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Berman DM, Lee AY, Lesurf R, Patel PG, Ebrahimizadeh W, Bayani J, Lee LA, Boufaied N, Selvarajah S, Jamaspishvili T, Guérard KP, Dion D, Kawashima A, Clarke GM, How N, Jackson CL, Scarlata E, Siddiqui K, Okello JBA, Aprikian AG, Moussa M, Finelli A, Chin J, Brimo F, Bauman G, Loblaw A, Venkateswaran V, Buttyan R, Chevalier S, Thomson A, Park PC, Siemens DR, Lapointe J, Boutros PC, Bartlett JMS. Multimodal Biomarkers That Predict the Presence of Gleason Pattern 4: Potential Impact for Active Surveillance. J Urol 2023; 210:257-271. [PMID: 37126232 DOI: 10.1097/ju.0000000000003507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE Latent grade group ≥2 prostate cancer can impact the performance of active surveillance protocols. To date, molecular biomarkers for active surveillance have relied solely on RNA or protein. We trained and independently validated multimodal (mRNA abundance, DNA methylation, and/or DNA copy number) biomarkers that more accurately separate grade group 1 from grade group ≥2 cancers. MATERIALS AND METHODS Low- and intermediate-risk prostate cancer patients were assigned to training (n=333) and validation (n=202) cohorts. We profiled the abundance of 342 mRNAs, 100 DNA copy number alteration loci, and 14 hypermethylation sites at 2 locations per tumor. Using the training cohort with cross-validation, we evaluated methods for training classifiers of pathological grade group ≥2 in centrally reviewed radical prostatectomies. We trained 2 distinct classifiers, PRONTO-e and PRONTO-m, and validated them in an independent radical prostatectomy cohort. RESULTS PRONTO-e comprises 353 mRNA and copy number alteration features. PRONTO-m includes 94 clinical, mRNAs, copy number alterations, and methylation features at 14 and 12 loci, respectively. In independent validation, PRONTO-e and PRONTO-m predicted grade group ≥2 with respective true-positive rates of 0.81 and 0.76, and false-positive rates of 0.43 and 0.26. Both classifiers were resistant to sampling error and identified more upgrading cases than a well-validated presurgical risk calculator, CAPRA (Cancer of the Prostate Risk Assessment; P < .001). CONCLUSIONS Two grade group classifiers with superior accuracy were developed by incorporating RNA and DNA features and validated in an independent cohort. Upon further validation in biopsy samples, classifiers with these performance characteristics could refine selection of men for active surveillance, extending their treatment-free survival and intervals between surveillance.
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Affiliation(s)
- D M Berman
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - A Y Lee
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - R Lesurf
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Now with Hospital for Sick Children, Toronto, Ontario, Canada
| | - P G Patel
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with Hospital for Sick Children, Toronto, Ontario, Canada
| | - W Ebrahimizadeh
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Now with IMV Inc, Dartmouth, Nova Scotia, Canada
| | - J Bayani
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, Ontario, Canada
| | - L A Lee
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - N Boufaied
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - S Selvarajah
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with University Health Network, Toronto, Ontario, Canada
| | - T Jamaspishvili
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - K-P Guérard
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - D Dion
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - A Kawashima
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with Osaka University, Osaka, Japan
| | - G M Clarke
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - N How
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - C L Jackson
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - E Scarlata
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - K Siddiqui
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Now with Sultan Qaboos University Hospital, Seeb, Oman
| | - J B A Okello
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - A G Aprikian
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - M Moussa
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - A Finelli
- Princess Margaret Cancer Centre. Toronto, Ontario, Canada
- Departments of Surgery and Oncology, University of Toronto, Toronto, Ontario, Canada
| | - J Chin
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - F Brimo
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Department of Pathology, McGill University, Montreal, Quebec, Canada
| | - G Bauman
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
| | - A Loblaw
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Departments of Radiation Oncology and Health Policy Management and Evaluation, University of Toronto, Toronto
| | - V Venkateswaran
- Departments of Surgery and Oncology, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - R Buttyan
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
- Departments of Experimental Medicine and Interdisciplinary Oncology, Vancouver, British Columbia, Canada
| | - S Chevalier
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - A Thomson
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
- Now with College of Science and Engineering Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - P C Park
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
- Now with Department of Pathology, Shared Health, Winnipeg, Manitoba, Canada
| | - D R Siemens
- Queen's University Cancer Research Institute, Kingston, Ontario, Canada
- Departments of Urology, Oncology and Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - J Lapointe
- Department of Surgery, McGill University and the Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - P C Boutros
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Now with University of California, Los Angeles, Los Angeles, California, United States
| | - J M S Bartlett
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathology, University of Toronto, Toronto, Ontario, Canada
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United Kingdom
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Bartlett J, Xu K, Wong J, Pond G, Zhang Y, Spears M, Salunga R, Mallon E, Taylor K, Hasenburg A, Markopoulos C, Dirix L, Seynaeve C, van de Velde C, Rea D, Schnabel C, Treuner K, Bayani J. 138MO Prognostic performance of Breast Cancer Index (BCI) in postmenopausal women with early-stage HR+ breast cancer in the TEAM trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cardoso F, Bartlett JMS, Slaets L, van Deurzen CHM, van Leeuwen-Stok E, Porter P, Linderholm B, Hedenfalk I, Schröder C, Martens J, Bayani J, van Asperen C, Murray M, Hudis C, Middleton L, Vermeij J, Punie K, Fraser J, Nowaczyk M, Rubio IT, Aebi S, Kelly C, Ruddy KJ, Winer E, Nilsson C, Lago LD, Korde L, Benstead K, Bogler O, Goulioti T, Peric A, Litière S, Aalders KC, Poncet C, Tryfonidis K, Giordano SH. Characterization of male breast cancer: results of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program. Ann Oncol 2019; 29:405-417. [PMID: 29092024 DOI: 10.1093/annonc/mdx651] [Citation(s) in RCA: 202] [Impact Index Per Article: 40.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Male breast cancer (BC) is rare, managed by extrapolation from female BC. The International Male BC Program aims to better characterize and manage this disease. We report the results of part I, a retrospective joint analysis of cases diagnosed during a 20-year period. Methods Patients with follow-up and tumor samples, treated between 1990 and 2010, in 93 centers/9 countries. Samples were centrally analyzed in three laboratories (the United Kingdom, the Netherlands and the United States). Results Of 1822 patients enrolled, 1483 were analyzed; 63.5% were diagnosed between 2001 and 2010, 57 (5.1%) had metastatic disease (M1). Median age at diagnosis: 68.4 years. Of 1054 M0 cases, 56.2% were node-negative (N0) and 48.5% had T1 tumors; 4% had breast conserving surgery (BCS), 18% sentinel lymph-node biopsy; half received adjuvant radiotherapy; 29.8% (neo)adjuvant chemotherapy and 76.8% adjuvant endocrine therapy (ET), mostly tamoxifen (88.4%). Per central pathology, for M0 tumors: 84.8% ductal invasive carcinomas, 51.5% grade 2; 99.3% estrogen receptor (ER)-positive; 81.9% progesterone receptor (PR)-positive; 96.9% androgen receptor (AR)-positive [ER, PR or AR Allred score ≥3]; 61.1% Ki67 expression low (<14% positive cells); using immunohistochemistry (IHC) surrogates, 41.9% were Luminal-A-like, 48.6% Luminal-B-like/HER-2-negative, 8.7% HER-2-positive, 0.3% triple negative. Median follow-up: 8.2 years (0.0-23.8) for all, 7.2 years (0.0-23.2), for M0, 2.6 years (0.0-12.7) for M1 patients. A significant improvement over time was observed in age-corrected BC mortality. BC-specific-mortality was higher for men younger than 50 years. Better overall (OS) and recurrence-free survival (RFS) were observed for highly ER+ (P = 0.001), highly PR+ (P = 0.002), highly AR+ disease (P = 0.019). There was no association between OS/RFS and HER-2 status, Ki67, IHC subtypes nor grade. Conclusions Male BC is usually ER, PR and AR-positive, Luminal B-like/HER2-negative. Of note, 56% patients had T1 tumors but only 4% had BCS. ER was highly positive in >90% of cases but only 77% received adjuvant ET. ER, PR and AR were associated with OS and RFS, whereas grade, Ki67 and IHC surrogates were not. Significant improvement in survival over time was observed.
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Affiliation(s)
- F Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal; European Organisation for Research and Treatment of Cancer-Breast Cancer Group, Toronto, Canada.
| | - J M S Bartlett
- Transformative Pathology, Ontario Institute for Cancer Research, Toronto, Canada; University of Edinburgh, Edinburgh, UK
| | - L Slaets
- European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - C H M van Deurzen
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands; Dutch Breast Cancer Research Group (BOOG), The Netherlands
| | | | - P Porter
- Divisions of Human Biology and Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, USA; Department of Pathology, University of Washington, Seattle, USA
| | - B Linderholm
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden; Swedish Association of Breast Oncologists (SABO), Lund University, Lund, Sweden
| | - I Hedenfalk
- Division of Oncology and Pathology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - C Schröder
- Dutch Breast Cancer Research Group (BOOG), The Netherlands; Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - J Martens
- Dutch Breast Cancer Research Group (BOOG), The Netherlands; Breast Cancer Genomics and Proteomics Lab, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J Bayani
- Transformative Pathology, Ontario Institute for Cancer Research, Toronto, Canada
| | - C van Asperen
- Dutch Breast Cancer Research Group (BOOG), The Netherlands; Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Murray
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - C Hudis
- Breast Medicine Service, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York
| | - L Middleton
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Vermeij
- Department of Medical Oncology, Hospital Network Antwerp (ZNA), Antwerp, Belgium
| | - K Punie
- Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - J Fraser
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - M Nowaczyk
- Specialist Hospital, St. Wojciech, Gdansk, Poland
| | - I T Rubio
- Breast Surgical Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - S Aebi
- Swiss Group for Clinical Cancer Research (SAKK), Switzerland
| | - C Kelly
- All Ireland Cooperative Oncology Research Group (ICORG), Ireland
| | - K J Ruddy
- Department of Oncology, Mayo Clinic, Rochester, USA
| | - E Winer
- Dana-Farber Cancer Institute, Boston, USA
| | - C Nilsson
- Department of Oncology, Västmanlands Hospital, Västerås, Sweden; Swedish Association of Breast Oncologists (SABO), Sweden
| | - L Dal Lago
- Department of Medical Oncology, Jules Bordet Institute, Brussels, Belgium
| | - L Korde
- University of Washington, Seattle, USA
| | - K Benstead
- Department of Oncology, Cheltenham General Hospital, UK
| | - O Bogler
- Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, USA
| | - T Goulioti
- Breast International Group, Brussels, Belgium
| | - A Peric
- European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - S Litière
- European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - K C Aalders
- European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - C Poncet
- European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - K Tryfonidis
- European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium
| | - S H Giordano
- Departments of Health Services Research and Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
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Bathurst L, Liao L, Crozier C, Lyttle N, Marcellus R, Bayani J, Al-awar R, Bartlett J, Spears M. Abstract P5-04-24: Molecular stratification of ER+/HER2- breast cancer cell lines to predict sensitivity to targeted agents. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-24] [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: Approximately 70% of all breast cancers are estrogen receptor positive (ER+) at diagnosis and are dependent on estrogen signaling for tumour growth and proliferation. Some ER+ breast cancers can be effectively treated with adjuvant endocrine therapies including tamoxifen, but despite favorable improvements in overall survival, resistance to endocrine therapy is common and has been associated with dysregulation of several signaling pathways. These pathways can be targeted with specific inhibitors, many of which are currently under clinical investigation. However currently there is a lack of predictive biomarkers to identify which patients should receive treatment with targeted therapy. The goal of this study was to determine whether alterations in specific signaling pathways can be identified and used to stratify breast cancer cell lines to the most effective experimental treatments.
Methods/Results: Fifteen ER+/HER2- cell lines were characterized using a NanoString PAM50-like assay as well as next generation sequencing and were then stratified according to alterations in three key signaling pathways: CCND/CDK, PI3K/AKT/mTOR and FGFR. High-throughput small-molecule screenings were performed to identify the IC50 values of 24 inhibitors across the strata. Variation in inhibitor sensitivity was observed between cell lines based on molecular alterations. Cell lines with a PIK3CA mutation in combination with a CDK-pathway alteration were more sensitive to CDK inhibitors (50 to 120nM) than cell lines with alterations in the CDK-pathway alone or PIK3CA mutations alone (170nM to >5000nM). In addition, cell lines with the dual alterations demonstrated stronger synergy between CDK and PI3K-pathway inhibitors compared to either alteration alone.
Conclusions: The results suggest that stratification according to molecular alterations in specific signaling pathways may predict sensitivity to targeted inhibitors in a panel of ER+/HER2- luminal breast cancer cell lines. Work is ongoing to identify the optimal synergistic inhibitor combinations for each strata. The ultimate goal is to translate this work into a novel personalized medicine approach, using molecular stratification based on a combination of molecular events in a functional pathway as opposed to single genes.
Citation Format: Bathurst L, Liao L, Crozier C, Lyttle N, Marcellus R, Bayani J, Al-awar R, Bartlett J, Spears M. Molecular stratification of ER+/HER2- breast cancer cell lines to predict sensitivity to targeted agents [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-24.
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Affiliation(s)
- L Bathurst
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - L Liao
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - C Crozier
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - N Lyttle
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - R Marcellus
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - J Bayani
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - R Al-awar
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - J Bartlett
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - M Spears
- University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
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Bayani J, Poncet C, Yao CQ, Crozier C, Anouk N, Piper T, Cunningham C, Sobol M, Aebi S, Benstead K, Bogler O, Dal Lago L, Fraser J, Hilbers FH, Hedenfalk I, Korde L, Linderholm B, Martens J, Middleton L, Murray M, Kelly C, Nilsson C, Nowaczyk M, Peeters S, Peric A, Porter P, Schröder C, Rubio IT, Ruddy KJ, van Asperen C, Van Den Weyngaert D, van Deurzen C, van Leeuwen-Stok E, Vermeij J, Winer E, Boutros PC, Giordano SH, Cardoso F, Bartlett JM. Abstract P6-19-01: Evaluation of multiple transcriptomic gene risk signatures in male breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-19-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Male breast cancer (MBC) is a rare disease accounting for less than 1% of all breast cancers (BC) and 1% of all cancers in males. The clinical management is largely extrapolated from female BC. Several multigene assays are increasingly used to guide clinical treatment decisions in female BC, however there is little data on the utility of these tests in MBC.
Methods: Here we present the gene expression results of 380 M0, ER+ve, HER2-ve MBCs enrolled in the Part 1 (retrospective joint analysis) International Male Breast Cancer Program of 1483 patients diagnosed between 1990-2010 (Cardoso et al. Annals of Oncology, 2018). Using a custom Nanostring™ panel comprised of the genes from the commercial risk tests Prosigna®, OncotypeDx® and Mammaprint®, risk scores and intrinsic subtyping data were generated to recapitulate the commercial tests as described by Bayani and Yao et al (npjBreast Cancer, 2017). Survival outcomes by risk classification were analyzed using Cox models with time-dependent covariates when the proportional hazard assumption was not met and adjusted for clinical and treatment variables.
Results: Prosigna-like risk scores identified 99 (26.1%) as low-risk, 159 (41.8%) as intermediate-risk, and 122 (32.1%) as high-risk. Using the TAILORx cut-off (25) for OncotypeDx-like risk of recurrence scoring, 158 (41.6%) were identified as low-risk, while 222 (58.4%) were identified as high-risk. MammaPrint-like results identified 175 (46.1%) as low-risk and 205 (53.9%) as high-risk. Overall, patients classified as high-risk had higher grade, more nodal involvement, larger tumors, and more frequently treated with chemotherapy than low-risk patients. Survival analyses demonstrated clear clinical utility for each test, showing patients at high-risk with poor relapse-free survival (RFS) as compared to patients classified as low-risk: Prosigna-like RFS at 3-years (HR=2.20, 95% CI, 1.28-3.80); Oncotype-like RFS at 3-years (HR=1.92, 95% CI, 1.17-3.17); MammaPrint-like RFS (HR=1.51, 95% CI, 1.00-2.27); with similar findings for distant relapse-free survival (DRFS) and overall survival (OS). Across outcomes and all gene signatures, patients with concordant Low/Low risk classification had better prognosis than those with concordant High/High risk classification. PAM50 intrinsic subtyping identified 147 (38.7%) as Luminal A, 57 (15.0%) as Luminal B, 80 (21.1%) as Her2-enriched and 96 (25.3%) as Basal-like; showing overall 34.5% concordance to clinic-pathological subtyping by central pathology (95% CI, 29.7%-39.5%). Comparison between the tests in the MBC cohort and a comparable cohort of female BC from the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial processed in the same way will be presented.
Conclusion: Common transcriptomic assays designed to assess residual risk, validated in female BC, provide similar information in male BC patients. Not surprisingly, disagreement between test results at the individual patient level was observed. To our knowledge, this is the largest study of MBC assayed to generate risk scores of the current commercial BC tests to demonstrate their clinical utility and their differences and similarity to female BC.
This work has been funded by the Breast Cancer Research Foundation (BCRF).
Citation Format: Bayani J, Poncet C, Yao CQ, Crozier C, Anouk N, Piper T, Cunningham C, Sobol M, Aebi S, Benstead K, Bogler O, Dal Lago L, Fraser J, Hilbers FH, Hedenfalk I, Korde L, Linderholm B, Martens J, Middleton L, Murray M, Kelly C, Nilsson C, Nowaczyk M, Peeters S, Peric A, Porter P, Schröder C, Rubio IT, Ruddy KJ, van Asperen C, Van Den Weyngaert D, van Deurzen C, van Leeuwen-Stok E, Vermeij J, Winer E, Boutros PC, Giordano SH, Cardoso F, Bartlett JM. Evaluation of multiple transcriptomic gene risk signatures in male breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-19-01.
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Affiliation(s)
- J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Poncet
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - CQ Yao
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Crozier
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - N Anouk
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - T Piper
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Cunningham
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - M Sobol
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - S Aebi
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - K Benstead
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - O Bogler
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - L Dal Lago
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - J Fraser
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - FH Hilbers
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - I Hedenfalk
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - L Korde
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - B Linderholm
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - J Martens
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - L Middleton
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - M Murray
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Kelly
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Nilsson
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - M Nowaczyk
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - S Peeters
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - A Peric
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - P Porter
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Schröder
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - IT Rubio
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - KJ Ruddy
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C van Asperen
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - D Van Den Weyngaert
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C van Deurzen
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - E van Leeuwen-Stok
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - J Vermeij
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - E Winer
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - PC Boutros
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - SH Giordano
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - F Cardoso
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - JM Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
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Dodson A, Sestak I, Bayani J, Dowsett M, Bartlett J, Cuzick J. Abstract P2-07-02: A newly derived combined clinical treatment score and immunohistochemical-4 prognostic tool. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-07-02] [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
AIM
To determine whether a modified Clinical Treatment Score (CTS) based on continuous tumor size and 5 lymph node categories provided more prognostic information in an independent test set than the original CTS with and without the Immunohistochemical-4 (IHC4) algorithm for prediction of residual distant recurrence risk over 10-years.
BACKGROUND
Risk of recurrence information in patients with estrogen receptor-positive (ER+), early breast cancer informs decision-making on chemotherapy use. The CTS and IHC4 algorithms provide such information, particularly when used in combination (IHC4+C). Their derivation in the translational cohort of the Arimidex Tamoxifen Alone or in Combination trial (TransATAC) was described by Cuzick et al in 2011. In the original model tumor size and nodal status were each classified into three categories, causing prognostic information to be lost.
METHODS
We modeled a novel CTSn algorithm on outcome data from patients in the anastrozole and tamoxifen arms in ATAC incorporating tumor size as a continuous variable and sub-dividing nodal status into five categories. IHC4n was re-derived in the TransATAC cohort independent of CTSn. Patients were chemotherapy-naïve. We compared ability to predict risk of residual distant recurrence of the new IHC4n+Cn model with that of the original one when tested in a training cohort and in a validation set of chemotherapy-naïve patients from the Tamoxifen vs. Exemestane Adjuvant Multicentre (TEAM) trial using Cox regression models and the C-index.
RESULTS
The ATAC training set for CTSn comprised 4056 patients, the TransATAC training set for IHC4n comprised 1125 patients; 2591 patients were in the TEAM validation set. Patients in the TEAM set were older (median age in TransATAC: 63.5, TEAM: 68.3 years), had a higher nodal-burden (node-positive in TransATAC: 29.4%, TEAM: 51.8%) and had more Grade 3 tumors (TransATAC: 18.3%, TEAM: 32.2%).
The new IHC4n+Cn was significantly prognostic, and non-significantly more prognostic than the original IHC4+C in both the training and validation cohorts. When assessed using the C-index statistic, IHC4n+Cn had a higher discriminatory ability than the original algorithm (Table 1).
Table 1 TransATAC (N=1125)TEAM (N=2591) HR* (95% CI)C-indexHR* (95% CI)C-indexOld Models CTS2.26 (2.01-2.53)0.6811.88 (1.73-2.03)0.650IHC41.67 (1.46-1.91)0.6301.49 (1.35-1.63)0.604IHC4+C2.76 (2.40-3.18)0.7242.03 (1.87-2.21)0.671New Models CTSn2.64 (2.26-3.09)0.7212.16 (1.96-2.39)0.687IHC4n1.74 (1.52-2.01)0.6421.51 (1.36-1.68)0.603IHC4n+Cn2.91 (2.47-3.42)0.7382.28 (2.06-2.51)0.695(*Hazard Ratio for change in one Standard Deviation).
CONCLUSION
By separately remodellng the part of the IHC4+C score based on clinicopathological characteristics using the whole ATAC chemo-naïve cohort, and the part that uses IHC-derived information in chemo-naïve TransATAC patients, we increased the precision of the individual risk estimates produced by both CTSn and IHC4n compared to those given by the original algorithms. The new IHC4n+Cn shows a trend for improved prognostic ability compared to the original IHC4+C. Like its predecessor, it relies on information that is readily available to clinicians and integrates it in an evidence-based way to improve prognostication in ER+ early breast cancer.
Citation Format: Dodson A, Sestak I, Bayani J, Dowsett M, Bartlett J, Cuzick J. A newly derived combined clinical treatment score and immunohistochemical-4 prognostic tool [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-07-02.
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Affiliation(s)
- A Dodson
- Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Centre for Cancer Prevention, Queen Mary, University of London, London, United Kingdom; Ontario Institute of Cancer Research, Ontario, Canada
| | - I Sestak
- Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Centre for Cancer Prevention, Queen Mary, University of London, London, United Kingdom; Ontario Institute of Cancer Research, Ontario, Canada
| | - J Bayani
- Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Centre for Cancer Prevention, Queen Mary, University of London, London, United Kingdom; Ontario Institute of Cancer Research, Ontario, Canada
| | - M Dowsett
- Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Centre for Cancer Prevention, Queen Mary, University of London, London, United Kingdom; Ontario Institute of Cancer Research, Ontario, Canada
| | - J Bartlett
- Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Centre for Cancer Prevention, Queen Mary, University of London, London, United Kingdom; Ontario Institute of Cancer Research, Ontario, Canada
| | - J Cuzick
- Ralph Lauren Centre for Breast Cancer Research, The Royal Marsden Hospital, London, United Kingdom; Centre for Cancer Prevention, Queen Mary, University of London, London, United Kingdom; Ontario Institute of Cancer Research, Ontario, Canada
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Martens JWM, Sieuwerts A, Ponchet C, Smid M, de Weerd V, Slaets L, Piper T, van Deurzen CHM, Schroder CP, Stangle C, Kloosterman W, van Leeuwen-Stok E, Nilsson C, Vermeij J, Peeters S, Goulioti T, Nowaczyk M, Aebi S, Rubio IT, Kelly C, Bayani J, Porter P, Murray M, Hudis C, Middleton L, Korde L, Ruddy K, Winer E, Bogler O, van den Weyngaert D, dal Lago L, Fraser J, Benstead K, van Asperen C, Linderholm B, Hedenfalk I, Tryfonidis K, Giordano S, Bartlett J, Cardoso F. Abstract PD7-12: Molecular subtyping of male breast cancer by the International male breast cancer program (IMBC): EORTC 10085/TBCRC 0-29/BIG 2-07/NABCG/BOOG 2009-04. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd7-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction. Male breast cancer (male BC) is a rare disease for which disease management is extrapolated from females. IMBC, an international consortium, which previously reported on clinico-pathological aspects, now reports on molecular subgroups revealed by RNA sequencing and their relation to patient outcome.
Methods. Tumor samples from the retrospective MALE BC registry diagnosed between 1990-2010 and with pathology and outcome data (relapse-free- (RFS) and overall survival (OS)) were included (n=699). To allow the discovery of prognostic features, we selected, stratified for known risk factors (TN stage, grade, age at diagnose and adjuvant endocrine treatment), from the cohort 152 cases with poor (RFS <= 4 yrs) and good outcome (RFS > 7yrs) evenly distributed. Here, we report RNA sequencing results of the first 73 cases, 38 with poor and 35 with good outcome. RNA sequencing reads were used to generate gene expression values and to report transcripts carrying driver mutations. Unsupervised clustering identified subgroups and within subgroups differentially expressed genes were identified. The reported prognostic male BC subgroups M1 and M2 (Johansson BCR 2012(14):R31) were also annotated. All identified subgroups were related to outcome using logistic regression (p-value using Wald test).
Results. Unsupervised clustering revealed 2 main subgroups of which group 1 was enriched for expression of ER target genes, WNT3 and genes from amplicons known for female BC, e.g. 19p13 (CCNE1), 8q24 (MYC), and 11q13 (CCND1). The biology of the smaller group 2 was less defined but TGFβ2 expression was high as were various kallikreins (KLK) including interestingly KLK3 (prostate specific antigen). Other known amplified regions [(8p11 (FGFR1), 20q13 (ZNF217) and 12q15 (MDM2)] and mutated transcripts [PIK3CA (H1047R/L/Q; E542K, E545K, N345K; 16% of cases), TP53 and SF3B1 (K700E) (2% of cases)] were identified. Profound tumor infiltrate gene expression was present in 5% of cases and one third of cases expressed proliferation markers. Except for TP53, none of these latter characteristics were unevenly distributed among the 2 main subgroups. ER and AR were highly correlated, particularly in group 1. The two main groups could be further subdivided. Group 1 comprised 3 subgroups of which subgroup 1a expressed TFF1/3 and NAT1, well-known ER targets, while subgroups 1b and 1c expressed other ER targets,respectively BEX1 and PITX1. HOXC cluster expression differentiated subgroup 1b from 1a and 1c. None of these intrinsic subgroups were, however, related to RFS. The previously reported M2 subgroup, which largely segregated with subclusters 1a and 1b, was associated with a better RFS than the M1 subgroup (OR=2.9; 95%CI 1.1-7.5; p-value=0.03).
Conclusions. 1) Intrinsic subtypes of male BC were revealed and their subgrouping is defined by ER associated subsets of genes. 2) The association of the reported M2 subgroup of male BC with longer RFS was validated; 3) Currently identified biological characteristics of male BC may improve future treatments. The full report on 152 cases including a comparison to female BC will be presented at the conference.
This research was funded by Breast Cancer Research Foundation
Citation Format: Martens JWM, Sieuwerts A, Ponchet C, Smid M, de Weerd V, Slaets L, Piper T, van Deurzen CHM, Schroder CP, Stangle C, Kloosterman W, van Leeuwen-Stok E, Nilsson C, Vermeij J, Peeters S, Goulioti T, Nowaczyk M, Aebi S, Rubio IT, Kelly C, Bayani J, Porter P, Murray M, Hudis C, Middleton L, Korde L, Ruddy K, Winer E, Bogler O, van den Weyngaert D, dal Lago L, Fraser J, Benstead K, van Asperen C, Linderholm B, Hedenfalk I, Tryfonidis K, Giordano S, Bartlett J, Cardoso F. Molecular subtyping of male breast cancer by the International male breast cancer program (IMBC): EORTC 10085/TBCRC 0-29/BIG 2-07/NABCG/BOOG 2009-04 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD7-12.
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Affiliation(s)
- JWM Martens
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - A Sieuwerts
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Ponchet
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - M Smid
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - V de Weerd
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L Slaets
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - T Piper
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - CHM van Deurzen
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - CP Schroder
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Stangle
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - W Kloosterman
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - E van Leeuwen-Stok
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Nilsson
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Vermeij
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - S Peeters
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - T Goulioti
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - M Nowaczyk
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - S Aebi
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - IT Rubio
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Kelly
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Bayani
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - P Porter
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - M Murray
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Hudis
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L Middleton
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L Korde
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - K Ruddy
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - E Winer
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - O Bogler
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - D van den Weyngaert
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L dal Lago
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Fraser
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - K Benstead
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C van Asperen
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - B Linderholm
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - I Hedenfalk
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - K Tryfonidis
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - S Giordano
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Bartlett
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - F Cardoso
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
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Bartlett JMS, Bayani J, Kornaga E, Piper T, Mallon E, Yao CQ, Boutros PC, Hasenburg A, Kieback DG, Markopoulos C, Dirix L, Seynaeve C, Can de Velde CJH, Rea DW. Abstract P1-06-02: Comparative survival analysis of multiparametric tests in the TEAM pathology study: What to do when molecular tests disagree? Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-06-02] [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
Multiparametric assays for risk are increasingly used in the management of node-negative and node-positive hormone receptor-positive invasive breast cancer. Data from multiple sources suggests different tests may provide different risk estimates at the individual patient level1. Analysis from the TEAM pathology study (Bayani and Yao et al npjBreast Cancer, 2017) allows direct comparison of prognostic information from gene signatures in a clinical trial cohort of postmenopausal patients. Risk classifications using genes comprising the following multi-parametric tests: OncotypeDx® (Genomic Health Inc.)2,3, Prosigna™(NanoString Technologies, Inc.)4-6, Mammaprint® (Agendia Inc.)7,8 were performed. For the OncotypeDX-Like Recurrence Score (RS), RNA abundance was processed to fit the measurement range as described2,3, with classification into high, intermediate or low risk groups based the derived RS and modeled for DRFS. For the Prosigna-Like Risk of Recurrence Score (ROR), samples were processed as previously outlined9, then modelled against DRFS. For the MammaPrint-Like Risk Score, samples were processed by published methods8 and modelled for DRFS. Comparing OncotypeDx-Like with Prosigna-Like showed that 45% of cases were classified identically by both (3.3% low risk, 20.9% intermediate, 20.7% high). Of 3370 cases, 353 (10.5%) had scores differing by more than 1 classification (i.e. hi/low or low/high). Almost all (343) of these were cases classified high risk by OncotypeDX-Like RS/low risk by Prosigna-Like ROR (Table 1). Univariate Cox regression analysis, using low/low cases as a reference (relative risk of distant metastasis =1.0), suggested that cases called low risk by Prosigna-Like ROR/High risk by OncotypeDx-Like RS did not perform differently from cases called low risk by both tests (Table 2). However, all cases called intermediate by one test and high risk by another appeared to be high risk (Table 2). Comparisons between Prosigna-Like ROR and MammaPrint-Like scores showed similar concordance between low/low and high/high (52.5% of cases with concordant results). In Prosigna-Like ROR intermediate risk cases, MammaPrint-Like results divided cases between low and high risk, as predicted. Comparisons between these tests is challenging, and evidence on their discordance in risk stratification presents further dilemmas. Preliminary analysis of TEAM suggests a complex inter-relationship between test results in the same patient cohorts requiring careful evaluation.
Table 1OncotypeDX-Like RSLowInt.HighTotalLow1126163431071Prosigna-Like RORInt.1677046151486High10106697813Total289142616553370
Table 2OncotypeDX-Like RSLowInt.HighLowRef1.26 (0.57-2.79)1.13 (0.49-2.62)Prosigna-Like RORInt.1.2 (0.47-3.05)2.22 (1.03-4.78)4.27 (2.01-9.08)High6.10 (1.58-23.6)4.15 (1.79-9.59)4.92 (2.32-10.42)
Citation Format: Bartlett JMS, Bayani J, Kornaga E, Piper T, Mallon E, Yao CQ, Boutros PC, Hasenburg A, Kieback DG, Markopoulos C, Dirix L, Seynaeve C, Can de Velde CJH, Rea DW. Comparative survival analysis of multiparametric tests in the TEAM pathology study: What to do when molecular tests disagree? [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-06-02.
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Affiliation(s)
- JMS Bartlett
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - J Bayani
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - E Kornaga
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - T Piper
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - E Mallon
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - CQ Yao
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - PC Boutros
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - A Hasenburg
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - DG Kieback
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Markopoulos
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - L Dirix
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Seynaeve
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - CJH Can de Velde
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - DW Rea
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre Translational Laboratories, Calgary, AB, Canada; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
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Spears M, Kornaga E, Lyttle N, Liao L, Bayani J, Quintayo MA, Yao CQ, D'Costa A, Boutros PC, Twelves CJ, Pritchard KI, Levine MN, Nielsen TO, Shepherd L, Bartlett JMS. Abstract P2-10-01: Validation that a histone gene signature predicts anthracycline response in early breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-10-01] [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: The use of anthracycline-based chemotherapies has improved overall and disease free survival in breast cancer. However, anthracyclines can have significant toxicities including cardiotoxicity and leukemia. It is, therefore, imperative to identify those patients who will benefit from adjuvant anthracycline treatment and patients who could be spared unnecessary toxicities and be considered for alternative adjuvant therapy. Previous work performed by our laboratory identified a histone gene expression signature as a predictive marker of anthracycline benefit in the BR9601 clinical trial. In this study we validate the 18 histone gene signature in the MA.5 clinical trial and examine the role of the signature in individual intrinsic subtypes of breast cancer.
Methods We analysed the CCTG MA.5 clinical trial in a prospectively planned retrospective biomarker approach to validate this signature and tested the role of intrinsic subtyping as predictive markers of anthracycline benefit. RNA was extracted from patients in the MA.5 adjuvant trial evaluating the addition of epirubicin (E) to CMF and analysed using NanoString technology. Log-rank analyses validated the predictive values of the signature on distant relapse-free survival (DRFS). Cox-regression models tested independent predictive value on DRFS in the presence of treatment, age, tumour size, nodal status, HER2, ER status and grade, and treatment by marker interactions.
Results Analysis of the MA.5 clinical cohort revealed that patients whose tumour had low histone gene signature expression experienced increased DRFS (HR: 0.54, 95% CI 0.38-0.76, p=0.001) when treated with CEF compared with patients treated with CMF alone. Conversely, there was no apparent benefit of CEF vs CMF in patients with high histone gene expression signature (HR: 1.01, 95%CI 0.66-1.55, p=0.963). After multivariate analysis and adjustment for HER2, nodal status, age, grade and ER, the treatment by marker interaction for the gene signature was 0.54 (95%CI 0.31-0.94, p=0.030) for DRFS.
The predictive impact of the histone signature was independent of intrinsic subtype.
Conclusion The histone gene expression signature is an independent predictor of anthracycline benefit and could be a potential candidate diagnostic assay for patients with early breast cancer.
Citation Format: Spears M, Kornaga E, Lyttle N, Liao L, Bayani J, Quintayo M-A, Yao CQ, D'Costa A, Boutros PC, Twelves CJ, Pritchard KI, Levine MN, Nielsen TO, Shepherd L, Bartlett JMS. Validation that a histone gene signature predicts anthracycline response in early breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-10-01.
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Affiliation(s)
- M Spears
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - E Kornaga
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - N Lyttle
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - L Liao
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - M-A Quintayo
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - CQ Yao
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - A D'Costa
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - PC Boutros
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - CJ Twelves
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - KI Pritchard
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - MN Levine
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - TO Nielsen
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - L Shepherd
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
| | - JMS Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Calgary, AB, Canada; Leeds Institute of Cancer and Pathology and Cancer Research UK Centre, Leeds, United Kingdom; Suunybrook Odette Cancer Centre, Toronto, ON, Canada; McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada; University of British Columbia, Vancouver, BC, Canada; Canadian Clinical Trials Group, Kingston, ON, Canada; Edinburgh Cancer Research UK Centre, Edinburgh, United Kingdom
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Bartlett JMS, Thomas J, Mallon E, Piper T, Bayani J, Hasenburg A, Kieback DG, Markopoulos C, Dirix L, Seynaeve C, van de Velde CJH, Rea DW. Abstract P1-06-04: Simplified histological grading of breast carcinoma – potential for improved concordance and consistency in breast cancer grading? Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-06-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Histological grade remains an independent predictor of outcome for invasive breast cancer. The internationally accepted standard grading system is the Elston and Ellis grading system based on a local hospital (Nottingham) cohort treated between 1951-1973. Histological grade, with nodal status, tumour size and receptor measurements (ER, PgR, HER2) give important information even in the context of current molecular testing for breast cancer. In 2009 we proposed a simplified approach to the EE system based on evidence from another hospital series (Thomas et al Histopathology 2009 DOI 10.1111/j.1365-2559.2009.03429.x). Here we report a second validation of this approach using a large phase III clinical trial cohort the Tamoxifen Exemestane Adjuvant multicentre Trial.
A single pathologist (EM) regraded over 4200 cases using a single H&E slide from the TEAM pathology study. Individual scores (1-3) were provided for tubule formation, nuclear pleomorphism and mitotic count and summed to provide the EE score (3-9) resulting in a final grade of 1, 2 or 3 for each case. As previously reported the Simplified Binary Scoring system (SBS) reorganizes this data such that each component is given a score of 1 or 2 with a sum ranging from 3-6. In the current analysis we compared the impact of this revised grading system on patient outcome.
Of 4264 centrally regraded tumours in the TEAM pathology cohort, EE scores for tubular formation were 1 in 102 cases (2.4%), 2 in 503 cases (11.8%) and 3 in 3659 (85.8%). For nuclear pleomorphism only 2 cases were EE score 1 (0.05%), 3117 were score 2 (73.1%) and 1146 score 3 (26.9%). For Mitotic count 3423 (80.3%) were scored 1, 707 (16.6%) scored 2 and 134 scored 3 using the EE system. As previously observed, most/all EE categories could be captured using a simple binary system (SBS, see Table 1).
Table 1 EE Grade SBS SCORE12335460043239705068217600618 GG Score EE GradeLowHigh 13327819.02%21377132248.98%35751790.07% GG Score SBS SCORELowHigh 33508419.35%4120284741.34%515947474.88%65751289.98%
In a comparison between conventional grading and molecular (using a Genomic-Grade signature) we observed the predicted equal split of EE Grade 2 cases into GG high/versus low. For the SBS score the higher scores were enriched for GG High cases.
We show a novel grading system can provides a potentially simple and more reproducible approach to immunohistochemical grading. Comparisons with molecular grading approaches may suggest improved concordance between novel grading approaches and molecular systems. Further comparisons with outcome and molecular signatures will be presented.
Citation Format: Bartlett JMS, Thomas J, Mallon E, Piper T, Bayani J, Hasenburg A, Kieback DG, Markopoulos C, Dirix L, Seynaeve C, van de Velde CJH, Rea DW. Simplified histological grading of breast carcinoma – potential for improved concordance and consistency in breast cancer grading? [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-06-04.
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Affiliation(s)
- JMS Bartlett
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - J Thomas
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - E Mallon
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - T Piper
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - J Bayani
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - A Hasenburg
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - DG Kieback
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Markopoulos
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - L Dirix
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Seynaeve
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - CJH van de Velde
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - DW Rea
- Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Western General Hospital, Edinburgh, United Kingdom; Western Infirmary, Glasgow, United Kingdom; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus MC Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
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Bayani J, Crozier C, Quintayo MA, Amemiya Y, Zhang X, Larivière M, Sadis S, Smith JM, Hasenburg A, Kieback D, Markopoulos C, Dirix L, Yaffe M, Seth A, Feilotter H, Rea D, Bartlett JMS. Abstract P2-09-17: Evaluation of the oncomine comprehensive assay for the identification of actionable mutations for therapeutic stratification from the TEAM pathology cohort. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-17] [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
Large-scale sequencing initiatives have revealed a wealth of common and novel variants as well as copy-number aberrations, across different malignancies. This growing list of variants/aberrations can sometimes be matched to specific therapeutics. Such “actionable mutations/changes” hold promise for personalized treatment in the future, with treatments tailored to molecular abnormalities. Presently, women with hormone positive early breast cancer continue to experience improved survival on adjuvant anti-hormone therapy, but a significant number of women continue to progress. Therefore, there is a need to identify those women for whom current therapies are insufficient and to identify alternative therapeutic interventions. We explored the used of genetic profiling using a comprehensive solid tumor next generation sequencing (NGS) assay (the Oncomine Comprehensive Assay, OCA) to characterize early invasive breast cancer. The OCA is based on the Ion Torrent™ NGS platform and Ion AmpliSeq™ library preparation technology, coupled to the Oncomine™ Knowledgebase, for target selection, variant calling, and data annotations. The OCA includes 87 genes for hotspot mutation detection, 48 genes for full length sequencing and 43 genes for focal copy number assessment. The OCA provides a standardized informatics workflow and quality control (QC) parameters to process samples in a translational clinical research setting. To explore the application of the OCA to early invasive breast cancers, we performed a retrospective pilot study in a subset of cases from the TEAM trial. From the TEAM pathology samples, 420 were chosen in a case-control fashion, 413 samples were analyzed, 388 samples passed standard QC metrics, and 254 samples (65%) were found to contain 368 variants with Oncomine Knowledgebase annotations. Briefly, variants of PIK3CA were most frequent at 42.7% (157/368), followed by TP53 at 27.2% (100/368), PTEN at 5.7% (21/368), BRCA2 at 3.8% (14/368), SF3B1 (12/368), AKT1 (11/368) and PTCH1 (11/368) at 3.3%, 3.0%, 3.0%; respectively. Other variants were detected in ATM, ERBB2, RB1, FGFR2, NF1, CDKN2A, PIK3R1 and others. Amongst the 43 genes assessed for copy-number, 23 showed copy-number changes across 132 samples totalling 167 CNVs. 256 samples showed no copy-number alterations in any of the genes on the panel. ERBB2 was most frequently altered at 28.1% (47/167), followed by FGFR1 at 23.4% (39/167), CCND1 at 15.0% (25/167) and MDM2 at 10.2% (17/167). Copy-number losses were identified in TP53, RB1, PTEN, BRCA2 at 0.6% each; as well as CDKN2A at 1.8% (3/167). Analytical validation of a subset of gene variants and copy-number changes will be presented in addition to the evidence of potential future application of the Oncomine Comprehensive Assay to precision oncology goals.
Citation Format: Bayani J, Crozier C, Quintayo MA, Amemiya Y, Zhang X, Larivière M, Sadis S, Smith JM, Hasenburg A, Kieback D, Markopoulos C, Dirix L, Yaffe M, Seth A, Feilotter H, Rea D, Bartlett JMS. Evaluation of the oncomine comprehensive assay for the identification of actionable mutations for therapeutic stratification from the TEAM pathology cohort [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-17.
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Affiliation(s)
- J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Crozier
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - MA Quintayo
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - Y Amemiya
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - X Zhang
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - M Larivière
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - S Sadis
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - JM Smith
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - A Hasenburg
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - D Kieback
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - C Markopoulos
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - L Dirix
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - M Yaffe
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - A Seth
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - H Feilotter
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - D Rea
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
| | - JMS Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; Thermo Fisher Scientific, San Francisco, CA; University of Mainz, Mainz, Germany; Helios Medical Center, Schleswig, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; University of Toronto, Toronto, ON, Canada; Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom
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Rimm DL, McShane LM, Leung SCY, Bai Y, Bane AL, Bartlett JMS, Bayani J, Chang MC, Dean M, Denkert C, Enwere E, Galderisi C, Gholap A, Hugh JC, Jadhav A, Kornaga E, Laurinavicius A, Levenson R, Lima J, Miller K, Pantanowitz L, Piper T, Ruan J, Srinivasan M, Virk S, Wu Y, Yang H, Hayes DF, Nielsen TO, Dowsett M. Abstract P1-03-01: An international multicenter study to evaluate reproducibility of automated scoring methods for assessment of Ki67 in breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-03-01] [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: 11/16/2022]
Abstract
Abstract
Background: The nuclear proliferation biomarker Ki67 has multiple potential roles in breast cancer, including prognosis-based decisions, but unacceptable between-laboratory variability has limited its clinical value. The International Ki67 Working Group (IKWG) has undertaken a systematic program to determine whether Ki67 immunohistochemistry can be analytically validated and standardized across laboratories. Technological advances and broader availability of devices for automated assessment of stained slides raise the possibility that these machines may improve on reproducibility of traditional pathologist-based visual Ki67 assessment.
Aims: To characterize reproducibility of automated machine-measured Ki67 expression using slides previously analyzed in the IKWG phase 3 study that evaluated reproducibility of visual Ki67 assessment.
Methods: Two sets of 30 previously stained slides containing core-cut biopsy sections of breast tumors were circulated to 14 laboratories for scanning and automated assessment of Ki67 expression. Sites were instructed to return average and maximum percentage of tumor cells positive for Ki67 for each slide, where maximum is designed to reflect “hot spot” analysis. Two laboratories returned scores from 2 operators; not all laboratories reported values for maximum Ki67 scores. Different operators were treated as distinct laboratories in analyses. Sixteen and 10 score sets were available for average and maximum Ki67 analyses, respectively, encompassing 7 unique scanner and 10 software platforms. Pre-specified analyses included evaluation of reproducibility across all laboratories as well as within a subgroup limited to those using Aperio scanners. The primary reproducibility metric was intraclass correlation coefficient between laboratories (ICC), regardless of device platform or software.
Results: Geometric means across 30 cases for 16 operators ranged from 11.06% to 38.11% with overall mean 16.75% (95% CI:14.45-19.42) for average scores. Geometric means for 10 operators ranged from 16.44% to 68.73% with overall mean 25.16% (95% CI: 18.71-33.84) for maximum scores. ICC for automated average scores across 16 operators was 0.83 (95% CI: 0.73-0.91) and ICC for maximum scores across 10 operators was 0.63 (95% CI: 0.44-0.80) although one outlier lab dramatically affected results. For the laboratories using the Aperio platform (8 score sets), ICC for automated average scores was 0.89 (95% CI; 0.81-0.96). These results are similar to ICC of 0.87 (95%CI; 0.81-0.93) reported using these same slides in the Phase 3 visual assessment reproducibility study in which observers counted 500 cells per slide (Leung et al, NPJBrCancer, in press).
Conclusions: Between-laboratory reproducibility for automated machine assessment of average Ki67 is similar to that for pathologist-based visual assessment of Ki67. However, the observed ICC was markedly numerically lower for the maximum score method compared to the average method, suggesting that the maximum score may not be useful as a reproducible measure of proliferation. Automated average scoring methods show promise for standardization of Ki67 scoring, supporting future studies to clinically validate Ki67.
Citation Format: Rimm DL, McShane LM, Leung SCY, Bai Y, Bane AL, Bartlett JMS, Bayani J, Chang MC, Dean M, Denkert C, Enwere E, Galderisi C, Gholap A, Hugh JC, Jadhav A, Kornaga E, Laurinavicius A, Levenson R, Lima J, Miller K, Pantanowitz L, Piper T, Ruan J, Srinivasan M, Virk S, Wu Y, Yang H, Hayes DF, Nielsen TO, Dowsett M. An international multicenter study to evaluate reproducibility of automated scoring methods for assessment of Ki67 in breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-03-01.
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Affiliation(s)
- DL Rimm
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - LM McShane
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - SCY Leung
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - Y Bai
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - AL Bane
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - JMS Bartlett
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - J Bayani
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - MC Chang
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - M Dean
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - C Denkert
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - E Enwere
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - C Galderisi
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - A Gholap
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - JC Hugh
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - A Jadhav
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - E Kornaga
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - A Laurinavicius
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - R Levenson
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - J Lima
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - K Miller
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - L Pantanowitz
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - T Piper
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - J Ruan
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - M Srinivasan
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - S Virk
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - Y Wu
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - H Yang
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - DF Hayes
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - TO Nielsen
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
| | - M Dowsett
- Yale University School of Medicine, New Haven, CT; Biometric Research Branch, National Cancer Institute, Bethesda, MD; University of British Columbia, Vancouver, BC, Canada; Juravinski Hospital and Cancer Centre, McMaster University, Hamilton, ON, Canada; Transformative Pathology, Ontario Institute for Cancer Research, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada; University of Alberta, Edmonton, AB, Canada; Institut für Pathologie, Charité Campus Mitte, Berlin, Germany; MolecularMD, Portland, OR; Optra Technologies, NeoPro SEZ, BlueRidge, Hinjewadi, India; National Center of Pathology, Vilnius University Hospital Santariskes Clinics, Vilnius, Lithuania; University of California Davis Medical Center, Sacramento, CA; Cancer Diagnostic Quality Assurance Services CIC, Poundbury Cancer Institute, Poundbury, Dorset, United Kingdom; University of Pittsburgh, Pittsburgh, PA; Biomarkers & Companion Diagnostics Group, Edinburgh Cancer Research Centre, Edinburgh, United Kingdom; Queen's University, K
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Bayani J, Crozier C, Zhang NX, Amemiya Y, Quintayo MA, Yan FJ, Dion D, Mccormack S, Yaffe M, Seth A, Feilotter H, Bartlett JMS. Abstract P1-05-27: Evaluation of the Oncomine focus and comprehensive assays for therapeutic stratification in early hormone receptor positive breast cancers. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-27] [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
Large-scale sequencing initiatives have revealed a wealth of common and novel variants as well as copy-number aberrations, across different solid tumours and hematological malignancies. The growing list of variants/aberrations can sometimes be matched to specific therapeutics. Such “actionable mutations/changes” hold promise for personalized treatment, as treatments could be tailored to molecular abnormalities, rather than disease site. In breast cancer, women with hormone positive early breast cancer continue to experience improved survival on adjuvant anti-hormone therapy, but even today, a significant number of women continue to progress. Therefore there is not only a need to identify those women for whom current therapies are insufficient, but to identify alternative therapeutic interventions. The ThermoFisher Scientific Oncomine™ Focus and Oncomine™ Comprehensive Assays (OFA and OCA) are based on the Ion Torrent™ next-generation sequencing platform and Ion AmpliSeq™ library preparation technology, coupled to the Oncomine™ Knowledgebase, for target selection, variant calling, and data annotations. Both panels interrogate the most referenced oncology biomarker variants that are matched to curated published evidence from clinical trials supporting the matching of driver genetic variants with relevant potential clinical therapeutic options. The ability to identify SNVs, CNVs and fusion events in a single assay provides an unprecedented approach to maximizing the molecular information to be derived from a single tumour sample. To explore the value of the Oncomine™ assays in early invasive breast cancers, we have performed a pilot study to assess the reproducibility and accuracy of the OFA and OCA from nucleic acids extracted from formalin-fixed paraffin embedded tissues. In addition to the sequencing and copy-number data generated by these assays, we will compare these results to copy-number information generated using the Oncoscan® (Affymetrix)copy-number assay as well as information derived by Multiplex Ligation-dependent Probe Amplification-based panels (MRC-Holland) and Fluorescent in situ Hybridization (FISH). Our preliminary analyses of 35 invasive breast cancers by Oncoscan® identified the frequent whole chromosomal gains of 2, 3, 5, 7, 18, 19 and 20; gains of 1q, 7p, 8q, 11p, 16p, 17q; losses at 1p, 8p, 11q, 13, 16q, 17p and chromosome 18. High level amplifications were also identified for breast cancer related genes such as ERBB2, CCND1, MYC, FGFR1; in addition to the frequent losses of TP53, RB1, CDKN2A. Copy-number changes were confirmed by locus-specific FISH and MLPA. Data generated from the OFA and OCA from these same samples will be compared to the other platform findings and provide a snapshot of the mutational landscape of early breast cancers across these pan-cancer panels. Having established the robustness and accuracy of the assays, the applicability of the OCA in the context of improved stratification for breast cancers for prognostic and predictive tests will be discussed.
Citation Format: Bayani J, Crozier C, Zhang NX, Amemiya Y, Quintayo MA, Yan FJ, Dion D, Mccormack S, Yaffe M, Seth A, Feilotter H, Bartlett JMS. Evaluation of the Oncomine focus and comprehensive assays for therapeutic stratification in early hormone receptor positive breast cancers [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-05-27.
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Affiliation(s)
- J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - C Crozier
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - NX Zhang
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - Y Amemiya
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - MA Quintayo
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - FJ Yan
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - D Dion
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - S Mccormack
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - M Yaffe
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - A Seth
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - H Feilotter
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - JMS Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Queen's University, Kingston, ON, Canada; University of Toronto, Toronto, ON, Canada
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14
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Felipe Lima J, Yao CQ, Yan F, Dion D, Quintayo MA, Lungu I, Nofech-Mozes S, Pruneri G, Viale G, Boutros PC, Bartlett JMS, Bayani J. Abstract P1-05-01: The epithelial to mesenchymal transition: Identifying a signature of recurrence in ductal carcinoma in situ. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-05-01] [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: The epithelial to mesenchymal transition (EMT) plays a critical role in the progression from non-invasive to invasive breast carcinomas (IBC). It is characterized by alterations in gene expression, changes in cellular polarity, the disruption of tight junctions; production of metalloproteinases, transforming growth factor-β (TGFβ) induction, expression of cancer stem cell markers, hypoxia, decrease in e-cadherin expression, along with other molecular biological events. Several transcription factors including ZEB1/2, TWIST1, SNAIL1/2, FOX family, GATA4/6 are involved in the process. There is a need to identify the molecular events driving the progression of ductal carcinoma in situ (DCIS); and to derive a signature that differentiates DCIS lesions that have the potential to recur as a subsequent DCIS, an IBC, or to not recur. To catalog the changes associated with EMT that may reveal a clinically relevant signature of progression from DCIS to DCIS or IBC recurrences using a panel of 200 genes related to EMT.
Methodology: RNA was extracted from formalin-fixed paraffin embedded (FFPE) sections of pure primary DCIS lesions representing three categories of outcome: those that did not recur; those that recurred with a subsequent DCIS; and those that recurred with invasive cancer. RNA abundance profiling was performed using Nanostring platform and data processing using an R statistical environment. Levels of mRNA abundance were modelled as a function of recurrence status. Coefficients were fit to terms representing the effect and the standard errors of the coefficient were adjusted with an empirical Bayes moderation. Model-based t-tests were then used to test if the coefficients were significantly different from zero.
Results: Using a technical control sample, pairwise comparisons across three replicates showed high correlation (ρ=0.99, Pρ<2.2x10-16 for all 3 comparisons), suggesting the robustness of the assay. In our preliminary survey of 45 patients across the three groups, we have identified a number of genes that showed differential mRNA abundance levels between patients who recurred (either DCIS or invasive recurrence) vs. those who did not recur. Using Random Forest analysis in a leave-one-out cross-validation approach, we were able to obtain a classifier with a sensitivity of 82% and specificity of 58%. Based on these initial findings, an additional 200 samples have been processed to support these initial findings.
Conclusion: The current literature provided increasing evidence that transcriptomic patterns reflecting the EMT may reveal novel biomarkers and elucidate molecular mechanisms leading to improved prognosis. Among breast carcinomas, differential expression of the EMT genes has been associated with a worse outcome, among estrogen receptor-negative and basal-like carcinomas. However, the understanding of the role of EMT genes in DCIS is limited; therefore, to elucidate whether the EMT plays a role in the progression of DCIS, we have designed an EMT gene panel that also includes genes that are significant prognosticators for IBC, including ER, PgR, Ki67 and HER2. In an exploratory analysis of cases trained based on clinical outcome, the sensitivity for predicting recurrence (whether DCIS or invasive) was 82%.
Citation Format: Felipe Lima J, Yao CQ, Yan F, Dion D, Quintayo MA, Lungu I, Nofech-Mozes S, Pruneri G, Viale G, Boutros PC, Bartlett JMS, Bayani J. The epithelial to mesenchymal transition: Identifying a signature of recurrence in ductal carcinoma in situ. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-05-01.
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Affiliation(s)
- J Felipe Lima
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - CQ Yao
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - F Yan
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - D Dion
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - MA Quintayo
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - I Lungu
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - S Nofech-Mozes
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - G Pruneri
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - G Viale
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - PC Boutros
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - JMS Bartlett
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
| | - J Bayani
- Ontario Institute of Cancer Research, Toronto, ON, Canada; Sunnybrook Health Centre, Toronto, ON, Canada; Istituto Europeu di Oncologia, Milan, Italy
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Bartlett JMS, Ahmed I, Regan MM, Sestak I, Mallon EA, Dell'Orto P, Thürlimann BJK, Seynaeve C, Putter H, Brookes CL, Forbes JF, Colleoni MA, Bayani J, van de Velde CJH, Viale G, Cuzick J, Dowsett M, Rea DW. Abstract S4-06: HER2 status as predictive marker for AI vs Tam benefit: A TRANS-AIOG meta-analysis of 12129 patients from ATAC, BIG 1-98 and TEAM with centrally determined HER2. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-s4-06] [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
There is now significant evidence emerging from the pivotal trials of AIs versus Tamoxifen (AIOG) demonstrating the value of meta-analysis of key clinical questions. The "Trans-AIOG" group has been tasked with the exploration of key molecular/biomarker questions that are pertinent to meta-analyses of biomarkers (past/present/future) in AIOG trials. HER2 has been long proposed as a marker of endocrine "resistance". Data from three trials, before the era of HER-directed therapy, suggest a potential role for HER2 to select patients for treatment with upfront AIs. However the individual trials lack power to test treatment-by-HER2 interaction due to sample size and low HER2+ve rates. A meta-analysis of the predictive value of HER2 status, specifically within the first 3 years of endocrine therapy, has the potential to inform patient selection for upfront or sequential strategies with AIs. The pre-existing standardization of methodology for HER2 (IHC/FISH) facilitates analysis of existing data from BIG-1-98, TEAM and ATAC for this key marker.
Analysis plan: Following a prospectively-designed analysis plan, patient-level data from 3 randomized phase III trials (ATAC, BIG 1-98, TEAM) comparing AIs to tamoxifen during the first 2-3 years of adjuvant treatment were collected at the CRCTU (Birmingham UK), accounting for both the established time-dependency of relapse in HER2+ve, anti-endocrine treated patients and to address the clinical question of "upfront" vs "sequential" strategies for AIs. For each trial, covariate-adjusted Cox models estimated HER2-by-treatment (AI vs Tam) interaction on distant recurrence-free interval-censored at 2-2.75 years follow-up. A meta-analysis of the HER2-by-treatment interaction terms and of treatment effects according to HER2 status was performed.
Results: 12129 patients with centrally-confirmed ER and HER2 status, 1092 (9%) HER2+ve, with 473 (4%; 111 among HER2+ve) distant recurrences were analyzed. The meta-analysis estimated a pooled HER2-by-treatment interaction of 1.61 (95% CI 1.01,2.57), reflecting treatment effect hazard ratio(AI/Tam) of HR=1.13 (0.75,1.71) among HER2+ve and HR=0.70 (0.56,0.87) among HER2-ve. There was heterogeneity among interaction terms (I-squared=59%, p=.09) that resulted from treatment effect heterogeneity among HER2+ve subgroup (I2=71%, p=.03), not the HER2-ve subgroup (I2=0%). The results for disease-free survival were similar.
Conclusion: An individual patient data meta-analysis across 3 trials (ATAC, BIG 1-98, TEAM) conducted prior to standard use of HER2-directed adjuvant therapy demonstrated a marginally-significant interaction between HER2 status and treatment with AIs vs Tamoxifen in the 2-2.75 years prior to potential "switching" between Tamoxifen and AIs. Patients with HER2-ve cancers experienced improved outcomes when treated with AIs vs Tamoxifen whilst patients with HER+ve cancers fared no better, or slightly worse, during AI treatment. However, the small number of HER2+ve cancers and events even in this meta-analysis may explain a large degree of heterogeneity in the treatment effects within the HER2+ve subgroups across the 3 trials. Other causes, perhaps related to subtle differences between AIs, cannot be excluded.
Citation Format: Bartlett JMS, Ahmed I, Regan MM, Sestak I, Mallon EA, Dell'Orto P, Thürlimann BJK, Seynaeve C, Putter H, Brookes CL, Forbes JF, Colleoni MA, Bayani J, van de Velde CJH, Viale G, Cuzick J, Dowsett M, Rea DW, On Behalf of the Translational Aromatase Inhibitor Overview Group (Trans-AIOG). HER2 status as predictive marker for AI vs Tam benefit: A TRANS-AIOG meta-analysis of 12129 patients from ATAC, BIG 1-98 and TEAM with centrally determined HER2. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr S4-06.
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Affiliation(s)
- JMS Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - I Ahmed
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - MM Regan
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - I Sestak
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - EA Mallon
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - P Dell'Orto
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - BJK Thürlimann
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - C Seynaeve
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - H Putter
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - CL Brookes
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - JF Forbes
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - MA Colleoni
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - CJH van de Velde
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - G Viale
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - J Cuzick
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - M Dowsett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
| | - DW Rea
- Ontario Institute for Cancer Research, Toronto, ON, Canada; University of Birmingham, Birmingham, United Kingdom; Dana-Farber Cancer Institute, Boston, MA; Queen Mary, University of London, London, United Kingdom; Western Infirmary, Glasgow, United Kingdom; Breast Center, Kantonsspital St. Gallen, St. Gallen, Switzerland; Erasmus Medical Center Cancer Institute, Rotterdam, Netherlands; Leiden University Medical Center, Leiden, Netherlands; The University of Newcastle, Newcastle, New South Wales, Australia; University of Milan, Milan, Italy; Royal Marsden Hospital, London, United Kingdom; European Institute of Oncology, Milan, Italy
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Bayani J, Yao CQ, Quintayo MA, Haider S, Brookes CL, Yan F, van de Velde CJH, Hasenburg A, Kieback DG, Markopoulos C, Dirix L, Seynaeve C, Boutros PC, Rea DW, Bartlett JMS. Abstract P2-08-29: Defining a signature of residual risk following endocrine treatment in the tamoxifen and exemestane adjuvant multinational (TEAM) trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-08-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: There are a number of commercially-available tests to stratify risk for women diagnosed with early breast cancer. While such "Generation I" tests are increasingly being used, a consensus is growing that these tests are moderately accurate in assessing risk. Moreover, Generation I tests fail to direct more personalized treatment. Therefore, there is a clear need for more informative "Generation II" tests that better assess risk, also on the long term, and provide theranostic targets. To this end, we have performed an mRNA abundance-based analysis trained in the 790 patients of the UK TEAM cohort to identify a signature of residual risk , to be validated in the remaining 3000 patients from the TEAM pathology study.
Methods: RNA extracted from the tumors of respective TEAM pathology study patients were profiled using a 165-gene NanoString code set. The gene list was compiled from targets that comprise many of the existing risk assessment tests, in addition to genes known to be of importance for breast cancer pathogenesis. Signal intensities were normalized using the R statistical environment; 336 different combinations of preprocessing methods were assessed and the most optimal method selected using unbiased criteria. A10-fold cross-validation approach, in combination with a network-based patient risk score calculation formula, was used to derive a 95-gene signature. Briefly, genes were first filtered based on a Cox regression p-value threshold of 0.25; the sum of the weighted mRNA abundance levels of the result genes was calculated for each patient as the risk score. Patient-wise risk scores were then used in a multivariate Cox proportional hazards model along with clinical covariates such as age, grade, HER2 status and nodal status, using DRFS truncated to 10 years as an end-point.
Results: Univariate survival analysis revealed a number of significantly prognostic candidates. The resulting 95-gene signature identified in the training set, stratified patients into high and low risk with an HRhigh of 2.74 (p<2.06 x10-4) when adjusted for age, grade, HER2 status and nodal status; resulting in an AUC of 0.73. Modular analyses of the genes comprising the 95-gene signature identified pathways associated with receptor tyrosine kinase signalling, regulation of cell cycle, and the spindle assembly checkpoint. Additionally, the composition of the gene-list made it possible to characterize the patients into their intrinsic subtypes and to determine their relative risk for recurrence relative to assessment tools available today . The validation of the 95-gene signature will be conducted in the remaining samples in the TEAM pathology study using the bioinformatics strategy described above.
Conclusions: The impact of test-guided therapy using multi-parametric tests is increasingly being felt in the clinic, and is reshaping modern health-care economics. A successful Generation II multi-parametric test will better discriminate those that are truly at high risk for recurrence following endocrine therapy and indicate potential therapeutic options for intervention for those who would not benefit from current modalities.
Citation Format: Bayani J, Yao CQ, Quintayo MA, Haider S, Brookes CL, Yan F, van de Velde CJH, Hasenburg A, Kieback DG, Markopoulos C, Dirix L, Seynaeve C, Boutros PC, Rea DW, Bartlett JMS. Defining a signature of residual risk following endocrine treatment in the tamoxifen and exemestane adjuvant multinational (TEAM) trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-29.
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Affiliation(s)
- J Bayani
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - CQ Yao
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - MA Quintayo
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - S Haider
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - CL Brookes
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - F Yan
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - CJH van de Velde
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - A Hasenburg
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - DG Kieback
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - C Markopoulos
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - L Dirix
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - C Seynaeve
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - PC Boutros
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - DW Rea
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
| | - JMS Bartlett
- Ontario Institute for Cancer Research (OICR), Toronto, ON, Canada; Univeristy of Birmingham, Cancer Research UK Clinical Trials Unit, Birmingham, United Kingdom; Leiden University Medical Center, Leiden, Netherlands; University Hospital, Freiburg, Germany; Helios Medical Center, Aue, Germany; Athens University Medical School, Athens, Greece; St. Augustinus Hospital, Antwerp, Belgium; Erasmus Medical Center-Daniel den Hoed, Rotterdam, Netherlands; University of Toronto, Toronto, Canada
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Dirks PB, Meyer M, Reimand J, Lan X, Head R, Zhu X, Kushida M, Bayani J, Pressey JC, Lionel A, Clarke ID, Cusimano M, Squire J, Scherer S, Bernstein M, Woodin MA, Bader GD. SINGLE CELL DERIVED CLONAL ANALYSIS OF HUMAN GLIOBLASTOMA LINKS FUNCTIONAL AND GENOMIC HETEROGENEITY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou206.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pandita A, Bayani J, Paderova J, Marrano P, Graham C, Barrett M, Prasad M, Zielenska M, Squire J. Integrated Cytogenetic and High-Resolution Array CGH Analysis of Genomic Alterations Associated with MYCN Amplification. Cytogenet Genome Res 2011; 134:27-39. [DOI: 10.1159/000324698] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2010] [Indexed: 01/05/2023] Open
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Boehm AK, Neff JR, Squire JA, Bayani J, Nelson M, Bridge JA. Cytogenetic Findings in 36 Osteosarcoma Specimens and a Review of the Literature. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/15513810009168645] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Selvarajah S, Yoshimoto M, Ludkovski O, Park PC, Bayani J, Thorner P, Maire G, Squire JA, Zielenska M. Genomic signatures of chromosomal instability and osteosarcoma progression detected by high resolution array CGH and interphase FISH. Cytogenet Genome Res 2008; 122:5-15. [PMID: 18931480 DOI: 10.1159/000151310] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2008] [Indexed: 11/19/2022] Open
Abstract
Osteosarcoma (OS) is characterized by an unstable karyotype which typically has a heterogeneous pattern of complex chromosomal abnormalities. High-resolution array comparative genomic hybridization (CGH) in combination with interphase fluorescence in situ hybridization (FISH) analyses provides a complete description of genomic imbalances together with an evaluation of the contribution of cell-to-cell variation to copy number changes. There have been no analyses to date documenting genomic signatures consistent with chromosomal instability mechanisms in OS tumors using array CGH. In this study, we utilized high-resolution array CGH to identify and characterize recurrent signatures of genomic imbalances using ten OS tumors. Comparison between the genomic profiles identified tumor groups with low, intermediate and high levels of genomic imbalance. Bands 6p22-->p21, 8q24 and 17p12--> p11.2 were consistently involved in high copy gain or amplification events. Since these three locations have been consistently associated with OS oncogenesis, FISH probes from each cytoband were used to derive an index of cellular heterogeneity for copy number within each region. OS with the highest degree of genomic imbalance also exhibited the most extreme cell-to-cell copy number variation. Significantly, the three OS with the most imbalance and genomic copy number heterogeneity also had the poorest response to preoperative chemotherapy. This genome wide analysis is the first utilizing oligonucleotide array CGH in combination with FISH analysis to derive genomic signatures of chromosomal instability in OS tumors by studying genomic imbalance and intercellular heterogeneity. This comprehensive genomic screening approach provides important insights concerning the mechanisms responsible for generating complex genomes. The resulting phenotypic diversity can generate tumors with a propensity for an aggressive disease course. A better understanding of the underlying mechanisms leading to OS tumor development could result in the identification of prognostic markers and therapeutic targets.
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Affiliation(s)
- S Selvarajah
- Department of Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Canada
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Vukovic B, Beheshti B, Park P, Lim G, Bayani J, Zielenska M, Squire JA. Correlating breakage-fusion-bridge events with the overall chromosomal instability and in vitro karyotype evolution in prostate cancer. Cytogenet Genome Res 2007; 116:1-11. [PMID: 17268171 DOI: 10.1159/000097411] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2006] [Accepted: 07/07/2006] [Indexed: 01/20/2023] Open
Abstract
Chromosomal instability (CIN) is thought to underlie the generation of chromosomal changes and genomic heterogeneity during prostatic tumorigenesis. The breakage-fusion-bridge (BFB) cycle is one of the CIN mechanisms responsible for characteristic mitotic abnormalities and the occurrence of specific classes of genomic rearrangements. However, there is little detailed information concerning the role of BFB and CIN in generating genomic diversity in prostate cancer. In this study we have used molecular cytogenetic methods and array comparative genomic hybridization analysis (aCGH) of DU145, PC3, LNCaP, 1532T and 1542T to investigate the in vitro role of BFB as a CIN mechanism in karyotype evolution. Analysis of mitotic structures in all five prostate cancer cell lines showed increased frequency of anaphase bridges and nuclear strings. Structurally rearranged dicentric chromosomes were observed in all of the investigated cell lines, and Spectral Karyotyping (SKY) analysis was used to identify the participating rearranged chromosomes. Multicolor banding (mBAND) and aCGH analysis of some of the more complex chromosomal rearrangements and associated amplicons identified inverted duplications, most frequently involving chromosome 8. Chromosomal breakpoint analysis showed there was a higher frequency of rearrangement at centromeric and pericentromeric genomic regions. The distribution of inverted duplications and ladder-like amplifications was mapped by mBAND and by aCGH. Adjacent spacing of focal amplifications and microdeletions were observed, and focal amplification of centromeric and end sequences was present, particularly in the most unstable line DU145. SKY analysis of this line identified chromosome segments fusing with multiple recipient chromosomes (jumping translocations) identifying potential dicentric sources. Telomere free end analysis indicated loss of DNA sequence. Moreover, the cell lines with the shortest telomeres had the most complex karyotypes, suggesting that despite the expression of telomerase, the reduced telomere length could be driving the observed BFB events and elevated levels of CIN in these lines.
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Affiliation(s)
- B Vukovic
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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Kennedy JA, Barabé F, Patterson BJ, Bayani J, Squire JA, Barber DL, Dick JE. Expression of TEL-JAK2 in primary human hematopoietic cells drives erythropoietin-independent erythropoiesis and induces myelofibrosis in vivo. Proc Natl Acad Sci U S A 2006; 103:16930-5. [PMID: 17077140 PMCID: PMC1629449 DOI: 10.1073/pnas.0604902103] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Activation of JAK2 by chromosomal translocation or point mutation is a recurrent event in hematopoietic malignancies, including acute leukemias and myeloproliferative disorders. Although the effects of activated JAK2 signaling have been examined in cell lines and murine models, the functional consequences of deregulated JAK2 in the context of human hematopoietic cells are currently unknown. Here we report that expression of TEL-JAK2, a constitutively active variant of the JAK2 kinase, in lineage-depleted human umbilical cord blood cells results in erythropoietin-independent erythroid differentiation in vitro and induces the rapid development of myelofibrosis in an in vivo NOD/SCID xenotransplantation assay. These studies provide functional evidence that activated JAK2 signaling in primitive human hematopoietic cells is sufficient to drive key processes implicated in the pathophysiology of polycythemia vera and idiopathic myelofibrosis. Furthermore, they describe an in vivo model of myelofibrosis initiated with primary cells, highlighting the utility of the NOD/SCID xenotransplant system for the development of experimental models of human hematopoietic malignancies.
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Affiliation(s)
- J. A. Kennedy
- Division of Cell and Molecular Biology and
- Departments of Molecular and Medical Genetics and
| | - F. Barabé
- Division of Cell and Molecular Biology and
| | - B. J. Patterson
- Department of Pathology, University Health Network, Toronto, ON, Canada M5G 1L7
| | - J. Bayani
- Medical Biophysics, University of Toronto, Toronto, ON, Canada M5S 1A8; and
- Divisions of Applied Molecular Oncology and
| | - J. A. Squire
- Medical Biophysics, University of Toronto, Toronto, ON, Canada M5S 1A8; and
- Divisions of Applied Molecular Oncology and
| | - D. L. Barber
- Medical Biophysics, University of Toronto, Toronto, ON, Canada M5S 1A8; and
- Stem Cell and Developmental Biology, Ontario Cancer Institute, Toronto, ON, Canada M5G 2M9
| | - J. E. Dick
- Division of Cell and Molecular Biology and
- Departments of Molecular and Medical Genetics and
- To whom correspondence should be addressed. E-mail:
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Yoshimoto M, Joshua AM, Chilton-Macneill S, Bayani J, Prasad M, Fleshner N, Finelli A, Evans A, Sweet J, Squire J, Zielenska M. Detection of novel variant TMPRSS2 /ERG fusion transcripts suggests independent genomic alterations may underlie origin of multi-centric prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10029 Background: Most of the early successes in identifying chromosomal translocations in neoplasias came from the study of hematological malignancies and sarcomas, with limited evidence that consistent genomic rearrangements were present in epithelial malignancies. Recently it was reported that ∼75% of prostate cancers carry a genomic rearrangement leading to fusion of the TMPRSS2 locus to either the ERG or ETV1 genes (both ETS transcription factors). In the fusion gene, the androgen-sensitive promoter elements of TMPRSS2 are thought to mediate over-expression of these ETS transcription factors. Over-activity of the ETS family of transcription factors has been suggested to be involved in the transition from pre-neoplasia to carcinoma as they regulate genes involved in processes such as adhesion, motility, invasion and angiogenesis. Methods: Using both RT-PCR and FISH with published primers and BACs respectively we analyzed 15 samples of prostatic carcinoma from radical prostatectomies and sequenced a subset of the TMPRSS2/ERG fusions. Results: We have found ERG-TMPRSS2 fusion transcripts in 6 samples and no ETV1-TMPRSS2 fusions. Of the 6 fusion tumours, 5 were Gleason 7 and 1 was Gleason 9. Tumour stages ranged from T2a-T3b. One sample with multi-centric carcinoma exhibited 2 distinct in-frame rearrangements generating novel TMPRSS2 /ERG fusion transcripts. Variant I TMPRSS2/ERG transcript was 430 bp and it led to fusion of exons 1 and 2 of the TMPRSS2 gene with exons 5 and 6 of the ERG gene. Variant II TMPRSS2/ERG fusion transcript was slightly smaller at 350 bp and it led to fusion of exon 1 of the TMPRSS2 gene to exons 5 and 6 of the ERG gene. These novel transcripts appear to be smaller than the published fusion proteins but preliminary analysis suggests that all known regulatory and functional protein domains are maintained. Conclusions: The demonstration of two new TMPRSS2/ERG variant fusion transcripts in prostate cancer deserves further study to evaluate their functional impact and prognostic and pathological importance. Moreover the presence of two distinct transcripts within a single multi-centric tumor provides genomic evidence that independent clonal neoplasms can arise synchronously in prostate cancer. No significant financial relationships to disclose.
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Affiliation(s)
- M. Yoshimoto
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - A. M. Joshua
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - S. Chilton-Macneill
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - J. Bayani
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - M. Prasad
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - N. Fleshner
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - A. Finelli
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - A. Evans
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - J. Sweet
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - J. Squire
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
| | - M. Zielenska
- Ontario Cancer Institute, Toronto, ON, Canada; Hospital for Sick Children, Toronto, ON, Canada; Princess Margaret Hospital, Toronto, ON, Canada
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Zielenska M, Marrano P, Thorner P, Pei J, Beheshti B, Ho M, Bayani J, Liu Y, Sun BC, Squire JA, Hao XS. High-resolution cDNA microarray CGH mapping of genomic imbalances in osteosarcoma using formalin-fixed paraffin-embedded tissue. Cytogenet Genome Res 2005; 107:77-82. [PMID: 15305059 DOI: 10.1159/000079574] [Citation(s) in RCA: 33] [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] [Received: 03/12/2004] [Accepted: 04/01/2004] [Indexed: 11/19/2022] Open
Abstract
Formalin-fixed paraffin embedded (FFPE) tumor tissue provides an opportunity to perform retrospective genomic studies of tumors in which chromosomal imbalances are strongly associated with oncogenesis. The application of comparative genomic hybridization (CGH) has led to the rapid accumulation of cytogenetic information on osteosarcoma (OS); however, the limited resolving power of metaphase CGH does not permit precise mapping of imbalances. Array CGH allows quantitative detection and more precise delineation of copy number aberrations in tumors. Unfortunately the high cost and lower density of BACs on available commercial arrays has limited the ability to comprehensively profile copy number changes in tumors such as OS that are recurrently subject to genomic imbalance. In this study a cDNA/EST microarray including 18,980 human cDNAs (which represent all 22 pairs of autosomal chromosomes and chromosome X) was used for CGH analysis of eight OS FFPE. Chromosomes 1, 12, 17, and X harbored the most imbalances. Gain/amplification of X was observed in 4/8 OS, and in keeping with other recent genomic analyses of OS, gain/amplification of 17p11.2 was often accompanied by a distal deletion in the region of the p53 gene. Gain/amplification of the X chromosome was verified using interphase FISH carried out on a subset of OS FFPE sections and OS tissue arrays.
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Affiliation(s)
- M Zielenska
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Princess Margaret Hospital and The Ontario Cancer Institute, Ont, Canada
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Hughes S, Lim G, Beheshti B, Bayani J, Marrano P, Huang A, Squire JA. Use of whole genome amplification and comparative genomic hybridisation to detect chromosomal copy number alterations in cell line material and tumour tissue. Cytogenet Genome Res 2004; 105:18-24. [PMID: 15218253 DOI: 10.1159/000078004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Accepted: 11/28/2003] [Indexed: 11/19/2022] Open
Abstract
We have established that whole genome amplification (WGA), in conjunction with genomic DNA array comparative genomic hybridisation (gaCGH) allows for the identification of genome-wide copy number abnormalities (CNAs) in DNA extracted from both cell line and patient material. To determine the fidelity and reproducibility of WGA to detect copy number imbalances using gaCGH, well characterized cell line genomic DNA was analysed. The gaCGH data obtained from non-amplified DNA and amplified DNA for the neuroblastoma cell line NUB7 and a paediatric medulloblastoma patient was almost identical. In addition, laser capture microdissection (LCM) of prostate tumour cells and subsequent WGA allowed for the detection of a number of CNAs that may not have been identified if DNA had been extracted in bulk from heterogeneous tissue. The results presented here demonstrate the use of WGA for generating sufficient DNA for gaCGH analysis without the introduction of significant sequence representation bias. The combination of amplification and gaCGH using DNA extracted from archival patient material has the potential for permitting the studying of DNA from small cancerous or pre-cancerous foci, which may help to identify potential genomic markers for early diagnosis.
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Affiliation(s)
- S Hughes
- Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
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Al-Romaih K, Bayani J, Vorobyova J, Karaskova J, Park PC, Zielenska M, Squire JA. Chromosomal instability in osteosarcoma and its association with centrosome abnormalities. Cancer Genet Cytogenet 2003; 144:91-9. [PMID: 12850370 DOI: 10.1016/s0165-4608(02)00929-9] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The mechanism that generates the extreme aneuploidy that characterizes osteosarcoma (OS) is poorly understood. In this study, interphase fluorescence in situ hybridization (FISH) analysis was used to enumerate cell-to-cell variation of several different chromosomes. We also investigated whether there was an association between TP53 mutation and centrosome aberrations in the generation of chromosomal aneuploidy in OS in four OS cell lines (HOS, SAOS2, U2OS, and MG63) and in a subset of seven tumors. Our analysis showed that there was a wide range of numerical changes affecting multiple chromosomes in OS cell lines and tumors. These data suggest that chromosomal instability (CIN) could be responsible for the extensive aneuploidy associated with this tumor. The results also showed an increased frequency of atypical mitotic figures in three OS cell lines with defective TP53, function and significantly, a more marked CIN phenotype was present in these lines. Furthermore, numerical aberrations of centrosomes were also present in these three OS cell lines with TP53 mutations. In two of three OS patients' tumors there was a large increase in the percentage of abnormal centrosome numbers. We conclude that CIN is a consistent feature of OS and that an intrinsic disturbance of the chromosomal segregation mechanisms is likely associated with centrosome aberrations.
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Affiliation(s)
- K Al-Romaih
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Taylor MD, Mainprize TG, Rutka JT, Becker L, Bayani J, Drake JM. Medulloblastoma in a child with Rubenstein-Taybi Syndrome: case report and review of the literature. Pediatr Neurosurg 2001; 35:235-8. [PMID: 11741116 DOI: 10.1159/000050428] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although medulloblastoma is usually sporadic, there are a number of uncommon predisposing germline mutation syndromes, including: Gorlin's Syndrome, Turcot's Syndrome and Li-Fraumeni Syndrome. Patients with Rubenstein-Taybi Syndrome secondary to mutation/deletion of the CBP gene on chromosome 16 are predisposed to a variety of developmental anomalies as well as cancer. We report a child with Rubenstein-Taybi syndrome who developed a cerebellar medulloblastoma and review the literature on Rubenstein-Taybi Syndrome and pediatric medulloblastoma. As the product of the CBP gene functions in a variety of signaling pathways, we discuss the molecular implications of findings a medulloblastoma in a child with Rubenstein-Taybi Syndrome.
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Affiliation(s)
- M D Taylor
- The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8 Canada
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28
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Zielenska M, Bayani J, Pandita A, Toledo S, Marrano P, Andrade J, Petrilli A, Thorner P, Sorensen P, Squire JA. Comparative genomic hybridization analysis identifies gains of 1p35 approximately p36 and chromosome 19 in osteosarcoma. Cancer Genet Cytogenet 2001; 130:14-21. [PMID: 11672768 DOI: 10.1016/s0165-4608(01)00461-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Osteosarcomas (OS) are aggressive tumors of the bone and often have a poor prognosis. Conventional cytogenetic analyses of OS have revealed highly complex karyotypes, with numerous abnormalities. In this study, we analyzed 18 untreated OS tumors from 17 patients of the younger incidence age group by comparative genomic hybridization (CGH), 4 tumors by spectral karyotyping (SKY) and fluorescence in situ hybridization (FISH). Comparative genomic hybridization identified frequent copy number changes of the chromosomal region 1p (10/17) and gain of part or all of chromosome 19(8/17). In addition gains were observed at 5p(3/17), 8q(3/17), 16p(3/17), and 17p(5/17); and losses at chromosomes 2q(3/17), 10(4/17) and 13(3/17). High level gains were detected in the 8q23 approximately q24 region in two tumors as well as at 17p in one primary and a metastatic tumor. Minimal regions of gain were present at 1p35 approximately p36.3 (8/17); 5p14 approximately p15.2 (3/17), and 8q22 approximately q24.3 (3/17). SKY analysis demonstrated that OS has a complex pattern of clonal and non-clonal rearrangements and helped confirm the structural basis for the imbalances detected by CGH. Spectral karyotyping confirmed an overall pattern of chromosomal gain affecting 1p in all four tumors. Fluorescence in situ hybridization analysis from these tumors confirmed the gain of the 1p36 region in 2 tumors as determined by CGH analysis as well as the amplification of 8q.
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Affiliation(s)
- M Zielenska
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Princess Margaret Hospital, Toronto, Ontario, Canada
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Luk C, Tsao MS, Bayani J, Shepherd F, Squire JA. Molecular cytogenetic analysis of non-small cell lung carcinoma by spectral karyotyping and comparative genomic hybridization. ACTA ACUST UNITED AC 2001; 125:87-99. [PMID: 11369051 DOI: 10.1016/s0165-4608(00)00363-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The overall pattern of chromosomal changes detected by spectral karyotype (SKY) analysis of two cell lines of each major histological subtype of NSCLC, namely squamous cell carcinoma (SQCC) and adenocarcinoma (ADC), indicated a greater degree of chromosomal rearrangement, than was present or predicted by either comparative genomic hybridization (CGH) or G-banding analysis alone. To investigate these observations, CGH was used to screen DNA derived from 8 primary tumors and 15 cell lines. The results indicated that the most frequently gained chromosome arms were 5p (70%), 8q (65%), 15q (52%), 20q (48%), 1q (43%), 19q (39%), 3q (35%), and 11q (35%). Chromosomal losses were less frequently observed, and included 18q (39%), 9 (35%), 6q (30%), 13q (21%), 5q12-q32 (17%), and 19p (17%). Amplifications were found on 2p23-p24, 3q24-q27, 5p, 6cen-p21.1, 6q26, 7p21, 7q31, 8q, 11q13-qter, 20q12-q13.2. Comparison between CGH findings of the two major histological subtypes showed that gains at 1q22-q32.2, 15q, 20q, and losses at 6q, 13q, and 18q was common in ADCs, whereas SQCCs exhibited gains/amplifications at 3q. Distal 8q was gained by CGH in 65% of tumors of both subtypes. Low level MYCC amplification was confirmed by direct fluorescence in situ hybridization (FISH) analysis. The pattern of overall chromosomal changes detected using combinations of molecular cytogenetic analytical methods suggests that it will be easier to detect recurrent subtype-dependent aberrations in NSCLC.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Carcinoma, Adenosquamous/genetics
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Large Cell/genetics
- Carcinoma, Large Cell/pathology
- Carcinoma, Non-Small-Cell Lung/genetics
- Carcinoma, Non-Small-Cell Lung/pathology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Chromosome Aberrations
- Chromosome Banding
- Chromosome Deletion
- Chromosomes, Human/genetics
- Chromosomes, Human/ultrastructure
- DNA, Neoplasm/genetics
- Gene Amplification
- Genes, myc
- Humans
- Image Processing, Computer-Assisted
- In Situ Hybridization, Fluorescence
- Karyotyping/methods
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Nucleic Acid Hybridization
- Tumor Cells, Cultured
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Affiliation(s)
- C Luk
- Departments of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Squire JA, Arab S, Marrano P, Bayani J, Karaskova J, Taylor M, Becker L, Rutka J, Zielenska M. Molecular cytogenetic analysis of glial tumors using spectral karyotyping and comparative genomic hybridization. Mol Diagn 2001; 6:93-108. [PMID: 11468694 DOI: 10.1054/modi.2001.22745] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Glial tumors are the most common tumors of the central nervous system, affecting individuals of all ages. Conventional cytogenetics have been unable to identify a consistent chromosomal translocation or rearrangement in this group of tumors; thus, more advanced molecular cytogenetic approaches are required. METHODS AND RESULTS In this study, 16 glial tumors, including two recurrences and six glioma cell lines, were analyzed by spectral karyotyping (SKY) and comparative genomic hybridization (CGH). From 169 rearrangements detected by SKY, chromosomes 1 and 10 were the most frequently affected by translocation (18 of 169 and 16 of 169 rearrangements, respectively). Other frequently altered chromosomes included chromosomes 3 (13 of 169 rearrangements), 5 (ten of 169 rearrangements), 7 (ten of 169 rearrangements ), and 11 (ten of 169 rearrangements). A clustering of centromeric breakpoints was detected in chromosomes 3, 5, 10, 11, 16, 17, and 20. CGH analysis identified consistent gain of part or all of chromosome 7 among the 10 astrocytic tumors (five of ten specimens) in the study group. Analysis of the three gangliogliomas and one ependymoma identified a much simpler pattern of primarily numerical change. CONCLUSION Application of improved cytogenetic methods can increase our abilities to progress toward effective strategies of molecular diagnosis and classification of glial tumors.
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Affiliation(s)
- J A Squire
- Department of Medical Biophysics and Laboratory Medicine and Pathology, Ontario Cancer Institute, University of Toronto, 610 University Ave., Toronto, Ontario, Canada M5G 2M9.
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31
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Zielenska M, Zhang ZM, Ng K, Marrano P, Bayani J, Ramirez OC, Sorensen P, Thorner P, Greenberg M, Squire JA. Acquisition of secondary structural chromosomal changes in pediatric ewing sarcoma is a probable prognostic factor for tumor response and clinical outcome. Cancer 2001; 91:2156-64. [PMID: 11391597 DOI: 10.1002/1097-0142(20010601)91:11<2156::aid-cncr1244>3.0.co;2-i] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Ewing sarcoma (ES) group of tumors commonly have the t(11;22)(q24;q12) or other rearrangements involving 22q12. In addition to these consistent aberrations, both numeric and structural aberrations have been reported: namely gains of chromosomes 8 and 12, the unbalanced translocation t(1;16), and deletions at the short arm of chromosome 1. METHODS To evaluate the frequency and to study the prognostic implications of some of these aberrations in children, the authors performed a pilot study of 26 ES pediatric patients by classic cytogenetics and/or interphase fluorescence in situ hybridization (FISH) and compared these data with clinical parameters. RESULTS Gains of chromosomes 8 and 12 were detected, by interphase FISH, in 48% (10 of 21) and 38% (6 of 16) of the tumors, respectively, and this was not significant with respect to treatment response. Statistical analysis revealed that the presence of additional secondary structural chromosomal aberrations was associated with an unfavorable outcome (P = 0.0034 as an independent prognostic value as an unfavorable marker). Presence of metastasis at diagnosis also was found to be associated with poor outcome (P = 0.0131). Spectral karyotyping analysis was shown to facilitate the detection of more complex structural chromosomal aberrations in a representative ES tumor. CONCLUSIONS It is important to determine whether additional structural chromosomal aberrations are present in ES tumors because it appears that a more complex karyotype with multiple chromosomal aberrations is associated with poor outcome in ES.
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MESH Headings
- Adolescent
- Bone Neoplasms/genetics
- Bone Neoplasms/pathology
- Child
- Child, Preschool
- Chromosome Aberrations/genetics
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 8/genetics
- Female
- Follow-Up Studies
- Humans
- In Situ Hybridization, Fluorescence
- Infant
- Karyotyping
- Male
- Prognosis
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/pathology
- Survival Analysis
- Treatment Outcome
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Affiliation(s)
- M Zielenska
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Abstract
Spectral karyotyping (SKY) is a powerful 24-color, whole chromosome-painting assay allowing the visualization of each chromosome in one experiment. Subtle karyotype rearrangements can be detected easily so that small translocations lead to a transition from one color to another at the chromosomal breakpoint region. SKY has enabled the elucidation of several examples of hidden or "cryptic" structural aberrations that may otherwise have been left undetected by classical cytogenetic methods. Furthermore, the chromosomal origins of abnormalities once designated "marker chromosomes" can now be determined rather than left unidentified. SKY analysis of cancer cytogenetics samples provides a much more detailed description of the highly abnormal karyotypes that characterize advanced tumors and cancer cell lines. In addition, SKY significantly adds to the power of clinical cytogenetic analysis of constitutional chromosomal aberrations by facilitating the identification of subtle structural rearrangements that may contain aneuploidy with potential pathological consequences.
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Affiliation(s)
- J Bayani
- University Health Network, Ontario Cancer Institute and the Departments of Medical Biophysics and Laboratory Medicine and Pathobiology, University of Toronto, Ontario M5G 2M9, Canada
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Abstract
Pleuropulmonary blastoma (PPB) is a rare, malignant intrathoracic pediatric tumor. It arises from the lung, pleura, or mediastinum and its pathogenesis and relationship to other pediatric solid tumors is not well understood. In this study, a case of PPB in a 3-year-old girl was studied using a combination of molecular genetic methods and cytogenetics. Molecular analysis of the commonly encountered fusion translocation gene products of pediatric solid tumors failed to detect a rearrangement. Cytogenetic analysis, supplemented by multicolor spectral karyotyping (SKY), identified an unbalanced translocation between chromosomes 1 and X, resulting in additional copies of 1q, an extra copy of Xq, and loss of part of Xp. In addition, trisomy 8 was detected. The identification of new chromosomal alterations and confirmation of previously reported ones in this rare neoplasm helps to improve our understanding of its pathogenesis and association with other pediatric tumors.
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Affiliation(s)
- M Barnard
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8
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Bayani J, Zielenska M, Marrano P, Kwan Ng Y, Taylor MD, Jay V, Rutka JT, Squire JA. Molecular cytogenetic analysis of medulloblastomas and supratentorial primitive neuroectodermal tumors by using conventional banding, comparative genomic hybridization, and spectral karyotyping. J Neurosurg 2000; 93:437-48. [PMID: 10969942 DOI: 10.3171/jns.2000.93.3.0437] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECT Medulloblastomas and related primitive neuroectodermal tumors (PNETs) of the central nervous system are malignant, invasive embryonal tumors with predominantly neuronal differentiation that comprise 20% of pediatric brain tumors. Cytogenetic analysis has shown that alterations in chromosome 17, particularly the loss of 17p and the formation of isochromosome 17q, as well as the gain of chromosome 7 are the most common changes among this group of tumors. Comparative genomic hybridization (CGH) studies have largely confirmed these cytogenetic findings and have also identified novel regions of gain, loss, and amplification. The advent of more sophisticated multicolored fluorescence in situ hybridization (FISH) procedures such as spectral karyotyping (SKY) now permits complete recognition of all aberrations including extremely complex rearrangements. The authors report a retrospective analysis of 19 medulloblastoma and five PNET cases studied using combinations of classic banding analysis, FISH, CGH, and SKY to examine comprehensively the chromosomal aberrations present in this tumor group and to attempt to identify common structural rearrangement(s). METHODS The CGH data demonstrate gains of chromosomes 17q and 7 in 60% of the tumors studied, which confirms data reported in the current literature. However, the authors have also combined the results of all three molecular cytogenetic assays (Giemsa banding, CGH, and SKY) to reveal the frequency of chromosomal rearrangement (gained, lost, or involved in structural rearrangement). CONCLUSIONS The combined results indicate that chromosomes 7 and 17 are the most frequently rearranged chromosomes (10.1% and 8.9%, respectively, in all rearrangements detected). Furthermore, chromosomes 3 (7.8%), 14 (7%), 10 (6.7%), and 22 (6.5%) were also found to be frequently rearranged, followed by chromosomes 6 (6.5%), 13 (6.2%), and 18 (6.2%). Eight (33%) of 24 tumors exhibited high-level gains or gene amplification. Amplification of MYCN was identified in four tumors, whereas amplification of MYCC was identified in one tumor. One tumor exhibited a high-level gain of chromosome 9p. Additionally, desmoplastic medulloblastomas and large-cell medulloblastomas exhibited higher karyotype heterogeneity, amplification, and aneusomy than classic medulloblastomas.
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Affiliation(s)
- J Bayani
- University Health Network, Hospital for Sick Children, and Department of Laboratory Medicine and Pathobiology and Medical Biophysics, Faculty of Medicine, University of Toronto, Ontario, Canada
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Markovic VD, Bouman D, Bayani J, Al-Maghrabi J, Kamel-Reid S, Squire JA. Lack of BCR/ABL reciprocal fusion in variant Philadelphia chromosome translocations: a use of double fusion signal FISH and spectral karyotyping. Leukemia 2000; 14:1157-60. [PMID: 10865986 DOI: 10.1038/sj.leu.2401718] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Squire JA, Li M, Perlikowski S, Fei YL, Bayani J, Zhang ZM, Weksberg R. Alterations of H19 imprinting and IGF2 replication timing are infrequent in Beckwith-Wiedemann syndrome. Genomics 2000; 65:234-42. [PMID: 10857747 DOI: 10.1006/geno.2000.6155] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Beckwith-Wiedemann syndrome (BWS) is an overgrowth disorder resulting from dysregulation of multiple imprinted genes through a variety of distinct mechanisms. A frequent alteration in BWS involves changes in the imprinting status of the coordinately regulated IGF2 and H19 genes on 11p15. Patients have been categorized according to alterations in the imprinted expression, allele-specific methylation, and regional replication timing of these genes. In this work, IGF2/H19 expression, H19 DNA methylation, and IGF2 regional replication timing were studied in nine karyotypically normal BWS fibroblasts and two BWS patients with maternally inherited 11p15 chromosomal rearrangements. Informative patients (9/9) maintained normal monoallelic H19 expression/methylation, despite biallelic IGF2 expression in 6/9. Replication timing studies revealed no changes in the pattern of asynchronous replication timing for both a patient with biallelic IGF2 expression and a patient carrying an 11p15 inversion. In contrast, a patient with a chromosome 11;22 translocation and normal H19 expression/methylation exhibited partial loss of asynchrony and a shift toward earlier replication times. These results indicate that in BWS, (1) H19 imprinting alterations are less frequent than previously estimated, (2) IGF2 imprinting and H19 imprinting are not necessarily coordinated, and (3) alterations in regional replication timing are generally not correlated with either chromosomal rearrangements or the imprinting status of IGF2 and H19.
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Affiliation(s)
- J A Squire
- Ontario Cancer Institute, The Hospital for Sick Children, Toronto, Canada
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Abstract
Chondromyxoid fibroma is a rare benign bone tumor most commonly arising in the metaphysis of long bones in young adults. Histopathologically, chondromyxoid fibroma may be difficult to distinguish from other cartilaginous neoplasms. Recently, a pericentric inversion of chromosome 6 [inv(6)(p25q13)] has been proposed as a specific genetic marker for chondromyxoid fibroma. In this study, cytogenetic and spectral karyotypic analyses of 2 chondromyxoid fibroma cases showed clonal abnormalities of chromosome 6 but at a breakpoint on the long arm (q25) distal to that described in the pericentric inversion. These findings suggest that several distinct breakpoints on chromosome 6 are nonrandomly involved in chondromyxoid fibroma.
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Affiliation(s)
- A Safar
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-3135, USA
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Abstract
BACKGROUND Clear cell sarcoma of the kidney (CCSK) is a rare malignant pediatric tumor, distinguished from the Wilms tumor by its characteristic histologic features and a more aggressive clinical behavior with a tendency to metastasize to bone. Genetic studies on CCSK are limited and no consistent findings have been reported. PROCEDURE We examined four cases of CCSK for presence of consistent genetic alterations using comparative genomic hybridization (CGH). This is the first report concerning CGH analysis of CCSK. RESULTS Three of the tumors showed no chromosome gains or losses. One of the tumors had gains of 1 q and the terminal end of 11 q. CONCLUSIONS These results are consistent with previous findings of limited chromosomal changes in CCSK karyotypes. Gain of 1 q in CCSK warrants further investigation. Copy number gains of 1 q have been repeatedly demonstrated in soft tissue and bone sarcomas, as well as other tumors, implying the presence of genes involved in tumor development and/or progression.
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Affiliation(s)
- M Barnard
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
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Jay V, Squire J, Bayani J, Alkhani AM, Rutka JT, Zielenska M. Oncogene amplification in medulloblastoma: analysis of a case by comparative genomic hybridization and fluorescence in situ hybridization. Pathology 1999; 31:337-44. [PMID: 10643003 DOI: 10.1080/003130299104693] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We describe amplification of the MYCC oncogene in a medulloblastoma with aggressive clinical behavior. The patient was a six year old boy who underwent gross total surgical excision of a cerebellar tumor. Despite chemotherapy and total neuraxis radiation, the clinical course was one of relentless progression, with extensive subarachnoid spread and death within eight months of presentation. The pathological features were consistent with the recently described, "large cell variant" of medulloblastoma. Tumor cells exhibited large vesicular nuclei, prominent nucleoli and strong immunoreactivity for synaptophysin. Polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) assay revealed no evidence of MYCN amplification or 1p deletion in the tumor. FISH analysis revealed evidence of MYCC amplification in the 20- to 30-fold range. Comparative genomic hybridization (CGH) revealed regions of gains and amplification in three locations, with gains of chromosome 7, amplification of 8q24 (corresponding to the MYCC locus) and gains of the long arm of chromosome 17 (suggestive of isochromosome 17q). While conventional karyotypic analysis was not successful in the present case, CGH provided invaluable information about gene amplification and losses/gains of chromosomes and chromosomal regions. Thus, CGH is a powerful technique applicable to frozen or paraffin-embedded material which helps to ascertain the presence of gene amplification even without prior knowledge of the gene to be tested.
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Affiliation(s)
- V Jay
- Division of Pathology, Hospital for Sick Children-University of Toronto, Ontario, Canada.
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Pandita A, Zielenska M, Thorner P, Bayani J, Godbout R, Greenberg M, Squire JA. Application of comparative genomic hybridization, spectral karyotyping, and microarray analysis in the identification of subtype-specific patterns of genomic changes in rhabdomyosarcoma. Neoplasia 1999; 1:262-75. [PMID: 10935481 PMCID: PMC1508078 DOI: 10.1038/sj.neo.7900036] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/1999] [Accepted: 06/11/1999] [Indexed: 11/09/2022]
Abstract
Rhabdomyosarcoma (RMS) in children occurs predominantly as two major histologically defined subtypes called embryonal RMS (RMS-E) and the prognostically less favorable alveolar RMS (RMS-A). Comparative genomic hybridization (CGH) was performed on 21 RMS and identified consistent gains affecting chromosomes 2 (8/10), 5 (5/10), 6 (3/10), 7 (7/10), 8 (9/10), 11 (6/ 10), and 12 (5/10) in RMS-E. Losses/deletions involved chromosomes 19 (2/10) and chromosomes 4, 9, 10, 17, 21 (1/10 each). High copy number amplification, involving the 2p24 region (5/11) and less frequently, the 12q13-21 (2/11), 9p22 (1/11), and 17q22-25 (1/11) regions, was detected in RMS-A. Gene amplification at band 2p24 was present in 6/12 alveolar tumors, and in each case, MYCN was amplified, together with the distally placed DDX1 gene. For these patients there was a shorter disease free interval and a higher mortality than patients with tumors without amplification. Detailed spectral karyotype analysis (SKY) was performed on two RMS cell lines (one of each subtype) and identified a surprisingly high level of structural change. Gene expression studies with the Atlas Human Cancer Array (588 genes) showed that 153 genes generated a signal of similar intensity in both cell lines, and 45 genes appeared to have subtype-specific expression. The chromosomal location of differentially expressed genes was compared to the pattern of genomic alteration in RMS as determined by CGH in this study and the literature.
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Affiliation(s)
- A Pandita
- Department of Medical Biophysics and Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada
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Pandita A, Godbout R, Zielenska M, Thorner P, Bayani J, Squire JA. Relational mapping of MYCN and DDXI in band 2p24 and analysis of amplicon arrays in double minute chromosomes and homogeneously staining regions by use of free chromatin FISH. Genes Chromosomes Cancer 1997; 20:243-52. [PMID: 9365831 DOI: 10.1002/(sici)1098-2264(199711)20:3<243::aid-gcc4>3.0.co;2-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
MYCN amplification has been observed in diverse neuronal tumors including neuroblastoma, retinoblastoma, and small cell carcinoma of the lung, and has been correlated with a poor prognosis in advanced-stage neuroblastomas. Recent studies have shown a co-amplification of DDXI, a DEAD box gene, and MYCN in retinoblastoma and neuroblastoma. DDXI has been mapped to within a megabase of the MYCN gene in band 2p24. In the present study, the relational map of DDXI and MYCN by fluorescence in situ hybridization (FISH) mapping to metaphase cells and extended free chromatin fibers indicated that DDXI is telomeric to MYCN. Dual-color FISH analysis of amplicons within arrays of extended chromatin fibers was performed to examine the physical relationship of MYCN and DDXI within double minute chromosomes (dmins) and homogeneously staining regions (hsrs). No regular reiterated amplicon repeat unit was present in the hsrs, but detailed analysis of the configurations of DDXI and MYCN within each array indicated that multiple rearrangements generated a complex hsr amplicon structure. Similarly, analysis of a cell line bearing dmins showed that a composite amplicon structure involving deletions and/or duplications of MYCN and DDXI is a feature of dmin formation. These data are consistent with a molecular mechanism involving many rearrangements during the evolution of gene amplification, resulting in complex amplicon structures with distinct changes in relative gene copy number and considerable variation in intragenic distances between coamplified genes.
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Affiliation(s)
- A Pandita
- Department of Medical Biophysics, University of Toronto, Ontario, Canada
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Hannigan GE, Bayani J, Weksberg R, Beatty B, Pandita A, Dedhar S, Squire J. Mapping of the gene encoding the integrin-linked kinase, ILK, to human chromosome 11p15.5-p15.4. Genomics 1997; 42:177-9. [PMID: 9177792 DOI: 10.1006/geno.1997.4719] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We have recently reported the identification and cloning of the gene encoding p59ILK, a novel protein ser/thr kinase that is found in physiologic complexes with beta integrin subunits. ILK is a potential protoonocogene that appears to function in mediating signal transduction by beta 1 family integrins. Fluorescence in situ hybridization analysis of metaphase and decondensed free chromatin fibers localized ILK to 11p15.5-p15.4. This position was also confirmed by relational mapping using well-characterized translocations with breakpoints in chromosome band 11p15. Our results indicate that ILK maps between HBBC and CALC loci, in the 11p15.5-p15.4 band interval. This location may be important in evaluating the potential role of p59ILK in tumorigenesis since it has been shown that this region is associated with both genomic imprinting and loss of heterozygosity in certain types of tumor.
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Affiliation(s)
- G E Hannigan
- Department of Paediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Canada.
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Thorner P, Squire J, Chilton-MacNeil S, Marrano P, Bayani J, Malkin D, Greenberg M, Lorenzana A, Zielenska M. Is the EWS/FLI-1 fusion transcript specific for Ewing sarcoma and peripheral primitive neuroectodermal tumor? A report of four cases showing this transcript in a wider range of tumor types. Am J Pathol 1996; 148:1125-38. [PMID: 8644855 PMCID: PMC1861517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The presence of t(11;22)(q24;q12) is often considered diagnostic of Ewing sarcoma and peripheral primitive neuroectodermal tumor. We report four cases, all of which possessed this translocation as detected by reverse transcriptase polymerase chain reaction and confirmed by sequencing with or without fluorescent in situ hybridization, but none of which were Ewing sarcoma or peripheral primitive neuroectodermal tumor by histological criteria. Two were polyphenotypic tumors and two were mixed embryonal and alveolar rhabdomyosarcomas. Only one case was positive for MIC2 by immunohistochemistry and only in a rare cell. Two cases (one polyphenotypic tumor and one rhabdomyosarcoma) had double minute chromosomes with > 100 copies of the MDM2 gene. The presence of the t(11;22)(q24;ql2) translocation should probably not be considered diagnostic of Ewing sarcoma and peripheral primitive neuroectodermal tumor in the absence of supporting histological evidence. The presence of this translocation in Ewing sarcoma and peripheral primitive neuroectodermal tumor has been taken as evidence that these two tumors are related. Extending this relationship to include some polyphenotypic tumors and some rhabdomyosarcomas may not be justified unless additional evidence is gathered. Pathologists and oncologists will need to decide whether treatment regimens for tumors are better based on phenotype rather than genotype when these two profiles are seemingly in conflict.
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MESH Headings
- Abdominal Neoplasms/pathology
- Biomarkers, Tumor/analysis
- Bone Neoplasms/pathology
- Brain Neoplasms/pathology
- Child, Preschool
- DNA-Binding Proteins/genetics
- Diagnosis, Differential
- Female
- Genetic Markers
- Humans
- Infant
- Male
- Neuroectodermal Tumors, Primitive/diagnosis
- Neuroectodermal Tumors, Primitive/genetics
- Neuroectodermal Tumors, Primitive/pathology
- Polymerase Chain Reaction
- Proto-Oncogene Protein c-fli-1
- Proto-Oncogene Proteins
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/pathology
- Trans-Activators/genetics
- Transcription, Genetic
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Affiliation(s)
- P Thorner
- Department of Pathology, The Hospital for Sick Children, Toronto, Canada
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Bayani J, Thorner P, Zielenska M, Pandita A, Beatty B, Squire JA. Application of a simplified comparative genomic hybridization technique to screen for gene amplification in pediatric solid tumors. Pediatr Pathol Lab Med 1995; 15:831-44. [PMID: 8705194 DOI: 10.3109/15513819509027020] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Conventional cytogenetic analysis of solid tumors is technically very demanding and requires a large number of viable cells. The technique of comparative genomic hybridization (CGH) circumvents these difficulties and has been shown to be particularly useful for identifying new gene amplifications. We have simplified the CGH technique for the detection of amplifications by utilizing a single labeling approach in which labeled tumor DNA is mixed with unlabeled normal human DNA and hybridized to normal metaphases on a slide. To examine the consistency and sensitivity of the method, initial experiments were performed using a retinoblastoma (RB) cell line and five pediatric solid tumors known to contain an amplification. The technique was easy to use and sensitive enough to detect low-level amplifications. The RB cell line showed reproducible signals at 2p24, indicative of amplified sequences, on both homologues in 95% of the metaphases (> 30) examined. Amplifications of the MYCN gene (2p24) were detected in three alveolar rhabdomyosarcomas and one medulloblastoma. CGH was then applied to six tumors in a prospective fashion, before data about specific gene amplification were available. In two, amplification of the MDM2 gene (12q13-14) was identified using CGH and later confirmed by Southern blot analysis. Four tumors negative for MDM2 and MYCN amplifications by CGH analysis were also negative by Southern blot analysis. Gene amplification as low as fourfold was detected in one tumor and the overall pattern of gene amplification detected by CGH in these tumors was not complex, involving just one amplification site for each case. Therefore, this simplified CGH technique is suitable for routine screening of pediatric solid tumors for amplifications when genetic studies are important but sample sizes are small and dividing cells are infrequent or unavailable.
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Affiliation(s)
- J Bayani
- Department of Pathology, Hospital for Sick Children, Toronto, Ontario, Canada
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