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Casulo C, Larson MC, Day JR, Habermann TM, Lossos IS, Wang Y, Nastoupil LJ, Strouse C, Chihara D, Martin P, Cohen JB, Kahl BS, Ruan J, Burack WR, Koff JL, Friedberg JW, Cerhan JR, Flowers C, Link BK, Maurer MJ. Therapy for patients with POD24 follicular lymphoma: Treatment patterns and outcomes from the Lymphoma Epidemiology of Outcomes (LEO) Consortium. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7573] [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
7573 Background: While most patients (pts) with follicular lymphoma (FL) usually have favorable outcomes, those with refractory disease after first-line anti-CD20 based immunochemotherapy (IC), or progression within 24 months of diagnosis (POD24) have higher risk of premature death. There are no standard approaches for treating this vulnerable group and studies testing novel agents are ongoing in this setting. We sought to investigate clinical practice treatment choices and efficacy for pts with POD24 that align with eligibility criteria for the randomized SWOG1608 which compares IC with novel agents in this population. Methods: This was a multicenter observational cohort study from the LEO Consortium. Eligible pts had grade 1-3a FL diagnosed between 1/1/2002 and 2/1/2019, and initiated therapy after POD24 to first-line bendamustine or CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) based IC. Observation, radiotherapy, or rituximab monotherapy were permitted prior to IC and pts with transformation prior to the subsequent therapy after IC were excluded as per S1608. Outcomes of interest were overall and complete response rate (ORR/CR), progression-free survival (PFS), and overall survival (OS). Results: We identified 196 eligible pts with early progression to IC (39% antiCD20 Benda; 61% antiCD20 CHOP) who received subsequent therapy. Median age at post IC treatment was 57 years, 78% grade 1-2 FL. Treatments for pts with POD24 included CHOP- or Benda-based in 31%, salvage/hematopoietic stem cell transplant (HSCT) in 27%, novel therapies in 10% (including phosphatidylinositol 3-kinase inhibitors), antiCD20 monotherapy in 9%, and lenalidomide-based treatment in 8% (table); 21% of pts were treated on clinical trials. Across all treatments, ORR (CR) was 63% (37%) (95% CI: 55-70). At a median follow up of 6.2 years, 2 year PFS was 22% (95% CI: 17%-29%) and 5 year OS was 71% (95% CI: 65-79). Outcomes by regimen are shown in the table. Conclusions: Pts with FL experiencing POD24 following first-line IC are treated heterogeneously, with many pts still receiving IC as subsequent therapy. Despite modest CR rates and low 2-year PFS, 5-year OS appear to be improving compared to historical outcomes. This supports the ongoing need to investigate novel treatments in this population. [Table: see text]
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Affiliation(s)
- Carla Casulo
- University of Rochester Medical Center-James P. Wilmot Cancer Center, Rochester, NY
| | | | | | | | - Izidore S. Lossos
- Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL
| | - Yucai Wang
- Mayo Clinic, Division of Hematology, Rochester, MN
| | | | | | - Dai Chihara
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Peter Martin
- Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY
| | | | - Brad S. Kahl
- University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Jia Ruan
- Weill Cornell Medicine and New York Presbyterian Hospital, New York, NY
| | | | - Jean Louise Koff
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | | | | | | | - Brian K. Link
- University of Iowa Hospitals and Clinics, Holden Comprehensive Cancer Center, Iowa City, IA
| | - Matthew J. Maurer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
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Lee HJ, Choi MY, Siddiqi T, Rhodes JM, Wierda WG, Isufi I, Tuscano JM, Lamanna N, Subbiah S, Koff JL, Leslie LA, Goldenberg A, Chung GG, Yazji S, Wang Y, Breitmeyer JB, Wang M, Jamieson C, Kipps TJ. Phase 1/2 study of zilovertamab and ibrutinib in mantle cell lymphoma (MCL) or chronic lymphocytic leukemia (CLL). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7520] [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
7520 Background: Zilovertamab (Zilo) is a humanized monoclonal antibody that inhibits the tumor promoting activity of ROR1 and has demonstrated additive/synergistic activity with many anti-cancer agents, including ibrutinib (Ibr). Methods: Patients (Pts) with relapsed or refractory (RR) MCL or treatment-naïve (TN) or RR CLL were enrolled. In Part 1 (Dose Escalation), multiple doses were examined. Zilo 600 mg IV starting q2wks x3 then q4wks + Ibr qD was selected as the recommended dosing regimen for use in Part 2 (Expansion) and Part 3 (CLL only, Zilo+Ibr vs. Ibr alone). Results: As of 18Jan2022 data cutoff, 26 evaluable RR MCL pts, including pts who received prior Ibr (5) or auto-SCT (7), and 34 evaluable CLL pts (12 TN and 22 RR) were enrolled into Parts 1&2. In Part 3, 22 evaluable pts were randomized (2:1) to receive either Zilo+Ibr (15) or Ibr (7). Safety: Treatment-emergent adverse events (TEAEs) (≥30%, N = 84), regardless of relationship, included fatigue (41.7%), contusion (39.3%), and diarrhea (38.1%). Most common (≥5%) Grade ≥3 TEAEs included hypertension (10.7%), pneumonia (7.1%), atrial fibrillation, fatigue, and neutropenia (all 6.0%). Grade ≥3 neutrophil decrease observed in 9.4% or 17.6%, platelet decrease in 12.5% or 2.9%, or hemoglobin decrease in 9.4% or 0% of pts with MCL or CLL, respectively in Parts 1&2. Investigators scored TEAEs as due to Ibr in 78.1% or 85.3%, or to Zilo in 15.6% or 23.5% of pts with MCL or CLL, respectively. Efficacy (MCL): Objective response rate (ORR) was 80.8% (34.6% CR, 46.2% PR). ORR for pts with prior Ibr was 80% (2CR, 2PR) and median duration of response (mDOR) was 13.7 months (M) (95%CI: 11.93, NE). ORR was 100% in pts who had prior SCT+/- CAR-T (5CR, 2PR), and mDOR was 34.1 M (95% CI 13.84, NE). Overall median PFS (mPFS) was 35.9 M (95% CI: 17.3, NE) at median follow-up of 15.0 M. For MCL pts with TP 53 aberrancy (6), Ki67 > 30% (13), ≥ 3 prior lines of therapies (4), blastoid histology (3), bulky disease ≥5 cm (4), intermediate MIPIb (6), or high MIPIb (11), the mPFS (in M) was 17.3 (95% CI: 2.85, NE), Not Reached (NR) (95% CI: 2.85, NE), 35.9 (95% CI: 16.52, NE), NR (min 9.18, max 27.87), 26.6 (95% CI: 0.03, NE), 35.9 (min 8.30, max 35.9) or 16.5 (95% CI: 2.72, NE). Efficacy (CLL): In Parts 1&2 ORR was 91.2% (8.8% CR, 82.3% PR/PR-L), and 8.8% had stable disease (SD). At median follow-up of 31.4 M, mDOR was 33.5 M and mPFS was NR (95% CI: 36.3, NE); the mPFS (in M) for pts with 1, 2, or ≥ 3 prior therapies was NR (min 19.3, max 41.3), NR (min 31.3, max 36.8) or 36.3 (95% CI: 15.7, NE). At median follow-up of 21.1 M in Part 3, mPFS was NR for TN or RR in both Zilo+Ibr and Ibr arms. Conclusions: Zilo+Ibr is well-tolerated. Striking responses were observed in MCL pts, with mPFS of 35.9 M (95% CI: 17.3, NE) and CR of 34.6%, which compares favorably to mPFS of 12.8 M (95% CI 8.5, 16.6) and CR of 20% reported for single agent Ibr (Rule 2017). For CLL, ORR and PFS compare very favorably to Ibr monotherapy data (Byrd 2019). Clinical trial information: NCT03088878.
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Affiliation(s)
- Hun Ju Lee
- The University of Texas MD Anderson Cancer Center, Department of Lymphoma/Myeloma, Houston, TX
| | - Michael Y. Choi
- Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Tanya Siddiqi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Joanna Meehan Rhodes
- Karches Center for Oncology Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY
| | | | - Iris Isufi
- Division of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT
| | | | - Nicole Lamanna
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | | | | | - Lori Ann Leslie
- Lymphoma Research Division, John Theurer Cancer Center, Hackensack, NJ
| | | | - Gina G. Chung
- The Christ Hospital, Lindner Center for Research and Education, Cincinnati, OH
| | | | - Yao Wang
- Oncternal Therapeutics, Inc., San Diego, CA
| | | | - Michael Wang
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Catriona Jamieson
- Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Thomas J. Kipps
- Moores Cancer Center, University of California San Diego, La Jolla, CA
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Lee HJ, Choi MY, Siddiqi T, Barrientos JC, Wierda WG, Isufi I, Tuscano JM, Lamanna N, Subbiah S, Koff JL, Leslie LA, Goldenberg A, Chung GG, Breitmeyer JB, Hsu FJ, Wang M, Jamieson C, Kipps TJ. Phase 1/2 study of cirmtuzumab and ibrutinib in mantle cell lymphoma (MCL) or chronic lymphocytic leukemia (CLL). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7556] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7556 Background: Cirmtuzumab (Cirm) is a humanized monoclonal antibody that inhibits the tumor promoting activity of ROR1 and had demonstrated additive/synergistic activity with many anti-cancer agents including ibrutinib (Ibr). Methods: Patients (Pts) with relapsed or refractory (RR) MCL or treatment naïve (TN) or RR CLL were enrolled. In Part 1 (Dose Escalation), doses of Cirm IV q2wks x5 then q4wks of 2-16 mg/kg and 300 or 600 mg were examined. Safety of Cirm alone was assessed during the first 28 days, then Ibr was started at approved doses for each indication. Cirm 600 mg IV q2wks x3 then q4wks in combination with Ibr starting day 0 was chosen as the recommended dosing regimen for use in Part 2 (Expansion) and Part 3 (CLL only, Cirm/Ibr vs. Ibr alone). Results: Twelve evaluable MCL pts were enrolled into Part 1, and 5 into Part 2. Median number of prior regimens was 2 (1-5), including pts relapsing after Ibr (4), auto-SCT (3), auto-SCT/ allo-SCT (1), auto-SCT/CAR-T (1). In CLL, 34 evaluable pts (12 TN and 22 RR) enrolled into Part 1 (18) or Part 2 (16). At least 74% of CLL pts in Parts 1 and 2 were high risk as determined by unmutated IGHV, del17p, and/or del11q. In Part 3, 22 evaluable pts received Cirm/Ibr (15) or Ibr (7). As of the 30OCT2020 safety cut-off for MCL and CLL, common TEAEs (all grades) included diarrhea (41%), contusion (39%), fatigue (39%), URI (31%), hypertension (25%) arthralgia (23%). Grade ≥3 neutropenia was 13% and thrombocytopenia 1%. There were no Cirm dose reductions or discontinuations for toxicity. Overall, Cirm did not appear to negatively impact the safety of Ibr. Efficacy (MCL): As of the 02FEB2021 efficacy cutoff, the best response of 17 evaluable pts in Parts 1 and 2 included an objective response rate (ORR) of 82%, 41% CR/CMR, 41% PR, 12% SD, and 6% PD. CR/CMR remain durable from 8-28+ mos. Most responses occurred rapidly after ̃3 mos of Cirm/Ibr. Notably, responses were achieved in all pts who received prior SCT+/- CAR-T (4CR, 1PR) or prior Ibr (2CR, 2PR). At a median follow-up of 14.6 mos, the median PFS (mPFS) had not been reached (NR) (95% CI: 17.5, NA). Efficacy (CLL): The best response of 34 evaluable pts in Parts 1 and 2 included 91% ORR, 3% CR, 88% PR/PR-L, 9% SD, 0% PD. In Part 3, both arms achieved 100% ORR (all PRs). At a median follow-up of 20.2 mos, the mPFS was NR (95% CI: NA, NA), and the PFS estimate at 24 months was 95% for R/R, and 87% for TN, respectively, for evaluable CLL pts receiving Cirm/Ibr. Conclusions: Cirm/Ibr is a well-tolerated, active regimen in both MCL and CLL. For MCL, the mPFS of NR (95% CI: 17.5, NA) and CRR (41%), with all CRs remaining without PD, compare favorably to mPFS of 12.8 mos (95% CI 8.5-16.6) and CRR (20%) reported for single agent Ibr (Rule 2017). For CLL, the high ORR and PFS are encouraging, particularly for RR CLL. The study is ongoing, with MCL enrollment expanded to study Cirm + Ibr in pts who have had a suboptimal response to an Ibr regimen, or who have failed other approved BTKi agents. Clinical trial information: NCT03088878.
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Affiliation(s)
- Hun Ju Lee
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael Y. Choi
- Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Tanya Siddiqi
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | | | | | - Iris Isufi
- Hematology, Yale University School of Medicine, New Haven, CT
| | | | - Nicole Lamanna
- Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
| | | | | | - Lori Ann Leslie
- Lymphoma Research Division, John Theurer Cancer Center, Hackensack, NJ
| | | | - Gina G. Chung
- The Christ Hospital, Lindner Center for Research and Education, Cincinnati, OH
| | | | | | - Michael Wang
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Catriona Jamieson
- Moores Cancer Center, University of California San Diego, La Jolla, CA
| | - Thomas J. Kipps
- Moores Cancer Center, University of California San Diego, La Jolla, CA
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Merdan S, Subramanian K, Ayer T, Koff JL, Chang A, Weyenbergh JV, Flowers C. Machine learning prediction of survival in diffuse large B-cell lymphoma based on gene-expression profiling. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8047] [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
8047 Background: The current clinical risk stratification of Diffuse Large B-cell Lymphoma (DLBCL) relies on the International Prognostic Index (IPI) comprising a limited number of clinical variables but is imperfect in the identification of high-risk disease. Our study aimed to: (1) develop a risk prediction model based on the genetic and clinical features; and (2) evaluate the model’s biological implications in association with the estimated profiles of immune infiltration. Methods: Gene-expression profiling was performed on 718 patients with DLBCL for which RNA sequencing data and clinical covariates were available by Reddy et al (2017). Unsupervised and supervised machine learning methods were used to discover and identify the best set of survival-associated gene signatures for prediction. A multivariate model of survival from these signatures was constructed in the training set and validated in an independent test set. The compositions of the tumor-infiltrating immune cells were enumerated using CIBERSORT for deconvolution analysis. Results: A four gene-signature-based score was developed that separated patients into high- and low-risk groups with a significant difference in survival in the training, validation and complete cohorts (p < 0.001), independently of the IPI. The combination of the gene-expression-based score with the IPI improved the discrimination on the validation and complete sets. The area-under-the-curve at 2 and 5 years increased from 0.71 and 0.69 to 0.75 and 0.74 in the validation set, respectively. Conclusions: By analyzing the gene-expression data with a systematic approach, we developed and validated a risk prediction model that outperforms existing risk assessment methods. Our study, which integrated the profiles of immune infiltration with prognostic prediction, unraveled important associations that have the potential to identify patients who could benefit from the various therapeutic interventions, as well as highlighting possible targets for new drugs.
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Affiliation(s)
| | - Kritika Subramanian
- Department of Internal Medicine Icahn School of Medicine at Mount Sinai, New York, NY
| | - Turgay Ayer
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA
| | - Jean Louise Koff
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | - Andres Chang
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
| | - Johan Van Weyenbergh
- Department of Clinical and Epidemiological Virology, Rega Institute for Medical Research, Leuven, Belgium
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Jagadeesh D, Tsai DE, Wei W, Alvarez Bustamante J, Wagner-Johnston ND, Berg S, Kim SH, Reddy NM, Sriram D, Portell C, Ghione P, Voorhees T, Kamdar MK, Koff JL, Dharnidharka V, Evens AM. Post-transplant lymphoproliferative disorder (PTLD) after solid organ transplant (SOT): A multicenter real world analysis (RWA) of 877 patients (pts) treated in the modern era. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e20026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20026 Background: Historically, SOT PTLD have modest outcomes in part due to heterogeneous treatment approaches. Additionally, there remains an absence of a large data repository in PTLD to help delineate contemporary pt outcomes & prognostic factors. We conducted a large, multicenter RWA to study outcomes & prognostication of SOT PTLD in the modern era. Methods: Retrospective data on 877 untreated SOT PTLD pts ages ≥18 years (yrs) (2000-2018) were analyzed from 15 academic centers. Prognostic factors for relapse free survival (RFS) & overall survival (OS) were assessed by Cox model. Results: The median age at diagnosis was 54 yrs (range 18-84). The majority of pts were white (78%) & male (67%). Median time from SOT to PTLD diagnosis was 57 months (range 0.23-470). SOT types: kidney (41%) liver (19%), lung (16%), and heart (11%); 11% multi-organ. Tumor was EBV+ in 52%. Graft involvement (18%) and rejection (21%) were seen in a proportion of pts. Most pts had reduction in immunosuppression (79%) and rituximab (R)-containing regimen (61%) as part of 1st line therapy (Tx). Most common Tx: R monotherapy (34%), R+chemotherapy (29%) & chemotherapy without R (8%). Maintenance R use was infrequent (6%). Overall response rate was 63% [51% complete response (CR) and 12% partial response (PR)] and 19% of pts had primary refractory disease. With 44-month median follow-up (0.1-304), 62% of pts were alive. Median OS & RFS for all pts were 12 & 9 yrs, respectively, while differential survival rates were identified for several pt subsets (Table). On univariate analysis, lung SOT was associated with borderline RFS (HR 0.68 [95% CI 0.44-1.03], P= 0.07) and inferior OS (HR 0.67 [95% CI 0.49-0.91], P= 0.012), while EBV negative PTLD was associated with poorer RFS (HR 1.51 [95% CI 1.12-2.04, P= 0.006). In addition, achievement of PR to 1st line Tx vs CR was strongly prognostic for inferior RFS (HR 2.58 [95% CI 1.88-3.54], P< .0001) and OS (HR 2.30 [95% CI 1.60-3.29], P< .0001). Conclusions: In this large, multicenter PTLD RWA, type of SOT was strongly associated with long-term RFS and OS and EBV status predicted RFS. Furthermore, depth of response to 1st line Tx was a critical determinant for long-term pt survival. [Table: see text]
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Affiliation(s)
- Deepa Jagadeesh
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | | | - Wei Wei
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | | | - Nina D. Wagner-Johnston
- Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | | | | | | | | | | | - Paola Ghione
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Jean Louise Koff
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA
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Ip A, Switchenko JM, Graiser M, Koff JL, Gupta VA, Lechowicz MJ, Nooka AK, Kaufman JL, Lonial S, Waller EK, Langston AA, Al-Kadhimi ZS, Kota V, Blum WG, Klisovic RB, Blum KA, Hofmeister CC, Allen PB, Flowers C, Cohen JB. Impact of individual comorbidities on post-transplant outcomes for elderly patients with non-Hodgkin lymphoma (NHL). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e19509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Andrew Ip
- Emory University, Winship Cancer Institute, Atlanta, GA
| | - Jeffrey M. Switchenko
- Emory University, Winship Cancer Institute, Department of Biostatistics and Bioinformatics, Atlanta, GA
| | | | | | | | | | - Ajay K. Nooka
- Emory University, Winship Cancer Institute, Atlanta, GA
| | | | - Sagar Lonial
- Emory University, Winship Cancer Institute, Atlanta, GA
| | | | | | | | - Vamsi Kota
- Emory University, Winship Cancer Institute, Atlanta, GA
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Shah N, Liu Y, Xi Y, Flowers C, Koff JL, Behera M, Cohen JB. Racial and socioeconomic disparities in mantle cell lymphoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Nikesh Shah
- Emory University School of Medicine, Atlanta, GA, US
| | - Yuan Liu
- Emory University Winship Cancer Institute, Atlanta, GA
| | - Yizhao Xi
- Emory University Rollins School of Public Health, Atlanta, GA
| | | | | | - Madhusmita Behera
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA
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Calzada O, Xi Y, Behera M, Koff JL, Flowers C, Liu Y, Cohen JB. Outcomes in non-Hodgkin lymphoma by Latino country-of-origin (COO). J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Oscar Calzada
- Department of Medicine - Emory University, Atlanta, GA
| | - Yizhao Xi
- Emory University Rollins School of Public Health, Atlanta, GA
| | - Madhusmita Behera
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA
| | | | | | - Yuan Liu
- Emory University Winship Cancer Institute, Atlanta, GA
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Guo X, Koff JL, Moffitt AB, Cinar M, Ramachandiran S, Chen Z, Switchenko JM, Mosunjac M, Neill SG, Mann KP, Bagirov M, Du Y, Natkunam Y, Khoury HJ, Rossi MR, Harris W, Flowers CR, Lossos IS, Boise LH, Dave SS, Kowalski J, Bernal-Mizrachi L. Molecular impact of selective NFKB1 and NFKB2 signaling on DLBCL phenotype. Oncogene 2017; 36:4224-4232. [PMID: 28368397 DOI: 10.1038/onc.2017.90] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 02/15/2017] [Accepted: 02/26/2017] [Indexed: 12/15/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) has been categorized into two molecular subtypes that have prognostic significance, namely germinal center B-cell like (GCB) and activated B-cell like (ABC). Although ABC-DLBCL has been associated with NF-κB activation, the relationships between activation of specific NF-κB signals and DLBCL phenotype remain unclear. Application of novel gene expression classifiers identified two new DLBCL categories characterized by selective p100 (NF-κB2) and p105 (NF-κB1) signaling. Interestingly, our molecular studies showed that p105 signaling is predominantly associated with GCB subtype and histone mutations. Conversely, most tumors with p100 signaling displayed ABC phenotype and harbored ABC-associated mutations in genes such as MYD88 and PIM1. In vitro, MYD88 L265P mutation promoted p100 signaling through TAK1/IKKα and GSK3/Fbxw7a pathways, suggesting a novel role for this protein as an upstream regulator of p100. p100 signaling was engaged during activation of normal B cells, suggesting p100's role in ABC phenotype development. Additionally, silencing p100 in ABC-DLBCL cells resulted in a GCB-like phenotype, with suppression of Blimp, IRF4 and XBP1 and upregulation of BCL6, whereas introduction of p52 or p100 into GC cells resulted in differentiation toward an ABC-like phenotype. Together, these findings identify specific roles for p100 and p105 signaling in defining DLBCL molecular subtypes and posit MYD88/p100 signaling as a regulator for B-cell activation.
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Affiliation(s)
- X Guo
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - J L Koff
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - A B Moffitt
- Duke Institute for Genome Sciences and Policy, Department of Medicine, Duke University, Durham, NC, USA
| | - M Cinar
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - S Ramachandiran
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Z Chen
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - J M Switchenko
- Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - M Mosunjac
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - S G Neill
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - K P Mann
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - M Bagirov
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Y Du
- Department of Pharmacology, Emory University, Atlanta, GA, USA
| | - Y Natkunam
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - H J Khoury
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - M R Rossi
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - W Harris
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - C R Flowers
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - I S Lossos
- Division of Hematology Oncology and Molecular and Cellular Pharmacology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - L H Boise
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - S S Dave
- Duke Institute for Genome Sciences and Policy, Department of Medicine, Duke University, Durham, NC, USA
| | - J Kowalski
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.,Department of Biostatistics and Bioinformatics, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - L Bernal-Mizrachi
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
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Singer JP, Blanc PD, Hoopes C, Golden JA, Koff JL, Leard LE, Cheng S, Chen H. The impact of pretransplant mechanical ventilation on short- and long-term survival after lung transplantation. Am J Transplant 2011; 11:2197-204. [PMID: 21831157 PMCID: PMC4249721 DOI: 10.1111/j.1600-6143.2011.03684.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Lung transplantation in mechanically ventilated (MV) patients has been associated with decreased posttransplant survival. Under the Lung Allocation Score (LAS) system, patients at greatest risk of death on the waiting list, particularly those requiring MV, are prioritized for lung allocation. We evaluated whether pretransplant MV is associated with poorer posttransplant survival in the LAS era. Using a national registry, we analyzed all adults undergoing lung transplantation in the United States from 2005 to 2010. Propensity scoring identified nonventilated matched referents for 419 subjects requiring MV at the time of transplantation. Survival was evaluated using Kaplan-Meier methods. Risk of death was estimated by hazard ratios employing time-dependent covariates. We found that pretransplant MV was associated with decreased overall survival after lung transplantation. In the first 6 months posttransplant, ventilated subjects had a twofold higher risk of death compared to nonventilated subjects. However, after 6 months posttransplant, survival did not differ by MV status. We also found that pretransplant MV was not associated with decreased survival in noncystic fibrosis obstructive lung diseases. These results suggest that under the LAS, pretransplant MV is associated with poorer short-term survival posttransplant. Notably, the increased risk of death appears to be strongest the early posttransplant period and limited to certain pretransplant diagnoses.
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Affiliation(s)
- JP Singer
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of California, San Francisco, USA,Cardiovascular Research Institute, University of California, San Francisco, USA
| | - PD Blanc
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of California, San Francisco, USA,Cardiovascular Research Institute, University of California, San Francisco, USA,Division of Occupation and Environmental Medicine, Department of Medicine, University of California, San Francisco, USA
| | - C Hoopes
- Division of Cardiothoracic Surgery, Department of Surgery, University of California, San Francisco, USA
| | - JA Golden
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of California, San Francisco, USA
| | - JL Koff
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of California, San Francisco, USA,Cardiovascular Research Institute, University of California, San Francisco, USA
| | - LE Leard
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of California, San Francisco, USA
| | - S Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | - H Chen
- Division of Pulmonary, Critical Care, Allergy and Sleep, Department of Medicine, University of California, San Francisco, USA,Cardiovascular Research Institute, University of California, San Francisco, USA
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