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You A, Gu J, Wang J, Li J, Zhang Y, Rao G, Ge X, Zhang K, Gao X, Wang D. Value of long non-coding RNA HAS2-AS1 as a diagnostic and prognostic marker of glioma. Neurologia 2024; 39:353-360. [PMID: 38616063 DOI: 10.1016/j.nrleng.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/11/2021] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Glioma presents high incidence and poor prognosis, and therefore more effective treatments are needed. Studies have confirmed that long non-coding RNAs (lncRNAs) basically regulate various human diseases including glioma. It has been theorized that HAS2-AS1 serves as an lncRNA to exert an oncogenic role in varying cancers. This study aimed to assess the value of lncRNA HAS2-AS1 as a diagnostic and prognostic marker for glioma. METHODS The miRNA expression data and clinical data of glioma were downloaded from the TCGA database for differential analysis and survival analysis. In addition, pathological specimens and specimens of adjacent normal tissue from 80 patients with glioma were used to observe the expression of HAS2-AS1. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic ability and prognostic value of HAS2-AS1 in glioma. Meanwhile, a Kaplan-Meier survival curve was plotted to evaluate the survival of glioma patients with different HAS2-AS1 expression levels. RESULTS HAS2-AS1 was significantly upregulated in glioma tissues compared with normal tissue. The survival curves showed that overexpression of HAS2-AS1 was associated with poor overall survival (OS) and progression-free survival (PFS). Several clinicopathological factors of glioma patients, including tumor size and WHO grade, were significantly correlated with HAS2-AS1 expression in tissues. The ROC curve showed an area under the curve (AUC) value of 0.863, indicating that HAS2-AS1 had good diagnostic value. The ROC curve for the predicted OS showed an AUC of 0.906, while the ROC curve for predicted PFS showed an AUC of 0.88. Both suggested that overexpression of HAS2-AS1 was associated with poor prognosis. CONCLUSIONS Normal tissues could be clearly distinguished from glioma tissues based on HAS2-AS1 expression. Moreover, overexpression of HAS2-AS1 indicated poor prognosis in glioma patients. Therefore, HAS2-AS1 could be used as a diagnostic and prognostic marker for glioma.
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Affiliation(s)
- A You
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - J Gu
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - J Wang
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - J Li
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - Y Zhang
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - G Rao
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - X Ge
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - K Zhang
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China
| | - X Gao
- Operating Theatre, Tangshan Central Hospital, 063000 Tangshan, China
| | - D Wang
- The Fourth Department of Neurosurgery, Tangshan Gongren Hospital, 063000 Tangshan, China.
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Yuan H, Ma X, Xu J, Han P, Rao G, Chen G, Zhang K, Yang R, Han C, Jiang M. Application of metagenomic next-generation sequencing in the clinical diagnosis of infectious diseases after allo-HSCT: a single-center analysis. BMC Infect Dis 2024; 24:279. [PMID: 38438967 PMCID: PMC10910774 DOI: 10.1186/s12879-024-09153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/19/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND We investigated the value of metagenomic next-generation sequencing (mNGS) in diagnosing infectious diseases in patients receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS Fifty-four patients who had fever following allo-HSCT from October 2019 to February 2022 were enrolled. Conventional microbiological tests (CMTs) and mNGS, along with imaging and clinical manifestations, were used to diagnose infection following allo-HSCT. The clinical diagnostic value of mNGS was evaluated. RESULTS A total of 61 mNGS tests were performed, resulting in the diagnosis of 46 cases of infectious diseases. Among these cases, there were 22 cases of viral infection, 13 cases of fungal infection, and 11 cases of bacterial infection. Moreover, 27 cases (58.7%) were classified as bloodstream infections, 15 (32.6%) as respiratory infections, 2 (4.3%) as digestive system infections, and 2 (4.3%) as central nervous system infections. Additionally, there were 8 cases with non-infectious diseases (8/54, 14.81%), including 2 cases of interstitial pneumonia, 2 cases of bronchiolitis obliterans, 2 cases of engraftment syndrome, and 2 cases of acute graft-versus-host disease. The positive detection rates of mNGS and CMT were 88.9% and 33.3%, respectively, with significant differences (P < 0.001). The sensitivity of mNGS was 97.82%, the specificity was 25%, the positive predictive value was 93.75%, and the negative predictive value was 50%. Following treatment, 51 patients showed improvement, and 3 cases succumbed to multidrug-resistant bacterial infections. CONCLUSIONS mNGS plays an important role in the early clinical diagnosis of infectious diseases after allo-HSCT, which is not affected by immunosuppression status, empiric antibiotic therapy, and multi-microbial mixed infection.
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Affiliation(s)
- Hailong Yuan
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China
| | - Xiaolu Ma
- Department of Hematology, Guangyuan Central Hospital, Guangyuan, Sichuan Province, China
| | - Jianli Xu
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China
| | - Peng Han
- Genskey Medical Technology Co., Ltd, Beijing, China
| | - Guanhua Rao
- Genskey Medical Technology Co., Ltd, Beijing, China
| | - Gang Chen
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China
| | - Kaile Zhang
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China
| | - Ruixue Yang
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China
| | - Chuixia Han
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China
| | - Ming Jiang
- Hematology Center, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Institute of Hematology, No.137 Liyushan South Road, Urumqi, 830054, China.
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Tian Y, Zhang D, Chen F, Rao G, Zhang Y. Machine learning-based colistin resistance marker screening and phenotype prediction in Escherichia coli from whole genome sequencing data. J Infect 2024; 88:191-193. [PMID: 37992876 DOI: 10.1016/j.jinf.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Yingxin Tian
- Department of Laboratory Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Di Zhang
- Department of Laboratory Medicine, Third Xiangya Hospital, Central South University, Changsha, China
| | | | - Guanhua Rao
- Genskey Medical Technology Co., Ltd, Beijing, China.
| | - Ying Zhang
- Department of Laboratory Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
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Feng S, Rao G, Wei X, Fu R, Hou M, Song Y, Xu C, Han P, Gong B, Chen X, Wang Y, Dong X, Jiang Z, Wang J. Clinical metagenomic sequencing of plasma microbial cell-free DNA for febrile neutropenia in patients with acute leukaemia. Clin Microbiol Infect 2024; 30:107-113. [PMID: 37271194 DOI: 10.1016/j.cmi.2023.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To evaluate the diagnostic performance and clinical impact of metagenomic next-generation sequencing (mNGS) of plasma microbial cell-free DNA (mcfDNA) in febrile neutropenia (FN). METHODS In a 1-year, multicentre, prospective study, we enrolled 442 adult patients with acute leukaemia with FN and investigated the usefulness of mNGS of plasma mcfDNA for identification of infectious pathogens. The results of mNGS were available to clinicians in real time. The performance of mNGS testing was evaluated in comparison with blood culture (BC) and a composite standard that incorporated standard microbiological testing and clinical adjudication. RESULTS In comparison with BC, the positive and negative agreements of mNGS were 81.91% (77 of 94) and 60.92% (212 of 348), respectively. By clinical adjudication, mNGS results were categorized by infectious diseases specialists as definite (n = 76), probable (n = 116), possible (n = 26), unlikely (n = 7), and false negative (n = 5). In 225 mNGS-positive cases, 81 patients (36%) underwent antimicrobials adjustment, resulting in positive impact on 79 patients and negative impact on two patients (antibiotics overuse). Further analysis indicated that mNGS was less affected by prior antibiotics exposure than BC. DISCUSSION Our results indicate that mNGS of plasma mcfDNA increased the detection of clinically significant pathogens and enabled early optimization of antimicrobial therapy in patients with acute leukaemia with FN.
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Affiliation(s)
- Sizhou Feng
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Guanhua Rao
- Department of Medicine, Genskey Medical Technology Co, Ltd, Beijing, China
| | - Xudong Wei
- Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Rong Fu
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Hou
- Shandong Provincial Key Laboratory of Immunohematology, Department of Hematology, Qilu Hospital of Shandong University, Shandong University, Jinan, China
| | - Yongping Song
- Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Chunhui Xu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Peng Han
- Department of Medicine, Genskey Medical Technology Co, Ltd, Beijing, China
| | - Benfa Gong
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Xin Chen
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Yihao Wang
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaoyuan Dong
- Shandong Provincial Key Laboratory of Immunohematology, Department of Hematology, Qilu Hospital of Shandong University, Shandong University, Jinan, China
| | - Zhi Jiang
- Department of Medicine, Genskey Medical Technology Co, Ltd, Beijing, China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
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Li Y, Rao G, Zhu G, Cheng C, Yuan L, Li C, Gao J, Tang J, Wang Z, Li W. Dysbiosis of lower respiratory tract microbiome are associated with proinflammatory states in non-small cell lung cancer patients. Thorac Cancer 2024; 15:111-121. [PMID: 38041547 PMCID: PMC10788479 DOI: 10.1111/1759-7714.15166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND The lung has a sophisticated microbiome, and respiratory illnesses are greatly influenced by the lung microbiota. Despite the fact that numerous studies have shown that lung cancer patients have a dysbiosis as compared to healthy people, more research is needed to explore the association between the microbiota dysbiosis and immune profile within the tumor microenvironment (TME). METHODS In this study, we performed metagenomic sequencing of tumor and normal tissues from 61 non-small cell lung cancer (NSCLC) patients and six patients with other lung diseases. In order to characterize the impact of the microbes in TME, the cytokine concentrations of 24 lung tumor and normal tissues were detected using a multiple cytokine panel. RESULTS Our results showed that tumors had lower microbiota diversity than the paired normal tissues, and the microbiota of NSCLC was enriched in Proteobacteria, Firmicutes, and Actinobacteria. In addition, proinflammatory cytokines such as IL-8, MIF, TNF- α, and so on, were significantly upregulated in tumor tissues. CONCLUSION We discovered a subset of bacteria linked to host inflammatory signaling pathways and, more precisely, to particular immune cells. We determined that lower airway microbiome dysbiosis may be linked to the disruption of the equilibrium of the immune system causing lung inflammation. The spread of lung cancer may be linked to specific bacteria.
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Affiliation(s)
- Yangqian Li
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
| | - Guanhua Rao
- Genskey Medical Technology Co., LtdBeijingChina
| | - Guonian Zhu
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
| | - Cheng Cheng
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
| | - Lijuan Yuan
- Genskey Medical Technology Co., LtdBeijingChina
| | - Chengpin Li
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
| | | | - Jun Tang
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
| | - Zhoufeng Wang
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease‐related Molecular Network, West China HospitalSichuan UniversityChengduChina
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Liu B, Gao J, Liu XF, Rao G, Luo J, Han P, Hu W, Zhang Z, Zhao Q, Han L, Jiang Z, Zhou M. Direct prediction of carbapenem resistance in Pseudomonas aeruginosa by whole genome sequencing and metagenomic sequencing. J Clin Microbiol 2023; 61:e0061723. [PMID: 37823665 PMCID: PMC10662344 DOI: 10.1128/jcm.00617-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/17/2023] [Indexed: 10/13/2023] Open
Abstract
Carbapenem resistance is a major concern in the management of antibiotic-resistant Pseudomonas aeruginosa infections. The direct prediction of carbapenem-resistant phenotype from genotype in P. aeruginosa isolates and clinical samples would promote timely antibiotic therapy. The complex carbapenem resistance mechanism and the high prevalence of variant-driven carbapenem resistance in P. aeruginosa make it challenging to predict the carbapenem-resistant phenotype through the genotype. In this study, using whole genome sequencing (WGS) data of 1,622 P. aeruginosa isolates followed by machine learning, we screened 16 and 31 key gene features associated with imipenem (IPM) and meropenem (MEM) resistance in P. aeruginosa, including oprD(HIGH), and constructed the resistance prediction models. The areas under the curves of the IPM and MEM resistance prediction models were 0.906 and 0.925, respectively. For the direct prediction of carbapenem resistance in P. aeruginosa from clinical samples by the key gene features selected and prediction models constructed, 72 P. aeruginosa-positive sputum samples were collected and sequenced by metagenomic sequencing (MGS) based on next-generation sequencing (NGS) or Oxford Nanopore Technology (ONT). The prediction applicability of MGS based on NGS outperformed that of MGS based on ONT. In 72 P. aeruginosa-positive sputum samples, 65.0% (26/40) of IPM-insensitive and 63.2% (24/38) of MEM-insensitive P. aeruginosa were directly predicted by NGS-based MGS with positive predictive values of 0.897 and 0.889, respectively. By the direct detection of the key gene features associated with carbapenem resistance of P. aeruginosa, the carbapenem resistance of P. aeruginosa could be directly predicted from cultured isolates by WGS or from clinical samples by NGS-based MGS, which could assist the timely treatment and surveillance of carbapenem-resistant P. aeruginosa.
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Affiliation(s)
- Bing Liu
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China
| | - Jianpeng Gao
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Xue Fei Liu
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China
| | - Guanhua Rao
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Jiajie Luo
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Peng Han
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Weiting Hu
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China
| | - Ze Zhang
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China
| | - Qianqian Zhao
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China
| | - Lizhong Han
- Department of Clinical Microbiology,, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi Jiang
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Min Zhou
- Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Emergency Prevention, Diagnosis and Treatment of Respiratory Infectious Diseases, Shanghai, China
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Yeboa DN, Woodhouse K, Prabhu S, Li J, Beckham T, Weinberg JS, Wang C, McCutcheon IE, Swanson TA, Kim BYS, McGovern SL, North R, McAleer MF, Alvarez-Breckenridge C, Jiang W, Ene C, Ejezie CL, Lang F, Rao G, Ferguson S. MD Anderson Phase III Randomized Preoperative Stereotactic Radiosurgery (SRS) vs. Postoperative SRS for Brain Metastases Trial. Int J Radiat Oncol Biol Phys 2023; 117:e160-e161. [PMID: 37784756 DOI: 10.1016/j.ijrobp.2023.06.990] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Postoperative stereotactic radiation therapy/radiosurgery (SRT/SRS) is being evaluated in comparison to Preoperative SRT for brain metastases (mets) in a limited number of prospective clinical trials. Our objective is to address the significant knowledge gap concerning the logistics of preoperative SRT in comparison to postoperative SRT in a randomized controlled study. MATERIALS/METHODS Patients with brain mets with at least 1 surgically operable met were randomized (1:1) to Preop vs Postop SRT. In this abstract, we present non-primary endpoint data on the trial concept and logistics of treatment for this data safety monitoring board reviewed study. Patients enrolled had 1-2 lesions resected and <15 lesions treated at time of SRT to best reflect the standard population that receive SRT and surgery at our institution. RESULTS From 12/2018 to 12/2022, 99 patients with 1-2 operable brain mets were enrolled and randomized to Preop (n = 49) or Postop (n = 50) SRT. Males represented 56% of the cohort compared to females, and <25% were age 18-49 years, while 27%, 29, and 19% respectively were 50-59, 60-69, and > = 70. The most frequent histologies enrolled were lung (29%), renal cell (15%), melanoma (14%), and breast (11%) cancers. The majority of patients (83%) had 1-4 brain mets on their baseline MRI and 91% subsequently had a single lesion resected. Seventy-nine patients completed both SRT and surgery, while 9% received no therapy due to drop out before study therapy initiation. Among patients receiving both therapies in the combined cohort, 68% received a non-invasive stereotactic radiosurgery instrument to the randomized cavity lesion compared to 32% receiving LINAC based SRT. Treatment of the lesion or cavity with single fraction SRT was 51% in the Preop arm vs 31% in the Postop arm. Multi-fraction (3-5 SRT) was 67% in the Postop cohort in contrast to 47% in the Preop cohort. Time from randomization to RT was 5.6 days and 33.7 days in the Preop and Postop cohorts respectively, and for surgery was 10.2 days vs 12.9 days in the Postop vs Preop cohorts. The average time from RT to surgery was 7.3 days in the Preop arm and 23.5 days in the Postop arm (to allow for incisional healing time). CONCLUSION In one of the early initiated randomized prospective cohorts of Preop vs Postop SRT, we demonstrated logistical feasibility with an efficient clinical trial workflow for study treatment. Differences in Preop vs Postop logistics reflect clinical practice differences in time-to-treatment. Therapy with various modalities reflected real-world practice and possibly provider preferences in technique when addressing the nature of delineating cavities and changes in cavity volume with regard to fractionation. Independent of the primary outcomes, our data provides insights in the practical management of patients receiving these two modalities of therapy, and further data at the completion of trial will address relevant primary outcomes.
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Affiliation(s)
- D N Yeboa
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - S Prabhu
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Li
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Beckham
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J S Weinberg
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
| | - C Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - I E McCutcheon
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
| | - T A Swanson
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B Y S Kim
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
| | - S L McGovern
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R North
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M F McAleer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - W Jiang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C Ene
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
| | - C L Ejezie
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - F Lang
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
| | - G Rao
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX
| | - S Ferguson
- Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston, TX
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8
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Hu X, Zhao Y, Han P, Liu S, Liu W, Mai C, Deng Q, Ren J, Luo J, Chen F, Jia X, Zhang J, Rao G, Gu B. Novel Clinical mNGS-Based Machine Learning Model for Rapid Antimicrobial Susceptibility Testing of Acinetobacter baumannii. J Clin Microbiol 2023; 61:e0180522. [PMID: 37022167 DOI: 10.1128/jcm.01805-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Multidrug-resistant (MDR) bacteria are important public health problems. Antibiotic susceptibility testing (AST) currently uses time-consuming culture-based procedures, which cause treatment delays and increased mortality. We developed a machine learning model using Acinetobacter baumannii as an example to explore a fast AST approach using metagenomic next-generation sequencing (mNGS) data. The key genetic characteristics associated with antimicrobial resistance (AMR) were selected through a least absolute shrinkage and selection operator (LASSO) regression model based on 1,942 A. baumannii genomes. The mNGS-AST prediction model was accordingly established, validated, and optimized using read simulation sequences of clinical isolates. Clinical specimens were collected to evaluate the performance of the model retrospectively and prospectively. We identified 20, 31, 24, and 3 AMR signatures of A. baumannii for imipenem, ceftazidime, cefepime, and ciprofloxacin, respectively. Four mNGS-AST models had a positive predictive value (PPV) greater than 0.97 for 230 retrospective samples, with negative predictive values (NPVs) of 100% (imipenem), 86.67% (ceftazidime), 86.67% (cefepime), and 90.91% (ciprofloxacin). Our method classified antibacterial phenotypes with an accuracy of 97.65% for imipenem, 96.57% for ceftazidime, 97.64% for cefepime, and 98.36% for ciprofloxacin. The average reporting time of mNGS-based AST was 19.1 h, in contrast to the 63.3 h for culture-based AST, thus yielding a significant reduction of 44.3 h. mNGS-AST prediction results coincided 100% with the phenotypic AST results when testing 50 prospective samples. The mNGS-based model could be used as a rapid genotypic AST approach to identify A. baumannii and predict resistance and susceptibility to antibacterials and could be applicable to other pathogens and facilitate rational antimicrobial usage.
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Affiliation(s)
- Xuejiao Hu
- Department of Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yunhu Zhao
- Department of Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Peng Han
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Suling Liu
- Department of Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Weijiang Liu
- Department of Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Cong Mai
- Department of Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Qianyun Deng
- Department of Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Jing Ren
- Tianjin Medical University General Hospital, Tianjin, China
| | - Jiajie Luo
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Fangyuan Chen
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Xuefeng Jia
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Jing Zhang
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Guanhua Rao
- Genskey Medical Technology Co., Ltd., Beijing, China
| | - Bing Gu
- Department of Laboratory Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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Nang S, Lu J, Yu H, Wickremasinghe H, Azad M, Han M, Rao G, Bergen P, Velkov T, Sherry N, Aslam S, Schooley R, Howden B, Barr J, Zhu Y, Li J. SY4.1: COMBINATION OF BACTERIOPHAGE AND ANTIBIOTIC: IS IT AN ULTIMATE SOLUTION TO MULTIDRUG RESISTANCE? J Glob Antimicrob Resist 2022. [DOI: 10.1016/s2213-7165(22)00278-8] [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: 12/23/2022] Open
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10
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Nang S, Lin Y, Hanafin P, Wang J, Chen K, Yu H, Wickremasinghe H, Bergen P, Chang R, Rao G, Chan H, Li J. 81: PHARMACOKINETICS/PHARMACODYNAMICS OF ANTI-PSEUDOMONAL PHAGE: LEVERAGING PRECLINCAL MODELS OF INFECTION AND MECHANISM-BASED MODELLING. J Glob Antimicrob Resist 2022. [DOI: 10.1016/s2213-7165(22)00360-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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11
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Vigouroux L, Cartier T, Rao G, Berton É. Pull-up forms of completion impacts deeply the muscular and articular involvements. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Garcia S, Delattre N, Berton E, Divrechy G, Rao G. Comparison of landing kinematics and kinetics between experienced and novice volleyball players during block and spike jumps. BMC Sports Sci Med Rehabil 2022; 14:105. [PMID: 35690791 PMCID: PMC9188216 DOI: 10.1186/s13102-022-00496-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/01/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND The practice of volleyball requires many jumps. During landing, anterior cruciate ligament injuries may occur with high-risk lower limb kinematics and kinetics. Differences in landing strategies between experienced and novice volleyball players have not been fully explored. The purpose of the study was to compare lower limb kinematics and kinetics in experienced and novice volleyball players when performing volleyball specific jumps. METHODS A total of 30 healthy males, 15 experienced and 15 novice volleyball players, participated in the study. Participants performed block and spike jumps at a controlled jump height. Hip, knee and ankle joints angles at initial ground contact and ranges of motion in the sagittal plane, knee joint angles and moments in the frontal plane, vertical ground reaction force peak and loading rate were analyzed to investigate the expertise effect. RESULTS Experienced volleyball players landed with larger ankle dorsiflexion range of motion compared to novices. For the spike jump, experienced players landed with larger ankle plantarflexion angles at initial contact and larger ankle dorsiflexion ranges of motion, and for the block jump, they landed with larger knee flexion ranges of motion. Experienced players jumped significantly higher than novices. No difference was found in vertical ground reaction force peaks and loading rates. CONCLUSIONS Although the experienced group jumped higher than the novice group, no difference was found in ground reaction force parameters. These findings highlight that the experience of volleyball players acquired during regular trainings and competitions may play an important role in landing kinematics and kinetics to reduce the injury risk.
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Affiliation(s)
- Sébastien Garcia
- Movement Sciences Department, Decathlon SportsLab, 59000, Lille, France. .,CNRS, Insitute of Movement Sciences, Aix-Marseille University, 13007, Marseille, France.
| | - N Delattre
- Movement Sciences Department, Decathlon SportsLab, 59000, Lille, France
| | - E Berton
- CNRS, Insitute of Movement Sciences, Aix-Marseille University, 13007, Marseille, France
| | - G Divrechy
- Movement Sciences Department, Decathlon SportsLab, 59000, Lille, France
| | - G Rao
- CNRS, Insitute of Movement Sciences, Aix-Marseille University, 13007, Marseille, France
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Sundaram V, Rao G, Nandi M, Reddy V, pokhala N, Mondal K, Prakash A, Bhattacharjee M. PO-1545 Comparison of PRO and PO algorithms in Rapid arc (VMAT) delivery for Head and Neck SIB treatments. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03509-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sundaram V, Rao G, Bhattacharjee M, Joseph J, Balaji B, Patil D. PO-1544 The role of dose rate and gantry speed variations in PRO and PO algorithms for rapidarc delivery. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03508-3] [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: 11/28/2022]
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15
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Pollock A, Risher H, Bentzen S, Roque D, Rao G, Nichols E, Mohindra P. Clinical Outcomes of Patients Treated With Intensity Modulated Proton Therapy (IMPT) Re-Irradiation for Gynecologic Malignancies. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Garcia E, Muhlebach M, Sharma R, Khoei A, Rao G. 415: Antimicrobial resistance—Modeling of prolonged treatment in vitro. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01839-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lohith G, Sekar K, Patil S, Bandemagal M, Murugan K, M V, Thungappa S, Rao V, Kudpaje A, Ramasamy M, Ramachandrappa S, Bharathan A, Rao G, Rao D, kumar B. A Randomized Control Trial Comparing Time to Healing of Radiation Induced Acute Skin Reactions Using Biological Membrane Dressing or Topical Methyl Pararosaniline Dye. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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You A, Gu J, Wang J, Li J, Zhang Y, Rao G, Ge X, Zhang K, Gao X, Wang D. Value of long non-coding RNA HAS2-AS1 as a diagnostic and prognostic marker of glioma. Neurologia 2021. [DOI: 10.1016/j.nrl.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Rao G, Meng Z. A commentary on "The efficacy and safety of probiotics for patients with constipation predominant irritable bowel syndrome: A systematic review and meta-analysis based on seventeen randomized controlled trials" [Int. J. Surg. 2020; 79: 111-119]. Int J Surg 2021; 91:105993. [PMID: 34118440 DOI: 10.1016/j.ijsu.2021.105993] [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] [Received: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Affiliation(s)
| | - Zhijian Meng
- Department of Orthopedics, The First People's Hospital of Qinzhou, Qinzhou, Guangxi, 535000, China.
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Mohindra P, Pollock A, Patel A, Roque D, Rao G, Nichols E. First Clinical Experience of Quality Assurance CT Scan Adapted Intensity Modulated Proton Therapy for Utero-cervical Cancers. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1537] [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]
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21
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Li J, Ludmir E, Wang Y, Guha-Thakurta N, McAleer M, Settle S, Yeboa D, Ghia A, McGovern S, Chung C, Woodhouse K, Briere T, Sullaway C, Liu D, Rao G, Chang E, Mahajan A, Sulman E, Brown P, Wefel J. Stereotactic Radiosurgery versus Whole-brain Radiation Therapy for Patients with 4-15 Brain Metastases: A Phase III Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2108] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sridhar P, Roopesh K, Anuradha P, Deputy M, Bharathan A, Senapati M, Ram A, Gupta M, Muttagi V, Rao G, Patil S, Chirodoni Thungappa S, Hussain S, Ajai kumar B. Understanding the Immune Profile of SBRT – Could It Evolve Into Becoming A Surrogate Biomarkers To Treatment Response. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1598] [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]
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23
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Soliman M, Wang Y, Farooqi A, Bishop A, Yeboa D, McGovern S, McAleer M, Briere T, Campbell M, Tu S, Ferguson S, Rao G, Nieto Y, Li J. Primary Management of Non-Seminomatous Germ Cell Brain Metastases with Stereotactic Radiosurgery: A Case Series. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim IK, Rao G, Zhao X, Fan R, Avantaggiati ML, Wang Y, Zhang YW, Giaccone G. Mutant GTF2I induces cell transformation and metabolic alterations in thymic epithelial cells. Cell Death Differ 2020; 27:2263-2279. [PMID: 32034314 DOI: 10.1038/s41418-020-0502-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/23/2022] Open
Abstract
The pathogenesis of thymic epithelial tumors (TETs) is poorly understood. Recently we reported the frequent occurrence of a missense mutation in the GTF2I gene in TETs and hypothesized that GTF2I mutation might contribute to thymic tumorigenesis. Expression of mutant TFII-I altered the transcriptome of normal thymic epithelial cells and upregulated several oncogenic genes. Gtf2i L424H knockin cells exhibited cell transformation, aneuploidy, and increase tumor growth and survival under glucose deprivation or DNA damage. Gtf2i mutation also increased the expression of several glycolytic enzymes, cyclooxygenase-2, and caused modifications of lipid metabolism. Elevated cyclooxygenase-2 expression by Gtf2i mutation was required for survival under metabolic stress and cellular transformation of thymic epithelial cells. Our findings identify GTF2I mutation as a new oncogenic driver that is responsible for transformation of thymic epithelial cells.
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Affiliation(s)
- In-Kyu Kim
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA.
| | - Guanhua Rao
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA
| | - Xiaoliang Zhao
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA
| | - Ruzong Fan
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA
| | - Maria Laura Avantaggiati
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA
| | - Yisong Wang
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA.,Basic and Mechanistic Research Branch, Division of Extramural Research, National Center for Complementary and Integrative Health (NCCAIH), NIH, Bethesda, MD, 20892, USA
| | - Yu-Wen Zhang
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA
| | - Giuseppe Giaccone
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, 20057, USA.
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Chadefaux D, Gueguen N, Thouze A, Rao G. 3D propagation of the shock-induced vibrations through the whole lower-limb during running. J Biomech 2019; 96:109343. [PMID: 31558309 DOI: 10.1016/j.jbiomech.2019.109343] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 11/30/2022]
Affiliation(s)
- D Chadefaux
- Aix-Marseille Univ, CNRS, ISM, Marseille, France; Université Paris 13 - Institut de Biomécanique Humaine Georges Charpak (EA 4494), Paris, France.
| | - N Gueguen
- Department of Movement Sciences, Décathlon, Villeneuve d'Ascq, France
| | - A Thouze
- Department of Movement Sciences, Décathlon, Villeneuve d'Ascq, France
| | - G Rao
- Aix-Marseille Univ, CNRS, ISM, Marseille, France
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Muhammad Adil ZA, Nur Zawani J, Hazariah AH, Rao G, Zailiza S, Mohd Nasir H. Methanol outbreak in the district of Hulu Langat, 2018. Med J Malaysia 2019; 74:413-417. [PMID: 31649218] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION A methanol outbreak occurred in the district of Hulu Langat on 16 September 2018. The Hulu Langat District Health Office received 25 notifications of a suspected methanol poisoning from Kajang and Ampang Hospital. An outbreak investigation was done to determine the source followed by a preventive and control measure. METHOD Active case detection was done on cases living quarters and workplaces. Patients were interviewed, and their blood and urine samples were sent for methanol analysis. Samples of suspected alcoholic beverages were also sent for analysis. A suspected case was defined as any person presented with clinical symptoms with a history of consuming alcoholic beverages within five days before symptoms and high anion gap metabolic acidosis. A confirmed case was defined as a suspected case with positive blood and urine methanol. RESULTS In total, there were 25 suspected cases, of which 12 cases were confirmed. The calculated attack rate was 48%. There were six mortalities (50%) secondary to severe metabolic acidosis. The most common presenting symptom was vomiting (75%) and abdominal pain (41.7%). These cases were linked to consumption of illicitly produced alcohol. Samples of the alcoholic drinks were positive containing high level of methanol. CONCLUSION The methanol outbreak in the Hulu Langat was successfully managed. Appropriate control and prevention measures were taken, including health promotion and joint enforcement activities. Steps were taken successfully through collaborations with multiple agencies and cooperation with Selangor Health Departments and the Ministry of Health. Continuous surveillance on the product of liquor, and health promotion are essential to prevent a similar outbreak from happening again in future.
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Affiliation(s)
- Z A Muhammad Adil
- Ministry of Health Malaysia, Hulu Langat District Health Office, Kajang, Selangor, Malaysia.
| | - J Nur Zawani
- Ministry of Health Malaysia, Hulu Langat District Health Office, Kajang, Selangor, Malaysia
| | - A H Hazariah
- Ministry of Health Malaysia, Hulu Langat District Health Office, Kajang, Selangor, Malaysia
| | - G Rao
- Ministry of Health Malaysia, Hulu Langat District Health Office, Kajang, Selangor, Malaysia
| | - S Zailiza
- Ministry of Health Malaysia, Hulu Langat District Health Office, Kajang, Selangor, Malaysia
| | - H Mohd Nasir
- Ministry of Health Malaysia, Hulu Langat District Health Office, Kajang, Selangor, Malaysia
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Traylor JI, Bastos DCA, Fuentes D, Muir M, Patel R, Kumar VA, Stafford RJ, Rao G, Prabhu SS. Dynamic Contrast-Enhanced MRI in Patients with Brain Metastases Undergoing Laser Interstitial Thermal Therapy: A Pilot Study. AJNR Am J Neuroradiol 2019; 40:1451-1457. [PMID: 31371353 DOI: 10.3174/ajnr.a6144] [Citation(s) in RCA: 2] [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] [Received: 04/22/2019] [Accepted: 06/19/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Tumor recurrence is difficult to predict in patients receiving laser ablation for intracranial malignancy. We assessed the efficacy of the initial area under the time-to-signal intensity curve at 60 seconds (iAUC60) from dynamic contrast-enhanced MR imaging in predicting progression-free survival in patients with brain metastases following laser interstitial thermal therapy. MATERIALS AND METHODS The study population was a consecutive series of patients undergoing laser interstitial thermal therapy for brain metastases. Patient demographics including age, sex, tumor histology, and Karnofsky Performance Scale were collected prospectively. Preoperative, postoperative, and 1-month follow-up dynamic contrast-enhanced MRIs were analyzed. Values of iAUC60 were computed using a trapezoidal rule applied to the time history of contrast uptake over the first 60 seconds postenhancement. The change in iAUC60 (ΔiAUC60) was calculated by taking the difference between the values of iAUC60 from 2 time points. Pearson correlation coefficients were calculated between progression-free survival, defined as the time from laser interstitial thermal therapy to tumor recurrence, and iAUC60 or ΔiAUC60 values. RESULTS Thirty-three cases of laser interstitial thermal therapy for 32 brain metastases in a cohort of 27 patients were prospectively analyzed. A significant relationship was observed between the values of iAUC60 from postoperative dynamic contrast-enhanced MR imaging and progression-free survival with Pearson correlation (P = .03) and Cox univariate analysis (P = .01). The relationship between preoperative and 1-month follow-up dynamic contrast-enhanced MR imaging was not significantly correlated with progression-free survival. Similarly, no statistically significant relationship was observed with ΔiAUC60 and progression-free survival between any time points. CONCLUSIONS Progression-free survival is difficult to predict in patients undergoing laser interstitial thermal therapy for brain metastases due to confounding with posttreatment change. iAUC60 extracted from postoperative dynamic contrast-enhanced MR imaging shows promise for accurately prognosticating patients following this operative therapy.
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Affiliation(s)
- J I Traylor
- From the Departments of Neurosurgery (J.I.T., D.C.A.B., M.M., R.P., G.R., S.S.P.)
| | - D C A Bastos
- From the Departments of Neurosurgery (J.I.T., D.C.A.B., M.M., R.P., G.R., S.S.P.)
| | | | - M Muir
- From the Departments of Neurosurgery (J.I.T., D.C.A.B., M.M., R.P., G.R., S.S.P.)
| | - R Patel
- From the Departments of Neurosurgery (J.I.T., D.C.A.B., M.M., R.P., G.R., S.S.P.)
| | - V A Kumar
- Diagnostic Radiology (V.A.K.), The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - G Rao
- From the Departments of Neurosurgery (J.I.T., D.C.A.B., M.M., R.P., G.R., S.S.P.)
| | - S S Prabhu
- From the Departments of Neurosurgery (J.I.T., D.C.A.B., M.M., R.P., G.R., S.S.P.)
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Lin D, Ji J, Niu D, Li L, Yu Y, Gao Y, Zhang W, Li Z, Rao G, Gao L, Cheng G. Evaluation of next generation sequencing for detecting HER2 copy number in breast and gastric cancers. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e13004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e13004 Background: Amplicon-based next generation sequencing (NGS) approaches have been preferentially adopted by the clinical laboratories on the basis of a short turnaround time (TAT) and small DNA input needs. However, little work has been done to assess the amplicon-based NGS methods for copy number variation (CNV) detection in comparison with current standard methods like immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). The correlation between NGS based CNV detection and the later standard methods has remained unexplored. Methods: We developed an amplicon-based panel to detect human epidermal receptor growth factor (HER2) amplification in formalin-fixed paraffin-embedded (FFPE) tumor tissue samples from 280 breast cancer and 50 gastric cancer patients. Assessment by IHC and FISH was conducted in parallel, and descriptive statistics were used to assess the concordance. Results: The copy number detected by NGS was correlated with either the average HER2 copy number (signals/cell) (r = 0.844; p < 0.001) or the HER2/CEP17 ratio (r = 0.815; p < 0.001). We determined a cut-off value for NGS to categorize HER2 amplification status by using 131 HER2 non-amplified FFPE samples. In breast cancer patients, the cut-off value was 2.910, with 95.28%, 99.23% and 97.29% sensitivity, specificity and concordance, respectively. However, this cut-off value displayed low sensitivity in gastric cancer patients (64.71%), and the following macro-dissection procedure was not effective for increasing sensitivity (57.14%). Thus indicated that HER2 copy number correlation between NGS and FISH in gastric cancer was different from breast cancer. Conclusions: Evaluation of HER2 copy number with NGS in our study was comparable with IHC and FISH in breast cancer patients, but concordance in gastric cancer was only moderate. NGS-based HER2 assessment may decrease the equivocal HER2 determinations in breast cancer patients assessed by FISH/IHC. The greater discordance in gastric cancer may reflect the underlying biological mechanisms, and further study is warranted.
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Affiliation(s)
- Dongmei Lin
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Jiafu Ji
- Peking University Cancer Hospital and Institute, Beijing, China
| | - Dongfeng Niu
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute., Beijing, China
| | - Lei Li
- Novogene Bioinformatics Institute, Beijing, China
| | - Yang Yu
- Beijing Novogene Bioinformatics Technology Co., Ltd, Beijing, China
| | - Yun Gao
- Beijing Novogene Bioinformatics Technology Co., Ltd., Beijing, China
| | - Wanchun Zhang
- Beijing Novogene Bioinformatics Technology Co., Ltd., Beijing, China
| | - Zhongwu Li
- Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Guanhua Rao
- Beijing Novogene Bioinformatics Technology Co., Ltd., Beijing, China
| | - Lianju Gao
- Novogene Bioinformatics Institute, Beijing, China
| | - Gang Cheng
- Beijing Novogene Bioinformatics Technology Co., Ltd., Beijing, China
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Room R, Callinan S, Greenfield T, Rekve D, Waleewong O, Stanesby O, Thamarangsi T, Benegal V, Casswell S, Florenzano R, Hanh T, Hettige S, Karriker-Jaffe K, Obot I, Rao G, Siengsounthone L, Laslett AM. The social location of harm from others' drinking in 10 societies. Addiction 2019; 114:425-433. [PMID: 30248718 PMCID: PMC6377290 DOI: 10.1111/add.14447] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/02/2018] [Accepted: 09/20/2018] [Indexed: 01/23/2023]
Abstract
AIMS Survey data from 10 diverse countries were used to analyse the social location of harms from others' drinking: which segments of the population are more likely to be adversely affected by such harm, and how does this differ between societies? METHODS General-population surveys in Australia, Chile, India, Laos, New Zealand, Nigeria, Sri Lanka, Thailand, United States and Vietnam, with a primary focus on the social location of the harmed person by gender, age groups, rural/urban residence and drinking status. Harms from known drinkers were analysed separately from harms from strangers. RESULTS In all sites, risky or moderate drinkers were more likely than abstainers to report harm from the drinking of known drinkers, with risky drinkers the most likely to report harm. This was also generally true for harm from strangers' drinking, although the patterns were more mixed in Vietnam and Thailand. Harm from strangers' drinking was more often reported by males, while gender disparity in harm from known drinkers varied between sites. Younger adults were more likely to experience harm both from known drinkers and from strangers in some, but not all, societies. Only a few sites showed significant urban/rural differences, with disparities varying in direction. In multivariate analyses, most relationships remained, although some were no longer significant. CONCLUSION The social location of harms from others' drinking, whether known or a stranger, varies considerably between societies. One near-commonality among the societies is that those who are themselves risky drinkers are more likely to suffer harm from others' drinking.
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Affiliation(s)
- R. Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden,
| | - S. Callinan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia,
| | - T.K. Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA,
| | - D. Rekve
- Mental Health and Substance Abuse, WHO, Geneva, Switzerland
| | - O. Waleewong
- Health Promotion Policy Research Center; International Health Policy Program, Ministry of Public Health, Nonthaburi Thailand,
| | - O. Stanesby
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia,
| | - T. Thamarangsi
- Department of Non-Communicable Diseases and Environmental Health, World Health Organization Regional Office for South-East Asia, New Delhi, India,
| | - V. Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and NeuroSciences, Bangalore, India,
| | - S. Casswell
- SHORE and Whariki Research Centre, School of Public Health, Massey University, Auckland, New Zealand,
| | - R. Florenzano
- Universidad del Desarrollo, Facultades de Psicología y de Ciencia Social; Universidades de Chile y de los Andes, Departamento de Psiquiatría, Santiago de Chile, Chile,
| | - T.M.H. Hanh
- Health Strategy and Policy Institute, Ministry of Health, Vietnam,
| | - S. Hettige
- Department of Sociology, University of Colombo, Colombo, Sri Lanka and Adjunct Professor, Globalism Research Centre, School of Social Sciences, RMIT University, Melbourne, Australia,
| | - K.J. Karriker-Jaffe
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA,
| | - I. Obot
- Department of Psychology, University of Uyo, Uyo, Nigeria & Centre for Research and Information on Substance Abuse (CRISA), Uyo, Nigeria,
| | - G. Rao
- Centre for Public Health, National Institute of Mental Health and NeuroSciences, Bangalore, India,
| | - L. Siengsounthone
- Research Outcomes Management Department, National Institute of Public Health, Ministry of Health, Vientiane Capital, Lao PDR,
| | - A.-M. Laslett
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; National Drug Research Institute, Curtin University, Fitzroy, Victoria, Australia,
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Hsu WH, Zhao X, Zhu J, Kim IK, Rao G, McCutcheon J, Hsu ST, Teicher B, Kallakury B, Dowlati A, Zhang YW, Giaccone G. Checkpoint Kinase 1 Inhibition Enhances Cisplatin Cytotoxicity and Overcomes Cisplatin Resistance in SCLC by Promoting Mitotic Cell Death. J Thorac Oncol 2019; 14:1032-1045. [PMID: 30771522 DOI: 10.1016/j.jtho.2019.01.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 11/28/2018] [Accepted: 01/27/2019] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Platinum-based chemotherapy remains the standard treatment for patients with SCLC, but the benefit of the treatment is often hampered by rapid development of drug resistance. Thus far, there is no targeted therapy available for SCLC. More than 90% of SCLC tumors harbor mutations in the tumor suppressor gene tumor protein p53 (p53), an important DNA damage checkpoint regulator, and these tumor cells rely predominantly on the checkpoint kinases to control DNA damage response. METHODS We examined whether and how inhibition of checkpoint kinase 1 (Chk1) affects cisplatin cytotoxicity in SCLC cells with and without p53 mutations, and evaluated the effect of Chk1 inhibitor and cisplatin combination in cisplatin-sensitive and -resistant preclinical models. RESULTS Inhibition of Chk1 synergized with cisplatin to induce mitotic cell death in the p53-deficeint SCLC cells. The effect was regulated in part through activation of caspase 2 and downregulation of E2F transcription factor 1 (E2F1). Furthermore, Chk1 inhibitors prexasertib and AZD7762 enhanced cisplatin antitumor activity and overcame cisplatin resistance in SCLC preclinical models in vitro an in vivo. We also observed that higher expression of Chk1 was associated with poorer overall survival of patients with SCLC. CONCLUSIONS Our data account Chk1 as a potential therapeutic target in SCLC, and rationalize clinical development of Chk1 inhibitor and cisplatin combinational strategy for the treatment of SCLC.
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Affiliation(s)
- Wei-Hsun Hsu
- Department of Oncology, Georgetown University Medical Center, Washington, DC; Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Xiaoliang Zhao
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Jianquan Zhu
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - In-Kyu Kim
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Guanhua Rao
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Justine McCutcheon
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Shuo-Tse Hsu
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Beverly Teicher
- National Institutes of Health, National Cancer Institute, Bethesda, Maryland
| | - Bhaskar Kallakury
- Department of Pathology, Georgetown University Medical Center, Washington, DC
| | | | - Yu-Wen Zhang
- Department of Oncology, Georgetown University Medical Center, Washington, DC
| | - Giuseppe Giaccone
- Department of Oncology, Georgetown University Medical Center, Washington, DC.
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Shillo P, Selvarajah D, Greig M, Gandhi R, Rao G, Wilkinson ID, Anand P, Tesfaye S. Reduced vitamin D levels in painful diabetic peripheral neuropathy. Diabet Med 2019; 36:44-51. [PMID: 30102801 DOI: 10.1111/dme.13798] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 12/25/2022]
Abstract
AIM Recent studies have reported an association between low vitamin D levels and diabetic peripheral neuropathy. However, many of these did not differentiate between people with painful diabetic peripheral neuropathy and those with painless diabetic peripheral neuropathy, or assess major confounding factors including sunlight exposure and daily activity. Our study addressed these limitations and evaluated vitamin D levels in people with carefully phenotyped diabetic peripheral neuropathy and controls. METHODS Forty-five white Europeans with Type 2 diabetes and 14 healthy volunteers underwent clinical and neurophysiological assessments. People with Type 2 diabetes were then divided into three groups (17 with painful diabetic peripheral neuropathy, 14 with painless diabetic peripheral neuropathy and 14 with no diabetic peripheral neuropathy). All had seasonal sunlight exposure and daily activity measured, underwent a lower limb skin biopsy and had 25-hydroxyvitamin D measured during the summer months, July to September. RESULTS After adjusting for age, BMI, activity score and sunlight exposure, 25-hydroxyvitamin D levels (nmol/l) (se) were significantly lower in people with painful diabetic peripheral neuropathy [painful diabetic peripheral neuropathy 34.9 (5.8), healthy volunteers 62.05 (6.7), no diabetic peripheral neuropathy 49.6 (6.1), painless diabetic peripheral neuropathy 53.1 (6.2); ANCOVAP = 0.03]. Direct logistic regression was used to assess the impact of seven independent variables on painful diabetic peripheral neuropathy. Vitamin D was the only independent variable to make a statistically significant contribution to the model with an inverted odds ratio of 1.11. Lower 25-hydroxyvitamin D levels also correlated with lower cold detection thresholds (r = 0.39, P = 0.02) and subepidermal nerve fibre densities (r = 0.42, P = 0.01). CONCLUSIONS We have demonstrated a significant difference in 25-hydroxyvitamin D levels in well-characterized people with painful diabetic peripheral neuropathy, while accounting for the main confounding factors. This suggests a possible role for vitamin D in the pathogenesis of painful diabetic peripheral neuropathy. Further prospective and intervention trials are required to prove causality between low vitamin D levels and painful diabetic peripheral neuropathy.
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Affiliation(s)
- P Shillo
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - D Selvarajah
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield
| | - M Greig
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - R Gandhi
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - G Rao
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - I D Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield
| | - P Anand
- Peripheral Neuropathy Unit, Imperial College London, London, UK
| | - S Tesfaye
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
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Callinan S, Rankin G, Room R, Stanesby O, Rao G, Waleewong O, Greenfield TK, Hope A, Laslett AM. Harms from a partner's drinking: an international study on adverse effects and reduced quality of life for women. Am J Drug Alcohol Abuse 2018; 45:170-178. [PMID: 30495983 DOI: 10.1080/00952990.2018.1540632] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Partners of heavy drinking individuals can be detrimentally affected as a result of their partner's drinking. OBJECTIVES The aim of this study was to identify the proportion of heterosexual intimate partner relationships with a heavy drinking male that resulted in reported alcohol-related harm and to investigate the impact of this on well-being in 9 countries. METHODS This study used survey data from the Gender and Alcohol's Harm to Others (GENAHTO) Project on Alcohol's Harm to Others in 9 countries (10,613 female respondents, 7,091 with intimate live-in partners). Respondents were asked if their partners drinking had negatively affected them as well as questions on depression, anxiety, and satisfaction with life. RESULTS The proportion of partnered respondents that reported having a harmful heavy drinking partner varied across countries, from 4% in Nigeria and the US to 33% in Vietnam. The most consistent correlate of experiencing harm was being oneself a heavy episodic drinker, most likely as a proxy measure for the acceptability of alcohol consumption in social circles. Women with a harmful heavy drinking partner reported significantly lower mean satisfaction with life than those with a partner that did not drink heavily. CONCLUSIONS Harms to women from heavy drinking intimate partners appear across a range of subgroups and impact on a wide range of women, at least demographically speaking. Women living with a heavy drinking spouse experience higher levels of anxiety and depression symptoms and lower satisfaction with life.
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Affiliation(s)
- S Callinan
- a Centre for Alcohol Policy Research , La Trobe University , Bundoora , Australia
| | - G Rankin
- a Centre for Alcohol Policy Research , La Trobe University , Bundoora , Australia
| | - R Room
- a Centre for Alcohol Policy Research , La Trobe University , Bundoora , Australia.,b Centre for Social Research on Alcohol & Drugs , Stockholm University , Stockholm , Sweden
| | - O Stanesby
- a Centre for Alcohol Policy Research , La Trobe University , Bundoora , Australia
| | - G Rao
- c Centre for Public Health , National Institute of Mental Health and NeuroSciences , Bangalore , India
| | - O Waleewong
- a Centre for Alcohol Policy Research , La Trobe University , Bundoora , Australia.,d School of Population and Global Health , University of Melbourne , Melbourne , Australia.,e International Health Policy Program (IHPP) , Ministry of Public Health , Nonthaburi , Thailand
| | - T K Greenfield
- f Alcohol Research Group , Public Health Institute , Emeryville , CA , USA
| | - A Hope
- g Department of Public Health and Primary Care , Trinity College , Dublin , Ireland
| | - A-M Laslett
- a Centre for Alcohol Policy Research , La Trobe University , Bundoora , Australia.,d School of Population and Global Health , University of Melbourne , Melbourne , Australia.,h National Drug Research Institute , Curtin University , Perth , Australia
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Mastall M, Majd N, Fuller G, Gule-Monroe M, Huse J, Khatua S, Rao G, Sandberg D, Wefel J, Yeboa D, Zaky W, Mahajan A, Puduvalli V, Suki D, Alfaro K, Weathers S, Harrison R, de Groot J, Penas-Prado M. P05.93 Adult medulloblastoma: analysis of use of chemotherapy in clinical practice. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.419] [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: 11/14/2022] Open
Affiliation(s)
- M Mastall
- University of Heidelberg, Heidelberg, Germany
| | - N Majd
- MD Anderson Cancer Center, Houston, TX, United States
| | - G Fuller
- MD Anderson Cancer Center, Houston, TX, United States
| | - M Gule-Monroe
- MD Anderson Cancer Center, Houston, TX, United States
| | - J Huse
- MD Anderson Cancer Center, Houston, TX, United States
| | - S Khatua
- MD Anderson Cancer Center, Houston, TX, United States
| | - G Rao
- MD Anderson Cancer Center, Houston, TX, United States
| | - D Sandberg
- MD Anderson Cancer Center, Houston, TX, United States
| | - J Wefel
- MD Anderson Cancer Center, Houston, TX, United States
| | - D Yeboa
- MD Anderson Cancer Center, Houston, TX, United States
| | - W Zaky
- MD Anderson Cancer Center, Houston, TX, United States
| | - A Mahajan
- Mayo Clinic, Rochester, MN, United States
| | - V Puduvalli
- Ohio State University, Columbus, OH, United States
| | - D Suki
- MD Anderson Cancer Center, Houston, TX, United States
| | - K Alfaro
- MD Anderson Cancer Center, Houston, TX, United States
| | - S Weathers
- MD Anderson Cancer Center, Houston, TX, United States
| | - R Harrison
- MD Anderson Cancer Center, Houston, TX, United States
| | - J de Groot
- MD Anderson Cancer Center, Houston, TX, United States
| | - M Penas-Prado
- MD Anderson Cancer Center, Houston, TX, United States
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Abstract
Herein, the first diazomethane-mediated synthesis of azetidine-embedded tetracyclic ketal systems is reported. Reactions of norbornyl hemiaminal acetals with diazomethane afford azetidine-embedded tetracyclic ketals in good to excellent yields. The bridgehead-bromo-substituted hemiaminal acetals give higher yields compared to the corresponding bridgehead-chloro-substituted hemiaminal acetals. The hemiaminal acetals are prepared stereoselectively via nucleophilic addition of various amines to norbornyl α-diketones from the exo face.
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Affiliation(s)
- G. Rao
- Department of Chemistry, Indian Institute of Technology Kanpur
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Hamdan A, Saxena A, Rao G, Ivanov M. Compression of a giant pseudomeningocele causing transient anoxic seizures-a case report. Acta Neurochir (Wien) 2018; 160:479-485. [PMID: 29299677 DOI: 10.1007/s00701-017-3446-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/21/2017] [Indexed: 11/28/2022]
Abstract
Transient anoxic seizure upon application of pressure on a giant pseudomeningocele has never been reported in the literature; such abrupt changes in intracranial pressure due to large volume of cerebrospinal fluid (CSF) translocation, if left untreated may lead to permanent cerebral hypoxic injury and death. Here we describe a case of a 26-year-old woman who had undergone lumbar disc surgery in another unit few months ago and developed a large lump around her back. Any pressure on the lump resulted in headaches and at times episodes of seizures. Clinical examination revealed a very large fluid-filled lump consistent with a giant pseudomeningocele, confirmed by an MRI. A video EEG while applying pressure on the lump was recorded. The patient developed a typical seizure attack with a characteristic pattern of cerebral anoxia, and a paired ECG showed irregular rhythm with junctional and ventricular ectopic beats during the latter part of the attack, raising a suspicion of asystole. Upon relieving the pressure off the lump, the patient gradually regained consciousness with no permanent neurological deficit. We then discuss the pathophysiology of anoxic seizures and highlight the need to be vigilant in managing patients with such lesions in order to prevent permanent cerebral hypoxic injury and death.
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Affiliation(s)
- Alhafidz Hamdan
- Department of Spinal Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
| | - A Saxena
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - G Rao
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - M Ivanov
- Department of Spinal Surgery, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Department of Neurosurgery, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Bashour SI, Ibrahim NK, Schomer DF, Colen RR, Sawaya R, Suki D, Rao G, Murthy RK, Moulder SL, Abugabal Y, Hess KR, Fuller GN. Abstract P6-03-04: Central nervous system miliary metastasis in breast cancer patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-03-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Little is known regarding central nervous system (CNS) miliary metastasis (MiM), which was first described as “carcinomatous encephalitis” by Madow and Alpers in 1951. The majority of reported cases arise from primary lung and gastrointestinal adenocarcinomas, with occasional melanoma primaries and one reported case in breast cancer. Moreover, clinicopathologic correlates, disease outcomes and prognostic factors in these patients are poorly understood. Although identified most frequently on neuroimaging, radiographic criteria to objectively diagnose MiM do not exist. In this analysis of patients with brain metastasis from primary breast cancer, we propose objective, stringent radiographic criteria for CNS MiM diagnosis and identify clinicopathologic factors contributing to disease outcomes.
Methods: Using a prospectively maintained electronic database, 1,002 female patients diagnosed with brain metastasis from primary breast cancer between 2000 and 2015 were identified. Only patients with neuroimaging available for direct review (CT or MRI) were included. Our radiographic criteria for MiM diagnosis were: 1) ≥20 metastatic lesions per image slice on ≥2 noncontiguous image slices by MRI, or 2) ≥10 lesions per image slice on ≥2 noncontiguous image slices by CT, and 3) MiM lesions were required to be present bilaterally and in both the supra- and infratentorial compartments. These criteria were established upon direct review of all neuroimaging by a neuroradiologist. Number and anatomic distribution of metastatic lesions were the patterns best observed to identify cases of CNS MiM on case review; lesion size was not a reliable pattern for MiM identification. Log rank tests were used for statistical analyses.
Results: Using stringent criteria, 486 patients were included in this analysis. Twenty patients with MiM were identified (4.1%). Ten patients were diagnosed with MiM at initial brain metastasis presentation; 10 developed MiM after known brain metastasis. Biomarker based subtype distribution was as follows: HR-/HER2- (TNBC) (n=8), HR+/HER2+ (n=3), HR+/HER2- (n=4), HR-/HER2+ (n=4), unknown (n=1).
Table 1: Disease Outcomes Based on Biomarker SubtypeBiomarker SubtypeMedian Time to MiM (months) (p=0.104)Median Survival after MiM (months) (p=0.008)TNBC (n=8)32.3 (12.1-132.5)1.8 (0.5-4.0)HR+/HER2+ (n=3)44.2 (33.2-71.5)10.8 (10.2-13.3)HR+/HER2- (n=4)110.2 (23.0-156.0)4.8 (0.8-9.8)HR-/HER2+ (n=4)27.1 (3.7-39.4)4.0 (1.8-5.0)All* (n=20)37.4 (3.7-156.0)3.7 (0.4-12.3)Key: BM: Brain metastasis; * Includes 1 patient with unknown subtype.
Conclusions: Reports of MiM consist overwhelmingly of lung and gastrointestinal adenocarcinoma primaries. This retrospective, observational study is the first to establish that CNS MiM occurs in breast cancer with an incidence of roughly 4%. Review of an additional 1,600 patient charts is underway, but this preliminary study is the first to identify clinicopathologic correlates and determine disease outcomes in patients with MiM; it is also the first to propose stringent radiographic criteria for the diagnosis of CNS MiM, and further updated data will be presented at the meeting.
Citation Format: Bashour SI, Ibrahim NK, Schomer DF, Colen RR, Sawaya R, Suki D, Rao G, Murthy RK, Moulder SL, Abugabal Y, Hess KR, Fuller GN. Central nervous system miliary metastasis in breast cancer patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-03-04.
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Affiliation(s)
- SI Bashour
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - NK Ibrahim
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - DF Schomer
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - RR Colen
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Sawaya
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D Suki
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G Rao
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - RK Murthy
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - SL Moulder
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Y Abugabal
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - KR Hess
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - GN Fuller
- The University of Texas MD Anderson Cancer Center, Houston, TX
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Zhong J, Li L, Wang Z, Bai H, Gai F, Duan J, Zhao J, Zhuo M, Wang Y, Wang S, Zang W, Wu M, An T, Rao G, Zhu G, Wang J. Potential Resistance Mechanisms Revealed by Targeted Sequencing from Lung Adenocarcinoma Patients with Primary Resistance to Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors (TKIs). J Thorac Oncol 2017; 12:1766-1778. [DOI: 10.1016/j.jtho.2017.07.032] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/19/2017] [Accepted: 07/20/2017] [Indexed: 11/30/2022]
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Conforti F, Zhang X, Rao G, De Pas T, Yonemori Y, Rodriguez JA, McCutcheon JN, Rahhal R, Alberobello AT, Wang Y, Zhang YW, Guha U, Giaccone G. Therapeutic Effects of XPO1 Inhibition in Thymic Epithelial Tumors. Cancer Res 2017; 77:5614-5627. [PMID: 28819023 PMCID: PMC8170838 DOI: 10.1158/0008-5472.can-17-1323] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 06/29/2017] [Accepted: 08/08/2017] [Indexed: 12/12/2022]
Abstract
Exportin 1 (XPO1) mediates nuclear export of many cellular factors known to play critical roles in malignant processes, and selinexor (KPT-330) is the first XPO1-selective inhibitor of nuclear export compound in advanced clinical development phase for cancer treatment. We demonstrated here that inhibition of XPO1 drives nuclear accumulation of important cargo tumor suppressor proteins, including transcription factor FOXO3a and p53 in thymic epithelial tumor (TET) cells, and induces p53-dependent and -independent antitumor activity in vitro Selinexor suppressed the growth of TET xenograft tumors in athymic nude mice via inhibition of cell proliferation and induction of apoptosis. Loss of p53 activity or amplification of XPO1 may contribute to resistance to XPO1 inhibitor in TET. Using mass spectrometry-based proteomics analysis, we identified a number of proteins whose abundances in the nucleus and cytoplasm shifted significantly following selinexor treatment in the TET cells. Furthermore, we found that XPO1 was highly expressed in aggressive histotypes and advanced stages of human TET, and high XPO1 expression was associated with poorer patient survival. These results underscore an important role of XPO1 in the pathogenesis of TET and support clinical development of the XPO1 inhibitor for the treatment of patients with this type of tumors. Cancer Res; 77(20); 5614-27. ©2017 AACR.
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Affiliation(s)
- Fabio Conforti
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
- Oncology Unit of Thymic Cancer, Rare Tumors and Sarcomas, European Institute of Oncology, Milan, Italy
| | - Xu Zhang
- Thoracic and Gastrointestinal Oncology Branch, NCI, NIH, Bethesda, Maryland
| | - Guanhua Rao
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
| | - Tommaso De Pas
- Oncology Unit of Thymic Cancer, Rare Tumors and Sarcomas, European Institute of Oncology, Milan, Italy
| | - Yoko Yonemori
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
- Department of Diagnostic Pathology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Jose Antonio Rodriguez
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country, Barrio Sarriena s/n, Leioa, Spain
| | - Justine N McCutcheon
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
| | - Raneen Rahhal
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
| | - Anna T Alberobello
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
| | - Yisong Wang
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia
| | - Yu-Wen Zhang
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia.
| | - Udayan Guha
- Thoracic and Gastrointestinal Oncology Branch, NCI, NIH, Bethesda, Maryland
| | - Giuseppe Giaccone
- Department of Oncology, Georgetown University Medical Center, Washington, District of Columbia.
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Jenkins T, Alix J, Rao G, Hoggard N, O'Brien E, Baster K, Bradburn M, Bigley J, McDermott C, Wilkinson I, Shaw P. Imaging denervation in motor neuron disease for future clinical trials: a longitudinal cohort study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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42
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Guerrero PA, Tchaicha JH, Chen Z, Morales JE, McCarty N, Wang Q, Sulman EP, Fuller G, Lang FF, Rao G, McCarty JH. Glioblastoma stem cells exploit the αvβ8 integrin-TGFβ1 signaling axis to drive tumor initiation and progression. Oncogene 2017; 36:6568-6580. [PMID: 28783169 DOI: 10.1038/onc.2017.248] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 12/13/2022]
Abstract
Glioblastoma (GBM) is a primary brain cancer that contains populations of stem-like cancer cells (GSCs) that home to specialized perivascular niches. GSC interactions with their niche influence self-renewal, differentiation and drug resistance, although the pathways underlying these events remain largely unknown. Here, we report that the integrin αvβ8 and its latent transforming growth factor β1 (TGFβ1) protein ligand have central roles in promoting niche co-option and GBM initiation. αvβ8 integrin is highly expressed in GSCs and is essential for self-renewal and lineage commitment in vitro. Fractionation of β8high cells from freshly resected human GBM samples also reveals a requirement for this integrin in tumorigenesis in vivo. Whole-transcriptome sequencing reveals that αvβ8 integrin regulates tumor development, in part, by driving TGFβ1-induced DNA replication and mitotic checkpoint progression. Collectively, these data identify the αvβ8 integrin-TGFβ1 signaling axis as crucial for exploitation of the perivascular niche and identify potential therapeutic targets for inhibiting tumor growth and progression in patients with GBM.
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Affiliation(s)
- P A Guerrero
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
| | - J H Tchaicha
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
| | - Z Chen
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
| | - J E Morales
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
| | - N McCarty
- The Brown Institute for Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Q Wang
- Department of Radiation Oncology, M. D. Anderson Cancer Center, Houston, TX, USA.,Department of Genomic Medicine, M. D. Anderson Cancer Center, Houston, TX, USA
| | - E P Sulman
- Department of Radiation Oncology, M. D. Anderson Cancer Center, Houston, TX, USA.,Department of Genomic Medicine, M. D. Anderson Cancer Center, Houston, TX, USA.,Department of Translational Molecular Pathology, M. D. Anderson Cancer Center, Houston, TX, USA
| | - G Fuller
- Departments of Pathology, M. D. Anderson Cancer Center, Houston, TX, USA
| | - F F Lang
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
| | - G Rao
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
| | - J H McCarty
- Department of Neurosurgery, M. D. Anderson Cancer Center, Houston, TX, USA
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43
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Rao G, Pierobon M, Kim IK, Hsu WH, Deng J, Moon YW, Petricoin EF, Zhang YW, Wang Y, Giaccone G. Inhibition of AKT1 signaling promotes invasion and metastasis of non-small cell lung cancer cells with K-RAS or EGFR mutations. Sci Rep 2017; 7:7066. [PMID: 28765579 PMCID: PMC5539338 DOI: 10.1038/s41598-017-06128-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 06/08/2017] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence supports a role of the PI3K-AKT pathway in the regulation of cell motility, invasion and metastasis. AKT activation is known to promote metastasis, however under certain circumstances, it also shows an inhibitory activity on metastatic processes, and the cause of such conflicting results is largely unclear. Here we found that AKT1 is an important regulator of metastasis and down-regulation of its activity is associated with increased metastatic potential of A549 cells. Inhibition of AKT1 enhanced migration and invasion in KRAS- or EGFR-mutant non-small cell lung cancer (NSCLC) cells. The allosteric AKT inhibitor MK-2206 promoted metastasis of KRAS-mutated A549 cells in vivo. We next identified that the phosphorylation of Myristoylated alanine-rich C-kinase substrate (MARCKS) and LAMC2 protein level were increased with AKT1 inhibition, and MARCKS or LAMC2 knockdown abrogated migration and invasion induced by AKT1 inhibition. This study unravels an anti-metastatic role of AKT1 in the NSCLC cells with KRAS or EGFR mutations, and establishes an AKT1-MARCKS-LAMC2 feedback loop in this regulation.
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Affiliation(s)
- Guanhua Rao
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Mariaelena Pierobon
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - In-Kyu Kim
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Wei-Hsun Hsu
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Jianghong Deng
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Yong-Wha Moon
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Emanuel F Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, USA
| | - Yu-Wen Zhang
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Yisong Wang
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA
| | - Giuseppe Giaccone
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA.
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Gao J, Wang H, Zang W, Li B, Rao G, Li L, Yu Y, Li Z, Dong B, Lu Z, Jiang Z, Shen L. Circulating tumor DNA functions as an alternative for tissue to overcome tumor heterogeneity in advanced gastric cancer. Cancer Sci 2017; 108:1881-1887. [PMID: 28677165 PMCID: PMC5581520 DOI: 10.1111/cas.13314] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/28/2017] [Accepted: 07/02/2017] [Indexed: 12/11/2022] Open
Abstract
Overcoming tumor heterogeneity is a major challenge for personalized treatment of gastric cancer, especially for human epidermal growth factor receptor‐2 targeted therapy. Analysis of circulating tumor DNA allows a more comprehensive analysis of tumor heterogeneity than traditional biopsies in lung cancer and breast cancer, but little is known in gastric cancer. We assessed mutation profiles of ctDNA and primary tumors from 30 patients with advanced gastric cancer, then performed a comprehensive analysis of tumor mutations by multiple biopsies from five patients, and finally analyzed the concordance of HER2 amplification in ctDNA and paired tumor tissues in 70 patients. By comparing with a single tumor sample, ctDNA displayed a low concordance of mutation profile, only approximately 50% (138/275) somatic mutations were found in paired tissue samples, however, when compared with multiple biopsies, most DNA mutations in ctDNA were also shown in paired tumor tissues. ctDNA had a high concordance (91.4%, Kappa index = 0.784, P < 0.001) of HER2 amplification with tumor tissues, suggesting it might be an alternative for tissue. It implied that ctDNA‐based assessment could partially overcome the tumor heterogeneity, and might serve as a potential surrogate for HER2 analysis in gastric cancer.
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Affiliation(s)
- Jing Gao
- Department of Gastrointestinal Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Haixing Wang
- Department of Gastrointestinal Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Wanchun Zang
- Novogene Bioinformatics Institute, Beijing, China
| | - Beifang Li
- Department of Gastrointestinal Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Guanhua Rao
- Novogene Bioinformatics Institute, Beijing, China
| | - Lei Li
- Novogene Bioinformatics Institute, Beijing, China
| | - Yang Yu
- Novogene Bioinformatics Institute, Beijing, China
| | - Zhongwu Li
- Department of pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Bin Dong
- Department of pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Zhihao Lu
- Department of Gastrointestinal Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
| | - Zhi Jiang
- Novogene Bioinformatics Institute, Beijing, China
| | - Lin Shen
- Department of Gastrointestinal Oncology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital and Institute, Beijing, China
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45
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Hsu WH, Zhao X, Kim IG, Rao G, McCutcheon J, Hsu ST, Dowlati A, Zhang YW, Giaccone G. Abstract 2026: CHK1 inhibition synergizes with cisplatin to promote mitotic cell death via activation of caspase 2 and downregulation of E2F1 in small cell lung cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Platinum-based chemotherapy remains the standard treatment for patients with small cell lung cancer (SCLC), one of the deadliest cancers, but the benefit of such therapy is often hampered by rapid emergence of drug resistance. Thus far, there is no targeted therapy available for SCLC, mainly due to the lack of targetable oncogenic driver alterations; nevertheless, over 90% of SCLC tumors harbor inactivating mutations in tumor suppressor p53, an important checkpoint regulator for the control of cell cycle progression in the event of DNA damage. SCLC cells with p53-deficiency heavily rely on the checkpoint kinase 1 (CHK1), a key checkpoint regulator, to prevent the progression of cell cycle through G2/M in the presence of damaged DNA. Using CHK1 inhibitors and siRNA knockdown approaches, we explored the potential therapeutic benefit of CHK1 inhibition in SCLC models in combination with cisplatin, a DNA damaging agent. We demonstrated that CHK1 inhibition was able to release G2/M cell cycle arrest induced by cisplatin, and synergized with cisplatin to induce mitotic cell death especially in the p53-deficient SCLC cell lines. CHK1 inhibition activated caspase 2 and downregulated the expression of E2F1 transcription factor in these cells. We showed that activation of caspase 2 was required for the mitotic cell death induced by the combination of cisplatin and CHK1 inhibition. Interestingly, the upregulation of E2F1 induced by CHK1 inhibition was mediated in part by caspase 2, and E2F1 played a role in the DNA damage checkpoint control as knockdown of E2F1 enhanced cytotoxicity induced by cisplatin or CHK1 inhibitor in GLC4 cells. However, ectopic overexpression of E2F1 also led to increase of phospho-histone H3, γH2AX and cleaved PARP, and significantly enhanced cisplatin cytotoxicity, indicating that proper dosage of E2F1 is critical for DNA damage checkpoint response. These data provide a mechanistic insight of CHK1-mediated DNA damage checkpoint control and the anticancer effect of CHK1 inhibition against SCLC. In tumor samples derived from SCLC patients treated with platinum based chemotherapy, we found that high expression of CHK1 and E2F1 significantly correlated with poorer overall survival, further suggesting a link between CHK1 and E2F1 and potentially collaborative roles of these two factors in DNA damage checkpoint response. Moreover, we showed that CHK1 inhibition resensitized cisplatin-resistant cells to cisplatin treatment and induced mitotic cell death via caspase activation in these cells. These data indicate that CHK1 inhibition may enhance the benefit of cisplatin treatment for SCLC and overcome cisplatin resistance. We are presently confirming the in vitro results of CHK1 inhibition in combination with cisplatin treatment in xenograft tumor models in athymic nude mice.
Citation Format: Wei-Hsun Hsu, Xiaoliang Zhao, In-Gyu Kim, Guanhua Rao, Justine McCutcheon, Shuo-Tse Hsu, Afshin Dowlati, Yu-Wen Zhang, Giuseppe Giaccone. CHK1 inhibition synergizes with cisplatin to promote mitotic cell death via activation of caspase 2 and downregulation of E2F1 in small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2026. doi:10.1158/1538-7445.AM2017-2026
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Affiliation(s)
| | | | - In-Gyu Kim
- 1Georgetown Univ. Medical Ctr., Washington, DC
| | - Guanhua Rao
- 1Georgetown Univ. Medical Ctr., Washington, DC
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Rao G, Pierobon M, Kim IK, Hsu WH, Deng J, Moon YW, Petricoin EF, Zhang YW, Wang Y, Giaccone G. Abstract 4893: AKT1 signaling negatively regulates invasion and metastasis of non-small cell lung cancer cells carrying mutations in KRAS or EGFR. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4893] [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
Signaling driven by the phosphoinositide-3 kinase (PI3K) and AKT/protein kinase B (PKB) pathway plays an important role in cancer development and progression, and thus this pathway is an attractive therapeutic target. Although many different inhibitors targeting either PI3K or AKT have been developed, the therapeutic benefit of these inhibitors in the clinic remains elusive, in part because of the perplexing role of AKT signaling in the regulation of cell motility, invasion and metastasis. AKT activation is known to promote migration, invasion and metastasis; however under certain circumstances and different cellular systems, it also exhibits an inhibitory activity on these cellular processes and the underlying cause of these conflicting results is unclear. Through analysis of the Reverse Phase Protein Array (RPPA) performed on a series of non-small cell lung cancer (NSCLC) brain metastasis models generated via intracardiac injection in mice, we identified AKT1 (one of three AKT family members) as a critical negative regulator of A549 tumor metastasis. AKT1 tyrosine phosphorylation (but not AKT2 or AKT3) inversely correlated with the metastatic potential of A549 cells which carry a KRAS mutation. Using AKT1 siRNAs, we demonstrated that inhibition of AKT1 significantly enhanced migration and invasion of KRAS- or EGFR-mutant NSCLC cells, but not wild type KRAS and EGFR cells. Similarly, the AKT inhibitor MK-2206 also enhanced the migration and invasion of KRAS- or EGFR-mutant NSCLC cells in vitro, and promoted metastasis of KRAS-mutant A549 cells in vivo. The PI3K-AKT pathway is downstream of both EGFR and KRAS, whose constitutive activation caused by mutations likely alter the signal output of PI3K-AKT pathway and thus the activity on cell invasiveness. Therefore, our results provide a sound explanation that under certain genetic backgrounds (as we demonstrated here with KRAS or EGFR mutations) the AKT signaling may switch from being a promoter to an inhibitor of cell migration, invasion and metastasis. This observation may have strong clinical implications for the development of inhibitors of this pathway for cancer treatment. Furthermore, we found that AKT1 blockade induced phosphorylation of Myristoylated alanine-rich C-kinase substrate (MARCKS) and elevation of Laminin subunit gamma-2 (LAMC2), which in turn inhibited AKT phosphorylation and promoted cell invasiveness. In contrast, MARCKS or LAMC2 knockdown abrogated the activities of migration and invasion induced by AKT1 inhibition. This study unravels an anti-metastatic role of AKT1 in NSCLC cells with KRAS or EGFR mutation, and provides mechanistic insights for the understanding of the potentially contrasting roles of AKT signaling in the regulation of cell invasiveness.
Citation Format: Guanhua Rao, Mariaelena Pierobon, In-Kyu Kim, Wei-Hsun Hsu, Jianghong Deng, Yong-Wha Moon, Emanuel F. Petricoin, Yu-Wen Zhang, Yisong Wang, Giuseppe Giaccone. AKT1 signaling negatively regulates invasion and metastasis of non-small cell lung cancer cells carrying mutations in KRAS or EGFR [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4893. doi:10.1158/1538-7445.AM2017-4893
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Affiliation(s)
- Guanhua Rao
- 1Georgetown Univ. Medical Ctr., Washington, DC
| | - Mariaelena Pierobon
- 2George Mason University, Institute for Advanced Biomedical Research, Manassas, VA
| | - In-Kyu Kim
- 1Georgetown Univ. Medical Ctr., Washington, DC
| | | | - Jianghong Deng
- 2George Mason University, Institute for Advanced Biomedical Research, Manassas, VA
| | | | - Emanuel F. Petricoin
- 2George Mason University, Institute for Advanced Biomedical Research, Manassas, VA
| | | | - Yisong Wang
- 1Georgetown Univ. Medical Ctr., Washington, DC
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Gu J, Zang W, Liu B, Li L, Huang L, Li S, Rao G, Yu Y, Zhou Y. Evaluation of digital PCR for detecting low-level EGFR mutations in advanced lung adenocarcinoma patients: a cross-platform comparison study. Oncotarget 2017; 8:67810-67820. [PMID: 28978074 PMCID: PMC5620214 DOI: 10.18632/oncotarget.18866] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/02/2017] [Indexed: 01/28/2023] Open
Abstract
Emerging evidence has indicated that circulating tumor DNA (ctDNA) from plasma could be used to analyze EGFR mutation status for NSCLC patients; however, due to the low level of ctDNA in plasma, highly sensitive approaches are required to detect low frequency mutations. In addition, the cutoff for the mutation abundance that can be detected in tumor tissue but cannot be detected in matched ctDNA is still unknown. To assess a highly sensitive method, we evaluated the use of digital PCR in the detection of EGFR mutations in tumor tissue from 47 advanced lung adenocarcinoma patients through comparison with NGS and ARMS. We determined the degree of concordance between tumor tissue DNA and paired ctDNA and analyzed the mutation abundance relationship between them. Digital PCR and Proton had a high sensitivity (96.00% vs. 100%) compared with that of ARMS in the detection of mutations in tumor tissue. Digital PCR outperformed Proton in identifying more low abundance mutations. The ctDNA detection rate of digital PCR was 87.50% in paired tumor tissue with a mutation abundance above 5% and 7.59% in paired tumor tissue with a mutation abundance below 5%. When the DNA mutation abundance of tumor tissue was above 3.81%, it could identify mutations in paired ctDNA with a high sensitivity. Digital PCR will help identify alternative methods for detecting low abundance mutations in tumor tissue DNA and plasma ctDNA.
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Affiliation(s)
- Jincui Gu
- Department of Respiratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wanchun Zang
- Novogene Bioinformatics Institute, Beijing, China
| | - Bing Liu
- Novogene Bioinformatics Institute, Beijing, China
| | - Lei Li
- Novogene Bioinformatics Institute, Beijing, China
| | - Lixia Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shaoli Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guanhua Rao
- Novogene Bioinformatics Institute, Beijing, China
| | - Yang Yu
- Novogene Bioinformatics Institute, Beijing, China
| | - Yanbin Zhou
- Department of Respiratory Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Madankan R, Stefan W, Fahrenholtz SJ, MacLellan CJ, Hazle JD, Stafford RJ, Weinberg JS, Rao G, Fuentes D. Accelerated magnetic resonance thermometry in the presence of uncertainties. Phys Med Biol 2017; 62:214-245. [PMID: 27991449 DOI: 10.1088/1361-6560/62/1/214] [Citation(s) in RCA: 2] [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: 11/11/2022]
Abstract
A model-based information theoretic approach is presented to perform the task of magnetic resonance (MR) thermal image reconstruction from a limited number of observed samples on k-space. The key idea of the proposed approach is to optimally detect samples of k-space that are information-rich with respect to a model of the thermal data acquisition. These highly informative k-space samples can then be used to refine the mathematical model and efficiently reconstruct the image. The information theoretic reconstruction was demonstrated retrospectively in data acquired during MR-guided laser induced thermal therapy (MRgLITT) procedures. The approach demonstrates that locations with high-information content with respect to a model-based reconstruction of MR thermometry may be quantitatively identified. These information-rich k-space locations are demonstrated to be useful as a guide for k-space undersampling techniques. The effect of interactively increasing the predicted number of data points used in the subsampled model-based reconstruction was quantified using the L2-norm of the distance between the subsampled and fully sampled reconstruction. Performance of the proposed approach was also compared with uniform rectilinear subsampling and variable-density Poisson disk subsampling techniques. The proposed subsampling scheme resulted in accurate reconstructions using a small fraction of k-space points, suggesting that the reconstruction technique may be useful in improving the efficiency of thermometry data temporal resolution.
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Affiliation(s)
- R Madankan
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Elwell M, Mahler J, Rao G. Invited Commentary. Toxicol Pathol 2016. [DOI: 10.1177/019262339802600521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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50
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Mohindra P, Bentzen S, Giacomelli I, Scartoni D, Roque D, Rao G, Hanna N, Nichols E. Adjuvant Whole-Pelvic Radiation Therapy (WPRT) for Endometrioid Adenocarcinoma (EA): 45 Gy or 50/50.4 Gy? Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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