italy
| | - Fabiola Lucchino
- Department of Surgical Sciences, Gynecology, AOU, Città della Salute e della Scienza, Turin, Italy
| | - Francesco Marocco
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
| | - Fulvio Borella
- Department of Surgical Sciences, Gynecology, AOU, Città della Salute e della Scienza, Turin, Italy
| | - Giorgio Valabrega
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy. .,Department of Oncology, University of Torino, Turin, Italy.
| | - Riccardo Ponzone
- Candiolo Cancer Institute FPO-IRCCS, Strada Provinciale 142 km 3.95, 10060, Candiolo, TO, Italy
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Wang Z, Katsaros D, Biglia N, Shen Y, Fu Y, Loo LWM, Jia W, Obata Y, Yu H. High expression of long non-coding RNA MALAT1 in breast cancer is associated with poor relapse-free survival. Breast Cancer Res Treat 2018; 171:261-271. [PMID: 29845475 DOI: 10.1007/s10549-018-4839-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 05/25/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) has been identified as a prognostic marker for the metastasis of early-stage non-small cell lung cancer (NSCLCs). We studied MALAT1 expression in breast cancer in relation to disease features and patient survival. METHODS Quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) was used to measure MALAT1 expression in tumor samples of 509 breast cancer patients. Hazards ratios (HRs) and 95% confidence intervals (CIs) were calculated to assess the association between MALAT1 expression and breast cancer survival using the Cox proportional hazards regression model, and the analysis was adjusted for age at surgery, tumor grade, disease stage, and hormone receptor status. Meta-analysis of multiple microarray datasets from online databases and our own study was performed to evaluate the association of MALAT1 with breast cancer survival. RESULTS Patients with low-grade or ER-positive tumors had higher expression of MALAT1 compared to those with high-grade (p = 0.013) or ER-negative (p = 0.0002) tumors. Patients with PR-positive tumors also had higher MALAT1 expression than those with PR-negative tumors (p < 0.0001). In patients with positive hormone receptors or low tumor grade, tumors with high MALAT1 expression were more likely to recur. Survival analysis showed that patients with high expression of MALAT1 had a twofold increase in risk of relapse (p = 0.0083) compared to those with low expression. This association remained significant after adjustment for age at surgery, disease stage, tumor grade, and hormone receptor status. Meta-analysis showed that high MALAT1 expression was associated with poor relapse-free survival in patients with hormone receptor-positive tumors (HR 1.44, 95% CI 1.08-1.92). CONCLUSIONS High expression of lncRNA MALAT1 is associated with breast cancer relapse and may play a role in tumor progression.
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Affiliation(s)
- Zhanwei Wang
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecology, AOU Città della Salute, University of Torino School of Medicine, Turin, Italy
| | - Nicoletta Biglia
- Department of Surgical Sciences, Division of Obstetrics and Gynecology, University of Torino School of Medicine, Mauriziano Hospital, Turin, Italy
| | - Yi Shen
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Yuanyuan Fu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
- Department of Molecular Biosciences & Bioengineering, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Lenora W M Loo
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Wei Jia
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA
| | - Yuki Obata
- College of Pharmacy, Kinjo Gakuin University, Nagoya, Aichi, Japan
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI, 96813, USA.
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De Boer S, Powell M, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger P, Ledermann J, Khaw P, Colombo A, Fyles A, Baron M, Jürgenliemk-Schulz I, Kitchener H, Nijman H, Wilson G, Kolodziej I, Carinelli S, Lutgens L, Smit V, Singh N, Nout R, Verhoeven-Adema K, Putter H, Creutzberg C. OC-0323: Patterns of recurrence in the randomised PORTEC-3 trial of chemoradiotherapy for endometrial cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30633-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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40
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Erriquez J, Olivero M, Mittica G, Scalzo MS, Vaira M, De Simone M, Ponzone R, Katsaros D, Aglietta M, Calogero R, Di Renzo MF, Valabrega G. Xenopatients show the need for precision medicine approach to chemotherapy in ovarian cancer. Oncotarget 2018; 7:26181-91. [PMID: 27027433 PMCID: PMC5041973 DOI: 10.18632/oncotarget.8325] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 03/14/2016] [Indexed: 01/17/2023] Open
Abstract
Platinum-based chemotherapy is the recommended first-line treatment for high-grade serous (HGS) epithelial ovarian cancer (EOC). However, most patients relapse because of platinum refractory/resistant disease. We aimed at assessing whether other drugs, commonly used to treat relapsed HGS-EOC and poorly active in this clinical setting, might be more effective against chemotherapy-naïve cancers. We collected couples of HGS-EOC samples from the same patients before and after neo-adjuvant platinum-based chemotherapy. Samples were propagated as Patient Derived Xenografts (PDXs) in immunocompromised mice ("xenopatients"). Xenopatients were treated in parallel with carboplatin, gemcitabine, pegylated liposomal doxorubicin (PLD) and trabectedin. PDXs derived from a naïve HSG-EOC showed responsiveness to carboplatin, trabectedin and gemcitabine. The PDXs propagated from a tumor mass of the same patient, grown after carboplatin therapy, did no longer respond to trabectedin and gemcitabine and showed heterogeneous response to carboplatin. In line, the patient experienced clinically platinum-sensitivity first and then discordant responses of different tumor sites to platinum re-challenge. Loss of PDX responsiveness to drugs was associated with 4-fold increase of NR2F2 gene expression. PDXs from another naïve tumor showed complete response to PLD, which was lost in the PDXs derived from a mass grown in the same patient after platinum-based chemotherapy. This patient showed platinum refractoriness and responded poorly to PLD as second-line treatment. PDX response to PLD was associated with high expression of TOP2A protein. PDXs demonstrated that chemotherapy-naïve HGS-EOC might display susceptibility to agents not used commonly as first line treatment. Data suggest the importance of personalizing also chemotherapy.
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Affiliation(s)
| | - Martina Olivero
- Department of Oncology, University of Torino, Candiolo, Torino, Italy.,Candiolo Cancer Institute, FPO-IRCCS Candiolo, Torino, Italy
| | - Gloria Mittica
- Department of Oncology, University of Torino, Candiolo, Torino, Italy.,Candiolo Cancer Institute, FPO-IRCCS Candiolo, Torino, Italy
| | | | - Marco Vaira
- Candiolo Cancer Institute, FPO-IRCCS Candiolo, Torino, Italy
| | | | | | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecologic Oncology, AO-Universitaria Città della Salute, Torino, Italy
| | - Massimo Aglietta
- Department of Oncology, University of Torino, Candiolo, Torino, Italy.,Candiolo Cancer Institute, FPO-IRCCS Candiolo, Torino, Italy
| | - Raffaele Calogero
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, University of Torino, Torino, Italy
| | - Maria Flavia Di Renzo
- Department of Oncology, University of Torino, Candiolo, Torino, Italy.,Candiolo Cancer Institute, FPO-IRCCS Candiolo, Torino, Italy
| | - Giorgio Valabrega
- Department of Oncology, University of Torino, Candiolo, Torino, Italy.,Candiolo Cancer Institute, FPO-IRCCS Candiolo, Torino, Italy
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41
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Yu H, Katsaros D, Biglia N, Shen Y, Loo L, Yu X, Lin H, Fu Y, Chu W, Fei P, Ni Y, Jia W, Deng X, Qian B, Wang Z. Abstract P5-07-03: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-07-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- H Yu
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - D Katsaros
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - N Biglia
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - Y Shen
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - L Loo
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - X Yu
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - H Lin
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - Y Fu
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - W Chu
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - P Fei
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - Y Ni
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - W Jia
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - X Deng
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - B Qian
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
| | - Z Wang
- University of Hawaii Cancer Center; S. Anna Hospital, n 5 and After Azienda Ospedaliero-Universitaria; University of Torino School of Medicine; Shanghai Jiao Tong University
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Fuso L, Evangelista A, Pagano E, Piovano E, Perotto S, Mazzola S, Bertoldo E, La Porta MR, Rosmino C, Furbatto G, Abate S, Di Costanzo G, Trossarelli G, Baù MG, Carnino F, Gambaro G, Piantanida P, Alabiso O, Galletto L, Zavallone L, Rossi A, Barbero M, Tessa M, Katsaros D, Danese S, Brignolo P, Gorzegno G, Grillo R, Apolone G, Ciccone G, Zola P. Variation in gynecological oncology follow-up practice: Attributable to cancer centers or to patient characteristics? A Piedmont Regional Oncology Network Study. Tumori 2018; 97:551-8. [DOI: 10.1177/030089161109700502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and background Although guidelines recommend minimalist follow-up, there is wide variability in gynecological oncology practice. The aims of this study were to describe between-center differences in the follow-up of endometrial, ovarian, and uterine cervical cancer; to identify the determinants of test prescription; to estimate the related costs; and to assess the weight of center habits and patient characteristics as sources of unexplained variability. Methods and study design The medical records of patients treated between August 2004 and July 2005 for gynecological malignancies and followed up for the detection of recurrent disease were retrospectively collected from 29 centers of the Piedmont Oncology Network. Multivariate multilevel analyses were performed to study the determinants of test prescription and costs. Results Analyses were performed on 351 patients (median follow-up: 578 days). The unexplained variability in computed tomography prescriptions (26%), ultrasound prescriptions (17%), and total cost of follow-up (15%) can be attributed to center habits, independenty of the clinical characteristics of the patients. Conclusions Much of the unexplained variability in the follow-up for gynecological malignancies is attributable to different habits of centers belonging to a cancer network. These results prompted us to design a multicenter randomized controlled trial to compare minimalist versus intensive follow-up programs in endometrial cancer.
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Affiliation(s)
- Luca Fuso
- Gynecology and Obstetrics Academic
Department, Azienda Ospedaliera Ordine Mauriziano, Turin
| | - Andrea Evangelista
- Unit of Cancer Epidemiology, Azienda
Ospedaliera US Giovanni Battista, CPO Piemonte, CeRMS, Turin
| | - Eva Pagano
- Unit of Cancer Epidemiology, Azienda
Ospedaliera US Giovanni Battista, CPO Piemonte, CeRMS, Turin
| | - Elisa Piovano
- Gynecology and Obstetrics Academic
Department, Azienda Ospedaliera Ordine Mauriziano, Turin
| | - Stefania Perotto
- Gynecology and Obstetrics Academic
Department, Azienda Ospedaliera Ordine Mauriziano, Turin
| | - Simona Mazzola
- Gynecology and Obstetrics Academic
Department, Azienda Ospedaliera Ordine Mauriziano, Turin
| | | | | | | | | | - Sergio Abate
- Gynecology and Obstetrics, Azienda
Ospedaliera Santa Croce e Carle, Cuneo
| | | | | | - Maria Grazia Baù
- Gynecology and Obstetrics, Azienda
Ospedaliera OIRM-Sant'Anna, Turin
| | | | | | - Paola Piantanida
- Gynecology and Obstetrics, Ospedale
Maggiore della Carità, Novara
| | - Oscar Alabiso
- Medical Oncology, Ospedale Maggiore
della Carità, Novara
| | - Luciano Galletto
- Gynecology and Obstetrics, Ospedale
Civile Edoardo Agnelli, Pinerolo
| | | | - Annalisa Rossi
- Radiotherapy, Azienda Ospedaliera
Ordine Mauriziano, Turin
| | | | - Maria Tessa
- Radiotherapy, Ospedale Cardinal
Massaia, Asti
| | - Dionyssios Katsaros
- Gynecology and Obstetrics Academic
Department, Azienda Ospedaliera OIRM-Sant'Anna, Turin
| | - Saverio Danese
- Gynecology and Obstetrics, Azienda
Ospedaliera OIRM-Sant'Anna, Turin
| | | | | | - Raffaella Grillo
- Medical Oncology, Centro Oncologico
ed Ematologico Subalpino, Azienda Ospedaliera San Giovanni Battista, Turin
| | - Giovanni Apolone
- Oncology Department, Istituto di
Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Giovannino Ciccone
- Unit of Cancer Epidemiology, Azienda
Ospedaliera US Giovanni Battista, CPO Piemonte, CeRMS, Turin
| | - Paolo Zola
- Gynecology and Obstetrics Academic
Department, Azienda Ospedaliera Ordine Mauriziano, Turin
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D'Hondt V, Lacroix-Triki M, Jarlier M, Boissiere-Michot F, Puech C, Coopman P, Katsaros D, Freiss G. High PTPN13 expression in high grade serous ovarian carcinoma is associated with a better patient outcome. Oncotarget 2017; 8:95662-95673. [PMID: 29221157 PMCID: PMC5707051 DOI: 10.18632/oncotarget.21175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/16/2017] [Indexed: 11/25/2022] Open
Abstract
Background Chromosome 4q loss of heterozygosity (LOH) is frequently observed in high-grade serous ovarian carcinoma (HGSOC). However, this LOH has not been clearly associated with the inactivation of any tumor suppressor gene(s). As the tumor suppressor gene PTPN13 is located on chromosome 4q21, we investigated its expression in HGSOC. Methods PTPN13 protein expression was investigated by immunohistochemistry (IHC) in normal ovary epithelium and in 30 HGSOC samples, whereas PTPN13 mRNA expression was quantified by RT-PCR in another independent cohort of 28 HGSOC samples. Patients in both cohorts were followed for more than 8.5 years. Results PTPN13 protein expression was lower in one third of HGSOC samples compared with normal ovary epithelium. In both cohorts, high PTPN13 expression level (mRNA or protein) in the tumor was associated with favorable outcome and significantly longer survival (HR=0.27; p=0.0087 and HR=0.42; p=0.03, respectively). Conclusion This study demonstrates, for the first time, that high PTPN13 expression level is a prognostic indicator of favorable outcome in patients with HGSOC. This finding, in conjunction with our previous mechanistic studies, suggests that PTPN13 loss, possibly by 4q LOH, enhances HGSOC aggressiveness and highlight the interest of studying PTPN13 signaling in HGSOC to identify new potential therapeutic targets.
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Affiliation(s)
- Véronique D'Hondt
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier F-34298, France.,Institut régional du Cancer de Montpellier, Montpellier F-34298, France
| | - Magalie Lacroix-Triki
- Département de Biologie et Pathologie Médicales, Gustave-Roussy Cancer Campus, 94805 Villejuif cedex, France
| | - Marta Jarlier
- Unité de Biométrie, Institut régional du Cancer de Montpellier, Montpellier F-34298, France
| | - Florence Boissiere-Michot
- Unité de Recherche Translationnelle, Institut Régional du Cancer de Montpellier, Montpellier F-34298, France
| | - Carole Puech
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier F-34298, France.,Institut régional du Cancer de Montpellier, Montpellier F-34298, France.,INSERM, U 1194, Montpellier F-34298, France.,Université de Montpellier, Montpellier F-34090, France
| | - Peter Coopman
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier F-34298, France.,Institut régional du Cancer de Montpellier, Montpellier F-34298, France.,INSERM, U 1194, Montpellier F-34298, France.,Université de Montpellier, Montpellier F-34090, France
| | - Dionyssios Katsaros
- Azienda Ospedaliero-Universitaria Cittadella Salute, Presidio S. Anna and Department of Surgical Science, Gynecology, University of Torino, Torino, Italy
| | - Gilles Freiss
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Montpellier F-34298, France.,Institut régional du Cancer de Montpellier, Montpellier F-34298, France.,INSERM, U 1194, Montpellier F-34298, France.,Université de Montpellier, Montpellier F-34090, France
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44
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de Boer SM, Powell ME, Mileshkin LR, Katsaros D, Bessette P, Haie-Meder C, Ottevanger PB, Ledermann JA, Khaw P, Colombo A, Fyles AW, Baron MH, Kitchener HC, Nijman H, Kruitwagen RF, Jurgenliemk-Schulz IM, Nout RA, Smit VT, Putter H, Creutzberg CL. Final results of the international randomized PORTEC-3 trial of adjuvant chemotherapy and radiation therapy (RT) versus RT alone for women with high-risk endometrial cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5502] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5502 Background: Women with high-risk endometrial cancer (HREC) are at increased risk of distant metastasis and endometrial cancer-related death. The randomized PORTEC-3 intergroup trial was initiated to investigate the benefit of adjuvant chemotherapy during and after radiotherapy (CTRT) versus pelvic radiotherapy (RT) alone for women with HREC. Methods: Women with HREC (FIGO stage I grade 3 with deep myometrial invasion and/or LVSI; stage II or III; or serous/clear cell histology) were randomly allocated (1:1) to RT (48.6 Gy in 1.8 Gy fractions) or CTRT (two cycles of cisplatin 50 mg/m² in week 1 and 4 of RT, followed by four cycles of carboplatin AUC5 and paclitaxel 175 mg/m² at 3-week intervals) with stratification for participating center, lymphadenectomy, stage, and histological type. The co-primary endpoints were overall survival (OS) and failure-free survival (FFS). The Kaplan-Meier method, log-rank test and Cox regression analysis were used for final analysis according to intention-to-treat. PORTEC-3 is registered with ISRCTN (ISRCTN14387080) and ClinicalTrials.gov (NCT00411138). Results: 686 women were enrolled between 2006 and 2013. 26 women were excluded; 13 withdrew consent early and 13 were ineligible, which left 660 patients in the analysis, with a median follow up time of 60.2 months (IQR 47.1–72.9): 330 CTRT and 330 RT. Three- and five-year OS for CTRT vs. RT was 84.4% versus 83.9%, and 81.8% versus 76.7%; overall HR 0.79 [95% CI 0.57-1.12, p=0.183]. Three-year FFS was 79.7% (CTRT) versus 71.8% (RT), and at 5 years 75.5% versus 68.9%, overall HR for FFS 0.77 [0.58-1.03, p=0.078]. Patients with stage III EC had lower 5-year FFS and OS compared to stage I-II (FFS 63.9% vs 78.9%, p<0.001, and OS 74.3% vs 83.1%, p=0.003). They also had greatest benefit of CTRT: 5-year FFS for stage III was 69.3% for CTRT vs 58.0% for RT [95% CI 0.45-0.97, p=0.032], and 5-year OS for stage III was 78.7 % vs 69.8% (p=0.114). Conclusions: Adjuvant chemotherapy given during and after pelvic radiotherapy for treatment of HREC did not significantly improve 5-year FFS and OS, compared with RT alone. For women with stage III EC FFS was however significantly improved with CTRT by 11% at 5 years. Follow-up will continue to evaluate long-term outcomes. Clinical trial information: NCT00411138.
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Affiliation(s)
- Stephanie M. de Boer
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Melanie E. Powell
- Department of Clinical Oncology, Barts Health NHS Trust, London, United Kingdom
| | - Linda R. Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecologic Oncology, Città della Salute and S Anna Hospital, University of Torino, Torino, Italy
| | - Paul Bessette
- National Cancer Institute of Canada, Clinical Trials Group, Department of Obstetrics and Gynaecology, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | | | | | - Pearly Khaw
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Alessandro Colombo
- Department of Radiation Oncology, A.O. della Provincia di Lecco, Lecco, Italy
| | - Anthony W. Fyles
- NCIC-CTG, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Marie-Helene Baron
- Department of Radiotherapy, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Henry C. Kitchener
- Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Hans Nijman
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Roy F.P.M. Kruitwagen
- Department of Gynaecology and Obstetrics, and GROW – School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Remi A. Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, Netherlands
| | - Carien L. Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
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Martini P, Paracchini L, Caratti G, Mello-Grand M, Fruscio R, Beltrame L, Calura E, Sales G, Ravaggi A, Bignotti E, Odicino FE, Sartori E, Perego P, Katsaros D, Craparotta I, Chiorino G, Cagnin S, Mannarino L, Ceppi L, Mangioni C, Ghimenti C, D'Incalci M, Marchini S, Romualdi C. lncRNAs as Novel Indicators of Patients' Prognosis in Stage I Epithelial Ovarian Cancer: A Retrospective and Multicentric Study. Clin Cancer Res 2016; 23:2356-2366. [PMID: 27827314 DOI: 10.1158/1078-0432.ccr-16-1402] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 10/24/2016] [Accepted: 10/30/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Stage I epithelial ovarian cancer (EOC) represents about 10% of all EOCs and is characterized by good prognosis with fewer than 20% of patients relapsing. As it occurs less frequently than advanced-stage EOC, its molecular features have not been thoroughly investigated. We have demonstrated that in stage I EOC miR-200c-3p can predict patients' outcome. In the present study, we analyzed the expression of long non-coding RNAs (lncRNA) to enable potential definition of a non-coding transcriptional signature with prognostic relevance for stage I EOC.Experimental Design: 202 snap-frozen stage I EOC tumor biopsies, 47 of which relapsed, were gathered together from three independent tumor tissue collections and subdivided into a training set (n = 73) and a validation set (n = 129). Median follow up was 9 years. LncRNAs' expression profiles were correlated in univariate and multivariate analysis with overall survival (OS) and progression-free survival (PFS).Results: The expression of lnc-SERTAD2-3, lnc-SOX4-1, lnc-HRCT1-1, and PVT1 was associated in univariate and multivariate analyses with relapse and poor outcome in both training and validation sets (P < 0.001). Using the expression profiles of PVT1, lnc-SERTAD2-3, and miR-200c-3p simultaneously, it was possible to stratify patients into high and low risk. The OS for high- and low-risk individuals are 36 and 123 months, respectively (OR, 15.55; 95% confidence interval, 3.81-63.36).Conclusions: We have identified a non-coding transcriptional signature predictor of survival and biomarker of relapse for stage I EOC. Clin Cancer Res; 23(9); 2356-66. ©2016 AACR.
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Affiliation(s)
- Paolo Martini
- Department of Biology, University of Padova, Padova, Italy
| | - Lara Paracchini
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Giulia Caratti
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Maurizia Mello-Grand
- Cancer Genomics Laboratory, Edo and Elvo Tempia Valenta Foundation, Biella, Italy
| | - Robert Fruscio
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Luca Beltrame
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Enrica Calura
- Department of Biology, University of Padova, Padova, Italy
| | - Gabriele Sales
- Department of Biology, University of Padova, Padova, Italy
| | - Antonella Ravaggi
- Division of Gynaecologic Oncology, "Angelo Nocivelli" Institute of Molecular Medicine, University of Brescia, Brescia, Italy
| | - Eliana Bignotti
- Division of Gynaecologic Oncology, "Angelo Nocivelli" Institute of Molecular Medicine, University of Brescia, Brescia, Italy
| | - Franco E Odicino
- Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Enrico Sartori
- Department of Obstetrics and Gynecology, University of Brescia, Brescia, Italy
| | - Patrizia Perego
- Pathology Unit University of Milan-Bicocca, San Gerardo Hospital, Monza, Italy
| | - Dionyssios Katsaros
- Azienda Ospedaliero-Universitaria Città della Salute, Presidio S Anna e Department of Surgical Science, Gynecology, University of Torino, Torino, Italy
| | - Ilaria Craparotta
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Giovanna Chiorino
- Cancer Genomics Laboratory, Edo and Elvo Tempia Valenta Foundation, Biella, Italy
| | - Stefano Cagnin
- Department of Biology, University of Padova, Padova, Italy.,C.R.I.B.I. Biotechnology Centre, University of Padova, Padova, Italy
| | - Laura Mannarino
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
| | - Lorenzo Ceppi
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
| | | | - Chiara Ghimenti
- Cancer Genomics Laboratory, Edo and Elvo Tempia Valenta Foundation, Biella, Italy
| | - Maurizio D'Incalci
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy.
| | - Sergio Marchini
- Department of Oncology, IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy
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46
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Fu Y, Biglia N, Wang Z, Shen Y, Risch HA, Lu L, Canuto EM, Jia W, Katsaros D, Yu H. Long non-coding RNAs, ASAP1-IT1, FAM215A, and LINC00472, in epithelial ovarian cancer. Gynecol Oncol 2016; 143:642-649. [PMID: 27667152 DOI: 10.1016/j.ygyno.2016.09.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/09/2016] [Accepted: 09/20/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Long non-coding RNAs (lncRNAs) are a class of non-protein coding transcripts that has gained significant attention lately due to their important biological actions and potential involvement in cancer. Ovarian cancer is a devastating disease with poor prognosis, and our understanding of lncRNA's involvement in the malignancy is limited. To further our knowledge, we measured the expression of three lncRNAs, ASAP1-IT1, FAM215A, and LINC00472, in tumor samples, and analyzed their associations with disease characteristics and patient survival. METHODS Two hundred sixty-six patients diagnosed with primary epithelial ovarian cancers were recruited for the study. Fresh-frozen tumor samples were obtained from the patients at tumor resection and analyzed by RT-qPCR for expression of ASAP1-IT1, FAM215A, and LINC00472. Associations of lncRNA expression with patient survival were determined using Cox proportional hazards regression models. RESULTS We observed high expression of ASAP1-IT1, FAM215A and LINC00472 more frequently in low grade tumors and early stage disease compared to high grade tumors and late stage disease, respectively. High expression of ASAP1-IT1 and FAM215A were associated with favorable overall survival, and the survival association with ASAP1-IT1 was independent of tumor grade and disease stage. Analyses of online data also demonstrated similar survival associations with ASAP1-IT1 and FAM215A, suggesting that these lncRNAs may be involved in ovarian cancer progression. CONCLUSIONS LncRNAs may play appreciable roles in ovarian cancer and more research is needed to elucidate their biological mechanisms and clinical implications in tumor characterization as well as disease prognosis and treatment.
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Affiliation(s)
- Yuanyuan Fu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, United States; Department of Molecular Biosciences and Bioengineering, University of Hawaii at Manoa, United States
| | - Nicoletta Biglia
- Department of Surgical Sciences, University of Turin, Torino, Italy
| | - Zhanwei Wang
- Cancer Epidemiology Program, University of Hawaii Cancer Center, United States
| | - Yi Shen
- Cancer Epidemiology Program, University of Hawaii Cancer Center, United States
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, United States
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, United States
| | - Emilie Marion Canuto
- Department of Surgical Sciences, Azienda Ospedaliero-Universitaria, Turin, Italy
| | - Wei Jia
- Cancer Epidemiology Program, University of Hawaii Cancer Center, United States
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Azienda Ospedaliero-Universitaria, Turin, Italy
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, United States.
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47
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de Boer SM, Powell ME, Mileshkin L, Katsaros D, Bessette P, Haie-Meder C, Ottevanger PB, Ledermann JA, Khaw P, Colombo A, Fyles A, Baron MH, Kitchener HC, Nijman HW, Kruitwagen RF, Nout RA, Verhoeven-Adema KW, Smit VT, Putter H, Creutzberg CL. Toxicity and quality of life after adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): an open-label, multicentre, randomised, phase 3 trial. Lancet Oncol 2016; 17:1114-1126. [PMID: 27397040 DOI: 10.1016/s1470-2045(16)30120-6] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND About 15% of patients with endometrial cancer have high-risk features and are at increased risk of distant metastases and endometrial cancer-related death. We designed the PORTEC-3 trial to investigate the benefit of adjuvant chemoradiotherapy compared with radiotherapy alone for women with high-risk endometrial cancer. METHODS PORTEC-3 was a multicentre, open-label, randomised, international trial. Women with high-risk endometrial cancer were randomly allocated (1:1) to radiotherapy alone (48·6 Gy) in 1·8 Gy fractions five times a week or chemoradiotherapy (two cycles concurrent cisplatin 50 mg/m(2) and four adjuvant cycles of carboplatin area under the curve [AUC] 5 and paclitaxel 175 mg/m(2)) using a biased coin minimisation procedure with stratification for participating centre, lymphadenectomy, stage of cancer, and histological type. The primary endpoints of the PORTEC-3 trial were overall survival and failure-free survival analysed in the intention-to-treat population. This analysis focuses on 2-year toxicity and health-related quality of life as secondary endpoints; analysis was done according to treatment received. Health-related quality of life was assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) the cervix cancer module and chemotherapy and neuropathy subscales of the ovarian cancer module at baseline, after radiotherapy and at 6, 12, 24, 36, and 60 months after randomisation. Adverse events were graded with Common Terminology Criteria for Adverse Events version 3.0. The study was closed on Dec 20, 2013, after achieving complete accrual, and follow-up remains ongoing for the primary outcomes analysis. This trial is registered with ISRCTN.com, number ISRCTN14387080, and with ClinicalTrials.gov, number NCT00411138. FINDINGS Between Sept 15, 2006, and Dec 20, 2013, 686 women were randomly allocated in the PORTEC-3 trial. Of these, 660 met eligibility criteria, and 570 (86%) were evaluable for health-related quality of life. Median follow-up was 42·3 months (IQR 25·8-55·1). At completion of radiotherapy and at 6 months, EORTC QLQ-C30 functioning scales were significantly lower (worse functioning) and health-related quality of life symptom scores higher (worse symptoms) for the chemoradiotherapy group compared with radiotherapy alone, improving with time. At 12 and 24 months, global health or quality of life was similar between groups, whereas physical functioning scores remained slightly lower in patients who received chemoradiotherapy compared with patients who received radiotherapy alone. At 24 months, 48 (25%) of 194 patients in the chemoradiotherapy group reported severe tingling or numbness compared with 11 (6%) of 170 patients in the radiotherapy alone group (p<0·0001). Grade 2 or worse adverse events were found during treatment in 309 (94%) of 327 patients in the chemoradiotherapy group versus 145 (44%) of 326 patients in the radiotherapy alone group, and grade 3 or worse events were found in 198 (61%) of 327 patients in the chemoradiotherapy group versus 42 (13%) of 326 patients in the radiotherapy alone group (p<0·0001), with most of the grade 3 adverse events being haematological (45%). At 12 and 24 months, no significant differences in grade 3 or worse adverse events were found between groups; only grade 2 or higher sensory neuropathy adverse events persisted at 24 months (25 [10%] of 240 patients in the chemoradiotherapy group vs one [<1%] of 247 patients in the radiotherapy alone group; p<0·0001). INTERPRETATION Despite the increased physician and patient-reported toxicities, this schedule of adjuvant chemotherapy given during and after radiotherapy in patients with high-risk endometrial cancer is feasible, with rapid recovery after treatment, but with persistence of patient-reported sensory neurological symptoms in 25% of patients. We await the analysis of primary endpoints before final conclusions are made. FUNDING Dutch Cancer Society, Cancer Research UK, National Health and Medical Research Council, Project Grant, Cancer Australia Grant, Italian Medicines Agency, and Canadian Cancer Society Research Institute.
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Affiliation(s)
- Stephanie M de Boer
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands.
| | - Melanie E Powell
- Department of Clinical Oncology, Barts Health NHS Trust, London, UK
| | - Linda Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - Dionyssios Katsaros
- Department of Surgical Sciences, Gynecologic Oncology, Città della Salute and S Anna Hospital, University of Torino, Torino, Italy
| | - Paul Bessette
- NCIC-CTG, Department of Obstetrics and Gynaecology, University of Sherbrooke, QC, Canada
| | | | | | - Jonathan A Ledermann
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, London, UK
| | - Pearly Khaw
- Division of Radiation Oncology & Cancer Imaging, Peter MacCallum Cancer Center, East Melbourne, VIC, Australia
| | - Alessandro Colombo
- Department of Radiation Oncology, Azienda Ospedaliera della Provincia di Lecco, Italy
| | - Anthony Fyles
- NCIC-CTG, Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Marie-Helene Baron
- Department of Radiotherapy, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Henry C Kitchener
- Institute of Cancer Sciences, University of Manchester, Manchester, UK
| | - Hans W Nijman
- Department of Gynaecologic Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Roy F Kruitwagen
- Department of Gynaecology and Obstetrics, and GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Remi A Nout
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Vincent T Smit
- Department of Pathology, Leiden University Medical Center, Leiden, Netherlands
| | - Hein Putter
- Department of Medical Statistics, Leiden University Medical Center, Leiden, Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands
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48
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Erriquez J, Olivero M, Mittica G, Scalzo MS, Vaira M, De Simone M, Ponzone R, Katsaros D, Aglietta M, Calogero R, Di Renzo MF, Valabrega G. Abstract LB-042: Xenopatients help in redefining medical therapeutic algorithms in high risk ovarian cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.am2016-lb-042] [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
Platinum-based chemotherapy is the recommended first-line treatment for high-grade serous (HGS) epithelial ovarian cancer (EOC). However, most patients relapse because of platinum refractory/resistant disease. We aimed at assessing whether other drugs, commonly used to treat relapsed HGS-EOC and poorly active in this clinical setting, might be more effective against chemotherapy-naïve cancers. We collected samples of advanced HGS-EOC from the same patients before and after neo-adjuvant platinum-based chemotherapy. Samples were propagated as Patient Derived Xenografts (PDXs) in immunocompromised mice (“xenopatients”). Xenopatients were treated with carboplatin, gemcitabine, pegylated liposomal doxorubicin (PLD) and trabectedin. One patient was studied who experienced clinically platinum-sensitivity first and then discordant responses of different tumor sites to platinum re-challenge. PDXs derived from this patient before chemotherapy showed responsiveness to carboplatin, trabectedin and gemcitabine. The PDXs from the same patient after chemotherapy did no longer respond to trabectedin and gemcitabine and showed a heterogeneous response to carboplatin. Expression profiling showed that loss of responsiveness to drugs of the post-chemotherapy PDXs was associated with the up-regulation of NR2F2 gene expression. A second patient with platinum refractory HGS-EOC responded poorly to PLD as second-line treatment. PDXs obtained from this patient's tumor before chemotherapy showed a complete response to PLD, which was lost in the post-chemotherapy PDXs. Response to PLD was associated with the over-expression of the TOP2A protein, which was lost in the post-chemotherapy PDXs. Thus, PDXs demonstrated that chemotherapy-naïve HGS-EOC might display susceptibility to agents not used commonly as first line treatment. These data suggest the importance of tailoring chemotherapy.
Citation Format: Jessica Erriquez, Martina Olivero, Gloria Mittica, Maria Stella Scalzo, Marco Vaira, Michele De Simone, Riccardo Ponzone, Dionyssios Katsaros, Massimo Aglietta, Raffaele Calogero, Maria Flavia Di Renzo, Giorgio Valabrega. Xenopatients help in redefining medical therapeutic algorithms in high risk ovarian cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-042.
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Affiliation(s)
| | - Martina Olivero
- 2University of Torino at the Candiolo Cancer Institute, Candiolo, Italy
| | - Gloria Mittica
- 2University of Torino at the Candiolo Cancer Institute, Candiolo, Italy
| | | | - Marco Vaira
- 1Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | | | | | | | - Massimo Aglietta
- 2University of Torino at the Candiolo Cancer Institute, Candiolo, Italy
| | | | | | - Giorgio Valabrega
- 2University of Torino at the Candiolo Cancer Institute, Candiolo, Italy
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49
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Calura E, Paracchini L, Fruscio R, DiFeo A, Ravaggi A, Peronne J, Martini P, Sales G, Beltrame L, Bignotti E, Tognon G, Milani R, Clivio L, Dell'Anna T, Cattoretti G, Katsaros D, Sartori E, Mangioni C, Ardighieri L, D'Incalci M, Marchini S, Romualdi C. A prognostic regulatory pathway in stage I epithelial ovarian cancer: new hints for the poor prognosis assessment. Ann Oncol 2016; 27:1511-9. [PMID: 27194815 DOI: 10.1093/annonc/mdw210] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 11/13/2015] [Accepted: 05/11/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Clinical and pathological parameters of patients with epithelial ovarian cancer (EOC) do not thoroughly predict patients' outcome. Despite the good outcome of stage I EOC compared with that of stages III and IV, the risk assessment and treatments are almost the same. However, only 20% of stage I EOC cases relapse and die, meaning that only a proportion of patients need intensive treatment and closer follow-up. Thus, the identification of cell mechanisms that could improve outcome prediction and rationalize therapeutic options is an urgent need in the clinical practice. PATIENTS AND METHODS We have gathered together 203 patients with stage I EOC diagnosis, from whom snap-frozen tumor biopsies were available at the time of primary surgery before any treatment. Patients, with a median follow-up of 7 years, were stratified into a training set and a validation set. RESULTS AND CONCLUSIONS Integrated analysis of miRNA and gene expression profiles allowed to identify a prognostic cell pathway, composed of 16 miRNAs and 10 genes, wiring the cell cycle, 'Activins/Inhibins' and 'Hedgehog' signaling pathways. Once validated by an independent technique, all the elements of the circuit resulted associated with overall survival (OS) and progression-free survival (PFS), in both univariate and multivariate models. For each patient, the circuit expressions have been translated into an activation state index (integrated signature classifier, ISC), used to stratify patients into classes of risk. This prediction reaches the 89.7% of sensitivity and 96.6% of specificity for the detection of PFS events. The prognostic value was then confirmed in the external independent validation set in which the PFS events are predicted with 75% sensitivity and 94.7% specificity. Moreover, the ISC shows higher classification performance than conventional clinical classifiers. Thus, the identified circuit enhances the understanding of the molecular mechanisms lagging behind stage I EOC and the ISC improves our capabilities to assess, at the time of diagnosis, the patient risk of relapse.
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Affiliation(s)
- E Calura
- Department of Biology, University of Padova, Padova
| | - L Paracchini
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - R Fruscio
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza MaNGO Group, Milano, Italy
| | - A DiFeo
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, USA
| | - A Ravaggi
- Division of Gynaecologic Oncology, 'Angelo Nocivelli' Institute of Molecular Medicine
| | - J Peronne
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, USA
| | - P Martini
- Department of Biology, University of Padova, Padova
| | - G Sales
- Department of Biology, University of Padova, Padova
| | - L Beltrame
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - E Bignotti
- Division of Gynaecologic Oncology, 'Angelo Nocivelli' Institute of Molecular Medicine
| | - G Tognon
- Department of Obstetrics and Gynaecology, Spedali Civili of Brescia, University of Brescia, Brescia
| | - R Milani
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza
| | - L Clivio
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - T Dell'Anna
- Clinic of Obstetrics and Gynaecology, University of Milano-Bicocca, San Gerardo Hospital, Monza
| | - G Cattoretti
- Anatomo-pathology Unit, University of Milan-Bicocca, San Gerardo Hospital, Monza
| | - D Katsaros
- MaNGO Group, Milano, Italy Department of Surgical Science and Gynecology, Azienda Ospedaliero Universitaria, Città della Salute, presidio S.Anna, University of Torino, Torino
| | - E Sartori
- Division of Gynaecologic Oncology, 'Angelo Nocivelli' Institute of Molecular Medicine
| | - C Mangioni
- MaNGO Group, Milano, Italy A.O. della Provincia di Lecco - P.O.A Manzoni, Lecco
| | - L Ardighieri
- Department of Molecular and Translational Medicine, 'Angelo Nocivelli' Institute for Molecular Medicine Department of Pathology, Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - M D'Incalci
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research MaNGO Group, Milano, Italy
| | - S Marchini
- Department of Oncology, IRCCS 'Mario Negri' Institute for Pharmacological Research
| | - C Romualdi
- Department of Biology, University of Padova, Padova
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50
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Despierre E, Vergote I, Anderson R, Coens C, Katsaros D, Hirsch FR, Boeckx B, Varella-Garcia M, Ferrero A, Ray-Coquard I, Green JA, Steer C, Berns EMJJ, Casado A, Lambrechts D, Jimeno A. Erratum to: Epidermal Growth Factor Receptor (EGFR) Pathway Biomarkers in the Randomized Phase III Trial of Erlotinib Versus Observation in Ovarian Cancer Patients with No Evidence of Disease Progression after First-Line Platinum-Based Chemotherapy. Target Oncol 2016; 11:429. [PMID: 27056749 DOI: 10.1007/s11523-016-0433-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Evelyn Despierre
- Gynecologic Oncology and Leuven Cancer Institute, and Department of Oncology, KU Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Ignace Vergote
- Gynecologic Oncology and Leuven Cancer Institute, and Department of Oncology, KU Leuven, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Ryan Anderson
- University of Colorado Cancer Center, Aurora, Colorado, USA
| | | | - Dionyssios Katsaros
- Azienda Ospedaliera, Presidio Santa Anna, SCDO 3 Ginecologia Oncologica, Università di Torino, Turin, Italy
| | - Fred R Hirsch
- University of Colorado Cancer Center, Aurora, Colorado, USA
| | - Bram Boeckx
- Laboratory for Translational Genetics, Department of Oncology, KU Leuven, Leuven, Belgium.,Vesalius Research Center (VRC), VIB, Leuven, Belgium
| | | | - Annamaria Ferrero
- Academic Division of Gynecological Oncology, Mauriziano Hospital, Turin, Italy
| | | | - John A Green
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool Clatterbridge Centre for Oncology, Bebington, Merseyside, CH63 4JY, United Kingdom
| | - Christopher Steer
- Border Medical Oncology, 1/69 Nordsvan Drive, Wodonga, Victoria, 3690, Australia
| | | | - Antonio Casado
- Hospital Universitario Clínico San Carlos, Servicio de Oncologia Medica, Madrid, Spain
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, KU Leuven, Leuven, Belgium.,Vesalius Research Center (VRC), VIB, Leuven, Belgium
| | - Antonio Jimeno
- University of Colorado Cancer Center, Aurora, Colorado, USA
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