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Enea D, Dray X, Guillerm E, Guilloux A, Yver M, Cervera P, Svrcek M. Inflammatory/juvenile-like polyps in neurofibromatosis type 1 associated with epithelial dysplasia. Virchows Arch 2024:10.1007/s00428-024-03769-w. [PMID: 38396165 DOI: 10.1007/s00428-024-03769-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
The term "juvenile-like (inflammatory/hyperplastic) mucosal polyps" (JLIHMP) has been recently introduced to describe a spectrum of polypoid lesions in patients with neurofibromatosis type 1 (NF-1). Due to the scarce number of reported cases and histopathological similarities with entities such as sporadic/syndromic juvenile polyps or inflammatory fibroid polyps, this entity remains a subject of debate. We describe herein a case of multiple JLIHMPs in a patient with NF-1, and we document the presence of low-grade dysplasia within one of these polyps.
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Affiliation(s)
- Diana Enea
- Department of Pathology, Saint-Antoine Hospital, AP-HP, Sorbonne Université, Paris, France.
| | - Xavier Dray
- Centre for Digestive Endoscopy, Saint-Antoine Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Erell Guillerm
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Antoine Guilloux
- Centre for Digestive Endoscopy, Saint-Antoine Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Matthieu Yver
- Department of Pathology, Saint-Antoine Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Pascale Cervera
- Department of Pathology, Saint-Antoine Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Magali Svrcek
- Department of Pathology, Saint-Antoine Hospital, AP-HP, Sorbonne Université, Paris, France
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2
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Guerrini-Rousseau L, Pasmant E, Muleris M, Abbou S, Adam-De-Beaumais T, Brugieres L, Cabaret O, Colas C, Cotteret S, Decq P, Dufour C, Guillerm E, Rouleau E, Varlet P, Zili S, Vidaud D, Grill J. Neurofibromatosis type 1 mosaicism in patients with constitutional mismatch repair deficiency. J Med Genet 2024; 61:158-162. [PMID: 37775264 PMCID: PMC10850717 DOI: 10.1136/jmg-2023-109235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/21/2023] [Indexed: 10/01/2023]
Abstract
Differential diagnosis between constitutional mismatch repair deficiency (CMMRD) and neurofibromatosis type 1 (NF1) is crucial as treatment and surveillance differ. We report the case of a girl with a clinical diagnosis of sporadic NF1 who developed a glioblastoma. Immunohistochemistry for MMR proteins identified PMS2 loss in tumour and normal cells and WES showed the tumour had an ultra-hypermutated phenotype, supporting the diagnosis of CMMRD. Germline analyses identified two variants (one pathogenic variant and one classified as variant(s) of unknown significance) in the PMS2 gene and subsequent functional assays on blood lymphocytes confirmed the diagnosis of CMMRD. The large plexiform neurofibroma of the thigh and the freckling were however more compatible with NF1. Indeed, a NF1 PV (variant allele frequencies of 20%, 3% and 9% and in blood, skin and saliva samples, respectively) was identified confirming a mosaicism for NF1. Retrospective analysis of a French cohort identified NF1 mosaicism in blood DNA in 2 out of 22 patients with CMMRD, underlining the existence of early postzygotic PV of NF1 gene in patients with CMMRD whose tumours have been frequently reported to exhibit somatic NF1 mutations. It highlights the potential role of this pathway in the pathogenesis of CMMRD-associated gliomas and argues in favour of testing MEK inhibitors in this context.
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Affiliation(s)
- Léa Guerrini-Rousseau
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- Molecular Predictors and New Targets in Oncology, Inserm U981 Team "Genomics and Oncogenesis of pediatric Brain Tumors", Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Eric Pasmant
- Department of Molecular Genetics, Hôpital Cochin, DMU BioPhyGen, AP-HP Centre-Université Paris Cité, Paris, France
- Inserm U1016-CNRS UMR8104, Institut Cochin, Université Paris Cité, CARPEM, Paris, France
| | - Martine Muleris
- Department of Genetics, Hôpital Pitié-Salpêtrière. AP-HP. Sorbonne Université, Paris, France
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - Samuel Abbou
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- Molecular Predictors and New Targets in Oncology, Inserm U981 Team "Genomics and Oncogenesis of pediatric Brain Tumors", Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Tiphaine Adam-De-Beaumais
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Laurence Brugieres
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- Molecular Predictors and New Targets in Oncology, Inserm U981 Team "Genomics and Oncogenesis of pediatric Brain Tumors", Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Odile Cabaret
- Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Chrystelle Colas
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
- Inserm U830, DNA Repair and Uveal Melanoma (D.R.U.M.), Equipe Labellisée Par la Ligue Nationale Contre le Cancer, Institut Curie, PSL Research University, Paris, France
| | - Sophie Cotteret
- Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Philippe Decq
- Neurosurgery Department, Beaujon Hospital, Paris Cité University, Paris, France
| | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- Molecular Predictors and New Targets in Oncology, Inserm U981 Team "Genomics and Oncogenesis of pediatric Brain Tumors", Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Erell Guillerm
- Department of Genetics, Hôpital Pitié-Salpêtrière. AP-HP. Sorbonne Université, Paris, France
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - Etienne Rouleau
- Department of Medical Biology and Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pascale Varlet
- Service de Neuropathologie, GHU Psychiatrie et Neurosciences, site Sainte-Anne, Paris, France
| | - Saïma Zili
- Molecular Predictors and New Targets in Oncology, Inserm U981 Team "Genomics and Oncogenesis of pediatric Brain Tumors", Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Dominique Vidaud
- Department of Molecular Genetics, Hôpital Cochin, DMU BioPhyGen, AP-HP Centre-Université Paris Cité, Paris, France
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
- Molecular Predictors and New Targets in Oncology, Inserm U981 Team "Genomics and Oncogenesis of pediatric Brain Tumors", Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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3
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Theodon H, Guillerm E, Wassermann J, Deniziaut G, Jaffrelot L, Denis JA, Chereau N, Bigorgne C, Potonnier W, Coulet F, Leenhardt L, Buffet C. Next-Generation-Sequencing on fine needle aspirates in neck recurrence of thyroid cancers. Eur Thyroid J 2024; 13:ETJ-23-0164. [PMID: 38236745 PMCID: PMC10895307 DOI: 10.1530/etj-23-0164] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVES Tumor molecular genotyping plays a key role in improving the management of advanced thyroid cancers. Molecular tests are classically performed on Formalin-Fixed Paraffin-Embedded (FFPE) carcinoma tissue. However alternative molecular testing strategies are needed when FFPE tumoral tissue is unavailable. The objective of our study was to retrospectively assess the performance of targeted DNA and RNA-based Next Generation Sequencing (NGS) on the fine needle aspirate from thyroid cancer cervical recurrences to determine if this strategy is efficient in clinical practice. DESIGN/METHODS A retrospective study of 33 patients who had had DNA and/or RNA-based NGS on ultrasound (US)-guided fine needle aspirates of cervical thyroid cancer recurrences in our Department from July 2019 to September 2022. RESULTS In total, 34 DNA and 32 RNA-based NGS analyses were performed. Out of the 34 DNA-based NGS performed, 27 (79%) were conclusive allowing the identification of an oncogenic driver for 18 patients (53%). The most common mutation (n = 13) was BRAF c.1799T>A. Out of the 32 RNA-based NGS performed, 26 were interpretable (81%) and no gene fusion was found. The identification of a BRAFV600E mutation was decisive for one patient in our series, who was prescribed dabrafenib and trametinib. CONCLUSIONS NGS performed on fine needle aspirates of neck lymph node metastases enabled the identification of an oncogenic driver alteration in 53% of the cases in our series of advanced thyroid cancer patients and could significantly alter patient management.
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Affiliation(s)
- Helene Theodon
- H Theodon, Thyroïde et tumeurs endocrines, University Hospital Pitié Salpêtrière, Paris, 75013, France
| | | | - Johanna Wassermann
- J Wassermann, Oncolgy, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | | | - Loic Jaffrelot
- L Jaffrelot, Oncology, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | | | - Nathalie Chereau
- N Chereau, Surgery, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Claude Bigorgne
- C Bigorgne, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Wiame Potonnier
- W Potonnier, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Florence Coulet
- F Coulet, Hôpital Universitaire Pitié Salpêtrière, Paris, France
| | - Laurence Leenhardt
- L Leenhardt, Hopital Universitaire Pitie Salpetriere Bibliotheque de La Pitié, Paris, 75651, France
| | - Camille Buffet
- C Buffet, Thyroid and Endocrine Tumors Department, AP-HP, Paris, 75184, France
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4
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Ratovomanana T, Nicolle R, Cohen R, Diehl A, Siret A, Letourneur Q, Buhard O, Perrier A, Guillerm E, Coulet F, Cervera P, Benusiglio P, Labrèche K, Colle R, Collura A, Despras E, Le Rouzic P, Renaud F, Cros J, Alentorn A, Touat M, Ayadi M, Bourgoin P, Prunier C, Tournigand C, de la Fouchardière C, Tougeron D, Jonchère V, Bennouna J, de Reynies A, Fléjou JF, Svrcek M, André T, Duval A. Prediction of Response to Immune Checkpoint Blockade in Patients with Metastatic Colorectal Cancer with Microsatellite Instability. Ann Oncol 2023:S0923-7534(23)00695-6. [PMID: 37269904 DOI: 10.1016/j.annonc.2023.05.010] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Mismatch repair deficient (dMMR) tumors displaying microsatellite instability (MSI) represent a paradigm for the success of immune checkpoint inhibitor (ICI)-based immunotherapy, particularly in patients with metastatic colorectal cancer (mCRC). However, a proportion of patients with dMMR/MSI mCRC exhibit resistance to ICI. Identification of tools predicting MSI mCRC patient response to ICI are required for the design of future strategies further improving this therapy. PATIENTS AND METHODS We combined high-throughput DNA and RNA sequencing of tumors from 116 patients with MSI mCRC treated with anti-PD-1 +/- anti-CTLA-4 of the NIPICOL phase II trial (C1, NCT03350126, discovery set) and the IMMUNOMSI prospective cohort (C2, validation set). The DNA/RNA predictors whose status was significantly associated with ICI status of response in C1 were subsequently validated in C2. Primary endpoint was iPFS (progression-free survival by iRECIST). RESULTS Analyses showed no impact of previously suggested DNA/RNA indicators of resistance to ICI, e.g., MSISensor score, tumor mutational burden, or specific cellular and molecular tumoral contingents. By contrast, iPFS under ICI was shown in C1 and C2 to depend both on a multiplex MSI signature involving the mutations of 19 microsatellites (HRC2 = 3.63; 95% CI [1.65-7.99] ; p = 1.4x10-3) and the expression of a set of 182 RNA markers with a non-epithelial TGFB-related desmoplastic orientation (HRC2 = 1.75 ; 95% CI [1.03-2.98] ; p = 0.035). Both DNA and RNA signatures were independently predictive of iPFS. CONCLUSIONS iPFS in patients with MSI mCRC can be predicted by simply analyzing the mutational status of DNA microsatellite-containing genes in epithelial tumor cells together with nonepithelial TGFB-related desmoplastic RNA markers.
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Affiliation(s)
- T Ratovomanana
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - R Nicolle
- Université Paris Cité, Centre de Recherche sur l'Inflammation (CRI), INSERM, U1149, CNRS, ERL 8252, F-75018 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France
| | - R Cohen
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - A Diehl
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - A Siret
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - Q Letourneur
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - O Buhard
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - A Perrier
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - E Guillerm
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - F Coulet
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - P Cervera
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - P Benusiglio
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France
| | - K Labrèche
- CinBioS, MS 37 PASS Production de données en Sciences de la vie et de la Santé, INSERM, Sorbonne Université et SIRIC CURAMUS, 75013 Paris
| | - R Colle
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - A Collura
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - E Despras
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - P Le Rouzic
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - F Renaud
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - J Cros
- Department of Pathology, Beaujon Hospital, AP-HP, Clichy, France
| | - A Alentorn
- Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M Touat
- Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - M Ayadi
- Programme "Cartes d'Identité des Tumeurs", Ligue Nationale Contre le Cancer, Paris, France
| | - P Bourgoin
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - C Prunier
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Signalisation TGFB, plasticité cellulaire et Cancer, F-75012 Paris, France
| | - C Tournigand
- Department of medical Oncology, Hôpital Henri-Mondor, APHP, Université Paris Est Creteil, INSERM U955
| | | | - D Tougeron
- ProDicET, UR 24144, University of Poitiers and Hepato-Gastroenterology Department, Poitiers University Hospital, 86000 Poitiers, France
| | - V Jonchère
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France
| | - J Bennouna
- Centre De Recherche En Cancérologie Et Immunologie Nantes-Angers (CRCINA), INSERM, Université d'Angers, Université De Nantes, Nantes, France
| | - A de Reynies
- Cartes d'Identité des Tumeurs Program, Ligue Nationale Contre Cancer, Paris, France
| | - J-F Fléjou
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - M Svrcek
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - T André
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; GERCOR, Groupe Coopérateur Multidisciplinaire en Oncologie, F-75011 Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, F-75012 Paris, France
| | - A Duval
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, F-75012 Paris, France; Sorbonne Université, Department of Molecular Biology and Medical Genetics, AP-HP, Hospital Pitié-Salpêtrière, F-75012 Paris, France.
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5
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Leclerc J, Beaumont M, Vibert R, Pinson S, Vermaut C, Flament C, Lovecchio T, Delattre L, Demay C, Coulet F, Guillerm E, Hamzaoui N, Benusiglio PR, Brahimi A, Cornelis F, Delhomelle H, Fert-Ferrer S, Fournier BPJ, Hovnanian A, Legrand C, Lortholary A, Malka D, Petit F, Saurin JC, Lejeune S, Colas C, Buisine MP. AXIN2 germline testing in a French cohort validates pathogenic variants as a rare cause of predisposition to colorectal polyposis and cancer. Genes Chromosomes Cancer 2023; 62:210-222. [PMID: 36502525 PMCID: PMC10107344 DOI: 10.1002/gcc.23112] [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: 09/26/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
Only a few patients with germline AXIN2 variants and colorectal adenomatous polyposis or cancer have been described, raising questions about the actual contribution of this gene to colorectal cancer (CRC) susceptibility. To assess the clinical relevance for AXIN2 testing in patients suspected of genetic predisposition to CRC, we collected clinical and molecular data from the French Oncogenetics laboratories analyzing AXIN2 in this context. Between 2004 and June 2020, 10 different pathogenic/likely pathogenic AXIN2 variants were identified in 11 unrelated individuals. Eight variants were from a consecutive series of 3322 patients, which represents a frequency of 0.24%. However, loss-of-function AXIN2 variants were strongly associated with genetic predisposition to CRC as compared with controls (odds ratio: 11.89, 95% confidence interval: 5.103-28.93). Most of the variants were predicted to produce an AXIN2 protein devoid of the SMAD3-binding and DIX domains, but preserving the β-catenin-binding domain. Ninety-one percent of the AXIN2 variant carriers who underwent colonoscopy had adenomatous polyposis. Forty percent of the variant carriers developed colorectal or/and other digestive cancer. Multiple tooth agenesis was present in at least 60% of them. Our report provides further evidence for a role of AXIN2 in CRC susceptibility, arguing for AXIN2 testing in patients with colorectal adenomatous polyposis or cancer.
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Affiliation(s)
- Julie Leclerc
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France.,Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - Marie Beaumont
- Laboratoire de Génétique Moléculaire et Génomique, CHU Rennes, Rennes, France
| | - Roseline Vibert
- UF d'Oncogénétique Clinique, Département de Génétique et Institut Universitaire de Cancérologie, Hôpitaux Pitié-Salpêtrière et Saint-Antoine, AP-HP. Sorbonne Université, Paris, France
| | - Stéphane Pinson
- Human Genetics Department, Hospices Civils de Lyon, Lyon, France
| | - Catherine Vermaut
- Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - Cathy Flament
- Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - Tonio Lovecchio
- Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - Lucie Delattre
- Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - Christophe Demay
- Bioinformatics Unit, Molecular Biology Facility, Lille University Hospital, Lille, France
| | - Florence Coulet
- Sorbonne University, INSERM, Saint-Antoine Research Center, Microsatellites instability and Cancer, CRSA, Genetics Department, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne University, Paris, France
| | - Erell Guillerm
- Sorbonne University, INSERM, Saint-Antoine Research Center, Microsatellites instability and Cancer, CRSA, Genetics Department, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne University, Paris, France
| | - Nadim Hamzaoui
- Service de Génétique et Biologie Moléculaires, Hôpital Cochin, AP-HP Centre, Université de Paris, and INSERM UMR_S1016, Institut Cochin, Université de Paris, Paris, France
| | - Patrick R Benusiglio
- UF d'Oncogénétique Clinique, Département de Génétique et Institut Universitaire de Cancérologie, Hôpitaux Pitié-Salpêtrière et Saint-Antoine, AP-HP. Sorbonne Université, Paris, France
| | | | - François Cornelis
- Department of Genetics-Oncogénétics-Prevention, Clermont-Ferrand Hospital, Clermont-Auvergne University, Clermont Ferrand, France
| | - Hélène Delhomelle
- Department of Genetics, Curie Institute, Paris Sciences & Lettres Research University, Paris, France
| | | | - Benjamin P J Fournier
- Centre de Recherche des Cordeliers, University of Paris, Sorbonne University, INSERM UMRS 1138 - Molecular Oral Pathophysiology, Paris, France.,Dental Faculty Garanciere, Oral Biology Department, Centre of Reference for Oral and Dental Rare Diseases, AP-HP, University of Paris, Paris, France
| | - Alain Hovnanian
- INSERM UMR 1163 - Laboratory of Genetic Skin Diseases, Imagine Institute, Paris, France.,University of Paris, Paris, France.,Department of Genetics, Necker Hospital for sick children, AP-HP, Paris, France
| | - Clémentine Legrand
- Service de Génétique, Génomique et Procréation, CHU Grenoble Alpes, Grenoble, France
| | - Alain Lortholary
- Centre Catherine de Sienne, hôpital privé du Confluent, Nantes, France
| | - David Malka
- Department of Cancer Medicine, Gustave Roussy, Paris-Saclay University, INSERM UMR 1279 - Unité Dynamique des Cellules Tumorales, Villejuif, France
| | - Florence Petit
- Clinique de Génétique, CHU Lille, Lille, France.,Univ. Lille, EA7364 - RADEME, CHU Lille, Lille, France
| | | | | | - Chrystelle Colas
- Department of Genetics, Curie Institute, Paris Sciences & Lettres Research University, Paris, France
| | - Marie-Pierre Buisine
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France.,Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
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6
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Favre L, Sako N, Tarfi S, Quang VT, Joy C, Dupuy A, Guillerm E, Gaulard P, Wagner‐Ballon O, Pujals A, Sloma I. Evaluation of two new highly multiplexed PCR assays as an alternative to next-generation sequencing for IDH1/2 mutation detection. Mol Oncol 2022; 16:3916-3926. [PMID: 36062346 PMCID: PMC9718115 DOI: 10.1002/1878-0261.13311] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/20/2022] [Accepted: 09/02/2022] [Indexed: 12/24/2022] Open
Abstract
IDH1 and IDH2 somatic mutations have been identified in solid tumors and blood malignancies. The development of inhibitors of mutant IDH1 and IDH2 in the past few years has prompted the development of a fast and sensitive assay to detect IDH1R132 , IDH2R140 and IDH2R172 mutations to identify patients eligible for these targeted therapies. This study aimed to compare two new multiplexed PCR assays - an automated quantitative PCR (qPCR) on the PGX platform and a droplet digital PCR (ddPCR) with next-generation sequencing (NGS) for IDH1/2 mutation detection. These assays were evaluated on 102 DNA extracted from patient peripheral blood, bone marrow and formalin-fixed paraffin-embedded tissue samples with mutation allelic frequency ranging from 0.6% to 45.6%. The ddPCR assay had better analytical performances than the PGX assay with 100% specificity, 100% sensitivity and a detection limit down to 0.5% on IDH1R132 , IDH2R140 and IDH2R172 codons, and a high correlation with NGS results. Therefore, the new highly multiplexed ddPCR is a fast and cost-effective assay that meets most clinical needs to identify and follow cancer patients in the era of anti-IDH1/2-targeted therapies.
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Affiliation(s)
- Loetitia Favre
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance,Univ Paris Est Creteil, INSERM, IMRBFrance
| | - Nouhoum Sako
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Sihem Tarfi
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Violaine Tran Quang
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Corine Joy
- Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | | | - Erell Guillerm
- Genetic DepartmentAP‐HP, University Hospital Pitié SalpêtrièreParisFrance
| | - Philippe Gaulard
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance,Univ Paris Est Creteil, INSERM, IMRBFrance
| | - Orianne Wagner‐Ballon
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
| | - Anaïs Pujals
- Department of PathologyAP‐HP, Henri Mondor University HospitalCreteilFrance,Univ Paris Est Creteil, INSERM, IMRBFrance
| | - Ivan Sloma
- Univ Paris Est Creteil, INSERM, IMRBFrance,Hematology and Immunology DepartmentAP‐HP, Henri Mondor University HospitalCreteilFrance
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7
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Eyries M, Ariste O, Legrand G, Basset N, Guillerm E, Perrier A, Duros C, Cohen-Haguenauer O, de la Grange P, Coulet F. Detection of a pathogenic Alu element insertion in PALB2 gene from targeted NGS diagnostic data. Eur J Hum Genet 2022; 30:1187-1190. [PMID: 35277653 PMCID: PMC9553905 DOI: 10.1038/s41431-022-01064-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/11/2022] [Accepted: 02/01/2022] [Indexed: 12/15/2022] Open
Abstract
Despite routine analysis of a large panel of genes, pathogenic variants are only detected in approximately 20% of families with hereditary breast and/or ovarian cancer. Mobile element insertions (MEI) are known to cause genetic diseases in humans, but remain challenging to detect. Retrospective analysis of targeted next-generation sequencing (NGS) data from 359 patients was performed using a dedicated MEI detection pipeline. We detected one MEI in exon 9 of the PALB2 gene in a woman with a family history of breast cancer. The pathogenic variant, c.2872_2888delins114AluL2, disrupts the PALB2 coding sequence and leads to the production of a truncated protein, p.(Gln958Valfs*38). This is the first report of a pathogenic MEI in PALB2. This study illustrates that MEI analysis may help to improve molecular diagnostic yield and can be performed from targeted NGS data used for routine diagnosis.
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Affiliation(s)
- Mélanie Eyries
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, F-75013, Paris, France.
| | | | - Gaelle Legrand
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Noémie Basset
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Erell Guillerm
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Alexandre Perrier
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
| | - Caroline Duros
- Hôpital Saint-Louis-Lariboisière-Fernand-Widal, Service d'oncologie médicale Assistance Publique-Hôpitaux de Paris, F-75010, Paris, France
| | - Odile Cohen-Haguenauer
- Hôpital Saint-Louis-Lariboisière-Fernand-Widal, Service d'oncologie médicale Assistance Publique-Hôpitaux de Paris, F-75010, Paris, France
| | | | - Florence Coulet
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, F-75013, Paris, France
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8
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Scherman N, Wassermann J, Tlemsani C, Guillerm E, Deniziaut G, Cochand-Priollet B, Shan L, Chereau N, Gaujoux S, Simon JM, Leenhardt L, Groussin L, Buffet C. Possible Primary Thyroid Nuclear Protein in Testis Carcinomas with NSD3::NUTM1 Translocation Revealed by RNA Sequencing: A Report of Two Cases. Thyroid 2022; 32:1271-1276. [PMID: 35880417 DOI: 10.1089/thy.2022.0136] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Nuclear protein in testis (NUT) carcinomas (NC) are a rare, highly aggressive, subset of squamous cell carcinomas, characterized by a translocation involving the NUTM1 gene. Thyroid location of NUT carcinomas has rarely been described. Methods: We report here two cases of thyroid NC with NSD3::NUTM1 translocation. Results: The first case presented as a very aggressive undifferentiated thyroid carcinoma in a 38-year-old man who died 21 months after the diagnosis. The second case was diagnosed after multiple lymphadenopathy recurrences mainly in the neck in a 37-year-old woman 7 years after total thyroidectomy for papillary thyroid carcinoma with a classic and a solid/trabecular component. Conclusions: Our case reports highlight the challenges in diagnosing these exceptional carcinomas. The therapeutic impact of the administration of pharmacological compounds with epigenetic action, in line with the physiopathology of these carcinomas, is also discussed.
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Affiliation(s)
- Noémie Scherman
- Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Johanna Wassermann
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Oncology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Camille Tlemsani
- Medical Oncology Department, Cochin Hospital, Paris Cancer Institute CARPEM, Université de Paris, Paris, France
| | - Erell Guillerm
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Oncogenetic Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Gabrielle Deniziaut
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Pathology Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | | | - Larrys Shan
- Endocrine Department, Centre Hospitalier de Polynésie Française, Papeete, French Polynesia
| | - Nathalie Chereau
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Sébastien Gaujoux
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Department of Endocrine Surgery, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Jean-Marc Simon
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Radiotherapy Department, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Laurence Leenhardt
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Thyroid and Endocrine Tumors Department; Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Lionel Groussin
- Endocrine Department; Cochin Hospital, Université de Paris, Paris, France
| | - Camille Buffet
- GRC No. 16, GRC Tumeurs Thyroïdiennes, Thyroid and Endocrine Tumors Department; Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
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9
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Buffet C, Allard L, Guillerm E, Ghander C, Mathy E, Lussey-Lepoutre C, Julien N, Touma E, Quilhot P, Godiris-Petit G, Lacorte JM, Leenhardt L, Denis JA. Detection of BRAFV600E by digital PCR on fine-needle aspirate enables rapid initiation of dabrafenib and trametinib in unresectable anaplastic thyroid carcinoma. Eur J Endocrinol 2022; 187:K33-K38. [PMID: 35900324 DOI: 10.1530/eje-22-0366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/06/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Recently, targeted therapies using BRAFV600E and MEK inhibitors (dabrafenib and trametinib, respectively) have been recommended in BRAF-mutated anaplastic thyroid carcinoma (ATC). Considering the fast development of ATC, droplet digital PCR (ddPCR) performed on fine-needle aspirate (FNA), which is a rapid, reliable, and low-cost method, appears interesting for the detection of BRAFV600E mutation in these patients and allows early initiation of targeted therapies. RESULTS In our two patients, both presenting extensive cervical masses inaccessible to surgery, ddPCR results were available in less than 24 h. Therefore, dabrafenib and trametinib were started only a few days after first contact. CONCLUSIONS We suggest that ddPCR on FNA be used in non-resectable cervical masses for rapid BRAFV600E mutation detection in the hope that starting targeted therapies early might improve outcomes.
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Affiliation(s)
- Camille Buffet
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Lucie Allard
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Erell Guillerm
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, UF d'Onco-angiogénétique et Génomique des Tumeurs Solides, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cécile Ghander
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elise Mathy
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Fonctionnelle de Radiothérapie Interne Vectorisée, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Nicolas Julien
- Service d'ORL, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eliane Touma
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Pauline Quilhot
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service d'Anatomo-Pathologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gaelle Godiris-Petit
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Chirurgie Générale et Endocrinienne, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Marc Lacorte
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service des Pathologies Thyroïdiennes et Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
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10
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Allard L, Denis JA, Godiris Petit G, Deniziaut G, Ghander C, Mathy E, Guillerm E, Lussey-Lepoutre C, Leenhardt L, Buffet C. Complete resection of ulcerating, infiltrative, voluminous differentiated thyroid carcinoma. Eur Thyroid J 2022; 11:e210091. [PMID: 35113038 PMCID: PMC8963168 DOI: 10.1530/etj-21-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
An 87-year-old woman was referred to our department for a 15 cm right-sided cervical tumor with bleeding and skin ulceration, developed on a 6 cm papillary thyroid carcinoma diagnosed two years earlier. Surprisingly, there were no other compressive symptoms. Unexpectedly, but successfully, total thyroidectomy and neck dissection were performed. There were no poorly differentiated or anaplastic components in the final histological analysis. Impressive dehiscence occurred shortly after surgery and was also successfully managed. Our case highlights the benefit of considering surgery in the context of a tertiary care center even for an apparent massive aggressive cervical mass and despite old age.
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Affiliation(s)
- Lucie Allard
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Biochimie Endocrinienne et Oncologique, UF Oncobiologie Cellulaire et Moléculaire, Pitié Salpêtrière, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gaëlle Godiris Petit
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Chirurgie Générale, Viscérale et Endocrinienne, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gabrielle Deniziaut
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service d’Anatomo-Pathologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cécile Ghander
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Elise Mathy
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Erell Guillerm
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, UF d’Onco-Angiogénétique et Génomique des Tumeurs Solides, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Charlotte Lussey-Lepoutre
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Service de Médecine Nucléaire, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Laurence Leenhardt
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Camille Buffet
- Sorbonne Université, GRC n°16, GRC Tumeurs Thyroïdiennes, Unité Thyroïde-Tumeurs Endocrines, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- Correspondence should be addressed to C Buffet:
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11
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Bouzidi A, Labreche K, Baron M, Veyri M, Denis JA, Touat M, Sanson M, Davi F, Guillerm E, Jouannet S, Charlotte F, Bielle F, Choquet S, Boëlle PY, Cadranel J, Leblond V, Autran B, Lacorte JM, Spano JP, Coulet F. Low-Coverage Whole Genome Sequencing of Cell-Free DNA From Immunosuppressed Cancer Patients Enables Tumor Fraction Determination and Reveals Relevant Copy Number Alterations. Front Cell Dev Biol 2021; 9:661272. [PMID: 34710202 PMCID: PMC8369887 DOI: 10.3389/fcell.2021.661272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/18/2021] [Indexed: 11/13/2022] Open
Abstract
Cell-free DNA (cfDNA) analysis is a minimally invasive method that can be used to detect genomic abnormalities by directly testing a blood sample. This method is particularly useful for immunosuppressed patients, who are at high risk of complications from tissue biopsy. The cfDNA tumor fraction (TF) varies greatly across cancer type and between patients. Thus, the detection of molecular alterations is highly dependent on the circulating TF. In our study, we aimed to calculate the TF and characterize the copy number aberration (CNA) profile of cfDNA from patients with rare malignancies occurring in immunosuppressed environments or immune-privileged sites. To accomplish this, we recruited 36 patients: 19 patients with non-Hodgkin lymphoma (NHL) who were either human immunodeficiency virus (HIV)-positive or organ transplant recipients, 5 HIV-positive lung cancer patients, and 12 patients with glioma. cfDNA was extracted from the patients' plasma and sequenced using low-coverage whole genome sequencing (LC-WGS). The cfDNA TF was then calculated using the ichorCNA bioinformatic algorithm, based on the CNA profile. In parallel, we performed whole exome sequencing of patient tumor tissue and cfDNA samples with detectable TFs. We detected a cfDNA TF in 29% of immune-suppressed patients (one patient with lung cancer and six with systemic NHL), with a TF range from 8 to 70%. In these patients, the events detected in the CNA profile of cfDNA are well-known events associated with NHL and lung cancer. Moreover, cfDNA CNA profile correlated with the CNA profile of matched tumor tissue. No tumor-derived cfDNA was detected in the glioma patients. Our study shows that tumor genetic content is detectable in cfDNA from immunosuppressed patients with advanced NHL or lung cancer. LC-WGS is a time- and cost-effective method that can help select an appropriate strategy for performing extensive molecular analysis of cfDNA. This technique also enables characterization of CNAs in cfDNA when sufficient tumor content is available. Hence, this approach can be used to collect useful molecular information that is relevant to patient care.
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Affiliation(s)
- Amira Bouzidi
- Sorbonne University, INSERM, Research Unit on Cardiovascular and Metabolic Disease UMR ICAN, Department of Endocrine Biochemistry and Oncology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Karim Labreche
- Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Marine Baron
- Sorbonne University, Center for Immunology and Infectious Diseases (CIMI-Paris), Department of Hematology, APHP, Hôpital Pitié Salpêtrière, Paris, France
| | - Marianne Veyri
- Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Theravir Team, Medical Oncology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Jérôme Alexandre Denis
- Sorbonne University, INSERM, Saint-Antoine Research Center, Cancer Biology and Therapeutics, CRSA, Department of Endocrine Biochemistry and Oncology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Mehdi Touat
- Sorbonne University, INSERM, CNRS, Brain and Spine Institute, ICM, Department of Neurology 2-Mazarin, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Marc Sanson
- Sorbonne University, INSERM, CNRS, Brain and Spine Institute, ICM, Department of Neurology 2-Mazarin, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Frédéric Davi
- Sorbonne University, INSERM, Centre de Recherche des Cordeliers, Department of Biological Hematology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Erell Guillerm
- Sorbonne University, INSERM, Saint-Antoine Research Center, Microsatellites Instability and Cancer, CRSA, Genetics Department, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Stéphanie Jouannet
- Sorbonne University, Neurosurgery Department, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Frédéric Charlotte
- Sorbonne University, Anatomy and Pathologic Cytology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Franck Bielle
- Sorbonne University, Neuropathology Department, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Sylvain Choquet
- Sorbonne University, Center for Immunology and Infectious Diseases (CIMI-Paris), Department of Hematology, APHP, Hôpital Pitié Salpêtrière, Paris, France
| | - Pierre-Yves Boëlle
- Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Jacques Cadranel
- Sorbonne University, Chest Department and Thoracic Oncology, GRC 04, Theranoscan, AP-HP, Hôpital Tenon, Paris, France
| | - Véronique Leblond
- Sorbonne University, Center for Immunology and Infectious Diseases (CIMI-Paris), Department of Hematology, APHP, Hôpital Pitié Salpêtrière, Paris, France
| | - Brigitte Autran
- Sorbonne University, INSERM, CNRS, Center for Immunology and Infectious Diseases (CIMI-Paris), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Marc Lacorte
- Sorbonne University, INSERM, Research Unit on Cardiovascular and Metabolic Disease UMR ICAN, Department of Endocrine Biochemistry and Oncology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Jean-Philippe Spano
- Sorbonne University, INSERM, Research Unit on Cardiovascular and Metabolic Disease UMR ICAN, Department of Endocrine Biochemistry and Oncology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
| | - Florence Coulet
- Sorbonne University, INSERM, Research Unit on Cardiovascular and Metabolic Disease UMR ICAN, Department of Endocrine Biochemistry and Oncology, AP-HP, Hôpital Pitié Salpêtrière, Paris, France
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Caputo SM, Golmard L, Léone M, Damiola F, Guillaud-Bataille M, Revillion F, Rouleau E, Derive N, Buisson A, Basset N, Schwartz M, Vilquin P, Garrec C, Privat M, Gay-Bellile M, Abadie C, Abidallah K, Airaud F, Allary AS, Barouk-Simonet E, Belotti M, Benigni C, Benusiglio PR, Berthemin C, Berthet P, Bertrand O, Bézieau S, Bidart M, Bignon YJ, Birot AM, Blanluet M, Bloucard A, Bombled J, Bonadona V, Bonnet F, Bonnet-Dupeyron MN, Boulaire M, Boulouard F, Bouras A, Bourdon V, Brahimi A, Brayotel F, Bressac de Paillerets B, Bronnec N, Bubien V, Buecher B, Cabaret O, Carriere J, Chiesa J, Chieze-Valéro S, Cohen C, Cohen-Haguenauer O, Colas C, Collonge-Rame MA, Conoy AL, Coulet F, Coupier I, Crivelli L, Cusin V, De Pauw A, Dehainault C, Delhomelle H, Delnatte C, Demontety S, Denizeau P, Devulder P, Dreyfus H, d’Enghein CD, Dupré A, Durlach A, Dussart S, Fajac A, Fekairi S, Fert-Ferrer S, Fiévet A, Fouillet R, Mouret-Fourme E, Gauthier-Villars M, Gesta P, Giraud S, Gladieff L, Goldbarg V, Goussot V, Guibert V, Guillerm E, Guy C, Hardouin A, Heude C, Houdayer C, Ingster O, Jacquot-Sawka C, Jones N, Krieger S, Lacoste S, Lallaoui H, Larbre H, Laugé A, Le Guyadec G, Le Mentec M, Lecerf C, Le Gall J, Legendre B, Legrand C, Legros A, Lejeune S, Lidereau R, Lignon N, Limacher JM, Doriane Livon, Lizard S, Longy M, Lortholary A, Macquere P, Mailliez A, Malsa S, Margot H, Mari V, Maugard C, Meira C, Menjard J, Molière D, Moncoutier V, Moretta-Serra J, Muller E, Nevière Z, Nguyen Minh Tuan TV, Noguchi T, Noguès C, Oca F, Popovici C, Prieur F, Raad S, Rey JM, Ricou A, Salle L, Saule C, Sevenet N, Simaga F, Sobol H, Suybeng V, Tennevet I, Tenreiro H, Tinat J, Toulas C, Turbiez I, Uhrhammer N, Vande Perre P, Vaur D, Venat L, Viellard N, Villy MC, Warcoin M, Yvard A, Zattara H, Caron O, Lasset C, Remenieras A, Boutry-Kryza N, Castéra L, Stoppa-Lyonnet D. Classification of 101 BRCA1 and BRCA2 variants of uncertain significance by cosegregation study: A powerful approach. Am J Hum Genet 2021; 108:1907-1923. [PMID: 34597585 DOI: 10.1016/j.ajhg.2021.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/01/2021] [Indexed: 12/18/2022] Open
Abstract
Up to 80% of BRCA1 and BRCA2 genetic variants remain of uncertain clinical significance (VUSs). Only variants classified as pathogenic or likely pathogenic can guide breast and ovarian cancer prevention measures and treatment by PARP inhibitors. We report the first results of the ongoing French national COVAR (cosegregation variant) study, the aim of which is to classify BRCA1/2 VUSs. The classification method was a multifactorial model combining different associations between VUSs and cancer, including cosegregation data. At this time, among the 653 variants selected, 101 (15%) distinct variants shared by 1,624 families were classified as pathogenic/likely pathogenic or benign/likely benign by the COVAR study. Sixty-six of the 101 (65%) variants classified by COVAR would have remained VUSs without cosegregation data. Of note, among the 34 variants classified as pathogenic by COVAR, 16 remained VUSs or likely pathogenic when following the ACMG/AMP variant classification guidelines. Although the initiation and organization of cosegregation analyses require a considerable effort, the growing number of available genetic tests results in an increasing number of families sharing a particular variant, and thereby increases the power of such analyses. Here we demonstrate that variant cosegregation analyses are a powerful tool for the classification of variants in the BRCA1/2 breast-ovarian cancer predisposition genes.
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13
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Ratovomanana T, Cohen R, Svrcek M, Renaud F, Cervera P, Siret A, Letourneur Q, Buhard O, Bourgoin P, Guillerm E, Dorard C, Nicolle R, Ayadi M, Touat M, Bielle F, Sanson M, Le Rouzic P, Buisine MP, Piessen G, Collura A, Fléjou JF, de Reyniès A, Coulet F, Ghiringhelli F, André T, Jonchère V, Duval A. Performance of Next-Generation Sequencing for the Detection of Microsatellite Instability in Colorectal Cancer With Deficient DNA Mismatch Repair. Gastroenterology 2021; 161:814-826.e7. [PMID: 33992635 DOI: 10.1053/j.gastro.2021.05.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Next-generation sequencing (NGS) was recently approved by the United States Food and Drug Administration to detect microsatellite instability (MSI) arising from defective mismatch repair (dMMR) in patients with metastatic colorectal cancer (mCRC) before treatment with immune checkpoint inhibitors (ICI). In this study, we aimed to evaluate and improve the performance of NGS to identify MSI in CRC, especially dMMR mCRC treated with ICI. METHODS CRC samples used in this post hoc study were reassessed centrally for MSI and dMMR status using the reference methods of pentaplex polymerase chain reaction and immunohistochemistry. Whole-exome sequencing (WES) was used to evaluate MSISensor, the Food and Drug Administration-approved and NGS-based method for assessment of MSI. This was performed in (1) a prospective, multicenter cohort of 102 patients with mCRC (C1; 25 dMMR/MSI, 24 treated with ICI) from clinical trials NCT02840604 and NCT033501260, (2) an independent retrospective, multicenter cohort of 113 patients (C2; 25 mCRC, 88 non-mCRC, all dMMR/MSI untreated with ICI), and (3) a publicly available series of 118 patients with CRC from The Cancer Genome Atlas (C3; 51 dMMR/MSI). A new NGS-based algorithm, namely MSICare, was developed. Its performance for assessment of MSI was compared with MSISensor in C1, C2, and C3 at the exome level or after downsampling sequencing data to the MSK-IMPACT gene panel. MSICare was validated in an additional retrospective, multicenter cohort (C4) of 152 patients with new CRC (137 dMMR/MSI) enriched in tumors deficient in MSH6 (n = 35) and PMS2 (n = 9) after targeted sequencing of samples with an optimized set of microsatellite markers (MSIDIAG). RESULTS At the exome level, MSISensor was highly specific but failed to diagnose MSI in 16% of MSI/dMMR mCRC from C1 (4 of 25; sensitivity, 84%; 95% confidence interval [CI], 63.9%-95.5%), 32% of mCRC (8 of 25; sensitivity, 68%; 95% CI, 46.5%-85.1%), and 9.1% of non-mCRC from C2 (8 of 88; sensitivity, 90.9%; 95% CI, 82.9%-96%), and 9.8% of CRC from C3 (5 of 51; sensitivity, 90.2%; 95% CI, 78.6%-96.7%). Misdiagnosis included 4 mCRCs treated with ICI, of which 3 showed an overall response rate without progression at this date. At the exome level, reevaluation of the MSI genomic signal using MSICare detected 100% of cases with true MSI status among C1 and C2. Further validation of MSICare was obtained in CRC tumors from C3, with 96.1% concordance for MSI status. Whereas misdiagnosis with MSISensor even increased when analyzing downsampled WES data from C1 and C2 with microsatellite markers restricted to the MSK-IMPACT gene panel (sensitivity, 72.5%; 95% CI, 64.2%-79.7%), particularly in the MSH6-deficient setting, MSICare sensitivity and specificity remained optimal (100%). Similar results were obtained with MSICare after targeted NGS of tumors from C4 with the optimized microsatellite panel MSIDIAG (sensitivity, 99.3%; 95% CI, 96%-100%; specificity, 100%). CONCLUSIONS In contrast to MSISensor, the new MSICare test we propose performs at least as efficiently as the reference method, MSI polymerase chain reaction, to detect MSI in CRC regardless of the defective MMR protein under both WES and targeted NGS conditions. We suggest MSICare may rapidly become a reference method for NGS-based testing of MSI in CRC, especially in mCRC, where accurate MSI status is required before the prescription of ICI.
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Affiliation(s)
- Toky Ratovomanana
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Romain Cohen
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Magali Svrcek
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Florence Renaud
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Université de Lille, CNRS, INSERM, CHU Lille, UMR9020-U1277 CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France
| | - Pascale Cervera
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Genetics Department, AP-HP, Hospital Pitié-Salpêtrière, Paris, France
| | - Aurélie Siret
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Quentin Letourneur
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Olivier Buhard
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Pierre Bourgoin
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Erell Guillerm
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Genetics Department, AP-HP, Hospital Pitié-Salpêtrière, Paris, France
| | - Coralie Dorard
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Remy Nicolle
- Programme "Cartes d'Identité des Tumeurs," Ligue Nationale Contre le Cancer, Paris, France
| | - Mira Ayadi
- Programme "Cartes d'Identité des Tumeurs," Ligue Nationale Contre le Cancer, Paris, France
| | - Mehdi Touat
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France
| | - Franck Bielle
- Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France; AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Département de Neuropathologie, Paris, France
| | - Marc Sanson
- Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France; AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Département de Neuropathologie, Paris, France
| | - Philippe Le Rouzic
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Genetics Department, AP-HP, Hospital Pitié-Salpêtrière, Paris, France
| | - Marie-Pierre Buisine
- Université de Lille, CNRS, INSERM, CHU Lille, UMR9020-U1277 CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France; Molecular Oncogenetics, Department of Biochemistry and Molecular Biology, Lille University Hospital, Lille, France
| | - Guillaume Piessen
- Université de Lille, CNRS, INSERM, CHU Lille, UMR9020-U1277 CANTHER-Cancer Heterogeneity Plasticity and Resistance to Therapies, Lille, France; Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, University Lille, Lille, France
| | - Ada Collura
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Jean-François Fléjou
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Department of Pathology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Aurélien de Reyniès
- Programme "Cartes d'Identité des Tumeurs," Ligue Nationale Contre le Cancer, Paris, France
| | - Florence Coulet
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Genetics Department, AP-HP, Hospital Pitié-Salpêtrière, Paris, France
| | - François Ghiringhelli
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France; INSERM, UMR866, Burgundy University, Dijon, France
| | - Thierry André
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Department of Medical Oncology, AP-HP, Hôpital Saint-Antoine, Paris, France
| | - Vincent Jonchère
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Genetics Department, AP-HP, Hospital Pitié-Salpêtrière, Paris, France
| | - Alex Duval
- Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Genetics Department, AP-HP, Hospital Pitié-Salpêtrière, Paris, France.
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14
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Berzero G, Di Stefano AL, Ronchi S, Bielle F, Villa C, Guillerm E, Capelle L, Mathon B, Laurenge A, Giry M, Schmitt Y, Marie Y, Idbaih A, Hoang-Xuan K, Delattre JY, Mokhtari K, Sanson M. IDH-wildtype lower-grade diffuse gliomas: the importance of histological grade and molecular assessment for prognostic stratification. Neuro Oncol 2021; 23:955-966. [PMID: 33173941 PMCID: PMC8168809 DOI: 10.1093/neuonc/noaa258] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Isocitrate dehydrogenase (IDH) wildtype (wt) grade II gliomas are a rare and heterogeneous entity. Survival and prognostic factors are poorly defined. METHODS We searched retrospectively all patients diagnosed with diffuse World Health Organization (WHO) grades II and III gliomas at our center (1989-2020). RESULTS Out of 517 grade II gliomas, 47 were "diffuse astrocytomas, IDHwt." Tumors frequently had fronto-temporo-insular location (28/47, 60%) and infiltrative behavior. We found telomerase reverse transcriptase (TERT) promoter mutations (23/45, 51%), whole chromosome 7 gains (10/37, 27%), whole chromosome 10 losses (10/41, 24%), and EGFR amplifications (4/43, 9%), but no TP53 mutations (0/22, 0%). Median overall survival (OS) was 59 months (vs 19 mo for IDHwt grade III gliomas) (P < 0.0001). Twenty-nine patients (29/43, 67%) met the definition of molecular glioblastoma according to cIMPACT-NOW update 3. Median OS in this subset was 42 months, which was shorter compared with patients with IDHwt grade II gliomas not meeting this definition (median OS: 57 mo), but substantially longer compared with IDHwt grade III gliomas meeting the definition for molecular glioblastoma (median OS: 17 mo, P < 0.0001). Most patients with IDHwt grade II gliomas met cIMPACT criteria because of isolated TERT promoter mutations (16/26, 62%), which were not predictive of poor outcome (median OS: 88 mo). Actionable targets, including 5 gene fusions involving FGFR3, were found in 7 patients (24%). CONCLUSIONS Our findings highlight the importance of histological grading and molecular profiling for the prognostic stratification of IDHwt gliomas and suggest some caution when assimilating IDHwt grade II gliomas to molecular glioblastomas, especially those with isolated TERT promoter mutation.
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Affiliation(s)
- Giulia Berzero
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, Department of Neurology 2 Mazarin, Paris, France
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
| | - Anna Luisa Di Stefano
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, Department of Neurology 2 Mazarin, Paris, France
- Department of Neurology, Foch Hospital, Suresnes, France
| | - Susanna Ronchi
- University Hospitals of Pitié Salpêtrière, Charles Foix, R Escourolle Laboratory, Paris, France
| | - Franck Bielle
- University Hospitals of Pitié Salpêtrière, Charles Foix, R Escourolle Laboratory, Paris, France
| | - Chiara Villa
- Department of Pathology, Foch Hospital, Suresnes, France
| | - Erell Guillerm
- University Hospitals of La Pitié Salpêtrière, Charles Foix, Functional Unit of Oncogenetics and Molecular Angiogenetics, Department of Genetics, Paris, France
| | - Laurent Capelle
- University Hospitals of La Pitié Salpêtrière, Charles Foix, Department of Neurology 2, Paris, France
| | - Bertrand Mathon
- University Hospitals of La Pitié Salpêtrière, Charles Foix, Department of Neurology 2, Paris, France
| | - Alice Laurenge
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, Department of Neurology 2 Mazarin, Paris, France
| | - Marine Giry
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
| | - Yohann Schmitt
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
| | - Yannick Marie
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- Onconeurotek Tumor Bank, University Hospitals of Pitié Salpêtrière, Charles Foix, Paris, France
| | - Ahmed Idbaih
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, Department of Neurology 2 Mazarin, Paris, France
| | - Khe Hoang-Xuan
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, Department of Neurology 2 Mazarin, Paris, France
| | - Jean-Yves Delattre
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, Department of Neurology 2 Mazarin, Paris, France
- Onconeurotek Tumor Bank, University Hospitals of Pitié Salpêtrière, Charles Foix, Paris, France
| | - Karima Mokhtari
- Sorbonne University, Brain and Spinal Cord Institute, Paris, France
- University Hospitals of Pitié Salpêtrière, Charles Foix, R Escourolle Laboratory, Paris, France
- Onconeurotek Tumor Bank, University Hospitals of Pitié Salpêtrière, Charles Foix, Paris, France
| | - Marc Sanson
- Corresponding Author: Marc Sanson, MD PhD, Service de Neurologie 2, GH Pitié-Salpêtrière, 47 bd de l’Hôpital, 75013 Paris, France ()
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15
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Callens C, Vaur D, Soubeyran I, Rouleau E, Just PA, Guillerm E, Golmard L, Goardon N, Sevenet N, Cabaret O, Harter P, Gonzalez-Martin A, Fujiwara K, Cecere SC, Colombo N, Marth C, Vergote I, Maenpaa J, Pujade-Lauraine E, Ray-Coquard I. Concordance Between Tumor and Germline BRCA Status in High-Grade Ovarian Carcinoma Patients in the Phase III PAOLA-1/ENGOT-ov25 Trial. J Natl Cancer Inst 2020; 113:917-923. [PMID: 33372675 DOI: 10.1093/jnci/djaa193] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/16/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND PAOLA1 is a phase III study assessing olaparib maintenance therapy in advanced high-grade ovarian carcinoma patients responding to first-line platinum-taxane-based chemotherapy plus bevacizumab as standard of care. Randomization was stratified by treatment outcome and tumor BRCA1/2 status (tBRCA) at screening. METHODS tBRCA was tested on formalin-fixed, paraffin-embedded tumor blocks on 5 French platforms using 2 next-generation sequencing methods based either on hybrid capture or amplicon technology. One of the exploratory objectives was to assess the concordance between germline (gBRCA) and tBRCA testing in French patients. gBRCA testing was performed on blood samples on the same platforms. RESULTS From May 2015 to July 2017, tBRCA tests were performed for 1176 screened patients. Only 52 (4.4%) tumor samples were noncontributive. The median interval between reception of the tumor sample and availability of the tBRCA status result was 37 days (range = 8-260). A pathogenic variant was reported in 27.1% tumor samples (319 of 1176 screened patients). tBRCA and gBRCA testing were performed for 451 French patients with negative results for both tests in 306 patients (67.8%) and positive results for both tests in 85 patients (18.8%). Only 1 large genomic rearrangement of BRCA1 was detected, exclusively in the blood sample. Interestingly, tBRCA testing revealed 6.4% of pathogenic variant (29 of 451) not detected by gBRCA testing. CONCLUSIONS tBRCA testing is an appropriate tool with an acceptable turnaround time for clinical practice and a low failure rate, ensuring reliable identification of patients likely to benefit from poly(ADP-ribose) polymerase inhibitor therapy.
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Affiliation(s)
- Céline Callens
- Genetics Department, Institut Curie and Paris Sciences Lettres University, Paris, France
| | - Dominique Vaur
- Laboratoire de Biologie Clinique et Oncologique, Centre François Baclesse, Caen, France
| | | | - Etienne Rouleau
- Biopathology Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Pierre-Alexandre Just
- Department of Pathological Anatomy and Cytology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France, Genetics Department, Hôpital Universitaire Pitié-Salpétrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Erell Guillerm
- Department of Pathological Anatomy and Cytology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France, Genetics Department, Hôpital Universitaire Pitié-Salpétrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Lisa Golmard
- Genetics Department, Institut Curie and Paris Sciences Lettres University, Paris, France
| | - Nicolas Goardon
- Laboratoire de Biologie Clinique et Oncologique, Centre François Baclesse, Caen, France
| | - Nicolas Sevenet
- Biopathology Department, Institut Bergonié, Bordeaux, France
| | - Odile Cabaret
- Biopathology Department, Institut Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Philipp Harter
- Obstetric and Gynecologic Department, Kliniken Essen Mitte, Essen, AGO De, Germany
| | - Antonio Gonzalez-Martin
- Oncology Department, Clínica Universidad de Navarra, Madrid, formerly MD Anderson Cancer Center, Madrid, GEICO, Spain
| | - Keiichi Fujiwara
- Gynecologic Oncologic Department, Saitama Medical University, Saitama, GOTIC, Japan
| | - Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Mito Italy
| | - Nicoletta Colombo
- Gynecology Oncology Division, European Institute of Oncology, Milan, Mango Italy
| | - Christian Marth
- Obstetric and Gynecologic Department, Medical University of Innsbruck, AGO Au, Austria
| | - Ignace Vergote
- Gynecologic Oncologic Department, University Hospital Leuven, Department of Gynecologic oncology, Leuven Cancer Institute, Leuven, BGOG, Belgium
| | - Johanna Maenpaa
- Gynecologic Oncologic Department, Tampere University and University Hospital Cancer Centre, Tampere, NSGO, Finland
| | | | - Isabelle Ray-Coquard
- Medical Oncology Department, Centre Léon Bérard and University, Claude Bernard Lyon 1, Lyon, GINECO, France
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16
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Benusiglio PR, Korenbaum C, Vibert R, Ezenfis J, Geoffron S, Paul C, Richard S, Byrde V, Lejeune M, Guillerm E, Basset N, Lotz JP, Chabbert-Buffet N, Gligorov J, Coulet F. Utility of a mainstreamed genetic testing pathway in breast and ovarian cancer patients during the COVID-19 pandemic. Eur J Med Genet 2020; 63:104098. [PMID: 33186762 PMCID: PMC7654320 DOI: 10.1016/j.ejmg.2020.104098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Mainstreamed genetic testing (MGT) obviates the need for a cancer genetics consultation, since trained oncologists (O) and gynaecologists (G) provide counseling, prescribe testing and deliver results. We report results from our MGT program and emphasize its utility during the COVID-19 lockdown, when cancer genetics clinics had suspended their activity. METHODS An MGT pathway for breast and ovarian cancer (BC/OC) patients was established in Jan-2018 between the Assistance Publique - Hôpitaux de Paris.Sorbonne Université Cancer Genetics team and the Oncology/Gynecology departments at one teaching and two regional hospitals. Trained O + G evaluated patients with the Manchester Scoring System. A 12-point threshold was recommended for testing. Next-generation sequencing of BRCA1, BRCA2, PALB2, RAD51C and RAD51D was performed. Results were delivered to the patient by O/G. Pathogenic variants (PV) carriers were referred to the genetics clinic. Results are reported for the 2nd-Jan-2018 to 1st-June-2020 period. That includes the eight-week COVID-19 lockdown and three-week de-confinement phase 1. RESULTS Results were available for 231/234 patients. Twenty-eight (12.1%) carried a PV. Of the 27 patients tested during the COVID-19 period, three carried a PV, two in BRCA1 and one in RAD51C. The clinical impact was immediate for the two BRCA1 BC cases undergoing neo-adjuvant chemotherapy, since double mastectomy and salpingo-oophorectomy will now be performed using two-step strategies. CONCLUSIONS MGT guaranteed care continuity in BC/OC patients during the critical phases of the COVID-19 pandemic, with immediate implications for PV carriers. More broadly, we report for the first time the successful implementation of MGT in France.
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Affiliation(s)
- Patrick R Benusiglio
- UF d'Oncogénétique, Département de Génétique et Institut Universitaire de Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP.Sorbonne Université, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France; Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, 184 rue du Faubourg Saint-Antoine, F-75012 Paris, France; Réseau Sein à Risque AP-HP, Service de Gynécologie Obstétrique et de Médecine de la Reproduction, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France.
| | - Clément Korenbaum
- Service d'Oncologie Médicale, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France
| | - Roseline Vibert
- UF d'Oncogénétique, Département de Génétique et Institut Universitaire de Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP.Sorbonne Université, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France
| | - Joël Ezenfis
- Service d'Oncologie Médicale, Centre Hospitalier Sud Francilien, avenue Serge Dassault, F-91106 Corbeil-Essonnes, France
| | - Sophie Geoffron
- Service de Gynécologie-Obstétrique, Groupe Hospitalier de l'Est Francilien, Site Marne-la-Vallée, 2-4 Cours de la Gondoire, F-77600 Jossigny, France
| | - Charlotte Paul
- Service de Gynécologie-Obstétrique, Groupe Hospitalier de l'Est Francilien, Site Marne-la-Vallée, 2-4 Cours de la Gondoire, F-77600 Jossigny, France
| | - Sandrine Richard
- Service d'Oncologie Médicale, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France
| | - Veronique Byrde
- Réseau Sein à Risque AP-HP, Service de Gynécologie Obstétrique et de Médecine de la Reproduction, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France
| | - Manon Lejeune
- UF d'Oncogénétique, Département de Génétique et Institut Universitaire de Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP.Sorbonne Université, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France
| | - Erell Guillerm
- UF d'Oncogénétique, Département de Génétique et Institut Universitaire de Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP.Sorbonne Université, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France
| | - Noemie Basset
- UF d'Oncogénétique, Département de Génétique et Institut Universitaire de Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP.Sorbonne Université, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France
| | - Jean-Pierre Lotz
- Service d'Oncologie Médicale, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France
| | - Nathalie Chabbert-Buffet
- Réseau Sein à Risque AP-HP, Service de Gynécologie Obstétrique et de Médecine de la Reproduction, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France
| | - Joseph Gligorov
- Service d'Oncologie Médicale, Institut Universitaire de Cancérologie, Hôpital Tenon, AP-HP.Sorbonne Université, 4 rue de la Chine, F-75020 Paris, France
| | - Florence Coulet
- UF d'Oncogénétique, Département de Génétique et Institut Universitaire de Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP.Sorbonne Université, 47-83 Boulevard de l'Hôpital, F-75013 Paris, France; Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 et SIRIC CURAMUS, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, 184 rue du Faubourg Saint-Antoine, F-75012 Paris, France
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17
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Touat M, Li YY, Boynton AN, Spurr LF, Iorgulescu B, Bohrson CL, Cortes-Ciriano I, Geduldig JE, Pelton K, Lim-Fat MJ, Pal S, Ramkissoon SH, Dubois F, Bellamy C, Currimjee N, Qian K, Malinowski S, Shetty A, Chow KH, Verreault M, Guillerm E, Ammari S, Beuvon F, Mokhtari K, Alentorn A, Dehais C, Houillier C, Laigle-Donadey F, Psimaras D, Carpentier A, Cornu P, Capelle L, Mathon B, Barnholtz-Sloan JS, Chakravarti A, Bi WL, Frampton GM, Sanson M, Alexander BM, Cherniack A, Wen PY, Reardon DA, Marabelle A, Park PJ, Idbaih A, Beroukhim R, Bandopadhayay P, Bielle F, Ligon KL. Abstract 5705: Mechanisms and therapeutic implications of hypermutation in gliomas. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-5705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
High tumor mutational burden (hypermutation) is observed in some gliomas; however, its mechanisms of development and whether it predicts immunotherapy response are poorly understood. Here, we comprehensively analyze the molecular determinants of mutational burden and signatures in 10,294 gliomas including AACR Project GENIE and institutional datasets. We delineate two main pathways to hypermutation: a de novo pathway associated with constitutional defects in DNA polymerase and mismatch repair (MMR) genes, and a more common post-treatment pathway associated with acquired resistance driven by MMR defects in chemotherapy-sensitive gliomas that recur after temozolomide treatment. Experimentally, the mutational signature of post-treatment hypermutated gliomas was only recapitulated by temozolomide-induced damage in cells harboring MMR deficiency. MMR-deficient gliomas exhibited unique features including the lack of prominent T-cell infiltrates, extensive intratumoral heterogeneity, poor survival and low response rate to PD-1 blockade. Moreover, while microsatellite instability in MMR-deficient gliomas was not detected by bulk analyses, single-cell whole-genome sequencing of post-treatment hypermutated glioma cells demonstrated microsatellite mutations. This study shows that chemotherapy can drive acquisition of hypermutated populations without promoting response to PD-1 blockade and supports diagnostic use of mutational burden and signatures in cancer.
Citation Format: Mehdi Touat, Yvonne Y. Li, Adam N. Boynton, Liam F. Spurr, Bryan Iorgulescu, Craig L. Bohrson, Isidro Cortes-Ciriano, Jack E. Geduldig, Kristine Pelton, Mary J. Lim-Fat, Sangita Pal, Shakti H. Ramkissoon, Frank Dubois, Charlotte Bellamy, Naomi Currimjee, Kenin Qian, Seth Malinowski, Aniket Shetty, Kin-Hoe Chow, Maïté Verreault, Erell Guillerm, Samy Ammari, Frédéric Beuvon, Karima Mokhtari, Agusti Alentorn, Caroline Dehais, Caroline Houillier, Florence Laigle-Donadey, Dimitri Psimaras, Alexandre Carpentier, Philippe Cornu, Laurent Capelle, Bertrand Mathon, Jill S. Barnholtz-Sloan, Arnab Chakravarti, Wenya L. Bi, Garrett M. Frampton, Marc Sanson, Brian M. Alexander, Andrew Cherniack, Patrick Y. Wen, David A. Reardon, Aurelien Marabelle, Peter J. Park, Ahmed Idbaih, Rameen Beroukhim, Pratiti Bandopadhayay, Franck Bielle, Keith L. Ligon. Mechanisms and therapeutic implications of hypermutation in gliomas [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 5705.
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Affiliation(s)
| | | | | | - Liam F. Spurr
- 2Broad Institute of MIT and Harvard, Cambridge, MA, MA
| | | | | | - Isidro Cortes-Ciriano
- 4European Molecular European Bioinformatics Institute, Wellcome Genome Campus, HInxton, United Kingdom
| | | | | | | | - Sangita Pal
- 5Broad Institute of MIT and Harvard, Cambridge, MA
| | | | - Frank Dubois
- 5Broad Institute of MIT and Harvard, Cambridge, MA
| | | | | | - Kenin Qian
- 1Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | - Erell Guillerm
- 8Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | - Alexandre Carpentier
- 11Sorbonne Université, Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | - Philippe Cornu
- 11Sorbonne Université, Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | - Laurent Capelle
- 11Sorbonne Université, Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | - Bertrand Mathon
- 11Sorbonne Université, Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | - Arnab Chakravarti
- 13Arthur G. James Hospital/Ohio State Comprehensive Cancer Center, Cleveland, OH
| | - Wenya L. Bi
- 14Brigham & Women's Hospital, Harvard Medical School, Boston, MA
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18
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Guillerm E, Svrcek M, Bardier-Dupas A, Basset N, Coulet F, Colas C. Molecular tumor testing in patients with Lynch-like syndrome reveals a de novo mosaic variant of a mismatch repair gene transmitted to offspring. Eur J Hum Genet 2020; 28:1624-1628. [PMID: 32678338 DOI: 10.1038/s41431-020-0689-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 02/19/2020] [Accepted: 06/18/2020] [Indexed: 11/09/2022] Open
Abstract
In Lynch-like syndrome, patients have tumors with microsatellite instability but no germline pathogenic variant in mismatch repair genes or somatic methylation of the MLH1 promoter. Identification of the mechanism that causes these tumors is crucial for guiding screening of the patients and their relatives. Double somatic hits are the usual explanation for these cases; however, we have previously reported a de novo mosaic pathogenic variant in a patient with Lynch-like syndrome. Using tumoral NGS analysis of a series of 16 patients with Lynch-like syndrome, we found six patients with double somatic hits, including one patient with mosaicism of a de novo pathogenic variant in MSH2. This variant was transmitted to the patient's offspring, which has significant implications for genetic counseling.
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Affiliation(s)
- Erell Guillerm
- Department of Genetics, Hôpital Universitaire Pitié Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris VI University, Paris, France. .,INSERM, UMRS 938-Centre de Recherche Saint-Antoine, Equipe 'Instabilité des Microsatellites et Cancers', Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France. .,France Université Pierre et Marie Curie, Paris, France.
| | - Magali Svrcek
- INSERM, UMRS 938-Centre de Recherche Saint-Antoine, Equipe 'Instabilité des Microsatellites et Cancers', Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.,France Université Pierre et Marie Curie, Paris, France.,Department of Pathology, Hôpital Saint Antoine (Assistance Publique-Hôpitaux de Paris), Paris VI University, Paris, France
| | - Armelle Bardier-Dupas
- Department of Pathology, Hôpital Universitaire Pitié Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris VI University, Paris, France
| | - Noémie Basset
- Department of Genetics, Hôpital Universitaire Pitié Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris VI University, Paris, France.,INSERM, UMRS 938-Centre de Recherche Saint-Antoine, Equipe 'Instabilité des Microsatellites et Cancers', Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.,France Université Pierre et Marie Curie, Paris, France
| | - Florence Coulet
- Department of Genetics, Hôpital Universitaire Pitié Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris VI University, Paris, France.,INSERM, UMRS 938-Centre de Recherche Saint-Antoine, Equipe 'Instabilité des Microsatellites et Cancers', Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.,France Université Pierre et Marie Curie, Paris, France
| | - Chrystelle Colas
- Department of Genetics, Hôpital Universitaire Pitié Salpêtrière (Assistance Publique-Hôpitaux de Paris), Paris VI University, Paris, France.,INSERM, UMRS 938-Centre de Recherche Saint-Antoine, Equipe 'Instabilité des Microsatellites et Cancers', Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.,France Université Pierre et Marie Curie, Paris, France.,Department of Genetics, Curie Institute, Paris, France
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19
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Touat M, Li YY, Boynton AN, Spurr LF, Iorgulescu JB, Bohrson CL, Cortes-Ciriano I, Birzu C, Geduldig JE, Pelton K, Lim-Fat MJ, Pal S, Ferrer-Luna R, Ramkissoon SH, Dubois F, Bellamy C, Currimjee N, Bonardi J, Qian K, Ho P, Malinowski S, Taquet L, Jones RE, Shetty A, Chow KH, Sharaf R, Pavlick D, Albacker LA, Younan N, Baldini C, Verreault M, Giry M, Guillerm E, Ammari S, Beuvon F, Mokhtari K, Alentorn A, Dehais C, Houillier C, Laigle-Donadey F, Psimaras D, Lee EQ, Nayak L, McFaline-Figueroa JR, Carpentier A, Cornu P, Capelle L, Mathon B, Barnholtz-Sloan JS, Chakravarti A, Bi WL, Chiocca EA, Fehnel KP, Alexandrescu S, Chi SN, Haas-Kogan D, Batchelor TT, Frampton GM, Alexander BM, Huang RY, Ligon AH, Coulet F, Delattre JY, Hoang-Xuan K, Meredith DM, Santagata S, Duval A, Sanson M, Cherniack AD, Wen PY, Reardon DA, Marabelle A, Park PJ, Idbaih A, Beroukhim R, Bandopadhayay P, Bielle F, Ligon KL. Mechanisms and therapeutic implications of hypermutation in gliomas. Nature 2020; 580:517-523. [PMID: 32322066 PMCID: PMC8235024 DOI: 10.1038/s41586-020-2209-9] [Citation(s) in RCA: 328] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
A high tumour mutational burden (hypermutation) is observed in some gliomas1-5; however, the mechanisms by which hypermutation develops and whether it predicts the response to immunotherapy are poorly understood. Here we comprehensively analyse the molecular determinants of mutational burden and signatures in 10,294 gliomas. We delineate two main pathways to hypermutation: a de novo pathway associated with constitutional defects in DNA polymerase and mismatch repair (MMR) genes, and a more common post-treatment pathway, associated with acquired resistance driven by MMR defects in chemotherapy-sensitive gliomas that recur after treatment with the chemotherapy drug temozolomide. Experimentally, the mutational signature of post-treatment hypermutated gliomas was recapitulated by temozolomide-induced damage in cells with MMR deficiency. MMR-deficient gliomas were characterized by a lack of prominent T cell infiltrates, extensive intratumoral heterogeneity, poor patient survival and a low rate of response to PD-1 blockade. Moreover, although bulk analyses did not detect microsatellite instability in MMR-deficient gliomas, single-cell whole-genome sequencing analysis of post-treatment hypermutated glioma cells identified microsatellite mutations. These results show that chemotherapy can drive the acquisition of hypermutated populations without promoting a response to PD-1 blockade and supports the diagnostic use of mutational burden and signatures in cancer.
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Affiliation(s)
- Mehdi Touat
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France.
| | - Yvonne Y Li
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Adam N Boynton
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Liam F Spurr
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - J Bryan Iorgulescu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women's Hospital, Boston, Harvard Medical School, MA, USA
| | - Craig L Bohrson
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
- Bioinformatics and Integrative Genomics PhD Program, Harvard Medical School, Boston, MA, USA
| | - Isidro Cortes-Ciriano
- European Molecular Biology Laboratory, European Bioinformatics Institute, Wellcome Genome Campus, Hinxton, UK
| | - Cristina Birzu
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Jack E Geduldig
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Kristine Pelton
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Mary Jane Lim-Fat
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sangita Pal
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Ruben Ferrer-Luna
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Foundation Medicine Inc., Cambridge, MA, USA
| | - Shakti H Ramkissoon
- Foundation Medicine Inc., Cambridge, MA, USA
- Wake Forest Comprehensive Cancer Center and Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Frank Dubois
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Charlotte Bellamy
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Naomi Currimjee
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Juliana Bonardi
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Kenin Qian
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Patricia Ho
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
| | - Seth Malinowski
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Leon Taquet
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Robert E Jones
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Aniket Shetty
- Center for Patient Derived Models, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Kin-Hoe Chow
- Center for Patient Derived Models, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | - Nadia Younan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Capucine Baldini
- Drug Development Department (DITEP), INSERM U1015, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | - Maïté Verreault
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Marine Giry
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Erell Guillerm
- Unité fonctionnelle d'Oncogénétique et Angiogénétique Moléculaire, Département de génétique, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France
| | - Samy Ammari
- Department of Diagnostic Radiology, Gustave Roussy, Villejuif, France
- IR4M (UMR8081), Université Paris-Sud, Centre National de la Recherche Scientifique, Orsay, France
| | - Frédéric Beuvon
- AP-HP, Université Paris Descartes, Hôpital Cochin, Service d'Anatomie et Cytologie Pathologiques, Paris, France
| | - Karima Mokhtari
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie Laboratoire Escourolle, Paris, France
| | - Agusti Alentorn
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Caroline Dehais
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Caroline Houillier
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Florence Laigle-Donadey
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Dimitri Psimaras
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Eudocia Q Lee
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lakshmi Nayak
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J Ricardo McFaline-Figueroa
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexandre Carpentier
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, Paris, France
| | - Philippe Cornu
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, Paris, France
| | - Laurent Capelle
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, Paris, France
| | - Bertrand Mathon
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurochirurgie, Paris, France
| | - Jill S Barnholtz-Sloan
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Arnab Chakravarti
- Department of Radiation Oncology, Arthur G. James Hospital/Ohio State Comprehensive Cancer Center, Columbus, OH, USA
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - E Antonio Chiocca
- Department of Neurosurgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Katie Pricola Fehnel
- Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sanda Alexandrescu
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Susan N Chi
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Daphne Haas-Kogan
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tracy T Batchelor
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Brian M Alexander
- Foundation Medicine Inc., Cambridge, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Raymond Y Huang
- Department of Radiology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Azra H Ligon
- Department of Pathology, Brigham & Women's Hospital, Boston, Harvard Medical School, MA, USA
| | - Florence Coulet
- Unité fonctionnelle d'Oncogénétique et Angiogénétique Moléculaire, Département de génétique, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Paris, France
| | - Jean-Yves Delattre
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
- Onconeurotek Tumor Bank, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Khê Hoang-Xuan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - David M Meredith
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women's Hospital, Boston, Harvard Medical School, MA, USA
| | - Sandro Santagata
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Pathology, Brigham & Women's Hospital, Boston, Harvard Medical School, MA, USA
- Ludwig Center at Harvard Medical School, Harvard Medical School, Boston, MA, USA
- Laboratory of Systems Pharmacology, Harvard Medical School, Boston, MA, USA
| | - Alex Duval
- Sorbonne Université, Inserm, UMR 938, Centre de Recherche Saint Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Marc Sanson
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
- Onconeurotek Tumor Bank, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Andrew D Cherniack
- Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Patrick Y Wen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David A Reardon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Aurélien Marabelle
- Drug Development Department (DITEP), INSERM U1015, Université Paris Saclay, Gustave Roussy, Villejuif, France
| | - Peter J Park
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Ahmed Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
| | - Rameen Beroukhim
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Pratiti Bandopadhayay
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Franck Bielle
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neuropathologie Laboratoire Escourolle, Paris, France.
| | - Keith L Ligon
- Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
- Broad Institute of Harvard and MIT, Cambridge, MA, USA.
- Department of Pathology, Brigham & Women's Hospital, Boston, Harvard Medical School, MA, USA.
- Center for Patient Derived Models, Dana-Farber Cancer Institute, Boston, MA, USA.
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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20
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Touat M, Li Y, Boynton A, Spurr L, Iorgulescu B, Birzu C, Pal S, Ferrer-Luna R, Geduldig J, Bellamy C, Younan N, Baldini C, Verreault M, Guillerm E, Ammari S, Beuvon F, Mokhtari K, Alentorn A, Dehais C, Houiller C, Laigle-Donadey F, Lee E, Nayak L, Carpentier A, Cornu P, mathon B, Bi W, Chiocca E, Alexandrescu S, Chi S, Haas-Kogan D, Alexander B, Huang R, Ligon A, Coulet F, Delattre JY, Hoang-Xuan K, Meredith D, Santagata S, Duval A, Sanson M, Cherniack A, Wen P, Reardon D, Marabelle A, Idbaih A, Beroukhim R, Bandopadhayay P, Bielle F, Ligon K. DRES-08. CLINICAL SIGNIFICANCE OF HYPERMUTATION IN GLIOMAS. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz175.296] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Hypermutation is an emerging biomarker for predicting response to immunotherapy in cancer patients, however its clinical value in gliomas is not established. We sought to assess the determinants of hypermutation in gliomas, and its value for predicting response to standard of care and immune checkpoint blockade (ICB).
METHODS
We performed comprehensive genomic characterization of 2,420 clinically annotated gliomas. We assessed the clinical and molecular characteristics associated with hypermutation and relationships between hypermutation and response to cancer treatments.
RESULTS
Hypermutation occurred predominantly as an adaptive resistance mechanism to temozolomide in gliomas and was most prevalent in recurrent gliomas with MGMTpromoter methylation (33.8%), IDH1/2mutation (41.0%) or 1p/19q co-deletion (59.5%). Hypermutation was almost always associated with molecular defects in DNA mismatch repair (MMR), and was associated with shorter survival after its appearance based on multivariate analysis (hazard ratio 1.91; 95% CI 1.24–2.94; P=0.004). The molecular mechanisms whereby gliomas undergo hypermutation during therapy with alkylating agents were dissected using patient-derived glioma models in vitro and in vivo. Outcomes of hypermutated gliomas treated with immune checkpoint blockade or with standard of care agents will be presented at the conference.
CONCLUSIONS
Using the largest set of hypermutated gliomas described to date, this study establishes that mutational burden and mutation signatures are clinically and biologically significant biomarkers that can be used to predict therapy response and guide treatment decisions in gliomas
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Affiliation(s)
- Mehdi Touat
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Yvonne Li
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Liam Spurr
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | - Sangita Pal
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | - Nadia Younan
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | | | - Erell Guillerm
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | - Eudocia Lee
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Alexandre Carpentier
- Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires La Pitié-Salpêtrière, Service de Neurochirurgie, Paris, France
| | - Philippe Cornu
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | - Wenya Bi
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Ennio Chiocca
- Department of Neurosurgery, Brigham and Women’s Hospital
- Harvard Medical School, Boston, MA, USA
| | | | - Susan Chi
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | | | - Azra Ligon
- Brigham and Women’s Hospital, Boston, MA, USA
| | | | | | - Khe Hoang-Xuan
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | | | - Alex Duval
- Sorbonne Universités, Inserm, Paris, France
| | - Marc Sanson
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | - Patrick Wen
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | | | - Ahmed Idbaih
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | | | | | - Franck Bielle
- Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France
| | - Keith Ligon
- Dana-Farber Cancer Institute, Boston, MA, USA
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21
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Bouvet D, Bodo S, Munier A, Guillerm E, Bertrand R, Colas C, Duval A, Coulet F, Muleris M. Methylation Tolerance-Based Functional Assay to Assess Variants of Unknown Significance in the MLH1 and MSH2 Genes and Identify Patients With Lynch Syndrome. Gastroenterology 2019; 157:421-431. [PMID: 30998989 DOI: 10.1053/j.gastro.2019.03.071] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/07/2019] [Accepted: 03/29/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Approximately 75% of patients with suspected Lynch syndrome carry variants in MLH1 or MSH2, proteins encoded by these genes are required for DNA mismatch repair (MMR). However, 30% of these are variants of unknown significance (VUS). A assay that measures cell response to the cytotoxic effects of a methylating agent can determine the effects of VUS in MMR genes and identify patients with constitutional MMR-deficiency syndrome. We adapted this method to test the effects of VUS in MLH1 and MSH2 genes found in patients with suspected Lynch syndrome. METHODS We transiently expressed MLH1 or MSH2 variants in MLH1- or MSH2-null human colorectal cancer cell lines (HCT116 or LoVo), respectively. The MMR process causes death of cells with methylation-damaged DNA bases, so we measured proportions of cells that undergo death following exposure to the methylating agent; cells that escaped its toxicity were considered to have variants that affect function of the gene product. Using this assay, we analyzed 88 variants (mainly missense variants), comprising a validation set of 40 previously classified variants (19 in MLH1 and 21 in MSH2) and a prospective set of 48 VUS (25 in MLH1 and 23 in MSH2). Prediction scores were calculated for all VUS according to the recommendations of the American College of Medical Genetics and Genomics, based on clinical, somatic, in silico, population, and functional data. RESULTS The assay correctly classified 39 of 40 variants in the validation set. The assay identified 12 VUS that did alter function of the gene product and 28 VUS that did not; the remaining 8 VUS had intermediate effects on MMR capacity and could not be classified. Comparison of assay results with prediction scores confirmed the ability of the assay to discriminate VUS that affected the function of the gene products from those that did not. CONCLUSIONS Using an assay that measures the ability of the cells to undergo death following DNA damage induction by a methylating agent, we were able to assess whether variants in MLH1 and MSH2 cause defects in DNA MMR. This assay might be used to help assessing the pathogenicity of VUS in MLH1 and MSH2 found in patients with suspected Lynch syndrome.
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Affiliation(s)
- Delphine Bouvet
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Sahra Bodo
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Annie Munier
- Sorbonne Université, Inserm, Centre de recherche Saint-Antoine, UMS30-LUMIC, Plateforme de Cytométrie en Flux CISA, site Saint-Antoine, Paris, France
| | - Erell Guillerm
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Genetics Department, AP-HP, Hôpital Universitaire Pitié-Salpétrière, Paris, France
| | - Romane Bertrand
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France
| | - Chrystelle Colas
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Institut Curie, Paris Sciences Lettres Research University, Department of Genetics, Paris, France
| | - Alex Duval
- Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Biochimie, biologie moléculaire, Paris, France
| | - Florence Coulet
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France; Genetics Department, AP-HP, Hôpital Universitaire Pitié-Salpétrière, Paris, France
| | - Martine Muleris
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, CRSA, Paris, France; Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France.
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22
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Touat M, Santagata S, Guillerm E, Bi W, Beuvon F, Mokhtari K, Giry M, Guegan J, Block S, Carpentier A, Delattre JY, Sanson M, Duval A, Beroukhim R, Bandopadhayay P, Reardon D, Wen P, Idbaih A, Coulet F, Ligon K, Bielle F. PATH-16. MOLECULAR PATHOLOGY AND CLINICAL CHARACTERISTICS OF MMR DEFICIENCY (MMRd) IN DIFFUSE GLIOMAS. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy148.672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mehdi Touat
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Sandro Santagata
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Erell Guillerm
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Wenya Bi
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Karima Mokhtari
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Marine Giry
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Justine Guegan
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Shannon Block
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | - Jean-Yves Delattre
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Marc Sanson
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Alex Duval
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, Paris, France
| | - Rameen Beroukhim
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | | | - Patrick Wen
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Ahmed Idbaih
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, France
| | - Florence Coulet
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Keith Ligon
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Franck Bielle
- AP-HP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
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23
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Denis JA, Guillerm E, Coulet F, Larsen AK, Lacorte JM. The Role of BEAMing and Digital PCR for Multiplexed Analysis in Molecular Oncology in the Era of Next-Generation Sequencing. Mol Diagn Ther 2018; 21:587-600. [PMID: 28667577 DOI: 10.1007/s40291-017-0287-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BEAMing polymerase chain reaction (PCR) and digital PCR (dPCR) are used for robust and accurate quantification of nucleic acids. These methods are particularly well suited for the identification of very small fractions (<1%) of variant copies such as the presence of mutant genes in a predominantly wild-type background. BEAMing and dPCR are increasingly used in diverse fields including bacteriology, virology, non-invasive prenatal testing, and oncology, in particular for the molecular analysis of liquid biopsies. In this review, we present the principles of BEAMing and dPCR as well as the trends of future technical development, focusing on the possibility of developing multiplexed mutation analysis. Finally, we will discuss why such techniques will remain useful despite the ever-decreasing costs and increased automatization of next-generation sequencing (NGS), using molecular characterization of cancer cells as an example.
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Affiliation(s)
- Jérôme Alexandre Denis
- UPMC Univ Paris 06, Sorbonne Universités, Paris, France. .,Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM, UMRS 938, 75571, Paris Cedex 12, France. .,Department of Endocrine and Oncological Biochemistry, AP-HP, University Hospitals of Pitié-Salpétrière - Charles Foix, 75651, Paris, France.
| | - Erell Guillerm
- UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,INSERM, UMRS 938 Centre de Recherche Saint-Antoine, "Instability of Microsatellites and Cancers", Team approved by the National League Against Cancer, 75571, Paris Cedex 12, France.,Departement of Genetics, Unit of Molecular Oncogenetics and Angiogenetics, AP-HP, University Hospitals of Pitié-Salpétrière - Charles Foix, 75651, Paris Cedex, France
| | - Florence Coulet
- UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,INSERM, UMRS 938 Centre de Recherche Saint-Antoine, "Instability of Microsatellites and Cancers", Team approved by the National League Against Cancer, 75571, Paris Cedex 12, France.,Departement of Genetics, Unit of Molecular Oncogenetics and Angiogenetics, AP-HP, University Hospitals of Pitié-Salpétrière - Charles Foix, 75651, Paris Cedex, France
| | - Annette K Larsen
- UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM, UMRS 938, 75571, Paris Cedex 12, France
| | - Jean-Marc Lacorte
- UPMC Univ Paris 06, Sorbonne Universités, Paris, France.,INSERM, UMR_S 1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, 75013, Paris, France.,Department of Endocrine and Oncological Biochemistry, AP-HP, University Hospitals of Pitié-Salpétrière - Charles Foix, 75651, Paris, France
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24
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Jonchere V, Marisa L, Greene M, Virouleau A, Buhard O, Bertrand R, Svrcek M, Cervera P, Goloudina A, Guillerm E, Coulet F, Landman S, Ratovomanana T, Job S, Ayadi M, Elarouci N, Armenoult L, Merabtene F, Dumont S, Parc Y, Lefèvre JH, André T, Fléjou JF, Guilloux A, Collura A, de Reyniès A, Duval A. Identification of Positively and Negatively Selected Driver Gene Mutations Associated With Colorectal Cancer With Microsatellite Instability. Cell Mol Gastroenterol Hepatol 2018; 6:277-300. [PMID: 30116770 PMCID: PMC6089198 DOI: 10.1016/j.jcmgh.2018.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 06/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Recent studies have shown that cancers arise as a result of the positive selection of driver somatic events in tumor DNA, with negative selection playing only a minor role, if any. However, these investigations were concerned with alterations at nonrepetitive sequences and did not take into account mutations in repetitive sequences that have very high pathophysiological relevance in the tumors showing microsatellite instability (MSI) resulting from mismatch repair deficiency investigated in the present study. METHODS We performed whole-exome sequencing of 47 MSI colorectal cancers (CRCs) and confirmed results in an independent cohort of 53 MSI CRCs. We used a probabilistic model of mutational events within microsatellites, while adapting pre-existing models to analyze nonrepetitive DNA sequences. Negatively selected coding alterations in MSI CRCs were investigated for their functional and clinical impact in CRC cell lines and in a third cohort of 164 MSI CRC patients. RESULTS Both positive and negative selection of somatic mutations in DNA repeats was observed, leading us to identify the expected true driver genes associated with the MSI-driven tumorigenic process. Several coding negatively selected MSI-related mutational events (n = 5) were shown to have deleterious effects on tumor cells. In the tumors in which deleterious MSI mutations were observed despite the negative selection, they were associated with worse survival in MSI CRC patients (hazard ratio, 3; 95% CI, 1.1-7.9; P = .03), suggesting their anticancer impact should be offset by other as yet unknown oncogenic processes that contribute to a poor prognosis. CONCLUSIONS The present results identify the positive and negative driver somatic mutations acting in MSI-driven tumorigenesis, suggesting that genomic instability in MSI CRC plays a dual role in achieving tumor cell transformation. Exome sequencing data have been deposited in the European genome-phenome archive (accession: EGAS00001002477).
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Key Words
- CRC, colorectal cancer
- Colorectal Cancer
- Driver Gene Mutations
- HR, hazard ratio
- MLH1, MutL Homolog 1
- MMR, mismatch repair
- MSH, MutS Homolog
- MSI, microsatellite instability
- Microsatellite Instability
- NR, nonrepetitive
- PBS, phosphate-buffered saline
- PCR, polymerase chain reaction
- Positive and Negative Selection
- R, repetitive
- RFS, relapse-free survival
- RTCA, Real-Time Cell Analyzer
- Tumorigenic Process
- UTR, untranslated region
- WES, whole-exome sequencing
- WGA, whole-genome amplification
- bp, base pair
- indel, insertion/deletion
- mRNA, messenger RNA
- shRNA, short hairpin RNA
- siRNA, small interfering RNA
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Affiliation(s)
- Vincent Jonchere
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Laetitia Marisa
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Malorie Greene
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France
| | - Alain Virouleau
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Laboratoire de Mathématiques et Modélisation d’Évry, University Évry, Évry, France,Centre National de la Recherche Scientifique, Université Paris-Saclay, Evry, France
| | - Olivier Buhard
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France
| | - Romane Bertrand
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France
| | - Magali Svrcek
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Service d’Anatomie et Cytologie Pathologiques, Assistance publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Pascale Cervera
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Service d’Anatomie et Cytologie Pathologiques, Assistance publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Anastasia Goloudina
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Inovarion, Collaborative research Department Paris, France
| | - Erell Guillerm
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Genetics Department, Assistance publique - Hôpitaux de Paris, Pitié Salpêtrière Hôpital, Paris, France
| | - Florence Coulet
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Genetics Department, Assistance publique - Hôpitaux de Paris, Pitié Salpêtrière Hôpital, Paris, France
| | - Samuel Landman
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France
| | - Toky Ratovomanana
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France
| | - Sylvie Job
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Mira Ayadi
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Nabila Elarouci
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Lucile Armenoult
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Fatiha Merabtene
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,University Pierre and Marie CURIE Paris 06, Unité Mixte de Service 30 L'Unité Mixte de service Imagerie Cytométrie, Plateforme d’Histomorphologie, Sorbonne Université Paris, France
| | - Sylvie Dumont
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,University Pierre and Marie CURIE Paris 06, Unité Mixte de Service 30 L'Unité Mixte de service Imagerie Cytométrie, Plateforme d’Histomorphologie, Sorbonne Université Paris, France
| | - Yann Parc
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Service de Chirurgie Générale et Digestive, Assistance publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Jérémie H. Lefèvre
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Service de Chirurgie Générale et Digestive, Assistance publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Thierry André
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Department of Oncology, Assistance publique - Hôpitaux de Paris, Hôpital Saint Antoine, Paris, France
| | - Jean-François Fléjou
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Service d’Anatomie et Cytologie Pathologiques, Assistance publique - Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Agathe Guilloux
- Laboratoire de Mathématiques et Modélisation d’Évry, University Évry, Évry, France,Centre National de la Recherche Scientifique, Université Paris-Saclay, Evry, France
| | - Ada Collura
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France
| | - Aurélien de Reyniès
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - Alex Duval
- Sorbonne Université, University Pierre and Marie CURIE Paris 06, INSERM, Unité Mixte de Recherche938, Equipe Instabilité des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France,Correspondence Address correspondence to: Alex Duval, MD, PhD, Sorbonne Universite, UPMC Univ Paris 06, Inserm, UMR938, Equipe Instabilite Des Microsatellites et Cancer, Centre de Recherche Saint Antoine, Paris, France. fax: (33) 149284603.
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25
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Denis JA, Patroni A, Guillerm E, Pépin D, Benali-Furet N, Wechsler J, Manceau G, Bernard M, Coulet F, Larsen AK, Karoui M, Lacorte JM. Droplet digital PCR of circulating tumor cells from colorectal cancer patients can predict KRAS mutations before surgery. Mol Oncol 2016; 10:1221-31. [PMID: 27311775 PMCID: PMC5423194 DOI: 10.1016/j.molonc.2016.05.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [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: 03/04/2016] [Revised: 05/13/2016] [Accepted: 05/29/2016] [Indexed: 01/24/2023] Open
Abstract
In colorectal cancer (CRC), KRAS mutations are a strong negative predictor for treatment with the EGFR-targeted antibodies cetuximab and panitumumab. Since it can be difficult to obtain appropriate tumor tissues for KRAS genotyping, alternative methods are required. Circulating tumor cells (CTCs) are believed to be representative of the tumor in real time. In this study we explored the capacity of a size-based device for capturing CTCs coupled with a multiplex KRAS screening assay using droplet digital PCR (ddPCR). We showed that it is possible to detect a mutant ratio of 0.05% and less than one KRAS mutant cell per mL total blood with ddPCR compared to about 0.5% and 50-75 cells for TaqMeltPCR and HRM. Next, CTCs were isolated from the blood of 35 patients with CRC at various stage of the disease. KRAS genotyping was successful for 86% (30/35) of samples with a KRAS codon 12/13 mutant ratio of 57% (17/30). In contrast, only one patient was identified as KRAS mutant when size-based isolation was combined with HRM or TaqMeltPCR. KRAS status was then determined for the 26 available formalin-fixed paraffin-embedded tumors using standard procedures. The concordance between the CTCs and the corresponding tumor tissues was 77% with a sensitivity of 83%. Taken together, the data presented here suggest that is feasible to detect KRAS mutations in CTCs from blood samples of CRC patients which are predictive for those found in the tumor. The minimal invasive nature of this procedure in combination with the high sensitivity of ddPCR might provide in the future an opportunity to monitor patients throughout the course of disease on multiple levels including early detection, prognosis, treatment and relapse as well as to obtain mechanistic insight with respect to tumor invasion and metastasis.
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Affiliation(s)
- Jérôme Alexandre Denis
- Sorbonne Universités, UPMC Univ. Paris 06, F-75005, Paris, France; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Oncology and Endocrine Biochemistry, Paris, France; Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Institut National de la Santé et de la Recherche Médicale (INSERM) U938, Institut Universitaire de Cancérologie (IUC), Université Pierre et Marie Curie (UPMC), Sorbonne Universities, Paris, France.
| | - Alexia Patroni
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Paris, France
| | - Erell Guillerm
- Sorbonne Universités, UPMC Univ. Paris 06, F-75005, Paris, France; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Oncogenetics and Molecular Angiogenetics, Paris, France
| | - Dominique Pépin
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Oncology and Endocrine Biochemistry, Paris, France
| | | | | | - Gilles Manceau
- Sorbonne Universités, UPMC Univ. Paris 06, F-75005, Paris, France; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Paris, France
| | - Maguy Bernard
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Oncology and Endocrine Biochemistry, Paris, France
| | - Florence Coulet
- Sorbonne Universités, UPMC Univ. Paris 06, F-75005, Paris, France; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Oncogenetics and Molecular Angiogenetics, Paris, France
| | - Annette K Larsen
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, Institut National de la Santé et de la Recherche Médicale (INSERM) U938, Institut Universitaire de Cancérologie (IUC), Université Pierre et Marie Curie (UPMC), Sorbonne Universities, Paris, France
| | - Mehdi Karoui
- Sorbonne Universités, UPMC Univ. Paris 06, F-75005, Paris, France; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Digestive and Hepato-Pancreato-Biliary Surgery, Paris, France
| | - Jean-Marc Lacorte
- Sorbonne Universités, UPMC Univ. Paris 06, F-75005, Paris, France; Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Department of Oncology and Endocrine Biochemistry, Paris, France; INSERM, UMR_S 1166, Institute of Cardiometabolism and Nutrition, ICAN, Paris, France
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26
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Buhard O, Lagrange A, Guilloux A, Colas C, Chouchène M, Wanherdrick K, Coulet F, Guillerm E, Dorard C, Marisa L, Bokhari A, Greene M, El-Murr N, Bodo S, Muleris M, Sourouille I, Svrcek M, Cervera P, Blanché H, Lefevre JH, Parc Y, Lepage C, Chapusot C, Bouvier AM, Gaub MP, Selves J, Garrett K, Iacopetta B, Soong R, Hamelin R, Garrido C, Lascols O, André T, Fléjou JF, Collura A, Duval A. HSP110T17 simplifies and improves the microsatellite instability testing in patients with colorectal cancer. J Med Genet 2016; 53:377-84. [DOI: 10.1136/jmedgenet-2015-103518] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 01/09/2016] [Indexed: 11/04/2022]
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27
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Charniot J, Khani-Bittar R, Albertini J, Giral P, Cherfils C, Cosson C, Guillerm E, Leprince P, Gandjbakhch I, Bonnefont-Rousselot D. Interpretation of lipoprotein-associated phospholipase A2 levels is influenced by cardiac disease, comorbidities, extension of atherosclerosis and treatments. Int J Cardiol 2013; 168:132-8. [DOI: 10.1016/j.ijcard.2012.09.054] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 06/26/2012] [Accepted: 09/14/2012] [Indexed: 10/27/2022]
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28
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Charniot JC, Khani-Bittar R, Albertini JP, Giral P, Cherfils C, Cosson C, Guillerm E, Isnard R, Leprince P, Gandjbakhch I, Bonnefont-Rousselot D. 167: Lipoprotein-associated phospholipase A2 prior to aortic valve surgery as independent predictor of associated coronary heart disease. Archives of Cardiovascular Diseases Supplements 2013. [DOI: 10.1016/s1878-6480(13)71097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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29
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Charniot JC, Bittar R, Albertini JP, Giral P, Cherfils C, Cosson C, Guillerm E, Leprince P, Gandjbakhch I, Bonnefont-Rousselot D. 202 Lipoprotein-associated phospholipase A2 levels are influenced by cardiac disease, comorbidities, extension of atherosclerosis and treatments. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70598-0] [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: 11/26/2022]
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30
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Charniot JC, Bittar R, Albertini JP, Giral P, Cherfils C, Cosson C, Guillerm E, Leprince P, Gandjbakhch I, Bonnefont-Rousselot D. 170 High levels of circulating lipoprotein-associated phospholipase A2, but not oxidized LDL, are associated with severe aortic stenosis; comparison with coronary artery disease. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70566-9] [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: 11/29/2022]
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31
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Charniot JC, Bittar R, Albertini JP, Cherfils C, Fesel-Fouqier V, Giral P, Daubord M, Cosson C, Guillerm E, Bonnefont-Rousselot D. 086 Lipoprotein-associated phospholipase a2 (Lp-PLA2) and markers of oxidative stress in patients with acute heart failure. Archives of Cardiovascular Diseases Supplements 2011. [DOI: 10.1016/s1878-6480(11)70088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Charniot JC, Bittar R, Albertini JP, Giral P, Cherfils C, Cosson C, Guillerm E, Daubord M, Bonnefont-Rousselot D. 108 Long term pronostic role of lipoprotein-associated phospholipase A2 levels in patients with acute heart failure without acute coronary syndrome. Archives of Cardiovascular Diseases Supplements 2011. [DOI: 10.1016/s1878-6480(11)70110-0] [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: 10/18/2022]
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Barthelemy O, Silvain J, Brieger D, Bellemain-Appaix A, Cayla G, Beygui F, Lancar R, Collet JP, Mercadier A, Montalescot G, Cha KS, Nam YH, Kim JH, Park SY, Park TH, Kim MH, Kim YD, Lee HC, Ahn MS, Hong TJ, Blanco R, Blanco F, Szarfer J, Garcia Escudero A, Gigena G, Gagliardi J, Rodriguez A, Sarmiento R, Affatatto S, Riccitelli M, Petris A, Datcu MD, Pop C, Radoi M, Arsenescu-Georgescu C, Petrescu I, Petrescu L, Serban L, Nechita E, Tatu-Chitoiu G, Tatu-Chitoiu G, Dorobantu M, Benedek I, Craiu E, Sinescu C, Ionescu DD, Radoi M, Pop C, Ginghina C, Minescu B, Izzo A, Mantovani P, Tomasi L, Dall'oglio L, Bonatti S, Rosiello R, Romano M, Agostini F, Zanini R, Zhao ZY, Wu YJ, Li JJ, Yany YJ, Qian HY, Tang YD, Timoteo AT, Toste A, Lousinha A, Ramos R, Oliveira JA, Ferreira ML, Ferreira RC, Cabades C, Diez Gil JL, Aguar P, Sanmiguel D, Lopez-March A, Marmol R, Guerra L, Girbes V, Ferrando J, Rincon De Arellano A, Timoteo AT, Ramos R, Toste A, Oliveira JA, Patricio L, Ferreira ML, Ferreira RC, Blondal M, Ainla T, Marandi T, Eha J, Timoteo AT, Oliveira MM, Silva MN, Cunha PS, Feliciano J, Silva S, Ferreira RC, Silva B, Oliveira R, Caires G, Drumond A, Araujo J, Suarez-Barrientos A, Vivas D, Castro-Ferreira F, Nunez-Gil I, Franco E, Kanovsky J, Garcia-Rubira JC, Fernandez-Ortiz A, Fuster V, Macaya C, Ibanez Cabeza B, Salinger S, Perisic Z, Milic D, Stanojlovic T, Apostolovic S, Kala P, Obradovic S, Djordjevic-Radojkovic D, Damjanovic M, Koracevic G, Kostic T, Khan MA, Vrapi F, Naeem K, Davar J, Hristova K, Parenica J, Hristova K, Pencheva G, Radeva R, Milanov S, Trambaiolo P, Poli M, De Luca M, Lukic V, Mustilli M, Corsi F, Poloczek M, Simonetti M, Ferraiuolo G, Fareed A, Oraby M, Nasr GM, Maklady F, Dupouy P, Sorensen JT, Terkelsen CJ, Lassen JF, Prymusova K, Trautner S, Christensen EF, Nielsen TT, Botker HE, Andersen HR, Thygesen KA, Checco L, Usmiani T, Sbarra PL, Boffini M, Kubkova L, Saviolo R, Grasso C, Conrotto F, Marchetti M, Rinaldi M, Marra S, Moscoso Costa F, Ferreira J, Raposo L, Aguiar C, Spinar J, Trabulo M, Silva JA, Faria R, Mimoso J, Marques N, Trigo J, Marques V, Gomes V, Swiatkowski A, Kowalczyk J, Olinic D, Lenarczyk R, Chodor P, Honisz G, Was T, Swierad M, Sredniawa B, Polonski L, Kalarus Z, Postadzhiyan AS, Velinov H, Homorodean C, Velchev V, Hazarbasanov D, Apostolova M, Finkov B, Petrovic M, Panic G, Jovelic A, Canji T, Srdanovic I, Popov T, Ober M, Golubovic M, Pavlovic K, Cemerlic-Adjic N, Bro-Jeppesen J, Kjaergaard J, Wanscher MC, Nielsen SL, Rasmussen LS, Hassager C, Bro-Jeppesen J, Olinic M, Kjaergaard J, Wanscher MC, Rasmussen LS, Hassager C, Khan M, Crolla E, Morley H, Akeroyd L, Beaini Y, Morley C, Andrioaia C, Dores H, Leal S, Rosario I, Abecasis J, Monge J, Correia MJ, Arroja I, Fonseca C, Aleixo A, Silva A, Condac A, Bekeredjian RH, Krumsdorf U, Rottbauer W, Katus HA, Pleger S, Providencia RA, Silva J, Barra S, Gomes PL, Seca L, Masmoudi M, Botelho A, Quintal N, Mota P, Leitao-Marques AM, Silva B, Santos N, Cafe H, Faria P, Serrao M, Gomes S, Berdaoui B, Oliveira R, Caires G, Drumond A, Araujo J, Roussel JC, Senage T, Perigaud C, Habash O, Michel M, Treilhaud M, Labidi S, Despins P, Trochu JN, Baron O, Duveau D, Kitsiou AN, Giannakopoulos K, Papadimitriou G, Karas S, Babic Z, Nikolic Heitzler V, Tapia Ballesteros C, Milicic D, Bergovec M, Raguz M, Mirat J, Strozzi M, Plazonic Z, Giunio L, Steiner R, Freynhofer M, Brozovic I, Hernandez Luis C, Bruno V, Leherbauer L, Djurkovic M, Jarai R, Willheim M, Huebl W, Wojta J, Huber K, Vogel B, Hahne S, Sandin MG, Kozanli I, Kalla K, Jarai R, Freynhofer M, Smetana P, Geppert A, Unger G, Huber K, Simoes Marques Assuncao Caetano AF, Barra S, Vegas JM, Silva J, Providencia R, Faustino C, Botelho A, Mota P, Leitao Marques A, Ariza Sole A, Sanchez Salado JC, Lorente Tordera V, Martinez Garcia V, Andion R, Salazar Mendiguchia Y Garcia J, Gomez Hospital JA, Maristany Daunert J, Berdejo Gago FJ, Esplugas Oliveras E, Brzozowska-Czarnek A, Urbanik A, Kakouros N, Kakouros S, Lekakis J, Martinez N, Rizos J, Kokkinos D, Venevtseva J, Melnikov A, Valiahmetov M, Gomova T, Perelomova I, Ferrer Hita JJ, Bosa-Ojeda F, Sanchez-Grande-Flecha A, Gonzalez IA, Yanes-Bowden G, Vargas-Torres MJ, Rodriguez-Gonzalez A, Rubio-Iglesias-Garcia C, Dominguez-Rodriguez A, Enjuanes-Grau C, Marrero-Rodriguez F, Parepa I, Suceveanu AI, Suceveanu A, Alvarado M, Mazilu L, Alexandrescu L, Dumitru E, Miu V, Jitari V, Craiu E, Voinea FL, Balachandran KP, Schofield R, Sankaranarayanan R, Amat IJ, Helm K, Crowe C, Singh R, Mcdonald J, Chuen MJ, Kobusiak-Prokopowicz M, Preglowska M, Mysiak A, Doi T, Sakoda T, San Roman JA, Akagami T, Naka T, Tsujino T, Masuyama T, Ohyanagi M, Kume N, Mitsuoka H, Hayashida K, Tanaka M, Biasucci LM, Garcia Gonzalez MJ, Della Bona R, Biasillo G, Leo M, Zaninotto M, Plebani M, Crea F, Biasucci LM, Dellabona R, Leo M, Biasillo G, Arroyo Ucar E, Zaninotto M, Plebani M, Crea F, Cavusoglu Y, Gok B, Birdane A, Demirustu C, Gorenek B, Unalir A, Ata N, Hernandez Garcia C, Timuralp B, Nikulina N, Yakushin SS, Nikulina N, Yakushin SS, Furmenko GI, Akinina SA, Dores H, Ingrid R, Leal S, Dorta Martin M, Correia MJ, Bronze L, Monge J, Arroja I, Fonseca C, Aleixo A, Silva A, Djambazov S, Zhivkov A, Maznev I, Marrero Rodriguez F, Ingeliev M, Slavov R, Cvetkova N, Patarinski V, Groch L, Horak J, Dimitrov N, Hayrapetyan HG, Raposeiras Roubin S, Abu-Assi E, Dragu R, Cabanas-Grandio P, Agra-Bermejo R, Garcia-Acuna JM, Pena-Gil C, Gonzalez-Juanatey JR, Barra SNC, Silva J, Providencia R, Seca L, Gomes P, Kapeliovich M, Leitao Marques A, Daly MJ, Mc Keag NA, Mc Cann CJ, Cardwell C, Young IS, Adgey AAJ, Mikhalchikova N, Burova N, Zaccaria M, Hammerman H, Palmisano P, Palumbo V, Ciccone MM, Favale S, Chen KC, Yin WH, Liu JH, Goncalves S, Santos JF, Amador P, Silva D, Soares LN, Zahidova K, Guliyev F, Zahidov N, Carrilho-Ferreira P, Cortez-Dias N, Marques JS, Silva D, Jorge C, Robalo Martins S, Cortez-Dias N, Almeida Ribeiro M, Calisto C, Carvalho De Sousa J, Lopes MG, Cortez-Dias N, Calisto C, Silva D, Jorge C, Carrilho-Ferreira P, Silva Marques J, Jorge C, Robalo Martins S, Correia MJ, Carvalho De Sousa J, Lopes MG, Uthoff H, Thalhammer C, Potocki M, Reichlin T, Noveanu M, Aschwanden M, Silva Marques J, Staub D, Arenja N, Socrates T, Mueller C, Zhao Y, Wu X, Xue Q, Gao L, Lin H, Wang S, Carilho Ferreira P, Watanabe K, Kawamura A, Seko T, Omura A, Sakabe S, Kasai A, Starodubova AV, Storozhakov G, Kisliak O, Hautieva F, Robalo Martins S, Tursheva M, Fedotova N, Di Maio RC, Mclaughlin J, Allen JD, Anderson JMC, Adgey AAJ, Khaled Nagi H, Abed N, Tayeh O, Almeida Ribeiro M, Farok W, Mousa A, Neuzil P, Skoda J, Petru J, Sediva L, Kralovec S, Holy F, Holdova K, Jehlicka P, Calisto C, Plasil P, Reddy VY, Alabakovska S, Labudovic D, Jovanova S, Tosheska K, Alabakovski M, Jeevaratnam K, Tee SP, Zhang Y, Fiuza M, Guzadhur L, Gurung IS, Duehmke R, Grace AA, Lei M, Huang CL, Ishibashi Y, Yamauchi M, Akashi Y, Musha H, Lopes MG, Miyake F, Hnatek T, Kamenik L, Sedlon P, Luxova J, Steuerova B, Skvaril J, Cernohous M, Zavoral M, Ratkovic N, Milicevic P, Nemanja Djenic NR, Aleksandra Jovelic AJ, Slobodan Obradovic SO, Branko Gligic BG, Kletsiou E, Giannakopoulou M, Bozas E, Iliodromitis EK, Anastasiou-Nana M, Papathanassoglou EDE, Panic M, Anton M, Anton G, Muraru M, Stanojlovic T, Salinger Martinovic S, Radosavljevic M, Glasnovic J, Stanojevic D, Zivkovic M, Cortez-Dias N, Stankovic I, Jorge C, Calisto C, Silva D, Carrilho-Ferreira P, Silva Marques J, Robalo Martins S, Pessoa T, Fiuza M, Lopes MG, Aspromonte N, Milicevic D, Ronco C, Tubaro M, Santini M, Colivicchi F, Aiello A, Cruz D, Anzoletti Boscolo A, Vianello G, Valle R, Cavusoglu Y, Kalezic T, Parspour A, Birdane A, Tek M, Gorenek B, Unalir A, Ata N, Lee WP, Ong BB, Watkins S, Datta D, Kafedzic S, Halcox JPJ, Providencia RA, Barra S, Gomes PL, Seca L, Silva J, Botelho A, Quintal N, Pais JR, Mota P, Ilic I, Leitao-Marques AM, Nikishin AG, Pirnazarov MM, Nurbaev TA, Motovska Z, Fischerova M, Osmancik P, Maly M, Widimsky P, Pavli E, Cerovic M, Dibra A, Mehilli J, Dibra L, Schoemig A, Kastrati A, Carmo P, Ferreira J, Aguiar C, Almeida M, Raposo L, Putnikovic B, Teles R, Goncalves P, Brito J, Silva A, D'ascenzo F, Gonella A, Longo G, Pullara A, Moretti C, Sciuto F, Neskovic A, Omede' P, Biondi Zoccai G, Trevi GP, Sheiban I, Santos N, Serrao M, Cafe H, Silva B, Oliveira R, Caires G, Rott D, Drumond A, Araujo J, Cafe HM, Silva B, Santos N, Faria P, Oliveira R, Pereira A, Caires G, Pereira D, Leibowitz D, Freitas D, Araujo J, Pittl U, Schratter A, Klemm T, Lehmann D, Demmin K, Mende M, Schuler G, Thiele H, Monhart Z, Salazar Mendiguchia Y Garcia J, Ariza Sole A, Martinez Garcia V, Sanchez Salado JC, Lorente Tordera V, Ortiz Berbel D, Rabasa Baraibar JM, Esplugas Oliveras E, Monge J, Leal S, Reissigova J, Dores H, Bronze Carvalho L, Rosario I, Abecasis J, Correia MJ, Leitao A, Aleixo A, Silva A, Leone AM, De Caterina A, Grunfeldova H, Aurelio A, Sciahbasi A, Lioy E, Trani C, Burzotta F, Porto I, Rebuzzi AG, Crea F, Trusinskis K, Juhnevica D, Jansky P, Strenge K, Sondore D, Kumsars I, Jegere S, Narbute I, Grave A, Zakke I, Erglis A, Mihaylov G, Marenzi G, Timoteo AT, Assanelli E, Ferrari C, Marana I, Lauri G, De Metrio M, Grazi M, Campodonico J, Moltrasio M, Bartorelli AL, Martins H, Valente B, Saraiva F, Baptista R, Jorge E, Mendes PL, Monteiro P, Costa S, Franco F, Providencia LA, Saeed M, Gaber R, Oliveira JA, Mornos C, Cozma D, Pescariu S, Dragulescu SI, Kamal HS, Abdelfattah A, Abdelbary AM, Elassar H, Naggar A, Khaled M, Ferreira ML, Fareed AM, Pernes JM, Gaux JC, Oraby M, Nasr GM, Maklady F, Dupouy P, Prull MW, Sasko B, Wirdemann H, Ferreira RC, Bittlinsky A, Butz T, Trappe HJ, Perazzolo Marra M, Cacciavillani L, Marzari A, De Lazzari M, Turri R, China P, Corbetti F, Villanueva Benito I, Iliceto S, Stazhadze LL, Spiridonova EA, Bulanova NA, Ermolaev AA, Savic L, Mrdovic I, Krljanac G, Perunicic J, Asanin M, Solla I, Lasica R, Matic M, Vasiljevic Z, Ostojic M, Pudil R, Tichy M, Blaha V, Andrys C, Vojacek J, Conti A, Paredes E, Poggioni C, Viviani G, Bulletti F, Boni V, Luzzi M, Vicidomini S, Donati M, Del Taglia B, Pini R, Sousa O, Diaz Castro O, Fontes-Carvalho R, Caeiro D, Dias Ferreira N, Silva G, Pereira E, Ribeiro J, Albuquerque A, Gama Ribeiro V, Murai M, Takeda Y, Calvo F, Shinmyo T, Tanigawa J, Hazui H, Nakakohji T, Ohishi Y, Hoshiga M, Ishihara T, Hanafusa T, Belohlavek J, Rohn V, Baz JA, Kunstyr J, Lips M, Semrad M, Horak J, Mlejnsky F, Tosovsky J, Linhart A, Lindner J, Sablik Z, Samborska-Sablik A, Iniguez A, Drozdz J, Gaszynski W, Ferrer Hita JJ, Rodriguez-Gonzalez A, Izquierdo-Gomez MM, Enjuanes-Grau C, Rubio-Iglesias-Garcia C, Sanchez-Grande-Flecha A, Juarez-Prera R, Blanco-Palacios G, Aleksova A, Bosa-Ojeda F, Marrero-Rodriguez F, Lakhdar R, Drissa M, Drissa M, Jedaida B, Drissa H, Sousa O, Dias Ferreira N, Sampaio F, Gerloni R, Caeiro D, Fontes-Carvalho R, Silva G, Pereira E, Ribeiro J, Albuquerque A, Gama Ribeiro V, Hsin HT, Huang JH, Chiu KM, Belfiore R, Chen ZS, Lin PC, Chen LY, Chu SH, Efthimiadis I, Skendros P, Sarantopoulos A, Boura P, Delewi R, Nijveldt R, Carriere C, Van Der Laan AM, Hirsch A, Van Der Vleuten PA, Klees M, Tijssen JGP, Zijlstra F, Van Rossum AC, Piek JJ, Backus BE, Six AJ, Barbati G, Kelder JH, Mosterd A, Mast EG, Mast TP, Braam R, Tio R, Veldkamp R, Doevendans PA, Delewi R, Nijveldt R, Fabris E, Van Der Laan AM, Hirsch A, Van Der Vleuten PA, Klees M, Tijssen JGP, Zijlstra F, Van Rossum AC, Piek JJ, Paarup Dridi N, Holmvang L, Possa F, Engstroem T, Rekik S, Brunet J, Hager FX, Bayet G, Meille L, Quatre JM, Sainsous J, Chu PH, Tang CH, Nait D, Ibatov A, Pogosova N, Koltunov IE, Sapunova ID, Vigodin VA, Uhliar R, Gilis-Januszewski T, Mellwig KP, Wiemer M, Gilis-Januszewski J, Milo M, Peterschroeder A, Schmidt A, Brockmeyer B, Horstkotte D, Suzuki A, Eki Y, Higuchi H, Yukawa A, Yamauchi R, Sato Y, Sinagra G, Endo Y, Martinez Garcia V, Salazar Mendigucha Garcia J, Ariza Sole A, Sanchez Salado JC, Lorente Tordera V, Homs Vila S, Gomez Hospital JA, Cequier Fillat A, Esplugas Oliveras E, Marques N, Andion Ogando R, Hernandez Luis C, Sandin Fuentes M, Tapia Ballesteros C, Vegas Valle JM, Gonzalez Garcia IA, Duro Aguado IA, Palomino Doza AJ, Gomez Salvador I, San Roman Calvar JA, Mimoso J, Nikishin AG, Mamarasulov TM, Pirnazarov MM, Koracevic G, Pavlovic M, Glasnovic J, Damjanovic M, Stojkovic A, Kostic T, Todorovic L, Gomes V, Petrovic S, Zivkovic M, Djordjevic-Radojkovic D, Cherneva ZCH, Denchev SD, Heltai K, Becker D, Merkely B, Nikulina N, Yakushin SS, Agra Bermejo RM, Akinina SA, Furmenko GI, Boytsov A, Yakushin SS, Nikulina NN, Furmenko GI, Akinina SA, Dores H, Leal S, Rosario I, Emad Abu Assi EAA, Bronze L, Abecasis J, Correia MJ, Arroja I, Fonseca C, Aleixo A, Silva A, Dores H, Leal S, Rosario I, Sergio Raposeiras Roubin SRR, Monge J, Abecasis J, Correia MJ, Bronze L, Arroja I, Aleixo A, Silva A, Rosario I, Leal S, Dores H, Pilar Cabanas Grandio PCG, Correia MJ, Monge JC, Abecasis J, Arroja I, Aleixo A, Silva A, Palmisano P, Zaccaria M, Zanna D, Marangelli V, Carlos Pena Gil CPG, Caiati C, Ciccone MM, Favale S, Picon Heras R, Loureiro MJ, Nunez-Gil I, Garcia Rubira JC, Acebal C, Ruiz-Mateos B, Ibanez B, Jose Maria Garcia Acuna JMGA, Fernandez-Ortiz A, Macaya C, Rosario I, Dores H, Leal S, Monge JC, Correia MJ, Bronze Carvalho L, Arroja I, Fonseca C, Jose Ramon Gonzalez Juanatey JRGJ, Aleixo A, Silva A, Urazovskaya I, Vinogradova D, Vasilieva E, Shpektor A, Faustino A, Seca L, Barra S, Providencia R, Daly MJ, Silva J, Gomes P, Costa G, Caetano F, Costa M, Leitao-Marques A, Conti E, Musumeci MB, Lauri FM, Dito E, Scott P, De Giusti M, Lallo A, Fusco D, Davoli M, Volpe M, Autore C, Gamra H, Dridi Z, Hassine M, Addad F, Owens CG, Gherissi I, Reda A, Mahjoub M, Bouraoui S, Abdennadher M, Betbout F, Mota PMFP, Silva JD, Providencia RA, Leitao-Marques A, Tomlin A, Nikolic Heitzler V, Babic Z, Milicic D, Bergovec M, Raguz M, Mirat J, Strozzi M, Plazonic Z, Giunio L, Steiner R, Smith B, Stanojevic D, Apostolovic S, Jankovic Tomasevic R, Pavlovic M, Djordjevic V, Djordjevic Radojkovic D, Salinger Martinovic S, Koracevic G, Damjanovic M, Ilic I, Adgey AAJ, Scafa Udriste A, Fruntelata A, Gainoiu E, Bogdan S, Calmac L, Zamfir D, Teodorescu C, Guran M, Constantinescu D, Dorobantu M, Alvarez-Contreras LR, Rosario I, Dores H, Leal S, Abecasis J, Monge JC, Bronze L, Arroja I, Fonseca C, Aleixo A, Silva A, Juarez U, Konopka A, Banaszewski M, Wojtkowska I, Stepinska J, Vidergold JV, Osipova IV, Tavrovskaya TV, Galkina JV, Timofeev AV, Vorobyov RI, Altamirano A, Vorobyova EN, Matos L, Carvalho ACC, Oliveira W, Cintra F, Poyares D, Andersen M, Martins R, Tufik S, Neuzil P, Arias A, Ostadal P, Skoda J, Holy F, Holdova K, Brada J, Horakova S, Mlcek M, Hrachovina V, Kittnar O, Gorudko IV, Alvarez-San Gabriel A, Buko IV, Cherenkevich SN, Polonetsky LZ, Plotkin VY, Timoshina MA, Azanchevskaya SV, Chromov-Borisov NN, Vorlat A, Snoep L, Claeys MJ, Gonzalez-Pacheco H, Vrints CJ, Palazzuoli A, Caputo M, Quatrini I, Calabro A, Antonelli G, Campagna MS, Franci B, Nuti R, Maisel A, Martinez-Sanchez C, Paulo C, Mascarenhas J, Patacho M, Pimenta J, Bettencourt P, Negrini M, Minora T, Marino P, Seregni R, Tavlueva E, Rahnavardi M, Barbarash O, Barbarash L, Janota T, Kudlicka J, Malik K, Wichterle D, Hradec J, Faria R, Mimoso J, Marques N, Keshtkar-Jahromi M, Trigo J, Marques V, Gomes V, Body R, Carley SD, Mcdowell G, Nuttall M, Wibberley C, France M, Cruickshank JK, Vakili H, Mackway-Jones K, Cavusoglu Y, Cavusoglu A, Unluoglu I, Tek M, Demirustu C, Unalacak M, Gorenek B, Birdane A, Yuksel F, Gholamin S, Ata N, Leon M, Cozma C, Mitu F, Matos L, Carvalho ACC, Almeida DR, Oliveira W, Dias CB, Barra SNC, Razavi SM, Gomes P, Silva J, Providencia R, Seca L, Leitao Marques A, Burazor I, Burazor M, Krstic M, Lazovic M, Stojkovic A, Gilis-Januszewski T, Vukmanovic M, Djordjevic J, Radovanovic Z, Ilic D, Bosnjakovic P, Margato R, Ferreira AC, Mateus PS, Ribeiro H, Fontes P, Mellwig KP, Moreira JI, Teixeira T, Silva JD, Costa M, Leitao-Marques A, Conte G, Menozzi A, Solinas E, Bolognesi MG, Tadonio I, Wiemer M, Mantovani F, Cattabiani A, Vignali L, Ardissino D, Scafa Udriste A, Fruntelata A, Tautu O, Calmac L, Alexandrescu A, Niculescu R, Gilis-Januszewski J, Tatu-Chitoiu G, Dorobantu M, Djordjevic Radojkovic D, Apostolovic S, Perisic Z, Damjanovic M, Jankovic R, Salinger Martinovic S, Koracevic G, Todorovic L, Peterschroeder A, Bozinovic N, Matos L, Carvalho ACC, Almeida DR, Oliveira W, Dias CB, Santos C, Ferreira J, Carmo P, Costa F, Koerfer J, Brito J, Sousa P, Cardoso G, Correia I, Aguiar C, Silva A, Fountoulaki K, Kastellanos S, Voltirakis E, Kokotos A, Horstkotte D, Michalakeas C, Kontsas K, Hasioti K, Iliodromitis ET, Anastasiou-Nana M, Andion Ogando R, Hernandez Luis C, Sandin Fuentes MG, Tapia Ballesteros C, Vegas Valle JM, Vrsalovic M, Zatarain Nicolas E, Amat Santos IJ, Martinez Uruena N, Alvarado Montes De Oca M, San Roman Calvar JA, Belohlavek J, Dytrych V, Kovarnik T, Smid O, Kral A, Getaldic B, Linhart A, Aroutunov AG, Intwala S, Sondore D, Juhnevica D, Trusinskis K, Strenge K, Jegere I, Narbute I, Grave A, Vrkic N, Erglis A, Shaalan HSH, Pagava Z, Agladze R, Shakarishvili R, Sharashidze N, Gujejiani L, Saatashvili G, Martins H, Saraiva F, Pintaric H, Baptista R, Jorge E, Mendes PL, Monteiro P, Costa S, Franco F, Providencia LA, Gaber R, Gaber R, Hristova K, Khan S, Katova TZ, Kostova V, Simova Y, Parepa I, Suceveanu AI, Suceveanu A, Mazilu L, Voinea FL, Craiu E, Obradovic S, Wasan B, Salinger S, Vukotic S, Rafajlovski S, Romanovic R, Koracevic G, Antonijevic N, Gligic B, Hutyra M, Skala T, Horak D, Moretti L, Vindis D, Taborsky M, Contine A, Del Pinto M, Angeli F, Verdecchia P, Borgognoni F, Grikstaite E, Pantano P, Ambrosio G, Grossi P, Cavallini C, Bonanad C, Sanchis J, Bodi V, Nunez J, Bosch X, Heras M, Pellicer M, Llacer A, Seca LF, Silenzi S, Fontes-Carvalho R, Caeiro D, Adao L, Oliveira M, Goncalves H, Primo J, Gama V, Fresco C, De Biasio M, Sappa R, Testa M, Muser D, Morocutti G, Bernardi G, Proclemer A, Lombardi C, Metra M, Bugatti S, Pasotti E, Quinzani F, Adamo M, Candelori L, Villa C, Rovetta R, Manerba A, Dei Cas L, Mariani M, Dushpanova A, Baroni M, Cerone E, Nardelli A, Gianetti J, Clementi LN, Berti S, Timoteo AT, Oliveira MM, Silva MN, Toste A, Ramos R, Cunha PS, Feliciano F, Soares R, Santos S, Forlini M, Ferreira RC, Ostadal P, Kruger A, Vondrakova D, Herget J, Di Maio RC, Navarro C, Cromie NA, Anderson JMC, Adgey JAA, Lando L, Tadel-Kocjancic S, Radsel P, Knafelj R, Gorjup V, Noc M, Caeiro Pereira D, Braga P, Fontes Carvalho R, Sousa O, Rodrigues A, Pezzuoli ML, Goncalves H, Ribeiro J, Goncalves M, Simoes L, Gama V, Borisov KV, Corradetti P, Leurent G, Pennec PY, Filippi E, Moquet B, Hacot JP, Druelles P, Rialan A, Rouault G, Coudert I, Le Breton H, Gevaert S, Tromp F, Vandecasteele E, De Somer F, Van Belleghem Y, Bouchez S, Martens F, Herck I, De Pauw M, Spinar J, Ludka O, Sepsi M, Miklik R, Dusek L, Tomcikova D, Marques N, Mimoso J, Gomes V, Garcia-Acuna JM, Aguiar-Souto P, Raposeiras Roubin S, Agra-Bermejo R, Jacquet M, Abu-Assi E, Gonzalez-Juanatey JR, Ibatov A, Labrova R, Spinar J, Karlik R, Kanovsky J, Lokaj P, She Q, Deng SB, Huang SH, Gu LJ, Rong JIAN, Wu ZK, Li Y, Zhang J, Parascan L, Campanile A, Spinelli L, Santulli G, Ciccarelli M, De Gennaro S, Assante Di Panzillo E, Trimarco B, Iaccarino G, Bobescu E, Radoi M, Datcu G, Dobreanu D, Doka B, Charniot JC, Cosson C, Albertini JP, Bittar R, Giral P, Cherfils C, Guillerm E, Bonnefont-Rousselot D, Craiu E, Rusali A, Cojocaru L, Parepa I, Koizumi T, Iida S, Sato J, Kikutani T, Muramatsu T, Nishimura S, Komiyama N, Lee WP, Ong BB, Haralambos K, Townsend D, Rees JAE, Williams EJ, Halcox JP, Mcdowell I, Damjanovic M, Koracevic G, Djordjevic-Radojkovic D, Pavlovic M, Krstic N, Ciric-Zdravkovic S, Stojkovic A, Perisic Z, Apostolovic S, Faustino A, Seca L, Barra S, Caetano F, Providencia R, Silva J, Gomes P, Costa G, Costa M, Leitao-Marques A, Volkova AL, Arutyunov GP, Bylova NA, Dayter II, Jao YTFN, Fang CC, Chen Y, Yu CL, Wang SP, Valencia J, Perez-Berbel P, Ruiz-Nodar JM, Pineda J, Bordes P, Quintanilla M, Mainar V, Sogorb F, Santos N, Serrao M, Cafe H, Silva B, Oliveira R, Caires G, Drumond A, Araujo J, Providencia RA, Gomes PL, Seca L, Barra S, Silva J, Faustino A, Caetano F, Pais JR, Mota P, Leitao-Marques AM, Farhan S, Jarai R, Tentzeris I, Vogel B, Freynhofer MK, Wojta J, Huber K, Poli M, Trambaiolo P, Corsi F, De Luca M, Mustilli M, Lukic V, Simonetti M, Ferraiuolo G, Lettino M, Casella G, Conte MR, De Luca L, Geraci G, Ceravolo R, Milo M, Pani A, Trambaiolo P, Fradella G, Schratter A, Thiele H, Klemm T, Demmin K, Lehmann D, Mende M, Schuler G, Pittl U, Chernova A, Nikulina SU, Naruke T, Inomata T, Yanagisawa T, Maekawa E, Mizutani T, Shinagawa H, Nishii M, Takeuchi I, Takehana H, Izumi T, Paulo C, Mascarenhas J, Patacho M, Pimenta J, Bettencourt P, Nardai S, Szabo GY, Berta B, Edes I, Merkely B, Delgado Silva J, Seca L, Baptista R, Providencia R, Mota P, Costa M, Leitao-Marques A, Faria R, Trigo J, Gago P, Mimoso J, Marques N, Gomes V, Gheorghe G, Nanea IT, Cristea A, Almarichi S, Martins H, Saraiva F, Baptista R, Jorge E, Mendes PL, Monteiro P, Costa S, Franco F, Providencia LA, Nanea T, Gheorghe GS, Visan S, Paun N, Gaber R, Gaber R, Delewi R, Nijveldt R, De Bruin HA, Hirsch A, Van Der Laan A, Bouma BJ, Tijssen JPG, Van Rossum AC, Zijlstra F, Piek JJ, Rus H, Radoi M, Donea M, Ciurea C, Ifteni G, Casolo G, Chioccioli M, Magnacca M, Del Meglio J, Comella A, Baratto M, Lera J, Salvadori L, Tessa C, Vignali C, Keca Z, Momcilov Popin T, Panic G, White R, Mateen F, Weaver A, Dragu R, Agmon Y, Kapeliovich M, Hammerman H, Timoteo AT, Lousinha A, Santos N, Oliveira JA, Ferreira ML, Ferreira RC, Okisheva E, Tsaregorodtsev D, Sulimov V, Amat Santos IJ, Gonzalez IA, Hernandez C, 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Guillerm E. [Hypoaerobic conditioning of divers: elements of biology and metabolic physiology]. Maroc Med 1971; 51:237-44. [PMID: 5556765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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