1
|
Sterlé M, Puszkiel A, Burlot C, Pereira E, Bellesoeur A, De Percin S, Beinse G, Fumet JD, Favier L, Niogret J, Blanchet B, Royer B, Bengrine-Lefevre L, Schmitt A. Improving olaparib exposure to optimize adverse effects management. Ther Adv Med Oncol 2024; 16:17588359241248328. [PMID: 38665845 PMCID: PMC11044803 DOI: 10.1177/17588359241248328] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Background Olaparib is an inhibitor of the human poly-(ADP-ribose)-polymerase enzymes (PARP1/2) needed to repair single-strand DNA breaks. It is used in breast, ovarian, prostate and pancreatic cancer. Objectives This work aimed to describe the pharmacokinetics/pharmacodynamics (PK/PD) relationship between olaparib plasma concentrations and common adverse effects (i.e. anaemia and hypercreatininaemia), in a real-life setting, to propose a target concentration for therapeutic drug monitoring. Methods Two PK/PD models describing the evolution of haemoglobinaemia and creatininaemia as a function of time were developed, based on data from, respectively, 38 and 37 patients receiving olaparib. The final model estimates were used to calculate the incidence of anaemia and creatinine increase according to plasma trough concentrations for 1000 virtual subjects to define target exposure. Results The final models correctly described the temporal evolution of haemoglobinaemia and creatininaemia for all patients. The haemoglobinaemia PK/PD model is inspired by Friberg's model, and the creatininaemia PK/PD model is an indirect response model. Model parameters were in agreement with physiological values and close to literature values for similar models. The mean (population) plasma haemoglobin concentration at treatment initiation, as estimated by the model, was 11.62 g/dL, while creatinine concentration was 71.91 µmol/L. Using simulations, we have identified a target trough concentration of 3500-4000 ng/mL, above which more than 20% of patients would report grade ≥3 anaemia. Conclusion Based on real-world data, we were able to properly describe the time course of haemoglobinaemia and plasma creatininaemia during olaparib treatment.
Collapse
Affiliation(s)
- Marylise Sterlé
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
- INSERM U1231, University of Burgundy Franche-Comté, Dijon, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, Paris, France
| | - Alicja Puszkiel
- Biologie du Médicament – Toxicologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, UMR-S1144, Paris, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, Paris, France
| | - Chloé Burlot
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
- INSERM U1231, University of Burgundy Franche-Comté, Dijon, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, Paris, France
| | - Eva Pereira
- Biologie du Médicament – Toxicologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Audrey Bellesoeur
- Institut Curie, Département d’Oncologie Médicale, Paris, France
- Institut Curie, Département de Radio-Pharmacologie, Saint-Cloud, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, Paris, France
| | | | - Guillaume Beinse
- Oncology Department, Cochin Hospital (AP-HP), CARPEM, Paris, France
- Cordeliers Research Center, Paris-Sorbonne University, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization, Paris, France
| | - Jean-David Fumet
- Oncology Department, Centre Georges-François Leclerc, INSERM U1231, UFR des Sciences de Santé, Dijon, France
| | - Laure Favier
- Oncology Department, Centre Georges-François Leclerc, INSERM U1231, UFR des Sciences de Santé, Dijon, France
| | - Julie Niogret
- Oncology Department, Centre Georges-François Leclerc, INSERM U1231, UFR des Sciences de Santé, Dijon, France
| | - Benoit Blanchet
- Biologie du Médicament – Toxicologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, Paris, France
| | - Bernard Royer
- Pharmacology and Toxicology Laboratory, CHRU Besançon, Besançon, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, Paris, France
| | - Leïla Bengrine-Lefevre
- Oncology Department, Centre Georges-François Leclerc, INSERM U1231, UFR des Sciences de Santé, Dijon, France
| | - Antonin Schmitt
- Pharmacy Department, Centre Georges-François Leclerc, 1 rue Pr Marion, Dijon 21079, France
- INSERM U1231, University of Burgundy Franche-Comté, Dijon, France
- Groupe de Pharmacologie Clinique Oncologique GPCO, France
| |
Collapse
|
2
|
Poulet G, Hulot JS, Blanchard A, Bergerot D, Xiao W, Ginot F, Boutonnet-Rodat A, Justine A, Beinse G, Geromel V, Pellegrina L, Azizi M, Laurent-Puig P, Benhaim L, Taly V. Circadian rhythm and circulating cell-free DNA release on healthy subjects. Sci Rep 2023; 13:21675. [PMID: 38065990 PMCID: PMC10709451 DOI: 10.1038/s41598-023-47851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
In the last decade, clinical studies have investigated the clinical relevance of circulating cell-free-DNA (ccfDNA) as a diagnostic and prognosis tool in various diseases including cancers. However, limited knowledge on ccfDNA biology restrains its full development in the clinical practice. To improve our understanding, we evaluated the impact of the circadian rhythm on ccfDNA release in healthy subjects over a 24-h period. 10 healthy female subjects underwent blood sampling at 8am and 20 healthy male subjects underwent serial blood sampling (8:00 AM, 9:00 AM, 12:00 PM, 4:00 PM, 8:00 PM, 12:00 AM, 4 AM (+ 1 Day) and 8 AM (+ 1 Day)). We performed digital droplet-based PCR (ddPCR) assays to target 2 DNA fragments (69 & 243 bp) located in the KRAS gene to determine the ccfDNA concentration and fragmentation profile. As control, half of the samples were re-analyzed by capillary miniaturized electrophoresis (BIAbooster system). Overall, we did not detect any influence of the circadian rhythm on ccfDNA release. Instead, we observed a decrease in the ccfDNA concentration after meal ingestion, suggesting either a post-prandial effect or a technical detection bias due to a higher plasma load in lipids and triglycerides. We also noticed a potential effect of gender, weight and creatinine levels on ccfDNA concentration.
Collapse
Affiliation(s)
- Geoffroy Poulet
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
- Eurofins-Biomnis, Gerland, Lyon, France
| | - Jean-Sébastien Hulot
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Anne Blanchard
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Damien Bergerot
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Wenjin Xiao
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
| | | | | | - Abdelli Justine
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
| | - Guillaume Beinse
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
| | | | | | - Michel Azizi
- CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, 75015, Paris, France
| | - Pierre Laurent-Puig
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France
- Biochemistry Department - Unit of Pharmacogenetic and Molecular Oncology, Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France
| | - Leonor Benhaim
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.
- Department of Visceral and Surgical Oncology, Gustave Roussy, Villejuif, France.
| | - Valerie Taly
- Université de Paris, UMR-S1138, CNRS SNC5096, Équipe Labélisée Ligue Nationale Contre le Cancer, Centre de Recherche des Cordeliers, Paris, France.
| |
Collapse
|
3
|
Pain FA, Beinse G, Azaïs H, Auvray-Kuentz M, Garcin LM, Delanoy N, Bentivegna E, Benoit L, Nguyen-Xuan HT, Blons H, Fabiano E, LE Frère Belda MA, Bats AS, Koual M. Patterns of recurrence in surgically treated women for TP53-mutated endometrial carcinomas. Eur J Surg Oncol 2023; 49:106954. [PMID: 37349159 DOI: 10.1016/j.ejso.2023.06.006] [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: 03/19/2023] [Revised: 06/06/2023] [Accepted: 06/10/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To describe the patterns of recurrence and the prognosis of patients with a recurrent TP53 mutated endometrial carcinoma treated initially by surgery. METHODS All patients with endometrial carcinoma, treated at hospital European Georges Pompidou between 2001 and 2021 were retrospectively included. Patients were separated into two groups: TP53-mutated and not TP53-mutated (POLE/ultramutated-like (POLEmut), dMMR (mismatch repair-deficient) and NSMP (No specific molecular profile)). We estimated survival using recurrence free survival, overall survival and overall survival from recurrence. The risk of recurrence according to TP53 status and the type of recurrence (locoregional recurrence, peritoneal recurrence, and metastasis) were also compared between the two groups. RESULTS Two hundred and ninety-one patients with endometrial carcinoma were included. Of these, 57 were TP53-mutated and 234 patients were not TP53-mutated. TP53 mutated patients had the worst recurrence free survival and overall survival (p < 0.001 for each). The hazard rate of recurrence was higher during the first three years for TP53 mutated endometrial carcinoma then tend to join the one of no TP53 mutated. There was a statistical difference between the two groups in terms of cumulative incidence of peritoneal recurrence (p = 0.002). There was, however, no statistical difference in overall survival from recurrence. CONCLUSIONS TP53-mutated endometrial carcinoma were more likely to experience a recurrence during the first three years and most often peritoneal recurrence compared to not TP53-mutated. TP53 status in endometrial carcinoma could be useful to define follow-up. Further prospective studies are required to assess the predictive impact of TP53 mutation on chemotherapy benefit.
Collapse
Affiliation(s)
- Flore-Anne Pain
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Université Paris Cité, France.
| | - Guillaume Beinse
- Université Paris Cité, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France; Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer » Sorbonne Université, Université de Paris, INSERM UMR1138, Paris, France; Department of Medical Oncology, Cochin Hospital, APHP.Centre, Paris, France
| | - Henri Azaïs
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Université Paris Cité, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France; Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer » Sorbonne Université, Université de Paris, INSERM UMR1138, Paris, France
| | - Marie Auvray-Kuentz
- Université Paris Cité, France; Department of Medical Oncology, Georges Pompidou European Hospital, APHP. Centre, Paris, France
| | - Louis-Marie Garcin
- Université Paris Cité, France; Department of Medical Oncology, Georges Pompidou European Hospital, APHP. Centre, Paris, France
| | - Nicolas Delanoy
- Université Paris Cité, France; Department of Medical Oncology, Georges Pompidou European Hospital, APHP. Centre, Paris, France
| | - Enrica Bentivegna
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France
| | - Louise Benoit
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Environmental Toxicity, Therapeutic Targets, Cellular Signaling and Biomarkers, T3S, INSERM UMR-S 1124, F-75006, Paris, France
| | - Huyen-Thu Nguyen-Xuan
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France
| | - Hélène Blons
- Université Paris Cité, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France; Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer » Sorbonne Université, Université de Paris, INSERM UMR1138, Paris, France; Department of Biochemistry, Pharmacogenetics and Molecular Oncology, Georges Pompidou European Hospital, APHP. Centre, Paris, France
| | - Emmanuelle Fabiano
- Institut du Cancer Paris CARPEM, F-75006, Paris, France; Department of Radiation Oncology, Georges Pompidou European Hospital, APHP. Centre, Paris, France
| | - Marie-Aude LE Frère Belda
- Institut du Cancer Paris CARPEM, F-75006, Paris, France; Department of Pathology, Georges Pompidou European Hospital, APHP. Centre, Paris, France
| | - Anne-Sophie Bats
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Université Paris Cité, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France; Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer » Sorbonne Université, Université de Paris, INSERM UMR1138, Paris, France
| | - Meriem Koual
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, APHP. Centre, Paris, France; Université Paris Cité, France; Institut du Cancer Paris CARPEM, F-75006, Paris, France; Environmental Toxicity, Therapeutic Targets, Cellular Signaling and Biomarkers, T3S, INSERM UMR-S 1124, F-75006, Paris, France
| |
Collapse
|
4
|
Garinet S, Didelot A, Marisa L, Beinse G, Sroussi M, Le Pimpec-Barthes F, Fabre E, Gibault L, Laurent-Puig P, Mouillet-Richard S, Legras A, Blons H. A novel Chr1-miR-200 driven whole transcriptome signature shapes tumor immune microenvironment and predicts relapse in early-stage lung adenocarcinoma. J Transl Med 2023; 21:324. [PMID: 37189151 DOI: 10.1186/s12967-023-04086-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/25/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND In Lung adenocarcinoma (LUAD), targeted therapies and immunotherapies have moved from metastatic to early stage and stratification of the relapse risk becomes mandatory. Here we identified a miR-200 based RNA signature that delineates Epithelial-to-mesenchymal transition (EMT) heterogeneity and predicts survival beyond current classification systems. METHODS A miR-200 signature was identified using RNA sequencing. We scored the miR-200 signature by WISP (Weighted In Silico Pathology), used GSEA to identify pathway enrichments and MCP-counter to characterize immune cell infiltrates. We evaluate the clinical value of this signature in our series of LUAD and using TCGA and 7 published datasets. RESULTS We identified 3 clusters based on supervised classification: I is miR-200-sign-down and enriched in TP53 mutations IIA and IIB are miR-200-sign-up: IIA is enriched in EGFR (p < 0.001), IIB is enriched in KRAS mutation (p < 0.001). WISP stratified patients into miR-200-sign-down (n = 65) and miR-200-sign-up (n = 42). Several biological processes were enriched in MiR-200-sign-down tumors, focal adhesion, actin cytoskeleton, cytokine/receptor interaction, TP53 signaling and cell cycle pathways. Fibroblast, immune cell infiltration and PDL1 expression were also significantly higher suggesting immune exhaustion. This signature stratified patients into high-vs low-risk groups, miR-200-sign-up had higher DFS, median not reached at 60 vs 41 months and within subpopulations with stage I, IA, IB, or II. Results were validated on TCGA data on 7 public datasets. CONCLUSION This EMT and miR-200-related prognostic signature refines prognosis evaluation independently of tumor stage and paves the way towards assessing the predictive value of this LUAD clustering to optimize perioperative treatment.
Collapse
Affiliation(s)
- Simon Garinet
- Assistance Publique-Hôpitaux de Paris, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, European Georges Pompidou Hospital, Paris Cancer Institute CARPEM, 20 Rue Leblanc, 75015, Paris, France.
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France.
- Department of Genetics and Molecular Medicine, Georges Pompidou European Hospital, APHP Centre, Paris, France.
| | - Audrey Didelot
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France
| | - Laetitia Marisa
- Department of Genetics and Molecular Medicine, Georges Pompidou European Hospital, APHP Centre, Paris, France
| | - Guillaume Beinse
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France
| | - Marine Sroussi
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France
| | | | - Elizabeth Fabre
- Department of Thoracic Oncology, Georges Pompidou European Hospital, APHP Centre, Paris, France
| | - Laure Gibault
- Department of Pathology, Georges Pompidou European Hospital, APHP Centre, Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France
- Department of Genetics and Molecular Medicine, Georges Pompidou European Hospital, APHP Centre, Paris, France
| | - Sophie Mouillet-Richard
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France
| | - Antoine Legras
- Department of Thoracic Surgery, Georges Pompidou European Hospital, APHP Centre, Paris, France
| | - Hélène Blons
- Assistance Publique-Hôpitaux de Paris, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, European Georges Pompidou Hospital, Paris Cancer Institute CARPEM, 20 Rue Leblanc, 75015, Paris, France.
- Centre de Recherche des Cordeliers, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Université de Paris, Sorbonne Université, Paris, France.
- Department of Genetics and Molecular Medicine, Georges Pompidou European Hospital, APHP Centre, Paris, France.
| |
Collapse
|
5
|
Frelaut M, Paillaud E, Beinse G, Scain AL, Culine S, Tournigand C, Poisson J, Bastuji-Garin S, Canoui-Poitrine F, Caillet P. External Validity of Two Scores for Predicting the Risk of Chemotherapy Toxicity Among Older Patients With Solid Tumors: Results From the ELCAPA Prospective Cohort. Oncologist 2023:7110929. [PMID: 37027521 DOI: 10.1093/oncolo/oyad050] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/30/2022] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Severe chemotherapy-related toxicities are frequent among older patients. The Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) and the Cancer and Aging Research Group Study (CARG) score were both developed to predict these events. PATIENTS AND METHODS The objective of this study was to evaluate the scores' predictive performance in a prospective cohort, which included patients aged 70 years and older referred for a geriatric assessment prior to chemotherapy for a solid tumor. The main endpoints were grades 3/4/5 toxicities for the CARG score and grades 4/5 hematologic toxicities and grades 3/4/5 non-hematologic toxicities for the CRASH score. RESULTS A total of 248 patients were included, of which 150 (61%) and 126 (51%) experienced at least one severe adverse event as defined respectively in CARG and CRASH studies. The incidence of adverse events was not significantly greater in the intermediate and high-risk CARG groups than in the low-risk group (odds ratio (OR) [95% CI] = 0.3 [0.1-1.4] (P = .1) and 0.4 [0.1-1.7], respectively). The area under curve (AUC) was 0.55. Similarly, the incidence of severe toxicities was no greater in the intermediate-low, intermediate-high, and high-risk CRASH groups than in the low-risk CRASH group (OR [95%CI] = 1 [0.3-3.6], 1 [0.3-3.4], and 1.5 [0.3-8.1], respectively). The AUC was 0.52. The type of cancer, performance status, comorbidities, body mass index, and MAX2 index were independently associated with grades 3/4/5 toxicities. CONCLUSION In an external cohort of older patients referred for a pretherapeutic GA, the CARG and CRASH scores were poor predictors of the risk of chemotherapy severe toxicities.
Collapse
Affiliation(s)
- Maxime Frelaut
- Gustave Roussy Cancer Campus, Department of Medical Oncology, Villejuif, France
| | - Elena Paillaud
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France
- AP-HP, Paris Cancer Institute CARPEM, Georges Pompidou European Hospital, Department of Geriatric Medicine, Paris, France
| | - Guillaume Beinse
- AP-HP, Cochin Hospital, Department of Clinical Oncology, Paris, France
- Cordeliers Research Center, Paris-Sorbonne University, INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Paris, France
| | - Anne-Laure Scain
- AP-HP, Henri Mondor Hospital, Department of Geriatric Medicine, Créteil, France
| | - Stéphane Culine
- Paris-Sorbonne University, Hemato-Immunology Research Department, CEA, Paris, France
- AP-HP, Saint-Louis Hospital, Department of Clinical Oncology, Paris, France
| | | | - Johanne Poisson
- AP-HP, Paris Cancer Institute CARPEM, Georges Pompidou European Hospital, Department of Geriatric Medicine, Paris, France
- Paris University, AP-HP, Inflammation Research Center, INSERM, UMR 1149 Paris, France
| | - Sylvie Bastuji-Garin
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France
- AP-HP, Henri-Mondor Hospital, Department of Public Health, Créteil, France
| | - Florence Canoui-Poitrine
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France
- AP-HP, Henri-Mondor Hospital, Department of Public Health, Créteil, France
| | - Philippe Caillet
- Univ. Paris Est Créteil, Inserm U955, IMRB, Créteil, France
- AP-HP, Paris Cancer Institute CARPEM, Georges Pompidou European Hospital, Department of Geriatric Medicine, Paris, France
| |
Collapse
|
6
|
Beinse G, Just PA, Le Frere Belda MA, Laurent-Puig P, Jacques S, Koual M, Garinet S, Leroy K, Delanoy N, Blons H, Gervais C, Durdux C, Chapron C, Goldwasser F, Terris B, Badoual C, Taly V, Bats AS, Borghese B, Alexandre J. Discovery and validation of a transcriptional signature identifying homologous recombination-deficient breast, endometrial and ovarian cancers. Br J Cancer 2022; 127:1123-1132. [PMID: 35752712 DOI: 10.1038/s41416-022-01900-9] [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] [Received: 03/01/2022] [Revised: 06/03/2022] [Accepted: 06/15/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Molecular alterations leading to homologous recombination deficiency (HRD) are heterogeneous. We aimed to identify a transcriptional profile shared by endometrial (UCEC), breast (BRCA) and ovarian (OV) cancers with HRD. METHODS Genes differentially expressed with HRD genomic score (continuous gHRD score) in UCEC/BRCA/OV were identified using edgeR, and used to train a RNAseq score (ridge-regression model) predictive of the gHRD score (PanCanAtlas, N = 1684 samples). The RNAseq score was applied in independent gynaecological datasets (CARPEM/CPTAC/SCAN/TCGA, N = 4038 samples). Validations used ROC curves, linear regressions and Pearson correlations. Overall survival (OS) analyses used Kaplan-Meier curves and Cox models. RESULTS In total, 656 genes were commonly up/downregulated with gHRD score in UCEC/BRCA/OV. Upregulated genes were enriched for nuclear/chromatin/DNA-repair processes, while downregulated genes for cytoskeleton (gene ontologies). The RNAseq score correlated with gHRD score in independent gynaecological cancers (R² = 0.4-0.7, Pearson correlation = 0.64-0.86, all P < 10-11), and was predictive of gHRD score >42 (RNAseq HRD profile; AUC = 0.95/0.92/0.78 in UCEC/BRCA/OV). RNAseq HRD profile was associated (i) with better OS in platinum-treated advanced TP53-mutated-UCEC (P < 0.001) and OV (P = 0.013), and (ii) with poorer OS (P < 0.001) and higher benefit of adjuvant chemotherapy in Stage I-III BRCA (interaction test, P < 0.001). CONCLUSIONS UCEC/BRCA/OV with HRD-associated genomic scars share a common transcriptional profile. RNAseq signatures might be relevant for identifying HRD-gynaecological cancers, for prognostication and for therapeutic decision.
Collapse
Affiliation(s)
- Guillaume Beinse
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Medical Oncology, Hopital Cochin, Paris, France
| | - Pierre-Alexandre Just
- Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Pathology, Hopital Cochin, Paris, France.,Université de Paris Cité, Paris, France
| | - Marie-Aude Le Frere Belda
- Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Pathology, Hopital Européen Georges Pompidou, Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France.,Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Biology, Hopital Européen Georges Pompidou, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Paris, France
| | | | - Meriem Koual
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Gynecological Surgery, Hopital Européen Georges Pompidou, Paris, France
| | - Simon Garinet
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France.,Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Biology, Hopital Européen Georges Pompidou, Paris, France
| | - Karen Leroy
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Biology, Hopital Européen Georges Pompidou, Paris, France
| | - Nicolas Delanoy
- Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Medical Oncology, Hopital Européen Georges Pompidou, Paris, France
| | - Helene Blons
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Biology, Hopital Européen Georges Pompidou, Paris, France
| | - Claire Gervais
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Medical Oncology, Hopital Européen Georges Pompidou, Paris, France
| | - Catherine Durdux
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Radiotherapy, Hopital Européen Georges Pompidou, Paris, France
| | - Charles Chapron
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Gynecological Surgery, Hopital Cochin, Paris, France
| | - François Goldwasser
- Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Medical Oncology, Hopital Cochin, Paris, France.,Université de Paris Cité, Paris, France
| | - Benoit Terris
- Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Pathology, Hopital Cochin, Paris, France.,Université de Paris Cité, Paris, France
| | - Cecile Badoual
- Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Pathology, Hopital Européen Georges Pompidou, Paris, France
| | - Valerie Taly
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France
| | - Anne-Sophie Bats
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France.,Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Gynecological Surgery, Hopital Européen Georges Pompidou, Paris, France
| | - Bruno Borghese
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France.,Université de Paris Cité, Paris, France.,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Gynecological Surgery, Hopital Cochin, Paris, France
| | - Jérôme Alexandre
- Centre de Recherche des Cordeliers, « Equipe labélisée Ligue Contre le Cancer », CNRS SNC 5096, Sorbonne Université, Université de Paris Cité, INSERM, Paris, France. .,Institut du Cancer Paris CARPEM, AP-HP, APHP.Centre, Department of Medical Oncology, Hopital Cochin, Paris, France. .,Université de Paris Cité, Paris, France.
| |
Collapse
|
7
|
Gorgeu V, Borghese B, Koual M, Just PA, Lefrere Belda MA, Delanoy N, Durdux C, Chapron C, Goldwasser F, Gervais C, Blons H, Terris B, Badoual C, Taly V, Laurent-Puig P, Bats AS, Alexandre J, Beinse G. Potential competing risk of death in older high-risk endometrial carcinoma patients: Results from a multicentric retrospective cohort. Gynecol Oncol 2022; 166:269-276. [DOI: 10.1016/j.ygyno.2022.05.016] [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] [Received: 02/27/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022]
|
8
|
Thietart S, Beinse G, Smets P, Karras A, Philipponnet C, Augusto JF, El Karoui K, Mesbah R, Titeca-Beauport D, Hamidou M, Carron PL, Maurier F, Sacre K, Cohen P, Liozon E, Blanchard-Delaunay C, Kostianovsky A, Pagnoux C, Mouthon L, Guillevin L, Terrier B, Puéchal X. Patients of 75 years and over with ANCA-associated vasculitis have a lower relapse risk than younger patients: A multicentre cohort study. J Intern Med 2022; 291:350-363. [PMID: 34755398 DOI: 10.1111/joim.13417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) in older patients. We aim to study relapse risk of granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) in patients diagnosed after 75 years and compare it with those of patients aged 65-75 years. METHODS Data from AAV patients aged ≥65 years were extracted from the French Vasculitis Study Group (FVSG) database and from a call for observation to FVSG members. Cox and Fine-Gray models were used to assess relapse risk, taking death into account either as a censoring or a competing event, respectively. RESULTS The analysis included 219 patients aged ≥75 years (median 79) and 80 patients aged 65-75 years (median 70), of those 155 had GPA (52%), 136 MPA (45%), with 95 (32%) anti-proteinase 3 positivity and 179 (61%) anti-myeloperoxidase. Patients aged ≥75 years had a lower relapse risk in multivariate analysis (cause-specific hazards ratio [CSHR] 0.54, 95% CI [0.33-0.89], p = 0.016, Cox model; subdistribution hazard ratio [SHR] 0.46, 95% CI [0.29-0.74], p = 0.001, Fine-Gray model) after taking into account vasculitis type. Patients aged ≥75 years had a lower probability of being treated for remission maintenance with a combination of glucocorticoids and immunosuppressants (vs. glucocorticoids alone, HR 0.28, 95% CI [0.11-0.68], p = 0.005) after adjusting to Five Factor Score, although relapse-free survival was significantly longer when receiving such combination (CSHR 0.40, 95% [CI 0.24-0.67], p < 0.001). CONCLUSIONS AAV patients ≥75 years have a lower relapse risk than patients aged 65-75 years despite a lower probability of having received maintenance therapy with a combination of glucocorticoids and immunosuppressants, but they still benefit from such treatment regimen.
Collapse
Affiliation(s)
- Sara Thietart
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Guillaume Beinse
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université INSERM, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), Paris, France
| | - Perrine Smets
- Department of Internal Medicine, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Alexandre Karras
- Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Carole Philipponnet
- Department of Nephrology, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Jean-François Augusto
- Department of Nephrology-Dialysis-Transplantation, Centre Hospitalier Universitaire, Angers, France
| | - Khalil El Karoui
- Department of Nephrology and Renal transplantation, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Rafik Mesbah
- Department of Nephrology, Centre Hospitalier, Boulogne-sur-Mer, France
| | | | - Mohamed Hamidou
- Department of Internal Medicine, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes, France
| | - Pierre-Louis Carron
- Department of Nephrology-Dialysis-Transplantation, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - François Maurier
- Department of Internal Medicine and Immunology, Groupe Hospitalier UNEOS, Metz-Vantoux, France
| | - Karim Sacre
- Department of Internal Medicine, Hôpital Bichat, Université de Paris, Assistance Publique Hôpitaux de Paris, INSERM U1149, Paris, France
| | - Pascal Cohen
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Eric Liozon
- Department of Internal Medicine and Clinical Immunology, Dupuytren University Hospital, Limoges, France
| | | | - Alex Kostianovsky
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Christian Pagnoux
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Luc Mouthon
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Loïc Guillevin
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | - Xavier Puéchal
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,APHP-CUP, Hôpital Cochin, Université de Paris, Paris, France
| | -
- National Referral Center for Rare Systemic Autoimmune Diseases, Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| |
Collapse
|
9
|
Garinet S, Didelot A, Denize T, Perrier A, Beinse G, Leclere JB, Oudart JB, Gibault L, Badoual C, Le Pimpec-Barthes F, Laurent-Puig P, Legras A, Blons H. Clinical assessment of the miR-34, miR-200, ZEB1 and SNAIL EMT regulation hub underlines the differential prognostic value of EMT miRs to drive mesenchymal transition and prognosis in resected NSCLC. Br J Cancer 2021; 125:1544-1551. [PMID: 34642464 PMCID: PMC8609001 DOI: 10.1038/s41416-021-01568-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/25/2021] [Revised: 08/31/2021] [Accepted: 09/24/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patients with non-small cell lung cancer (NSCLC) receiving curative surgery have a risk of relapse, and adjuvant treatments only translate into a 5% increase in 5-year survival. We assessed the clinical significance of epithelial-mesenchymal transition (EMT) and explored its association with the [SNAIL/miR-34]:[ZEB/miR-200] regulation hub to refine prognostic information. METHODS We validated a 7-gene EMT score using a consecutive series of 176 resected NSCLC. We quantified EMT transcription factors, microRNAs (miRs) of the miR-200, miR-34 families and miR-200 promoter hypermethylation to identify outcome predictors. RESULTS Most tumours presented with an EMT-hybrid state and the EMT score was not predictive of outcome. Individually, all miR-200 were inversely associated with the EMT score, but only chromosome-1 miRs, miR-200a, b, 429, were associated with disease-free survival (p = 0.08, 0.05 and 0.025) and overall survival (p = 0.013, 0.003 and 0.006). We validated these associations on The Cancer Genome Atlas data. Tumour unsupervised clustering based on miR expression identified two good prognostic groups, unrelated to the EMT score, suggesting that miR profiling may have an important clinical value. CONCLUSION miR-200 family members do not have similar predictive value. Core EMT-miR, regulators and not EMT itself, identify NSCLC patients with a low risk of relapse after surgery.
Collapse
Affiliation(s)
- Simon Garinet
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, Paris Cancer Institute CARPEM, Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Audrey Didelot
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Thomas Denize
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, Paris Cancer Institute CARPEM, Paris, France
| | - Alexandre Perrier
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Guillaume Beinse
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Jean-Baptiste Leclere
- Department of Thoracic Surgery, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Baptiste Oudart
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, Paris Cancer Institute CARPEM, Paris, France
| | - Laure Gibault
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Pathology, Paris Cancer Institute CARPEM, Paris, France
| | - Cecile Badoual
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Pathology, Paris Cancer Institute CARPEM, Paris, France
| | - Françoise Le Pimpec-Barthes
- Department of Thoracic Surgery, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Laurent-Puig
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, Paris Cancer Institute CARPEM, Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Antoine Legras
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
- Department of Thoracic Surgery, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Helene Blons
- Assistance publique-hôpitaux de Paris, European Georges Pompidou Hospital, Department of Biochemistry, Pharmacogenetics and Molecular Oncology, Paris Cancer Institute CARPEM, Paris, France.
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France.
| |
Collapse
|
10
|
Velev M, Puszkiel A, Blanchet B, de Percin S, Delanoy N, Medioni J, Gervais C, Balakirouchenane D, Khoudour N, Pautier P, Leary A, Ajgal Z, Hirsch L, Goldwasser F, Alexandre J, Beinse G. Association between Olaparib Exposure and Early Toxicity in BRCA-Mutated Ovarian Cancer Patients: Results from a Retrospective Multicenter Study. Pharmaceuticals (Basel) 2021; 14:ph14080804. [PMID: 34451901 PMCID: PMC8399031 DOI: 10.3390/ph14080804] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 12/27/2022] Open
Abstract
Factors associated with olaparib toxicity remain unknown in ovarian cancer patients. The large inter-individual variability in olaparib pharmacokinetics could contribute to the onset of early significant adverse events (SAE). We aimed to retrospectively analyze the pharmacokinetic/pharmacodynamic relationship for toxicity in ovarian cancer patients from “real life” data. The clinical endpoint was the onset of SAE (grade III/IV toxicity or dose reduction/discontinuation). Plasma olaparib concentration was assayed using liquid chromatography at any time over the dosing interval. Trough concentrations (CminPred) were estimated using a population pharmacokinetic model. The association between toxicity and clinical characteristics or CminPred was assessed by logistic regression and non-parametric statistical tests. Twenty-seven patients were included, among whom 13 (48%) experienced SAE during the first six months of treatment. Olaparib CminPred was the only covariate significantly associated with increased risk of SAE onset (odds ratio = 1.31, 95% CI = [1.10; 1.57], for each additional 1000 ng/mL). The ROC curve identified a threshold of CminPred = 2500 ng/mL for prediction of SAE onset (sensitivity/specificity 0.62 and 1.00, respectively). This study highlights a significant association between olaparib plasma exposure and SAE onset and identified the threshold of 2500 ng/mL trough concentration as potentially useful to guide dose adjustment in ovarian cancer patients.
Collapse
Affiliation(s)
- Maud Velev
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
| | - Alicja Puszkiel
- Department of Pharmacokinetics and Pharmacochemistry, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (A.P.); (B.B.); (D.B.); (N.K.)
- INSERM UMR-S1144, Faculté de Pharmacie, Université de Paris, 75006 Paris, France
| | - Benoit Blanchet
- Department of Pharmacokinetics and Pharmacochemistry, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (A.P.); (B.B.); (D.B.); (N.K.)
- UMR8038 CNRS, U1268 INSERM, Faculté de Pharmacie, Université de Paris, PRES Sorbonne Paris Cité, CARPEM, 75006 Paris, France
| | - Sixtine de Percin
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
| | - Nicolas Delanoy
- Department of Medical Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France; (N.D.); (J.M.); (C.G.)
| | - Jacques Medioni
- Department of Medical Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France; (N.D.); (J.M.); (C.G.)
| | - Claire Gervais
- Department of Medical Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France; (N.D.); (J.M.); (C.G.)
| | - David Balakirouchenane
- Department of Pharmacokinetics and Pharmacochemistry, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (A.P.); (B.B.); (D.B.); (N.K.)
| | - Nihel Khoudour
- Department of Pharmacokinetics and Pharmacochemistry, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (A.P.); (B.B.); (D.B.); (N.K.)
| | - Patricia Pautier
- Gustave Roussy Cancer Center, Department of Medical Oncology, Université Paris-Saclay, 94805 Villejuif, France; (P.P.); (A.L.)
| | - Alexandra Leary
- Gustave Roussy Cancer Center, Department of Medical Oncology, Université Paris-Saclay, 94805 Villejuif, France; (P.P.); (A.L.)
| | - Zahra Ajgal
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
| | - Laure Hirsch
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
| | - François Goldwasser
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
| | - Jerome Alexandre
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), 75006 Paris, France
- Correspondence: ; Tel.: +33-01-(58)-414141
| | - Guillaume Beinse
- Department of Medical Oncology, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; (M.V.); (S.d.P.); (Z.A.); (L.H.); (F.G.); (G.B.)
- Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, Team Personalized Medicine, Pharmacogenomics and Therapeutic Optimization (MEPPOT), 75006 Paris, France
| |
Collapse
|
11
|
Thietart S, Beinse G, Smets P, Karras A, Philipponnet C, Augusto J, El Karoui K, Mesbah R, Titeca-Beauport D, Hamidou M, Carron P, Maurier F, Sacré K, Liozon E, Blanchard-Delaunay C, Pagnoux C, Mouthon L, Guillevin L, Terrier B, Puéchal X. Risque de rechute des vascularites associées aux ANCA diagnostiquées après 75 ans. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.016] [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]
|
12
|
Beinse G, Reitter D, Segaux L, Carvahlo-Verlinde M, Rousseau B, Tournigand C, Cudennec T, Laurent M, Boudou-Rouquette P, Paillaud E, Canouï-Poitrine F, Caillet P. Potential drug-drug interactions and risk of unplanned hospitalization in older patients with cancer: A survey of the prospective ELCAPA (ELderly CAncer PAtients) cohort. J Geriatr Oncol 2020; 11:586-592. [DOI: 10.1016/j.jgo.2019.07.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/02/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022]
|
13
|
Beinse G, Rance B, Just PA, Izac B, Letourneur F, Saidu NEB, Chouzenoux S, Nicco C, Goldwasser F, Batteux F, Durdux C, Chapron C, Pasmant E, Leroy K, Alexandre J, Borghese B. Identification of TP53 mutated group using a molecular and immunohistochemical classification of endometrial carcinoma to improve prognostic evaluation for adjuvant treatments. Int J Gynecol Cancer 2020; 30:640-647. [PMID: 32169874 DOI: 10.1136/ijgc-2019-000871] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Molecular classification of endometrial carcinoma has been proposed to predict survival. However, its role in patient management remains to be determined. We aimed to identify whether a molecular and immunohistochemical classification of endometrial carcinoma could improve decision-making for adjuvant therapy. METHODS All consecutive patients treated for endometrial carcinoma between 2010 and 2017 at Cochin University Hospital were included. Clinical risk of relapse was based on European Society for Medical Oncology-European Society of Gynaecological Oncology-European SocieTy for Radiotherapy & Oncology (ESMO-ESGO-ESTRO) consensus. The clinical event of interest was event-free survival. Formalin-fixed paraffin-embedded tissue samples were processed for histopathological analysis and DNA extraction. The nuclear expression of mismatch repair and TP53 proteins was analyzed by immunohistochemistry. Next-generation sequencing of a panel of 15 genes including TP53 and POLE was performed using Ampliseq panels on Ion Torrent PGM (ThermoFisher). Tumors were allocated into four molecular groups using a sequential method based on next-generation sequencing and immunohistochemistry data: (1) POLE/ultramutated-like; (2) MSI/hypermutated-like (mismatch repair-deficient); (3) TP53-mutated (without POLE mutations or mismatch repair deficiency); (4) not otherwise specified (the remaining tumors). RESULTS 159 patients were included; 125 tumors were available for molecular characterization and distributed as follows: (1) POLE/ultramutated-like: n=4 (3%); (2) MSI/hypermutated-like: n=35 (30%); (3) TP53-mutated: n=30 (25%); and (4) not otherwise specified: n=49 (42%). Assessing the TP53 status by immunohistochemistry only rather than next-generation sequencing would have misclassified 6 tumors (5%). TP53-mutated tumors were associated with poor prognosis, independently of International Federation of Gynecology and Obstetrics (FIGO) stage and histological grade (Cox-based adjusted hazard ratio (aHR) 5.54, 95% CI 2.30 to 13.4), and independently of clinical risk of relapse (aHR 3.92, 95% CI 1.59 to 9.64). Among patients with FIGO stage I-II tumors, 6 (38%) TP53-mutated tumors had low/intermediate clinical risk of relapse and did not receive adjuvant chemotherapy or radiotherapy. CONCLUSION Endometrial carcinoma molecular classification identified potentially under-treated patients with poor molecular prognosis despite being at low/intermediate clinical risk of relapse. Consideration of molecular classification in adjuvant therapeutic decisions should be evaluated in prospective trials.
Collapse
Affiliation(s)
- Guillaume Beinse
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France
| | - Bastien Rance
- Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Medical Informatics, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Pierre-Alexandre Just
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Pathological Anatomy and Cytology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Brigitte Izac
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France
| | | | | | | | - Carole Nicco
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France
| | - François Goldwasser
- Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Medical Oncology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Frederic Batteux
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France
| | - Catherine Durdux
- Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Departement of Radiation Oncology, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Charles Chapron
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Gynecologic Surgery, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Eric Pasmant
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Genetics and Molecular Biology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Karen Leroy
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Genetics and Molecular Biology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Jerome Alexandre
- Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Medical Oncology, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| | - Bruno Borghese
- U1016 Institut Cochin, INSERM, CARPEM, Paris, Île-de-France, France .,Université Paris Descartes, Sorbonne Paris Cité, Paris, Île-de-France, France.,Department of Gynecologic Surgery, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, Île-de-France, France
| |
Collapse
|
14
|
Beinse G, Tellier V, Charvet V, Deutsch E, Borget I, Massard C, Hollebecque A, Verlingue L. Prediction of Drug Approval After Phase I Clinical Trials in Oncology: RESOLVED2. JCO Clin Cancer Inform 2019; 3:1-10. [DOI: 10.1200/cci.19.00023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Drug development in oncology currently is facing a conjunction of an increasing number of antineoplastic agents (ANAs) candidate for phase I clinical trials (P1CTs) and an important attrition rate for final approval. We aimed to develop a machine learning algorithm (RESOLVED2) to predict drug development outcome, which could support early go/no-go decisions after P1CTs by better selection of drugs suitable for further development. METHODS PubMed abstracts of P1CTs reporting on ANAs were used together with pharmacologic data from the DrugBank5.0 database to model time to US Food and Drug Administration (FDA) approval (FDA approval-free survival) since the first P1CT publication. The RESOLVED2 model was trained with machine learning methods. Its performance was evaluated on an independent test set with weighted concordance index (IPCW). RESULTS We identified 462 ANAs from PubMed that matched with DrugBank5.0 (P1CT publication dates 1972 to 2017). Among 1,411 variables, 28 were used by RESOLVED2 to model the FDA approval-free survival, with an IPCW of 0.89 on the independent test set. RESOLVED2 outperformed a model that was based on efficacy/toxicity (IPCW, 0.69). In the test set at 6 years of follow-up, 73% (95% CI, 49% to 86%) of drugs predicted to be approved were approved, whereas 92% (95% CI, 87% to 98%) of drugs predicted to be nonapproved were still not approved (log-rank P < .001). A predicted approved drug was 16 times more likely to be approved than a predicted nonapproved drug (hazard ratio, 16.4; 95% CI, 8.40 to 32.2). CONCLUSION As soon as P1CT completion, RESOLVED2 can predict accurately the time to FDA approval. We provide the proof of concept that drug development outcome can be predicted by machine learning strategies.
Collapse
Affiliation(s)
| | | | | | - Eric Deutsch
- Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Le Kremlin-Bicêtre, France
- Université Paris-Saclay, Villejuif, France
| | - Isabelle Borget
- Gustave Roussy Cancer Campus, Villejuif, France
- Université Versailles Saint-Quentin-en-Yvelines, Villejuif, France
- Université Paris-Sud, Paris, France
| | | | | | | |
Collapse
|
15
|
Bouaoud J, Beinse G, Epaillard N, Amor-Sehlil M, Bidault F, Brocheriou I, Hervé G, Spano JP, Janot F, Boudou-Rouquette P, Benassarou M, Schouman T, Goudot P, Malouf G, Goldwasser F, Bertolus C. Lack of efficacy of neoadjuvant chemotherapy in adult patients with maxillo-facial high-grade osteosarcomas: A French experience in two reference centers. Oral Oncol 2019; 95:79-86. [DOI: 10.1016/j.oraloncology.2019.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/08/2019] [Accepted: 06/07/2019] [Indexed: 02/07/2023]
|
16
|
Beinse G, Tellier V, Charvet V, Borget I, Massard C, Hollebecque A, Verlingue L. Abstract 668: A recommender system to enhance drug development in oncology from phase I trials: The RESOLVED2 project. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-668] [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
The industry and investigators’ communities are currently facing a conjunction of increasing number of anti-neoplastic agents (ANA) candidate for phase 1 clinical trials (P1CT) and an important attrition rate for final approval. Improvement of the drug development strategies in oncology could be achieved by machine learning supporting go/no-go decisions after phase I trial.
PubMed abstracts of P1CT reporting ANA were used together with pharmacological classification and molecular targets of ANA from DrugBank5.0 database. To account for heterogeneous follow-up we computed a new metric entitled Food & Drug Administration approval-free-survival (FDA-aFS). FDA-aFS is a right-censored variable defined by the time between first P1CT publication and the FDA approval date or censoring for compounds not approved up to 2018, July. A training set and a test set were randomly generated from the whole dataset with a 70%/30% ratio. A regression and a classification version of RESOLVED2 have been developed in the training set and evaluated independently on the test set. The RESOLVED2 regression model has been optimized using a Cox logistic regression on FDA-aFS, penalized by Lasso with cross validation on the training set. RESOLVED2 predictions have been compared to a model including common variables used for go/no-go decisions (toxicity, clinical activity, observation of complete tumor response). The RESOLVED2 classification model (predicted approved ANA vs predicted non-approved ANA) was computed in the training set using predicted probabilities derived from the regression model, by the identification of the cut-off reaching minimal log-rank derived p-value when comparing FDA-aFS of predicted approved versus predicted non-approved ANA.
We identified 462 ANA matching with DrugBank entries (P1CT publication interval: 1972-2017). Among 1411 variables, 28 remained in the model after Lasso penalization. The relation of the model to the FDA-aFS had a weighted concordance index of 0.89 on the independent test set, versus 0.69 for a classical model based on efficacy/toxicity. Classified approval predictions achieved a p<10e-10 for association with observed FDA-aFS in the test set: at 6 years of follow-up, 73% (95%CI [49%; 86%]) of predicted approved drugs were indeed approved and 92% (95%CI [87%; 98%]) of predicted non-approved drugs were still not approved. A predicted approved drug was 16 times more likely to be approved compared to a predicted non-approved drug (Hazard ratio=16.4; 95%CI [8.40; 32.2]; p<10e-10).
RESOLVED2 is an applicable machine learning model that could support early go/no-go decision as soon as P1CT completion based on accurate prediction of FDA approval for drugs in oncology.
Citation Format: Guillaume Beinse, Virgile Tellier, Valentin Charvet, Isabelle Borget, Christophe Massard, Antoine Hollebecque, Loic Verlingue. A recommender system to enhance drug development in oncology from phase I trials: The RESOLVED2 project [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 668.
Collapse
|
17
|
Beinse G, Just PA, Rance B, Izac B, Letourneur F, Saidu NEB, Chouzenoux S, Nicco C, Goldwasser F, Pasmant E, Batteux F, Borghese B, Alexandre J, Leroy K. The NRF2 transcriptional target NQO1 has low mRNA levels in TP53-mutated endometrial carcinomas. PLoS One 2019; 14:e0214416. [PMID: 30908539 PMCID: PMC6433262 DOI: 10.1371/journal.pone.0214416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/12/2019] [Indexed: 12/11/2022] Open
Abstract
Background NRF2 is a major transcription factor regulating the expression of antioxidative/detoxifying enzymes, involved in oncogenic processes and drug resistance. We aimed to identify molecular alterations associated with NRF2 activation in endometrial carcinoma (EC). Methods Ninety patients treated (2012–2017) for localized/locally advanced EC were included in this study. Formalin-fixed paraffin-embedded tissue samples were processed for immunohistochemical (NRF2 and Mismatch Repair proteins) analyses. Next generation sequencing (NGS) of a panel of genes including POLE, TP53, NFE2L2, KEAP1 and CUL3 was performed using Ampliseq panels on Ion Torrent PGM (ThermoFisher). NRF2 activity was assessed by NQO1, GCLC, and AKR1C3 mRNA expressions, using TaqMan assays and quantitative RT-PCR. Results Tumors were classified as POLE exonuclease domain mutated (N = 3, 3%), MMR-deficient (MSI-like) (N = 28, 31%), TP53 mutated (Copy-number high-like) (N = 22, 24%), and other tumors (Copy-number low-like) (N = 32, 36%). NRF2 nuclear immunostaining did not correlate with NRF2 target genes expression. The 3 tumors with highest NRF2 target genes expression harbored oncogenic KEAP1 or NFE2L2 mutations. Low NQO1 mRNA and protein levels were observed in the TP53 mutated subgroup compared to others tumors (p < .05) and in silico analyses of The Cancer Genome Atlas data further indicated that NQO1 mRNA levels were lower in serous compared to endometrioid copy-number high EC. Conclusion In contrast with previous reports based on immunohistochemistry, our study indicates that NRF2 activation is a rare event in EC, associated with NFE2L2 or KEAP1 mutations. The subset of aggressive EC with low NQO1 mRNA level might represent a specific subgroup, which could be sensitive to combination therapies targeting oxidative stress.
Collapse
Affiliation(s)
| | - Pierre-Alexandre Just
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Pathology, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Bastien Rance
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Medical Informatics, HEGP, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Brigitte Izac
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- INSERM U1016, Cochin Institute, GENOMIC platform, Paris, France
| | - Franck Letourneur
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- INSERM U1016, Cochin Institute, GENOMIC platform, Paris, France
| | | | | | - Carole Nicco
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - François Goldwasser
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Medical Oncology, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Eric Pasmant
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Genetics and Molecular Biology, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Frederic Batteux
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Immunology, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Bruno Borghese
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Gynecologic Surgery, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Jérôme Alexandre
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Medical Oncology, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
| | - Karen Leroy
- INSERM U1016, Cochin Institute, CARPEM, Paris, France
- Paris Descartes University, Sorbonne Paris Cité, Paris, France
- Department of Genetics and Molecular Biology, Cochin Hospital, Assistance Publique–Hopitaux de Paris, Paris, France
- * E-mail:
| |
Collapse
|
18
|
Beinse G, Hulin A, Rousseau B. Axitinib pharmacologic therapeutic monitoring reveals severe under-exposure despite titration in patients with metastatic renal cell carcinoma. Invest New Drugs 2019; 37:1289-1291. [DOI: 10.1007/s10637-019-00743-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/06/2019] [Indexed: 11/24/2022]
|
19
|
Malouf GG, Beinse G, Adam J, Mir O, Chamseddine AN, Terrier P, Honore C, Spano JP, Italiano A, Kurtz JE, Coindre JM, Blay JY, Le Cesne A. Brain Metastases and Place of Antiangiogenic Therapies in Alveolar Soft Part Sarcoma: A Retrospective Analysis of the French Sarcoma Group. Oncologist 2019; 24:980-988. [PMID: 30626710 DOI: 10.1634/theoncologist.2018-0074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 02/06/2018] [Accepted: 11/28/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Alveolar soft part sarcoma (ASPS) is a rare sarcoma characterized by a slow evolution, brain metastasis (BM), and resistance to doxorubicin. Antiangiogenic therapies (AAT) have shown clinical activity, but little is known about the optimal therapeutic strategy, specifically considering BM. SUBJECTS, MATERIALS, AND METHODS We performed a retrospective analysis of all patients with ASPS treated in three referral centers of the French Sarcoma Group. We aimed to describe factors associated with overall survival (OS) and the impact of BM on outcome of patients treated by AAT. RESULTS We identified 75 patients between 1971 and 2012 (median age = 23, range: 5-96 years). Median follow-up was 74 months. Patients with localized (n = 44, 59%) and metastatic (n = 31, 41%) diseases had a 10-year OS of 69% and 25%, respectively. Only surgical incomplete resection was associated with shorter OS in localized disease (hazard ratio [HR] = 5.2, 95% confidence interval [CI] 1.2-22.4, p = .02). Fifty-two (69%) patients developed lung metastasis (LM; baseline: n = 31, [41%]; de novo: n = 21, [28%]). Thirteen patients developed BM, all occurring after LM. Tumor size ≥5 cm was associated with poorer BM-free survival (HR = 8.4, 95% CI 2.1-33.9, p = .002). Median OS post-BM was 17 months (95% CI 15 to not assessable). Overall, 12 patients were treated with AAT (sunitinib n = 10): 5 patients had BM and achieved poor outcomes compared with patients without, with median progression-free-survivals of 2 versus 11 months, respectively. CONCLUSION Baseline larger tumors were associated with increased risk of brain metastasis in patients with ASPS. Patients with BM seem to have little benefit from AAT, suggesting the need to develop antineoplastic agents with high central nervous system penetrance in this setting. IMPLICATIONS FOR PRACTICE Alveolar soft part sarcoma (ASPS) is an extremely rare subtype of sarcoma that is particularly resistant to conventional therapies. Antiangiogenic therapies (AAT) have shown promising results. However, patients with ASPS still die of tumor evolution. This study highlights the prognostic shift induced by brain metastasis (BM), identifying this event as a major contributor to the death of patients with ASPS, and observes a striking lack of effectiveness of AAT in patients who had previously developed BM. This observation is of interest for the therapeutic development in ASPS, highlighting the need to develop strategies dedicated to BM, such as radiosurgery or high-central nervous system penetrance tyrosine kinase inhibitors.
Collapse
Affiliation(s)
- Gabriel G Malouf
- Department of Medical Oncology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Guillaume Beinse
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Julien Adam
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Olivier Mir
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Ali N Chamseddine
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| | - Philippe Terrier
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Charles Honore
- Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Philippe Spano
- Department of Medical Oncology, Pitie-Salpêtrière Hospital, Paris, France
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM 1136, Paris, France
| | - Antoine Italiano
- Early Phase Trials and Sarcoma Units, Institut Bergonié, Bordeaux, France
| | - Jean-Emmanuel Kurtz
- Department of Medical Oncology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Jean-Yves Blay
- Department of Adult Medical Oncology, Centre Leon Berard, Lyon, France
| | - Axel Le Cesne
- Department of Cancer Medicine, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
20
|
Pudlarz T, Naoun N, Beinse G, Grazziotin-Soares D, Lotz JP. AACR 2019 — Congrès de l’association américaine de recherche contre le cancer. ONCOLOGIE 2019. [DOI: 10.3166/onco-2019-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Dans ce numéro spécial de la revueOncologie, les principaux points discutés au congrès de l’Association américaine pour la recherche sur le cancer (AACR) sont rapportés. L’objectif ici est de présenter de manière concise des exposés qui méritent une attention toute particulière. Le programme de la réunion de l’AACR de cette année, qui a eu lieu à Atlanta, a couvert les dernières découvertes de tout le spectre de la recherche sur le cancer — des sciences de la population à la prévention ; biologie du cancer, études translationnelles et cliniques ; à la survie et à la défense des droits — et souligne le travail des meilleurs esprits en matière de recherche et de médecine d’institutions du monde entier. Le congrès qui a duré cinq jours a proposé un programme multidisciplinaire couvrant tous les aspects de la recherche sur le cancer depuis ses bases fondamentales jusqu’à ses applications translationnelles et cliniques. Grâce à notre compréhension accrue des bases moléculaires du cancer, de nombreuses thérapies ciblées nouvelles ont émergé. Ainsi, notre compréhension sur la façon dont les tumeurs échappent aux attaques du système immunitaire a conduit au développement de nouvelles thérapies. Compte tenu de l’importance accrue de l’immunothérapie dans le traitement du cancer, nous présentons ici les dernières avancées dans ce domaine. Enfin, d’autres approches telles que l’étude du microbiome, l’épigénétique et l’intelligence artificielle comme un outil dans la recherche sur le cancer ont aussi été discutées au congrès de l’AACR 2019.
Collapse
|
21
|
Beinse G, Just PA, Rance B, Izac B, Letourneur F, Saidu NE, Chouzenoux S, Goldwasser F, Pasmant E, Batteux F, Borghese B, Leroy K, Alexandre J. Abstract 4609: High-grade TP53-mutated endometrial carcinomas have decreased NRF2 antioxidant activity. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-4609] [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
NRF2 is a major transcription factor regulating the expression of antioxidative/detoxifying enzymes. Its activation, due to mutations or activation of signaling pathways, has been associated with chemoresistance and poor prognosis in several tumors. NRF2 status remains unclear in endometrial carcinoma (EC). We aimed to identify molecular alterations associated with NRF2 activation in the four molecular subgroups of EC described by the Cancer Genome Atlas (TCGA), and explored its impact on EC prognosis.
Methods
Ninety patients treated in Cochin Hospital (2012 to 2017) for EC were included. Formalin-fixed paraffin-embedded tissue samples were processed for histopathological analysis and DNA and RNA extractions. Next generation sequencing (NGS) of NFE2L2 (encoding NRF2), KEAP1 and CUL3 genes and a panel of 15 genes significantly mutated in EC was performed using AmpliseqTM panels on Ion TorrentTM PGM (Thermo Fisher). The nuclear expression of mismatch repair (MMR) and NRF2 proteins were analyzed by immunochemistry (IHC). NRF2 activity was assessed by NQO1, GCLC, and AKR1C3 mRNA expressions, normalized to MRPL19 and TBP housekeeping genes, using TaqManTM assays and quantitative RT-PCR. Clinical event of interest was event-free survival (EFS) (progression, relapse, or death).
Results
Tumors were classified according to NGS and IHC data as POLE exonuclease domain mutated (N=3, 3%), MMR-deficient (dMMR) (N=28, 31%), TP53 mutated (N=23, 25%), and MMR-proficient tumors (N=32, 36%). NRF2 nuclear immunostaining was not correlated to NRF2 activity. The 3 tumors with highest NRF2 target genes expression harbored known NRF2 pathway activating mutations (NFE2L2 p.W24G, KEAP1 p.R336*, KEAP1 p.D422N). In addition, 2 dMMR tumors showed intermediate/high (1st quartile) NRF2 target genes expression and low allele ratio NFE2L2 mutations, suggesting NRF2 subclonal activation. No correlation was observed between NRF2 activity and PI3K or KRAS pathways mutations. The TP53 subgroup showed a strikingly lower NQO1 expression compared to dMMR or pMMR tumors (ANOVA p<.05). This observation was confirmed by in silico analyses of publicly available TCGA data. NQO1 low expression was significantly associated with poor EFS, independently of tumor stage (Cox p<.01).
Conclusion
In contrast with previous reports based on IHC, NRF2 activation is a rare event in EC, associated with NFE2L2 or KEAP1 mutations. NQO1 downregulation in the TP53-mutated subgroup might be explained by the interaction of NRF2 with TP53 missense mutants, which has been shown to impair its anti-oxidant transcriptional activity while enhancing proteasome expression (Walerych et al. Nat Cell Biol 2016). Very low levels of NQO1 expression identifies a subset of EC with a poor prognosis, which might be sensitive to specific combination therapies (Liu et al. Nat Commun. 2017).
Citation Format: Guillaume Beinse, Pierre-Alexandre Just, Bastien Rance, Brigitte Izac, Franck Letourneur, Nathaniel Edward Saidu, Sandrine Chouzenoux, François Goldwasser, Eric Pasmant, Frederic Batteux, Bruno Borghese, Karen Leroy, Jérome Alexandre. High-grade TP53-mutated endometrial carcinomas have decreased NRF2 antioxidant activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4609.
Collapse
Affiliation(s)
- Guillaume Beinse
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| | | | | | - Brigitte Izac
- 4INSERM U1016, Cochin Institute, GENOMIC plateform, PARIS, France
| | | | - Nathaniel Edward Saidu
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| | - Sandrine Chouzenoux
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| | - François Goldwasser
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| | | | - Frederic Batteux
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| | | | - Karen Leroy
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| | - Jérome Alexandre
- 1Paris Descartes University, Sorbonne Paris Cité, INSERM U1016, Cochin Institute, CARPEM, PARIS, France
| |
Collapse
|
22
|
Beinse G, Berger F, Cottu P, Dujaric ME, Kriegel I, Guilhaume MN, Diéras V, Cabel L, Pierga JY, Bidard FC. Circulating tumor cell count and thrombosis in metastatic breast cancer. J Thromb Haemost 2017; 15:1981-1988. [PMID: 28779538 DOI: 10.1111/jth.13792] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 05/11/2016] [Indexed: 11/28/2022]
Abstract
Essentials Tumor cells circulating in blood (CTC) may favor thrombotic events in cancer patients. We assessed the impact of CTC on the risk of thrombosis in metastatic breast cancer. Baseline CTC detection was the only independent factor associated with the risk of thrombosis. CTC detection under therapy may be the hidden link between tumor progression & thrombosis. SUMMARY Background Circulating tumor cell (CTC) count is a major prognostic factor in metastatic breast cancer (MBC) and has been reported to be associated with thrombosis in short-term studies on MBC patients. Objective To assess whether CTC detection (CellSearch® ) before first-line chemotherapy impacts the risk of thrombosis throughout the course of MBC. Patients/Methods Among patients included before first-line chemotherapy for MBC in the prospective IC2006-04 CTC detection study (NCT00898014), the electronic medical files of those patients treated at Institut Curie (Paris, France) were searched in silico and manually checked for incident venous or arterial thrombotic events (TE) in the course of MBC. Univariate and multivariate analyses were performed using Cox and Fine-Gray models, adjusted for age and Khorana score. Results/Conclusions With a median follow-up of 64 months (25-81 months), among the 142 patients included, 34 (24%) experienced a TE (incidence rate, 8 TE/100 patient-years). The TE incidence rate was 13 TE/100 patient-years for the 80 patients with ≥ 1 CTC/7.5 mL of blood before initiating first-line chemotherapy, vs. only 4 TE/100 patient-years for the 62 CTC-negative patients. Fine-Gray multivariate analysis (with death as competing event) included age, Khorana score and baseline lactate dehydrogenase and CTC levels: detectable CTC was the only factor significantly associated with an increased risk of TE (sub-distribution hazard ratio [SHR] for patients with [1-4] CTC = 3.1, 95% CI [1.1; 8.6], SHR for patients with ≥ 5 CTC = 1.4, 95% CI [0.5; 4.6]). This study shows that CTC detection before starting first-line chemotherapy is an independent risk factor for TE in MBC patients.
Collapse
Affiliation(s)
- G Beinse
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| | - F Berger
- Institut Curie, Unit of Biometry, PSL Research University, INSERM U900, Paris, France
| | - P Cottu
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| | - M-E Dujaric
- Institut Curie, Unit of Biometry, PSL Research University, INSERM U900, Paris, France
| | - I Kriegel
- Department of Anesthesiology, Institut Curie, PSL Research University, Paris, France
| | - M-N Guilhaume
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| | - V Diéras
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| | - L Cabel
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| | - J-Y Pierga
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
- Université Paris Descartes, Paris, France
| | - F-C Bidard
- Department of Medical Oncology, Institut Curie, PSL Research University, Paris, France
| |
Collapse
|
23
|
Beinse G, Reitter D, Segaux L, Carvalho-Verlinde M, Tournigand C, Rousseau B, Cudennec T, Paillaud E, Canouï-Poitrine F, Caillet P. Potential drug interactions in older patients with cancer: Updated data from the ELCAPA cohort survey. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.043] [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: 11/12/2022] Open
|
24
|
Malouf G, Beinse G, Mir O, Adam J, Terrier P, Spano JP, Honore C, Italiano A, Coindre JM, Blay JY, Lecesne A. Natural history of alveolar soft part sarcoma (ASPS): Impact of brain metastases and role of anti-angiogenic therapies (AAT). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx387.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Vienot A, Beinse G, Louvet C, de Mestier L, Meurisse A, Fein F, Heyd B, Cleau D, d’Engremont C, Dupont-Gossart AC, Lakkis Z, Tournigand C, Bouché O, Rousseau B, Neuzillet C, Bonnetain F, Borg C, Vernerey D. Overall Survival Prediction and Usefulness of Second-Line Chemotherapy in Advanced Pancreatic Adenocarcinoma. J Natl Cancer Inst 2017; 109:3105956. [DOI: 10.1093/jnci/djx037] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/21/2017] [Indexed: 02/07/2023] Open
|
26
|
Vienot A, Beinse G, Louvet C, de Mestier L, Meurisse A, Fein F, Heyd B, Cleau D, d'Engremont C, Dupont-Gossard AC, Lakkis Z, Tournigand C, Bouche O, Rousseau B, Neuzillet C, Bonnetain F, Borg C, Vernerey D. Development and validation of a prognostic nomogram and score to predict overall survival and usefulness of second-line chemotherapy in advanced pancreatic adenocarcinoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
354 Background: In advanced pancreatic ductal adenocarcinoma (aPDAC), there is no consensual strategy for second-line chemotherapy (L2). Better discrimination of overall survival (OS) may help clinical decision-making in this setting. We aimed to predict OS from the beginning of L2 and to assess the benefit from chemotherapy among the identified risk groups. Methods: Analyses were derived from all consecutive aPDAC patients treated at Besancon hospital, France, during 11 years. The association of 50 parameters with OS was evaluated using univariate and multivariate Cox analyses. Based on the final model, a prognostic nomogram and score were developed, and externally validated in patients receiving L2 in three other French centers, between 2010 and 2016. Results: The development cohort included 462 patients. 395 patients (85%) were eligible for L2, of which 261 (66%) were treated. Age, smoking status, liver metastases, Eastern Cooperative Oncology Group performance status, pain, jaundice, ascites, duration of first-line chemotherapy, and type of L2 regimen were identified as independent prognostic factors for OS in L2. The final model exhibited excellent calibration and discrimination (C-index = 0.75, 95% confidence interval 0.72 to 0.78), and robust internal validity. Based on the final model, a prognostic nomogram was built. The nomogram total points were input into a prognostic score that delineated three risk groups with median OS of 11.3, 3.6 and 1.4 months (P < 0.0001). By applying the score in the population eligible for L2 but untreated, the chemotherapy benefit was significant across all groups but with a magnitude of the effect decreased significantly from low to high-risk groups (P = 0.0123 for treatment and risk groups interaction term). The clinical benefit centered accuracy of the final model was confirmed by a decision curve analysis. The score ability to discriminate OS was externally confirmed in 162 patients, by identifying the same risk groups. Conclusions: These prognostic tools in patients with aPDAC can accurately predict OS before administration of L2 and strengthen the prognosis-based decision making for clinicians.
Collapse
Affiliation(s)
- Angélique Vienot
- Department of Gastroenterology, Besancon University Hospital, Besancon, France
| | - Guillaume Beinse
- Henri Mondor University Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Creteil, France
| | | | - Louis de Mestier
- Department of Hepato-Gastroenterology, Reims University Hospital, Reims, France
| | | | | | - Bruno Heyd
- Department of Digestive Surgery and Liver Transplantation, Besancon University Hospital, Besancon, France
| | - Denis Cleau
- Department of Gastroenterology, Vesoul Hospital, Vesoul, France
| | | | | | - Zaher Lakkis
- Department of Digestive Surgery and Liver Transplantation, Besancon University Hospital, Besancon, France
| | | | | | - Benoit Rousseau
- Oncology Department, Hopital Henri Mondor, APHP, Creteil, France
| | - Cindy Neuzillet
- Department of Medical Oncology, Henri Mondor University Hospital, Creteil, France
| | - Franck Bonnetain
- Methodology and Quality of Life Unit, Department of Oncology, INSERM UMR 1098, University Hospital of Besancon; French National Platform Quality of Life and Cancer, Besancon, France
| | - Christophe Borg
- Department of Medical Oncology, Besancon University Hospital, Besancon, France
| | - Dewi Vernerey
- Methodological and Quality of Life in Oncology Unit, CHRU Besancon, Besancon, France
| |
Collapse
|
27
|
Beinse G, Emile G, Cessot A, Tigaud J, Boudou-rouquette P, Borghese B, Goldwasser F, Pujade-lauraine E, Alexandre J. 2747 A real life experience of bevacizumab in elderly women with advanced ovarian carcinoma. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31513-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
28
|
Cassinat B, Zassadowski F, Ferry C, Llopis L, Bruck N, Lainey E, Duong V, Cras A, Despouy G, Chourbagi O, Beinse G, Fenaux P, Rochette Egly C, Chomienne C. New role for granulocyte colony-stimulating factor-induced extracellular signal-regulated kinase 1/2 in histone modification and retinoic acid receptor α recruitment to gene promoters: relevance to acute promyelocytic leukemia cell differentiation. Mol Cell Biol 2011; 31:1409-18. [PMID: 21262770 PMCID: PMC3135284 DOI: 10.1128/mcb.00756-10] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The induction of the granulocytic differentiation of leukemic cells by all-trans retinoic acid (RA) has been a major breakthrough in terms of survival for acute promyelocytic leukemia (APL) patients. Here we highlight the synergism and the underlying novel mechanism between RA and the granulocyte colony-stimulating factor (G-CSF) to restore differentiation of RA-refractory APL blasts. First, we show that in RA-refractory APL cells (UF-1 cell line), PML-RA receptor alpha (RARα) is not released from target promoters in response to RA, resulting in the maintenance of chromatin repression. Consequently, RARα cannot be recruited, and the RA target genes are not activated. We then deciphered how the combination of G-CSF and RA successfully restored the activation of RA target genes to levels achieved in RA-sensitive APL cells. We demonstrate that G-CSF restores RARα recruitment to target gene promoters through the activation of the extracellular signal-regulated kinase (ERK)/mitogen-activated protein kinase (MAPK) pathway and the subsequent derepression of chromatin. Thus, combinatorial activation of cytokines and RARs potentiates transcriptional activity through epigenetic modifications induced by specific signaling pathways.
Collapse
MESH Headings
- Cell Differentiation/drug effects
- Cell Differentiation/genetics
- Cell Line, Tumor
- Chromatin Assembly and Disassembly/drug effects
- Enzyme Activation/drug effects
- Enzyme Induction/drug effects
- Extracellular Signal-Regulated MAP Kinases/biosynthesis
- Gene Expression Regulation, Leukemic/drug effects
- Granulocyte Colony-Stimulating Factor/pharmacology
- Histones/metabolism
- Humans
- Leukemia, Promyelocytic, Acute/enzymology
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- MAP Kinase Signaling System/drug effects
- Mitogen-Activated Protein Kinase 3/biosynthesis
- Mitogen-Activated Protein Kinase 6/biosynthesis
- Phosphorylation/drug effects
- Promoter Regions, Genetic/genetics
- Protein Binding/drug effects
- Protein Processing, Post-Translational/drug effects
- Receptors, Retinoic Acid/metabolism
- Retinoic Acid Receptor alpha
- Transcription, Genetic/drug effects
- Tretinoin/pharmacology
Collapse
Affiliation(s)
- B Cassinat
- INSERM UMR-S-940, Université Paris Diderot, Hopital Saint-Louis, 75010 Paris, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|