1
|
Gigic B, van Roekel E, Holowatyj AN, Brezina S, Geijsen AJMR, Ulvik A, Ose J, Koole JL, Damerell V, Kiblawi R, Gumpenberger T, Lin T, Kvalheim G, Koelsch T, Kok DE, van Duijnhoven FJ, Bours MJ, Baierl A, Li CI, Grady W, Vickers K, Habermann N, Schneider M, Kampman E, Ueland PM, Ulrich A, Weijenberg M, Gsur A, Ulrich C. Cohort profile: Biomarkers related to folate-dependent one-carbon metabolism in colorectal cancer recurrence and survival - the FOCUS Consortium. BMJ Open 2022; 12:e062930. [PMID: 36549742 PMCID: PMC9772678 DOI: 10.1136/bmjopen-2022-062930] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The overarching goal of the FOCUS (biomarkers related to folate-dependent one-carbon metabolism in colorectal cancer (CRC) recurrence and survival) Consortium is to unravel the effect of folate and folate-mediated one-carbon metabolism (FOCM) biomarkers on CRC prognosis to provide clinically relevant advice on folate intake to cancer patients and define future tertiary prevention strategies. PARTICIPANTS The FOCUS Consortium is an international, prospective cohort of 2401 women and men above 18 years of age who were diagnosed with a primary invasive non-metastatic (stages I-III) CRC. The consortium comprises patients from Austria, two sites from the Netherlands, Germany and two sites from the USA. Patients are recruited after CRC diagnosis and followed at 6 and 12 months after enrolment. At each time point, sociodemographic data, data on health behaviour and clinical data are collected, blood samples are drawn. FINDINGS TO DATE An increased risk of cancer recurrences was observed among patients with higher compared with lower circulating folic acid concentrations. Furthermore, specific folate species within the FOCM pathway were associated with both inflammation and angiogenesis pathways among patients with CRC. In addition, higher vitamin B6 status was associated with better quality of life at 6 months post-treatment. FUTURE PLANS Better insights into the research on associations between folate and FOCM biomarkers and clinical outcomes in patients with CRC will facilitate the development of guidelines regarding folate intake in order to provide clinically relevant advice to patients with cancer, health professionals involved in patient care, and ultimately further tertiary prevention strategies in the future. The FOCUS Consortium offers an excellent infrastructure for short-term and long-term research projects and for combining additional biomarkers and data resulting from the individual cohorts within the next years, for example, microbiome data, omics and multiomics data or CT-quantified body composition data.
Collapse
Affiliation(s)
- Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Eline van Roekel
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Andreana N Holowatyj
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA
| | - Stefanie Brezina
- Center for Cancer Research, Medical University of Vienna, Wien, Austria
| | - Anne J M R Geijsen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | | | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Janna L Koole
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Victoria Damerell
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Rama Kiblawi
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | - Torsten Koelsch
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Franzel J van Duijnhoven
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Martijn J Bours
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Wien, Austria
| | - Christopher I Li
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - William Grady
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Kathy Vickers
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Nina Habermann
- Genome Biology, European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | | | - Alexis Ulrich
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
- Surgical Department I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
| | - Matty Weijenberg
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Andrea Gsur
- Center for Cancer Research, Medical University of Vienna, Wien, Austria
| | - Cornelia Ulrich
- Huntsman Cancer Institute, Salt Lake City, Utah, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
2
|
Holowatyj AN, Ose J, Gigic B, Lin T, Ulvik A, Geijsen AJMR, Brezina S, Kiblawi R, van Roekel EH, Baierl A, Böhm J, Bours MJL, Brenner H, Breukink SO, Chang-Claude J, de Wilt JHW, Grady WM, Grünberger T, Gumpenberger T, Herpel E, Hoffmeister M, Keulen ETP, Kok DE, Koole JL, Kosma K, Kouwenhoven EA, Kvalheim G, Li CI, Schirmacher P, Schrotz-King P, Singer MC, van Duijnhoven FJB, van Halteren HK, Vickers K, Vogelaar FJ, Warby CA, Wesselink E, Ueland PM, Ulrich AB, Schneider M, Habermann N, Kampman E, Weijenberg MP, Gsur A, Ulrich CM. Higher vitamin B6 status is associated with improved survival among patients with stage I-III colorectal cancer. Am J Clin Nutr 2022; 116:303-313. [PMID: 35394006 PMCID: PMC9348990 DOI: 10.1093/ajcn/nqac090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Folate-mediated 1-carbon metabolism requires several nutrients, including vitamin B6. Circulating biomarker concentrations indicating high vitamin B6 status are associated with a reduced risk of colorectal cancer (CRC). However, little is known about the effect of B6 status in relation to clinical outcomes in CRC patients. OBJECTIVES We investigated survival outcomes in relation to vitamin B6 status in prospectively followed CRC patients. METHODS A total of 2031 patients with stage I-III CRC participated in 6 prospective patient cohorts in the international FOCUS (folate-dependent 1-carbon metabolism in colorectal cancer recurrence and survival) Consortium. Preoperative blood samples were used to measure vitamin B6 status by the direct marker pyridoxal 5'-phosphate (PLP), as well as the functional marker HK-ratio (HKr)[3'-hydroxykynurenine: (kynurenic acid + xanthurenic acid + 3'-hydroxy anthranilic acid + anthranilic acid)]. Using Cox proportional hazards regression, we examined associations of vitamin B6 status with overall survival (OS), disease-free survival (DFS), and risk of recurrence, adjusted for patient age, sex, circulating creatinine concentrations, tumor site, stage, and cohort. RESULTS After a median follow-up of 3.2 y for OS, higher preoperative vitamin B6 status as assessed by PLP and the functional marker HKr was associated with 16-32% higher all-cause and disease-free survival, although there was no significant association with disease recurrence (doubling in PLP concentration: HROS, 0.68; 95% CI: 0.59, 0.79; HRDFS, 0.84; 95% CI: 0.75, 0.94; HRRecurrence, 0.96; 95% CI: 0.84, 1.09; HKr: HROS, 2.04; 95% CI: 1.67, 2.49; HRDFS, 1.56; 95% CI: 1.31, 1.85; HRRecurrence, 1.21; 95% CI: 0.96,1. 52). The association of PLP with improved OS was consistent across colorectal tumor site (right-sided colon: HROS, 0.75; 95% CI: 0.59, 0.96; left-sided colon: HROS, 0.71; 95% CI: 0.55, 0.92; rectosigmoid junction and rectum: HROS, 0.61; 95% CI: 0.47, 0.78). CONCLUSION Higher preoperative vitamin B6 status is associated with improved OS among stage I-III CRC patients.
Collapse
Affiliation(s)
- Andreana N Holowatyj
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA,Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | | | - Anne J M R Geijsen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Stefanie Brezina
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Austria
| | - Rama Kiblawi
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA,Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Austria
| | - Jürgen Böhm
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Martijn J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Hermann Brenner
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany,Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stéphanie O Breukink
- Department of Surgery, GROW School for Oncology and Development Biology, Maastricht University, The Netherlands
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg Germany
| | - Johannes H W de Wilt
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Radboud University Medical Center, The Netherlands
| | - William M Grady
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Tanja Gumpenberger
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Austria
| | - Esther Herpel
- Institute of Pathology, University of Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric T P Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Janna L Koole
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Katharina Kosma
- Department of Surgery, Kaiser Franz Josef Hospital, Vienna, Austria
| | | | | | - Christopher I Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | | | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
| | - Marie C Singer
- Department of Surgery, Kaiser Franz Josef Hospital, Vienna, Austria
| | | | - Henk K van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, The Netherlands
| | - Kathy Vickers
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - F Jeroen Vogelaar
- Department of Surgery, VieCuri Medical Center, Venlo, The Netherlands
| | - Christy A Warby
- Huntsman Cancer Institute, Salt Lake City, Utah, USA,Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | | | - Alexis B Ulrich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
| | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Germany
| | - Nina Habermann
- Genome Biology, European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, The Netherlands
| | - Andrea Gsur
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Austria
| | | |
Collapse
|
3
|
Geijsen AJMR, Ulvik A, Gigic B, Kok DE, van Duijnhoven FJB, Holowatyj AN, Brezina S, van Roekel EH, Baierl A, Bergmann MM, Böhm J, Bours MJL, Brenner H, Breukink SO, Bronner MP, Chang-Claude J, de Wilt JHW, Grady WM, Grünberger T, Gumpenberger T, Herpel E, Hoffmeister M, Huang LC, Jedrzkiewicz JD, Keulen ETP, Kiblawi R, Kölsch T, Koole JL, Kosma K, Kouwenhoven EA, Kruyt FM, Kvalheim G, Li CI, Lin T, Ose J, Pickron TB, Scaife CL, Schirmacher P, Schneider MA, Schrotz-King P, Singer MC, Swanson ER, van Duijvendijk P, van Halteren HK, van Zutphen M, Vickers K, Vogelaar FJ, Wesselink E, Habermann N, Ulrich AB, Ueland PM, Weijenberg MP, Gsur A, Ulrich CM, Kampman E. Circulating Folate and Folic Acid Concentrations: Associations With Colorectal Cancer Recurrence and Survival. JNCI Cancer Spectr 2020; 4:pkaa051. [PMID: 33134831 PMCID: PMC7583160 DOI: 10.1093/jncics/pkaa051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 04/30/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Folates, including folic acid, may play a dual role in colorectal cancer development. Folate is suggested to be protective in early carcinogenesis but could accelerate growth of premalignant lesions or micrometastases. Whether circulating concentrations of folate and folic acid, measured around time of diagnosis, are associated with recurrence and survival in colorectal cancer patients is largely unknown. METHODS Circulating concentrations of folate, folic acid, and folate catabolites p-aminobenzoylglutamate and p-acetamidobenzoylglutamate were measured by liquid chromatography-tandem mass spectrometry at diagnosis in 2024 stage I-III colorectal cancer patients from European and US patient cohort studies. Multivariable-adjusted Cox proportional hazard models were used to assess associations between folate, folic acid, and folate catabolites concentrations with recurrence, overall survival, and disease-free survival. RESULTS No statistically significant associations were observed between folate, p-aminobenzoylglutamate, and p-acetamidobenzoylglutamate concentrations and recurrence, overall survival, and disease-free survival, with hazard ratios ranging from 0.92 to 1.16. The detection of folic acid in the circulation (yes or no) was not associated with any outcome. However, among patients with detectable folic acid concentrations (n = 296), a higher risk of recurrence was observed for each twofold increase in folic acid (hazard ratio = 1.31, 95% confidence interval = 1.02 to 1.58). No statistically significant associations were found between folic acid concentrations and overall and disease-free survival. CONCLUSIONS Circulating folate and folate catabolite concentrations at colorectal cancer diagnosis were not associated with recurrence and survival. However, caution is warranted for high blood concentrations of folic acid because they may increase the risk of colorectal cancer recurrence.
Collapse
Affiliation(s)
- Anne J M R Geijsen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Andreana N Holowatyj
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Stefanie Brezina
- Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Eline H van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, Vienna, Austria
| | | | - Jürgen Böhm
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Martijn J L Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Hermann Brenner
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stéphanie O Breukink
- Department of Surgery, GROW School for Oncology and Development Biology, Maastricht University, Maastricht, the Netherlands
| | - Mary P Bronner
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Johannes H W de Wilt
- Department of Surgery, Division of Surgical Oncology and Gastrointestinal Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - William M Grady
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Tanja Gumpenberger
- Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Esther Herpel
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lyen C Huang
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Eric T P Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Sittard, the Netherlands
| | - Rama Kiblawi
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
- Medical Faculty, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Torsten Kölsch
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Janna L Koole
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Katharina Kosma
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Flip M Kruyt
- Department of Surgery, Hospital Gelderse Vallei, Ede, the Netherlands
| | | | - Christopher I Li
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tengda Lin
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jennifer Ose
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | | | | | - Martin A Schneider
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Petra Schrotz-King
- Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
| | - Marie C Singer
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Eric R Swanson
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | | | - Henk K van Halteren
- Department of Internal Medicine, Admiraal de Ruyter Hospital, Goes, the Netherlands
| | - Moniek van Zutphen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Kathy Vickers
- Department of Surgery, Hospital Gelderse Vallei, Ede, the Netherlands
| | - F Jeroen Vogelaar
- Department of Surgery, VieCuri Medical Center, Venlo, the Netherlands
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Nina Habermann
- Genome Biology, European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Alexis B Ulrich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | | | - Matty P Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Andrea Gsur
- Department of Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| |
Collapse
|
4
|
Thomsen L, Honoré A, Almås B, Reisæter L, Førde K, Kristoffersen E, Kaada S, Melve G, Helle S, Kvalheim G, Azeem W, Olsen J, Halvorsen O, Akslen L, Bahn D, Pantel K, Riethdorf S, Ragde H, Gjertsen B, Øyan A, Kalland K, Beisland C. Safety and efficacy of dendritic cell (DC)-based cryoimmunotherapy (CryoIT) combined with checkpoint inhibition in a prospective non-randomized Phase I trial of metastatic castration resistant prostate cancer (mCRPC). EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33842-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
5
|
Lazarova P, Wu Q, Kvalheim G, Suo Z, Haakenstad KW, Metodiev K, Nesland JM. Growth Factor Receptors in Hematopoietic Stem Cells: EPH Family Expression in CD34+ and CD133+ Cell Populations from Mobilized Peripheral Blood. Int J Immunopathol Pharmacol 2018. [DOI: 10.1177/205873920601900105] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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] Open
Abstract
Cell-surface antigen expression of hematopoietic stem cells has a crucial role in characterizing cell subpopulation with distinct functional properties. The Eph receptors are the largest receptor tyrosine kinase family being involved in processes like vascular remodelling during development and physiological and pathological angiogenesis. Some Eph/Ephrin members are expressed in hematopoietic cells. The ability to isolate purified cell populations co-expressing CD34 and CD133 antigens as most commonly used markers for identification of hematopoietic progenitors has provided the opportunity to identify their surface-receptor profile. As positively expressed CD34 and CD133 cells take place not only in hematopoietic but also in endothelial differentiation, we aimed to define the Eph/Ephrin characteristic of these cells and relate these findings to new therapy strategies. Positive selections of CD34 and CD133 cells from PBPC in lymphoma patients were performed using magnetic beads and AutoMACS (Miltenyi Biotec) device. The purity of isolated cells was tested by flow cytometry. Immunocytochemistry was used to assess the Eph/Ephrin expression profile of positively selected samples. Our study revealed that all samples (10 from CD34+ and 8 from CD133+ cells) expressed one or more of Eph/Ephrin antigens in different proportions. All CD34 + cell samples, and 6 of 8 in the CD133+ cell fraction were strongly immunoreactive for EphA2. EphB2 was strongly expressed in all CD133+ cases, but 50% of the CD34 positive group lacked or weakly expressed this receptor. EphB4 was negative in 9 of 10 CD34+ cases and in all CD133 +cells. Thus, we have shown the surface marker profile of positively selected CD34 and CD133 cells in leukapheresis samples from lymphoma patients with regard to Eph/Ephrin receptors and discussed their biological clinical potential.
Collapse
Affiliation(s)
- P. Lazarova
- Lab for Cellular Therapy, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 0310, Norway
| | - Q. Wu
- Department of Pathology, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 0310, Norway
| | - G. Kvalheim
- Lab for Cellular Therapy, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 0310, Norway
| | - Z. Suo
- Department of Pathology, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 0310, Norway
| | - K. W. Haakenstad
- Lab for Cellular Therapy, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 0310, Norway
| | - K. Metodiev
- Department of Microbiology and Immunology, Medical University, Varna 9002, Bulgaria
| | - J. M. Nesland
- Department of Pathology, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 0310, Norway
| |
Collapse
|
6
|
Minhas PS, Liu L, Moon PK, Mhatre SD, Wang Q, Coronado M, Contrepois K, Joshi AU, Dove CG, Kvalheim G, Midttun O, Majeti R, Bernstein D, Mochly-Rosen D, Snyder M, Rabinowitz J, Andreasson K. O4‐02‐05: DE NOVO NAD+ SYNTHESIS RESCUES NEUROINFLAMMATION AND ALZHEIMER'S DISEASE PHENOTYPES: MODULATING IMMUNE CELL RESPONSES AND MITOCHONDRIAL BIOENERGETICS. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Ling Liu
- Princeton UniversityPrincetonNJUSA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Walchli S, Sektioglu I, Köksal H, Josefsson S, Faane A, Huse K, Holte H, Kvalheim G, Smeland E, Myklebust J, Inderberg E. Targeting lymphoma with CD37CAR: A pre-clinical study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx710.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Inderberg E, Myhre M, Mensali N, Fåne A, Lislerud K, Kvalheim G, Gaudernack G, Wälchli S. Tapping CD4 T cells for cancer immunotherapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw525.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
9
|
Wälchli S, Inderberg E, Mensali N, Stenvik B, Oksvold M, Progida C, Bakke O, Fallang LE, Kvalheim G, Myklebust J. Csk overexpression makes T cell dummy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw525.20] [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: 11/14/2022] Open
|
10
|
Midttun Ø, McCann A, Aarseth O, Krokeide M, Kvalheim G, Meyer K, Ueland PM. Combined Measurement of 6 Fat-Soluble Vitamins and 26 Water-Soluble Functional Vitamin Markers and Amino Acids in 50 μL of Serum or Plasma by High-Throughput Mass Spectrometry. Anal Chem 2016; 88:10427-10436. [DOI: 10.1021/acs.analchem.6b02325] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Øivind Midttun
- Bevital AS, Laboratory Building,
Ninth Floor, Jonas Lies veg 87, 5021 Bergen, Norway
| | - Adrian McCann
- Bevital AS, Laboratory Building,
Ninth Floor, Jonas Lies veg 87, 5021 Bergen, Norway
| | - Ove Aarseth
- Bevital AS, Laboratory Building,
Ninth Floor, Jonas Lies veg 87, 5021 Bergen, Norway
| | - Marit Krokeide
- Bevital AS, Laboratory Building,
Ninth Floor, Jonas Lies veg 87, 5021 Bergen, Norway
| | - Gry Kvalheim
- Bevital AS, Laboratory Building,
Ninth Floor, Jonas Lies veg 87, 5021 Bergen, Norway
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Klaus Meyer
- Bevital AS, Laboratory Building,
Ninth Floor, Jonas Lies veg 87, 5021 Bergen, Norway
| | - Per M. Ueland
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
- Laboratory
of Clinical Biochemistry, Haukeland University Hospital, 5021 Bergen, Norway
| |
Collapse
|
11
|
Josefsen D, Fløisand Y, Holte H, Kvalheim G. Poor Mobilizing Lymphoma Patients Successfully Harvested after Addition of Plerixafor during Stem Cell Mobilization Have Similar Survival as Good Mobilizers When Given High Dose Therapy with Autologous Stem Cell Support. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.088] [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]
|
12
|
Wälchli S, Inderberg E, Myklebust J, Skorstad G, Myhre M, Faane A, Gaudernack G, Kvalheim G. A universal killer T-cell for adoptive cell therapy of cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv513.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
13
|
Bigalke I, Torhaug S, Lundby M, Mollatt C, Inderberg-Suso E, Kolstad A, Gaudernack G, Rasmussen A, Aamdal S, Kvalheim G. hTERT/survivin mRNA-loaded dendritic cell vaccination combined with ex-vivo expanded T cell transfer in stage IV melanoma patients show a longer overall survival in patients with sustained immune responses against hTERT. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.066] [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: 11/24/2022]
|
14
|
Almåsbak H, Walseng E, Kristian A, Myhre MR, Inderberg ES, Munthe L, Wang M, Kvalheim G, Gaudernack G, Kyte J. Spacer design influences the in vivo efficacy of CD19-CAR redirected T cells. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.123] [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: 10/25/2022]
|
15
|
Anderson K, Dybedal I, Bigalke I, Schendel D, Chowdhury O, Woll P, Jacobsen S, Kvalheim G. Third generation autologous myeloid-derived dendritic cells developed from patients with CMML and MDS demonstrate phenotypic properties of mature functional dendritic cells. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
16
|
Andreassen G, Skoge L, Lundby M, Smith R, Kvalheim G, Josefsen D. Spectra optia™ and elutra™ for the production of monocyte-derived dendritic cell vaccines. Cytotherapy 2014. [DOI: 10.1016/j.jcyt.2014.01.164] [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: 10/25/2022]
|
17
|
Lichtenegger FS, Beck B, Bigalke I, Geiger C, Hiddemann W, Henschler R, Kvalheim G, Schendel DJ, Subklewe M. P55. Dendritic cell vaccination for postremission therapy in AML. J Immunother Cancer 2014. [PMCID: PMC4072282 DOI: 10.1186/2051-1426-2-s2-p29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
18
|
Hetland G, Tangen J, Tryggestad A, Dyrhaug M, Kvalheim G. The medicinal mushroom agaricus blazei murill activates NF-κB via TLR2 in monocytic cells, induces expansion of CD56+ but not other HSC, and activation of human monocyte-derived DC in vitro. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.136] [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: 10/27/2022]
|
19
|
Bigalke I, Lundby M, Kasten J, Saeboe-Larssen S, Haakenstad H, Shendel D, Kvalheim G. Large scale (GMP) production and first clinical experience with a new generation of fast DCs transfected with mRNA hTERT and survivin. Cytotherapy 2013. [DOI: 10.1016/j.jcyt.2013.01.151] [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: 10/27/2022]
|
20
|
Midttun Ø, Kvalheim G, Ueland PM. High-throughput, low-volume, multianalyte quantification of plasma metabolites related to one-carbon metabolism using HPLC-MS/MS. Anal Bioanal Chem 2012; 405:2009-17. [DOI: 10.1007/s00216-012-6602-6] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/20/2012] [Accepted: 11/23/2012] [Indexed: 01/25/2023]
|
21
|
Jung AY, Botma A, Lute C, Blom HJ, Ueland PM, Kvalheim G, Midttun Ø, Nagengast F, Steegenga W, Kampman E. Plasma B vitamins and LINE-1 DNA methylation in leukocytes of patients with a history of colorectal adenomas. Mol Nutr Food Res 2012; 57:698-708. [PMID: 23132835 DOI: 10.1002/mnfr.201200069] [Citation(s) in RCA: 3] [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] [Received: 02/02/2012] [Revised: 07/23/2012] [Accepted: 09/10/2012] [Indexed: 12/21/2022]
Abstract
SCOPE Low concentrations of folate, other B vitamins, and methionine are associated with colorectal cancer risk, possibly by changing DNA methylation patterns. Here, we examine whether plasma concentrations of B vitamins and methionine are associated with methylation of long interspersed nuclear element-1 (LINE-1) among those at high risk of colorectal cancer, i.e. patients with at least one histologically confirmed colorectal adenoma (CRA) in their life. METHODS AND RESULTS We used LINE-1 bisulfite pyrosequencing to measure global DNA methylation levels in leukocytes of 281 CRA patients. Multivariable linear regression was used to assess associations between plasma B vitamin concentrations and LINE-1 methylation levels. Plasma folate was inversely associated with LINE-1 methylation in CRA patients, while plasma methionine was positively associated with LINE-1 methylation. CONCLUSION This study does not provide evidence that in CRA patients, plasma folate concentrations are positively related to LINE-1 methylation in leukocytes but does suggest a direct association between plasma methionine and LINE-1 methylation in leukocytes.
Collapse
Affiliation(s)
- Audrey Y Jung
- Department of Epidemiology, Biostatistics, and HTA, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Fløisand Y, Brinch L, Gedde-Dahl T, Tjønnfjord GE, Dybedal I, Holte H, Heldal D, Torfoss D, Aurlien E, Lauritzsen GF, Fosså A, Lehne G, Baggerød E, Kvalheim G, Egeland T, Bishop MR, Fowler DH, Kolstad A. Ultra-short course sirolimus contributes to effective GVHD prophylaxis after reduced-intensity allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2012; 47:1552-7. [PMID: 22522568 DOI: 10.1038/bmt.2012.63] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Reduced-intensity conditioning (RIC) allo-SCT is a potentially curative treatment approach for patients with relapsed Hodgkin's or non-Hodgkin's lymphoma. In the present study, 37 patients underwent RIC allo-SCT after induction treatment with EPOCH-F(R) using a novel form of dual-agent immunosuppression for GVHD prophylaxis with CsA and sirolimus. With a median follow-up of 28 months among survivors, the probability for OS at 3 and 5 years was 56%. Treatment-related mortality was 16% at day +100 and 30% after 1 year of transplant. Acute GVHD grades II-IV developed in 38% of patients, suggesting that the regimen consisting of CsA and an ultra-short course of sirolimus is effective in the prevention of acute GVHD.
Collapse
Affiliation(s)
- Y Fløisand
- Department of Hematology, Oslo University Hospital, Oslo, Norway.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Mathiesen RR, Nesland JM, Renolen A, Løkkevik E, Anker G, Østenstad B, Lundgren S, Riisberg T, Mjaaland I, Kvalheim G, Lønning PE, Naume B. P4-06-05: Prognostic Impact of Disseminated and Circulating Tumor Cells in Patients Treated for Locally Advanced Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-06-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
INTRODUCTION: Neoadjuvant systemic therapy (NST) in breast cancer patients is an established approach to reduce tumor size prior to surgery and to assess the clinical effect of therapy on the breast cancer disease. The current study was designed to identify primary tumor resistance factors to epirubicin and paclitaxel therapy in patients with locally advanced breast cancer (Chrisanthar et al PLoSOne 2008 and 2011). As a substudy, the incidence of disseminated tumor cells (DTCs) and circulating tumor cells (CTCs) before and after therapy, was investigated. The aim was to evaluate the prognostic impact of DTCs and CTCs as well as to evaluate the effect of NST on DTCs and CTCs.
PATIENTS AND METHODS: Patients with locally advanced non-inflammatory breast cancer (T3-4and/or N2) were included in the study. The patients were randomly allocated to primary treatment either with epirubicin 90mg/m2 or paclitaxel 200mg/m2, with cross-over design if no response/progression, followed by mastectomy and axillary dissection. Bone marrow (BM) aspiration and peripheral blood (PB) samples were collected before NST (BM1/PB1)(n=230), at the time of surgery (BM2/PB2)(n=69; logistic reasons caused reduced sampling) and 12 months after randomization (BM3/PB3)(n=162). Detection of DTCs/CTCs was performed by standard immunocytochemical analysis of 2×106 mononuclear cells stained for cytokeratin by AE1AE3 antibodies. Patient outcomes were evaluated over a 10-year follow-up period. Univariate and multivariable proportional hazards models were estimated to assess the prognostic significance of DTC for disease-free survival (DFS) and overall survival (OS).
RESULTS: Before NST (BM1) 21.3% were DTC positive, compared to 15.9% and 26.5% at BM2 and BM3, respectively. Of those that both had BM1 and BM3 performed, 68% concordance and 22% overlap among positive cases was observed. Presence of DTCs in BM3 predicted reduced DFS (HR 2.2; 95% CI 1.3−3.7; p=0.007) and OS (HR 3.0; 95% CI 1.8−5.2; p>0.001). DTC status before NST had no impact on outcome. No difference in the results was observed after exclusion of patients with limited M1 status at diagnosis (25 and 13 of those analysed for BM1 and BM3, respectively). The incidence of CTCs before NST was 4.9 % compared to 1.4% and 4.3 % at PB2 and PB3, respectively. Presence of CTC before NST was associated with reduced overall survival (HR 2.4; 95% CI 1.2−5.0; p=0.018), but CTC status was not significant for DFS or at other time points. In the multivariable analysis, DTC status at BM3 remained as a prognostic factor for both DFS (HR 2.0; 95% CI 1.1−3.6) and OS (HR 2.1; 95% CI 1.04−4.2).
CONCLUSION: In patients with locally advanced breast cancer, the presence of CTCs at the time of diagnosis identified high risk patients. However, the sensitivity of the performed CTC analysis was too low for further interpretation. Presence of DTCs 12 months after neoadjuvant therapy increased the risk for relapse and death. The best clinical utility of DTC analysis appears to be as a monitoring tool during follow up, in a “window of opportunity” for selection of patients to secondary adjuvant treatment intervention within clinical trials.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-06-05.
Collapse
Affiliation(s)
- RR Mathiesen
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - JM Nesland
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - A Renolen
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - E Løkkevik
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - G Anker
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - B Østenstad
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - S Lundgren
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - T Riisberg
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - I Mjaaland
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - G Kvalheim
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - PE Lønning
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| | - B Naume
- 1Oslo University Hospital The Radium Hospital, Oslo, Norway; Oslo University Hospital, Oslo, Norway; University of Bergen, Bergen, Norway; Haukeland University Hospital, Bergen, Norway; St. Olavs University Hospital, Trondheim, Norway; Norwegian University of Science and Technology, Trondheim, Norway; University Hospital of Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Stavanger University Hospital, Stavanger, Norway; Oslo University Hospital, The Radium Hospital, Oslo, Norway; University of Oslo, Oslo, Norway
| |
Collapse
|
24
|
Torfoss D, Sandstad B, Mollnes TE, Høiby EA, Holte H, Bjerner J, Bjøro T, Gaudernack G, Kvalheim G, Kvaløy S. The mild inflammatory response in febrile neutropenic lymphoma patients with low risk of complications is more pronounced in patients receiving tobramycin once daily compared with three times daily. Scand J Immunol 2011; 74:632-9. [PMID: 21883353 DOI: 10.1111/j.1365-3083.2011.02618.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We evaluated inflammatory markers in febrile neutropenic lymphoma patients undergoing high-dose chemotherapy with autologous stem cell support. Based on MASCC scores, our patients had a low risk of serious complications and a perspective of a benign initial clinical course of the febrile neutropenia. We also studied the impact of tobramycin given once versus three times daily on these immune markers. Sixty-one patients participating in a Norwegian multicentre prospective randomized clinical trial, comparing tobramycin once daily versus three times daily, given with penicillin G to febrile neutropenic patients, constituted a clinically homogenous group. Four patients had bacteraemia, all isolates being Gram-positive. Thirty-two patients received tobramycin once daily, and 29 patients received tobramycin three times daily. Blood samples were taken at the onset of febrile neutropenia and 1-2 days later. All samples were frozen at -70 °C and analysed at the end of the clinical trial for C-reactive protein (CRP), procalcitonin (PCT), complement activation products, mannose-binding lectin (MBL) and 17 cytokines. We found a mild proinflammatory response in this series of patients. CRP was non-specifically elevated. Ten patients with decreased MBL levels showed the same mild clinical and proinflammatory response. Patients receiving tobramycin once daily showed a more pronounced proinflammatory response compared with patients receiving tobramycin three times daily. Overall, febrile neutropenic cancer patients with a benign clinical course show a mild proinflammatory immune response.
Collapse
Affiliation(s)
- D Torfoss
- Department of Oncology, The Norwegian Radium Hospital, Division of Surgery and Cancer Medicine, Oslo University Hospital, Oslo, Norway.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Ugelstad J, Berge A, Ellingsen T, Aune O, Kilaas L, Nilsen T, Schmid R, Stenstad P, Funderud S, Kvalheim G, Nustad K, Lea T, Vartdal F, Danielsen H. Monosized magnetic particles and their use in selective cell separation. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/masy.19880170113] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
26
|
Borgen E, Naume B, Nesland JM, Kvalheim G, Beiske K, Fodstad O, Diel I, Solomayer EF, Theocharous P, Coombes RC, Smith BM, Wunder E, Marolleau JP, Garcia J, Pantel K. Standardization of the immunocytochemical detection of cancer cells in BM and blood: I. establishment of objective criteria for the evaluation of immunostained cells. Cytotherapy 2010; 1:377-88. [PMID: 20426539 DOI: 10.1080/0032472031000141283] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Detection of isolated tumor cells (TC) in BM from carcinoma patients can predict future relapse. Various molecular and immunocytochemical (ICC) methods have been used to detect these cells, which are present at extremely low frequencies of 10(-5) - 10(-6). The specificity and sensitivity of these techniques may vary widely. In 1996, a European ISHAGE Working Group was founded to standardize and optimize procedures used for the detection of minimal residual disease. We have attempted to develop objective criteria for the evaluation of immunocytochemically identifiable cancer cells. METHODS An interlaboratory ring experiment was performed, to compare the screening and detection of micrometastasis-positive events between different laboratories. The discrepant results induced us to establish a common consensus on morphological criteria applicable to the identification of immunostained micrometastatic TC. RESULTS Bared on this consensus evaluation, we propose a classification of stained elements into three groups: (1) 'TC's show pathognomonic signs of epithelial TC-nature, as defined by a clearly enlarged nucleus or clusters of > or = 2 immunopositive cells. (2) 'Probable TC's represent morphological overlap between hematopoietic cells (HC) and TC which lack pathognomonic signs of TC-nature, but do not exhibit clear morphological features of HC. These cells are considered as TC if control staining with an isotype-specific, unrelated Ab is negative. (3) 'TC-negative' cells are defined as 'false positive' HC, skin squamous epithelial cells and artefacts. DISCUSSION The proposed classification of immunostained events is a first step towards the development of standardized immunocytochemical assays for the detection of occult micrometastatic TC in BM or blood.
Collapse
Affiliation(s)
- E Borgen
- Department of Pathology, Institute for Cancer Research, The Norwegian Radium Hospital, Oslo, Norway
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
|
28
|
Hetland G, Tryggestad A, Espevik T, Ryan L, Tangen J, Johnson E, Kvalheim G. 247 The medicinal and antitumour mushroom, agaricus blazei murill, activates NF-KB via TLR2 in monocytic cells and induces expression of cell surface markers and production of cytokines in human monocyte-derived dendritic cells (MDDC) in vitro. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71054-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
29
|
Kvalheim G, Wang M, Zinocker S, Camilio K, Rolstad B, Vaage J, Rekdal O. Remission and tumor cell protection in PVG rats by subcutaneous injection of LTX-315 into an aggressive malignant rat mesenchymal tumor with stemness characteristics. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e21046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
30
|
Johnsen HE, Geisler C, Juvonen E, Remes K, Juliusson G, Hörnsten P, Kvaloy S, Kvalheim G, Jürgensen GW, Pedersen LM, Bergmann OJ, Schmitz A, Boegsted M. Priming with r-metHuSCF and filgrastim or chemotherapy and filgrastim in patients with malignant lymphomas: a randomized phase II pilot study of mobilization and engraftment. Bone Marrow Transplant 2010; 46:44-51. [PMID: 20436517 DOI: 10.1038/bmt.2010.84] [Citation(s) in RCA: 4] [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: 11/09/2022]
Abstract
SCF has been shown to synergize with G-CSF to mobilize CD34(+) PBPCs. In this study we report results from this combination after a phase II trial of 32 patients with malignant lymphoma randomized to receive recombinant methionyl human SCF (ancestim, r-metHuSCF) in combination with recombinant methionyl human G-CSF (filgrastim, r-metHuG-CSF) (experimental arm A) or routine chemotherapy plus filgrastim (conventional arm B). The primary objective was to evaluate the side effects and toxicity during priming and mobilization. The secondary objectives were efficacy by the level of blood-circulating PBPCs, the number of harvest days and the time to three-lineage engraftment after autografting. First, during priming 5 patients had 8 serious events, 4 in each arm. A summary of all adverse events revealed 30 (94%) patients suffering from 132 events of all grading. Second, neutropenia and thrombocytopenia was documented in arm B. Third, 9/14 (64%) patients in arm A reached the target of 5 million CD34(+) cells/kg body weight (bw) compared with 13/15 (87%) in arm B. The results represent the first randomized trial of growth factor plus chemotherapy priming and indicate that a formal phase III trial very unlikely may challenge chemotherapy plus r-metHuG-CSF priming in candidates for high-dose therapy.
Collapse
Affiliation(s)
- H E Johnsen
- Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Jarnjak-Jankovic S, Saebøe-Larssen S, Kvalheim G, Gaudernack G. mRNA transfection of DC in the immature or mature state: comparable in vitro priming of Th and cytotoxic T lymphocytes against DC electroporated with tumor cell line-derived mRNA. Cytotherapy 2007; 9:587-92. [PMID: 17882723 DOI: 10.1080/14653240701466354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The use of mRNA in vaccine studies has generally been through loading or transfection of immature DC followed by a maturation step. A recent study has suggested that this strategy may result in inferior priming of cytotoxic T lymphocytes (CTL). Furthermore the study did not address any possible effects on the priming of CD4(+) T-cell responses. METHODS We compared mRNA transfection of mature DC with that of immature DC, using as a read-out their capacity to prime autologous T cells during one cycle of in vitro stimulation. In this model system we used mRNA from the tumor cell line Jurkat E6. DC transfected at either the immature stage (day 5) or mature stage (day 7) displayed a similar phenotype. RESULTS Interestingly, no major differences in their ability to prime CD4 and CD8 T-cell responses were observed. As in vitro priming to some extent may reflect the capacity of these DC to prime T cells in vivo after vaccination, these studies support the use of mRNA-transfected mature DC in clinical protocols. DISCUSSION Transfection of DC at the end of the maturation process represents a logistical improvement in the GMP production of mRNA-transfected DC for clinical protocols.
Collapse
Affiliation(s)
- S Jarnjak-Jankovic
- Section for Immunotherapy, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway.
| | | | | | | |
Collapse
|
32
|
Berg A, Berner A, Lilleby W, Bruland ØS, Fosså SD, Nesland J, Kvalheim G. Clinical impact of disseminated tumor cells in patients with non-metastatic prostate cancer treated by definitive radiotherapy. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4575 Background: Detection of disseminated tumor cells (DTCs) in bone marrow (BM) has been proven to be an independent prognostic factor in breast cancer. To our knowledge, we here present the first larger study of radically treated prostate cancer (PC) with sufficiently long-term follow-up where the association between DTCs at diagnosis and clinical outcome has been studied. Methods: We screened 272 cT1–4pN0M0 PC patients for DTCs in BM-aspirates between 1994 and 2004. Monoclonal antibodies against cytokeratins (AE1/AE3) and standardized immunocytochemical methods were applied for detection. BM-status was compared with clinical and histopathological factors at diagnosis in all patients and with long-term clinical outcome in 131 patients. They all started treatment including definitive radiotherapy (RT) before June, 2000 and had a relatively poor prognosis defined as cT3–4 or Gleason score (GS) ≥ 7B (4 + 3) or PSA ≥ 10 μg/l. Kaplan-Meier plots were generated by BM-status with the following end-points: Overall death, cause-specific death, distant metastases (DM) as first clinical relapse, local failure as first clinical relapse and biochemical failure. Results: DTCs were detected in 18% of the patients and were significantly associated with increasing percentage Gleason grade 4/5 (p = .035, Mann-Whitney) but not with dichotomized GS, tumor-stage or PSA. In the follow-up cohort (median observation time 6.9 years), the 7-year cumulative risk of DM was 21% in BM-positive patients vs. 6% in BM-negative patients (p = .069, log rank). No association was found between DTCs and other end-points. A sub-group analysis of 73 patients with GS ≥ 7B yielded a 34% 7-year cumulative risk of DM in BM-positive patients vs. 10% in BM-negative patients (p = .039, log rank). DTCs did not predict DM in 55 patients with GS ≤ 7A (3 + 4). In a multivariate analysis, dichotomized GS (RR = 7.8 [95% confidence interval (CI) = 1.0–60.7], p = .049) and BM-status (RR = 3.0 [95% CI = .9–9.4], p = .066) had independent impact on DM. Conclusions: The presence of DTCs in BM at diagnosis of non-metastatic PC is associated with the histological differentiation of the primary tumor and seems to predict development of DM after definitive RT. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- A. Berg
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| | - A. Berner
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| | - W. Lilleby
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| | - Ø. S. Bruland
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| | - S. D. Fosså
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| | - J. Nesland
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| | - G. Kvalheim
- University of Oslo, Oslo, Norway; National Hospital, Oslo, Norway
| |
Collapse
|
33
|
Kyte JA, Mu L, Aamdal S, Kvalheim G, Dueland S, Hauser M, Gullestad HP, Ryder T, Lislerud K, Hammerstad H, Gaudernack G. Phase I/II trial of melanoma therapy with dendritic cells transfected with autologous tumor-mRNA. Cancer Gene Ther 2006; 13:905-18. [PMID: 16710345 DOI: 10.1038/sj.cgt.7700961] [Citation(s) in RCA: 145] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We have developed an individualized melanoma vaccine based on transfection of autologous dendritic cells (DCs) with autologous tumor-mRNA. Dendritic cells loaded with complete tumor-mRNA may generate an immune response against a broad repertoire of antigens, including unique patient-specific antigens. The purpose of the present phase I/II trial was to evaluate the feasibility and safety of the vaccine, and the ability of the DCs to elicit T-cell responses in melanoma patients. Further, we compared intradermal (i.d.) and intranodal (i.n.) vaccine administration. Twenty-two patients with advanced malignant melanoma were included, each receiving four weekly vaccines. Monocyte-derived DCs were transfected with tumor-mRNA by electroporation, matured and cryopreserved. We obtained successful vaccine production for all patients elected. No serious adverse effects were observed. A vaccine-specific immune response was demonstrated in 9/19 patients evaluable by T-cell assays (T-cell proliferation/interferon-gamma ELISPOT) and in 8/18 patients evaluable by delayed-type hypersensitivity (DTH) reaction. The response was demonstrated in 7/10 patients vaccinated intradermally and in 3/12 patients vaccinated intranodally. We conclude that immuno-gene-therapy with the described DC-vaccine is feasible and safe, and that the vaccine can elicit in vivo T-cell responses against antigens encoded by the transfected tumor-mRNA. The response rates do not suggest an advantage in applying i.n. vaccination.
Collapse
Affiliation(s)
- J A Kyte
- Section for Immunotherapy, Department of Immunology, Cancer Research Institute, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Lazarova P, Wu Q, Kvalheim G, Suo Z, Haakenstad KW, Metodiev K, Nesland JM. Growth factor receptors in hematopoietic stem cells: EPH family expression in CD34+ and CD133+ cell populations from mobilized peripheral blood. Int J Immunopathol Pharmacol 2006; 19:49-56. [PMID: 16569339] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Cell-surface antigen expression of hematopoietic stem cells has a crucial role in characterizing cell subpopulation with distinct functional properties. The Eph receptors are the largest receptor tyrosine kinase family being involved in processes like vascular remodelling during development and physiological and pathological angiogenesis. Some Eph/Ephrin members are expressed in hematopoietic cells. The ability to isolate purified cell populations co-expressing CD34 and CD133 antigens as most commonly used markers for identification of hematopoietic progenitors has provided the opportunity to identify their surface-receptor profile. As positively expressed CD34 and CD133 cells take place not only in hematopoietic but also in endothelial differentiation, we aimed to define the Eph/Ephrin characteristic of these cells and relate these findings to new therapy strategies. Positive selections of CD34 and CD133 cells from PBPC in lymphoma patients were performed using magnetic beads and AutoMACS (Miltenyi Biotec) device. The purity of isolated cells was tested by flow cytometry. Immunocytochemistry was used to assess the Eph/Ephrin expression profile of positively selected samples. Our study revealed that all samples (10 from CD34+ and 8 from CD133+ cells) expressed one or more of Eph/Ephrin antigens in different proportions. All CD34+ cell samples, and 6 of 8 in the CD133+ cell fraction were strongly immunoreactive for EphA2. EphB2 was strongly expressed in all CD133+ cases, but 50% of the CD34 positive group lacked or weakly expressed this receptor. EphB4 was negative in 9 of 10 CD34+ cases and in all CD133+ cells. Thus, we have shown the surface marker profile of positively selected CD34 and CD133 cells in leukapheresis samples from lymphoma patients with regard to Eph/Ephrin receptors and discussed their biological clinical potential.
Collapse
Affiliation(s)
- P Lazarova
- Lab for Cellular Therapy, The National Hospital-The Norwegian Radium Hospital, University of Oslo, Oslo 310, Norway
| | | | | | | | | | | | | |
Collapse
|
35
|
Affiliation(s)
- Jw Gratama
- Laboratory for Clinical and Tumor Immunology, Department of Medical Oncology, Rotterdam, Erasmus MC, the Netherlands
| | | | | |
Collapse
|
36
|
Mu LJ, Kyte JA, Kvalheim G, Aamdal S, Dueland S, Hauser M, Hammerstad H, Waehre H, Raabe N, Gaudernack G. Immunotherapy with allotumour mRNA-transfected dendritic cells in androgen-resistant prostate cancer patients. Br J Cancer 2005; 93:749-56. [PMID: 16136047 PMCID: PMC2361645 DOI: 10.1038/sj.bjc.6602761] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Here, we present results from a clinical trial employing a new vaccination method using dendritic cells (DCs) transfected with mRNA from allogeneic prostate cancer cell lines (DU145, LNCaP and PC-3). In all, 20 patients were enrolled and 19 have completed vaccination. Each patient received at least four weekly injections with 2 × 107 transfected DCs either intranodally or intradermally. Safety and feasibility of vaccination were determined. Immune responses were measured as delayed-type hypersensitivity and by in vitro immunoassays including ELISPOT and T-cell proliferation in pre- and postvaccination peripheral blood samples. Serum prostate-specific antigen (PSA) levels and bone scans were monitored. No toxicity or serious adverse events related to vaccinations were observed. A total of 12 patients developed a specific immune response to tumour mRNA-transfected DCs. In total, 13 patients showed a decrease in log slope PSA. This effect was strengthened by booster vaccinations. Clinical outcome was significantly related to immune responses (n=19, P=0.002, r=0.68). Vaccination with mRNA-transfected DCs is safe and results in cellular immune responses specific for antigens encoded by mRNA derived from the prostate cancer cell lines. The observation that in some patients vaccination affected the PSA level suggests that this approach may become useful as a treatment modality for prostate cancer patients.
Collapse
Affiliation(s)
- L J Mu
- Section for Immunotherapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
- Laboratory of Cellular Therapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - J A Kyte
- Section for Immunotherapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - G Kvalheim
- Laboratory of Cellular Therapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - S Aamdal
- Department of Clinical Cancer Research, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - S Dueland
- Department of Clinical Cancer Research, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - M Hauser
- Department of Radiology, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - H Hammerstad
- Laboratory of Cellular Therapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - H Waehre
- Department of Surgery, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - N Raabe
- Department of Oncology, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
| | - G Gaudernack
- Section for Immunotherapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway
- Section for Immunotherapy, The Norwegian Radium Hospital, University of Oslo, Montebello, Oslo 0310, Norway. E-mail:
| |
Collapse
|
37
|
Affiliation(s)
- G Kvalheim
- The Norwegian Radium Hospital, Montebello, Oslo, Norway
| |
Collapse
|
38
|
Windelberg A, Arseth O, Kvalheim G, Ueland PM. Automated assay for the determination of methylmalonic acid, total homocysteine, and related amino acids in human serum or plasma by means of methylchloroformate derivatization and gas chromatography-mass spectrometry. Clin Chem 2005; 51:2103-9. [PMID: 16123148 DOI: 10.1373/clinchem.2005.053835] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The combined measurement of methylmalonic acid (MMA) and total homocysteine (tHcy) in serum or plasma is useful in diagnosing and distinguishing between cobalamin and folate deficiencies. We developed and validated an isotope-dilution gas chromatography-mass spectrometry (GC-MS) method with automated sample workup for the determination of MMA, tHcy, and the related amino acids Met, total cysteine (tCys), Ser, and Gly in serum or plasma. METHODS Serum or plasma samples (100 microL) were treated with a reductant (dithioerythritol), deproteinized with ethanol, and derivatized and extracted in a single step by the addition of methylchloroformate and toluene. All liquid handling was performed in 96-well (1 mL) microtiter plates by a robotic workstation. The N(S)-methoxycarbonyl ethyl ester derivatives were analyzed by GC-MS in the selected-ion monitoring mode. RESULTS Detection limits (signal-to-noise ratio, 5:1) were between 0.03 micromol/L (MMA) and 10 micromol/L (Ser, tCys). The assay was linear to 100 micromol/L for MMA and tHcy and to 1000 micromol/L for Met, tCys, Ser, and Gly. The within-day CVs ranged from 0.7% to 3.6% (n = 20), and the between-day CVs from 2.1% to 8.1% (n = 20). The recovery was between 79% and 99% for the different analytes. CONCLUSION This assay combines a simple and automated sample preparation with selective and sensitive GC-MS analysis and is well suited for the combined measurement of MMA, tHcy, and the related amino acids.
Collapse
Affiliation(s)
- Amrei Windelberg
- LOCUS for Homocysteine and Related Vitamins, and Section for Pharmacology, Institute of Medicine, University of Bergen, Norway.
| | | | | | | |
Collapse
|
39
|
Brunsvig P, Gjertsen M, Kvalheim G, Sve I, Møller M, Eriksen J, Aamdal S. PD-067 Telomerase peptide vaccination of patients with advancednon-small cell lung cancer —A phase I–II trial. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80400-3] [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]
|
40
|
Brunsvig PF, Gjertsen MK, Kvalheim G, Aamdal S, Markowski-Grimsrud CJ, Sve I, Dyrhaug M, Trachsel S, Møller M, Eriksen J, Gaudernack G. A phase I/II study of telomerase peptide vaccination of patients with non-small cell lung cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P. F. Brunsvig
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - M. K. Gjertsen
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - G. Kvalheim
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - S. Aamdal
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - C. J. Markowski-Grimsrud
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - I. Sve
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - M. Dyrhaug
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - S. Trachsel
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - M. Møller
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - J. Eriksen
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| | - G. Gaudernack
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway; GemVax AS, Oslo, Norway; GemVax AS, Oslo, Norway
| |
Collapse
|
41
|
Aamdal S, Kyte J, Dueland S, Mu L, Gullestad HP, Ryder T, Hauser M, Kvalheim G, Sæbøe-Larsen S, Gaudernack G. Phase I/II trial of vaccine therapy with tumor-RNA transfected dendritic cells in patients with advanced malignant melanoma. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Aamdal
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - J. Kyte
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - S. Dueland
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - L. Mu
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | | | - T. Ryder
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - M. Hauser
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - G. Kvalheim
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | | | - G. Gaudernack
- The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| |
Collapse
|
42
|
Dueland S, Mu LJ, Kvalheim G, Hauser M, Waehre H, Aamdal S, Gaudernack G. Dendritic cells transfected with allo-tumor mRNA as cancer vaccine in treatment of hormone resistant prostate cancer patients. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.2541] [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: 11/20/2022] Open
Affiliation(s)
- S. Dueland
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - L.-J. Mu
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - G. Kvalheim
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - M. Hauser
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - H. Waehre
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - S. Aamdal
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| | - G. Gaudernack
- The Norwegian Radium Hosp, Oslo, Norway; The Norwegian Radium Hosp, Univ of Oslo, Oslo, Norway
| |
Collapse
|
43
|
Mu LJ, Lazarova P, Gaudernack G, Saeboe-Larssen S, Kvalheim G. Development of a clinical grade procedure for generation of mRNA transfected dendritic cells from purified frozen CD34(+) blood progenitor cells. Int J Immunopathol Pharmacol 2005; 17:255-63. [PMID: 15461859 DOI: 10.1177/039463200401700305] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Enriched CD34(+) peripheral blood progenitor cells (PBPC) are frequently used as stem cell support in cancer patients following high dose therapy. Since precursor dendritic cells (DCs) originate from haematopoietic progenitor cells, purified CD34(+) cells might also serve as starting cells for ex- vivo production of DC. In the present study we developed a clinical grade procedure for ex- vivo production of DC derived from enriched CD34(+) cells. Different concentrations of CD34(+) cells were grown in gas-permeable Teflon bags with different serum-free and serum-containing media supplemented with GM-CSF, IL-4, TNF-alpha, SCF, Flt-3L and INF-alpha. Serum-free CellGroSCGM medium for 7 days followed by CellGroDC medium in 7 days gave the same results as serum-containing medium. After incubation the cultured cells containing immature DCs were concentrated and transfected with tumour mRNA from human prostate cancer cell lines employing a highly efficient electroporation procedure. Thawed transfected DCs were able to elicit primary T-cell responses in vitro against antigens encoded by the prostate cancer mRNA as shown by ELISPOT assay using mock-transfected DCs as control. Our results show that frozen enriched CD34(+) cells can be an alternative and efficient source for production of DCs for therapeutic purpose.
Collapse
Affiliation(s)
- L J Mu
- Laboratory for Cellular Therapy, Norwegian Radium Hospital, University of Oslo, Oslo, Norway
| | | | | | | | | |
Collapse
|
44
|
Smeland S, Blystad AK, Kvaløy SO, Ikonomou IM, Delabie J, Kvalheim G, Hammerstrøm J, Lauritzsen GF, Holte H. Treatment of Burkitt's/Burkitt-like lymphoma in adolescents and adults: a 20-year experience from the Norwegian Radium Hospital with the use of three successive regimens. Ann Oncol 2004; 15:1072-8. [PMID: 15205201 DOI: 10.1093/annonc/mdh262] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Burkitt's/Burkitt-like lymphoma (BL/BLL) are highly aggressive lymphomas mainly affecting children and young adults. We report the results in adolescent and adult patients with the use of three successive regimens. PATIENTS AND METHODS Forty-nine patients aged 15-70 years admitted to the Norwegian Radium Hospital in the period 1982-2001 with a diagnosis of BL/BLL on histological review and who were given chemotherapy with curative intent are included in this analysis. Up to 1987 patients were given doxorubicin-based chemotherapy supplemented with intravenous and intrathecal methotrexate (MmCHOP). From 1987 to 1994, patients who obtained complete remission upon this regimen were consolidated with high-dose therapy with stem-cell support (MmCHOP + HDT). In 1995 we introduced as frontline therapy the German Berlin-Frankfurt-Munster (BFM) regimen. RESULTS By intention to treat analyses, the progression-free survival rates for patients who received MmCHOP (n=13), MmCHOP + HDT (n=17) or BFM therapy (n=19) are 30.8%, 70.6% and 73.7%, respectively. In the groups of patients who received either the BFM regimen or MmCHOP + HDT, all patients who obtained complete remission upon induction therapy are continuously disease free. There was no treatment-related death. CONCLUSIONS BL/BLL in adolescents and adults can successfully be treated with 5-day blocks of intensified chemotherapy such as the BFM regimen or CHOP/methotrexate-based chemotherapy consolidated with high-dose therapy. Using the BFM regimen, continuous remissions are obtained without additional myeloablative chemotherapy.
Collapse
Affiliation(s)
- S Smeland
- Department of Medical Oncology, Norwegian Radium Hospital, University of Oslo, Montebello, Oslo, Norway
| | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Naume B, Wiedswang G, Borgen E, Schirmer C, Kvalheim G, Kaaresen R, Nesland JM. Clinical significance of isolated tumor cell detection in peripheral blood in breast cancer patients three years after diagnosis. Comparison between analysis of peripheral blood and bone marrow. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B. Naume
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| | - G. Wiedswang
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| | - E. Borgen
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| | - C. Schirmer
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| | - G. Kvalheim
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| | - R. Kaaresen
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| | - J. M. Nesland
- The Norwegian Radium Hospital, Oslo, Norway; Ullevaal University Hospital, Oslo, Norway
| |
Collapse
|
46
|
Affiliation(s)
- G Kvalheim
- Laboratory for Cellular Therapy, Department of Medical Oncology and Radiotherapy The Norwegian Radium Hospital, University of Oslo, Oslo, Norway
| | | | | |
Collapse
|
47
|
Blystad AK, Delabie J, Kvaløy S, Holte H, Vålerhaugen H, Ikonomou I, Kvalheim G. Infused CD34+
cell dose, but not tumour cell content of peripheral blood progenitor cell grafts, predicts clinical outcome in patients with diffuse large B-cell lymphoma and follicular lymphoma grade 3 treated with high-dose therapy. Br J Haematol 2004; 125:605-12. [PMID: 15147376 DOI: 10.1111/j.1365-2141.2004.04951.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previously, we have shown that patients with diffuse large B-cell lymphoma (DLBCL) transplanted with contaminated bone marrow (BM) generally have a poor outcome. Whether this is also the case when peripheral blood progenitor cell (PBPC) grafts are used is not known. Forty-three patients with chemosensitive DLBCL or follicular lymphoma grade 3 (FLgr3) were treated with high-dose therapy (HDT) and autologous stem cell support. Nine patients received purged grafts. Quantitative real-time polymerase chain reaction (QRT-PCR) for either the BCL2/IgH translocation or allele specific oligonucleotide (ASO) QRT-PCR for the immunoglobulin heavy chain (IgH) complementarity-determining region 3 were used. Nine of 25 (36%) PBPC grafts contained tumour cells as tested by QRT-PCR, including two grafts purged by CD34(+) cell enrichment combined with B-cell depletion. The level of contamination of the PBPC/CD34(+) cells ranged from 0 to 8.28%. No relationship could be shown between the total number of tumour cells infused and relapse. Patients receiving PCR-positive or PCR-negative PBPC grafts had similar progression-free survival (PFS) (P = 0.49). However, a significant difference was seen in PFS and overall survival (OS) for the patients given >/=6.1 x 10(6) CD34(+) cells/kg compared with those given <6.1 x 10(6) CD34(+) cells/kg (P = 0.01 and P < 0.05 respectively).
Collapse
Affiliation(s)
- A K Blystad
- Department of Oncology, The Norwegian Radium Hospital, Oslo, Norway.
| | | | | | | | | | | | | |
Collapse
|
48
|
Mu LJ, Gaudernack G, Saebøe-Larssen S, Hammerstad H, Tierens A, Kvalheim G. A protocol for generation of clinical grade mRNA-transfected monocyte-derived dendritic cells for cancer vaccines. Scand J Immunol 2003; 58:578-86. [PMID: 14629630 DOI: 10.1046/j.1365-3083.2003.01333.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
With the aim of producing large quantities of mRNA-transfected monocyte-derived dendritic cells (DCs) to be used as cancer vaccines, a new clinical grade procedure has been developed. Peripheral blood mononuclear cells (PBMCs) obtained by leukapheresis were enriched for monocytes by immunomagnetic depletion of CD19+ B cells and CD2+ T cells employing the ISOLEX 300i device. After 5 days of culture of enriched monocytes in gas permeable Teflon bags, using serum-free medium supplemented with granulocyte/macrophage-colony stimulating factor and interleukin-4 (IL-4), immature DCs were generated. Following transfection with mRNA from three human prostate cancer cell lines (DU145, LNCaP and PC-3), employing a newly developed square wave electroporation procedure, the immature DCs were immediately transferred to Teflon bags and matured for 48 h, using serum-free medium supplemented with IL-1alpha, IL-6, tumour necrosis factor-alpha and PGE2. The electroporation procedure efficiently transferred mRNA into the DCs with minor effect on the viability of the cells. The generated matured transfected DCs show high expression of the antigens CD83, CD80, CD86 and human leucocyte antigen-DR. Freezing and thawing of the transfected matured DCs had minor effect on cell viability and the phenotype. From 4 x 109 PBMCs, about 1 x 108 transfected matured DCs are produced. The thawed transfected DCs were able to elicit primary T-cell responses in vitro against antigens encoded by the prostate cancer mRNA as shown by enzyme-linked immunospot assay using mock-transfected DCs as control. Based on these results, clinical trials in cancer patients have been initiated.
Collapse
Affiliation(s)
- L J Mu
- Laboratory for Cellular Therapy, The Norwegian Radium Hospital, University of Oslo, Oslo, Norway
| | | | | | | | | | | |
Collapse
|
49
|
Wiedswang G, Borgen E, Kåresen R, Kvalheim G, Nesland JM, Qvist H, Schlichting E, Sauer T, Janbu J, Harbitz T, Naume B. Detection of isolated tumor cells in bone marrow is an independent prognostic factor in breast cancer. J Clin Oncol 2003; 21:3469-78. [PMID: 12972522 DOI: 10.1200/jco.2003.02.009] [Citation(s) in RCA: 215] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study was performed to disclose the clinical impact of isolated tumor cell (ITC) detection in bone marrow (BM) in breast cancer. PATIENTS AND METHODS BM aspirates were collected from 817 patients at primary surgery. Tumor cells in BM were detected by immunocytochemistry using anticytokeratin antibodies (AE1/AE3). Analyses of the primary tumor included histologic grading, vascular invasion, and immunohistochemical detection of c-erbB-2, cathepsin D, p53, and estrogen receptor (ER)/progesterone receptor (PgR) expression. These analyses were compared with clinical outcome. The median follow-up was 49 months. RESULTS ITC were detected in 13.2% of the patients. The detection rate rose with increasing tumor size (P =.011) and lymph node involvement (P <.001). Systemic relapse and death from breast cancer occurred in 31.7% and 26.9% of the BM-positive patients versus 13.7% and 10.9% of BM-negative patients, respectively (P <.001). Analyzing node-positive and node-negative patients separately, ITC positivity was associated with poor prognosis in the node-positive group and in node-negative patients not receiving adjuvant therapy (T1N0). In multivariate analysis, ITC in BM was an independent prognostic factor together with node, tumor, and ER/PgR status, histologic grade, and vascular invasion. In separate analysis of the T1N0 patients, histologic grade was independently associated with both distant disease-free survival (DDFS) and breast cancer-specific survival (BCSS), ITC detection was associated with BCSS, and vascular invasion was associated with DDFS. CONCLUSION ITC in BM is an independent predictor of DDFS and BCSS. An unfavorable prognosis was observed for node-positive patients and for node-negative patients not receiving systemic therapy. A combination of several independent prognostic factors can classify subgroups of patients into excellent and high-risk prognosis groups.
Collapse
Affiliation(s)
- G Wiedswang
- Surgical Department, Ullevål University Hospital, Kirkeveien 165, N-0407 Oslo, Norway.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Holm PI, Ueland PM, Kvalheim G, Lien EA. Determination of choline, betaine, and dimethylglycine in plasma by a high-throughput method based on normal-phase chromatography-tandem mass spectrometry. Clin Chem 2003; 49:286-94. [PMID: 12560353 DOI: 10.1373/49.2.286] [Citation(s) in RCA: 254] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The quaternary ammonium compounds, choline and betaine, and dimethylglycine (DMG) reside along a metabolic pathway linked to the synthesis of neurotransmitters and membrane phospholipids and to homocysteine remethylation and, therefore, folate status. Lack of a convenient, high-throughput method for the determination of these compounds has prevented population-based studies of their possible associations with lifestyle, nutrition, and chronic diseases. METHODS Serum or plasma samples were deproteinized by mixing with three volumes of acetonitrile that contained d(9)-choline and d(9)-betaine as internal standards. We used a normal-phase silica column for the separation of choline (retention time, 2.8 min), betaine (1.3 min), DMG (1.15 min), and internal standards, which were detected as positive ions by tandem mass spectroscopy in the multiple-reaction monitoring mode, using the molecular transitions m/z 104-->60 (choline), m/z 113-->69 (d(9)-choline), m/z 118-->59 (betaine), m/z 127-->68 (d(9)-betaine), and m/z 104-->58 (DMG). RESULTS For all three metabolites, the assay was linear in the range 0.4-400 micromol/L, and the lower limit of the detection (signal-to-noise ratio = 5) was < or =0.3 micromol/L. The within- and between-day imprecision (CVs) was 2.1-7.2% and 3.5-8.8%, respectively. The analytical recovery was 87-105%. The fasting plasma concentrations (median, 25th-75th percentiles) were 8.0 (7.0-9.3) micromol/L for choline, 31.7 (27.0-41.1) micromol/L for betaine, and 1.66 (1.30-2.02) micromol/L for DMG in 60 healthy blood donors. In individuals who had eaten a light breakfast, plasma concentrations of all three metabolites were significantly (25-30%) higher than in fasting individuals. CONCLUSION This is the first method for the combined measurement of choline, betaine, and DMG in human plasma or serum. The assay is characterized by simple sample preparation, no derivatization, high throughput, imprecision (CV) <10%, detection limits below the values seen in volunteers, and the high specificity provided by tandem mass spectroscopy.
Collapse
Affiliation(s)
- Pål I Holm
- LOCUS for Homocysteine and Related Vitamins, University of Bergen, N-5021 Bergen, Norway
| | | | | | | |
Collapse
|