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DiPeri TP, Evans KW, Wang B, Zhao M, Akcakanat A, Raso MG, Rizvi YQ, Zheng X, Korkut A, Varadarajan K, Uzunparmak B, Dumbrava EE, Pant S, Ajani JA, Pohlmann PR, Jensen VB, Javle M, Rodon J, Meric-Bernstam F. Co-clinical Trial of Novel Bispecific Anti-HER2 Antibody Zanidatamab in Patient-Derived Xenografts. Cancer Discov 2024; 14:828-845. [PMID: 38358339 PMCID: PMC11064988 DOI: 10.1158/2159-8290.cd-23-0838] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/20/2023] [Accepted: 02/09/2024] [Indexed: 02/16/2024]
Abstract
Zanidatamab is a bispecific human epidermal growth factor receptor 2 (HER2)-targeted antibody that has demonstrated antitumor activity in a broad range of HER2-amplified/expressing solid tumors. We determined the antitumor activity of zanidatamab in patient-derived xenograft (PDX) models developed from pretreatment or postprogression biopsies on the first-in-human zanidatamab phase I study (NCT02892123). Of 36 tumors implanted, 19 PDX models were established (52.7% take rate) from 17 patients. Established PDXs represented a broad range of HER2-expressing cancers, and in vivo testing demonstrated an association between antitumor activity in PDXs and matched patients in 7 of 8 co-clinical models tested. We also identified amplification of MET as a potential mechanism of acquired resistance to zanidatamab and demonstrated that MET inhibitors have single-agent activity and can enhance zanidatamab activity in vitro and in vivo. These findings provide evidence that PDXs can be developed from pretreatment biopsies in clinical trials and may provide insight into mechanisms of resistance. SIGNIFICANCE We demonstrate that PDXs can be developed from pretreatment and postprogression biopsies in clinical trials and may represent a powerful preclinical tool. We identified amplification of MET as a potential mechanism of acquired resistance to the HER2 inhibitor zanidatamab and MET inhibitors alone and in combination as a therapeutic strategy. This article is featured in Selected Articles from This Issue, p. 695.
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Affiliation(s)
- Timothy P. DiPeri
- Department of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas
| | - Kurt W. Evans
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Bailiang Wang
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Ming Zhao
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Argun Akcakanat
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Maria Gabriela Raso
- Department of Translational Molecular Pathology, UT MD Anderson Cancer Center, Houston, Texas
| | - Yasmeen Q. Rizvi
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Xiaofeng Zheng
- Department of Bioinformatics and Computational Biology, UT MD Anderson Cancer Center, Houston, Texas
| | - Anil Korkut
- Department of Bioinformatics and Computational Biology, UT MD Anderson Cancer Center, Houston, Texas
| | - Kaushik Varadarajan
- Department of Surgical Oncology, UT MD Anderson Cancer Center, Houston, Texas
| | - Burak Uzunparmak
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Ecaterina E. Dumbrava
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Shubham Pant
- Department of Gastrointestinal Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas
| | - Jaffer A. Ajani
- Department of Gastrointestinal Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas
| | - Paula R. Pohlmann
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
- Department of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas
| | - V. Behrana Jensen
- Department of Veterinary Medicine and Surgery, UT MD Anderson Cancer Center, Houston, Texas
| | - Milind Javle
- Department of Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, Texas
| | - Jordi Rodon
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, UT MD Anderson Cancer Center, Houston, Texas
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Meric-Bernstam F, Lloyd MW, Koc S, Evrard YA, McShane LM, Lewis MT, Evans KW, Li D, Rubinstein LV, Welm AL, Dean DA, Srivastava A, Grover JW, Ha MJ, Chen H, Huang X, Varadarajan K, Wang J, Roth JA, Welm BE, Govindan R, Ding L, Kaochar S, Mitsiades N, Carvajal-Carmona LG, Herlyn M, Davies MA, Shapiro GI, Fields RC, Trevino JG, Harrell JC, Doroshow JH, Chuang JH, Moscow JA. Assessment of Patient-Derived Xenograft Growth and Antitumor Activity: The NCI PDXNet Consensus Recommendations. Mol Cancer Ther 2024:743155. [PMID: 38641411 DOI: 10.1158/1535-7163.mct-23-0471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/08/2023] [Accepted: 03/29/2024] [Indexed: 04/21/2024]
Abstract
Although patient-derived xenografts (PDXs) are commonly used for preclinical modeling in cancer research, a standard approach to in vivo tumor growth analysis and assessment of antitumor activity is lacking, complicating comparison of different studies and determination of whether a PDX experiment has produced evidence needed to consider a new therapy promising. We present consensus recommendations for assessment of PDX growth and antitumor activity, providing public access to a suite of tools for in vivo growth analyses. We expect that harmonizing PDX study design and analysis and access to a suite of analytical tools will enhance information exchange and facilitate identification of promising novel therapies and biomarkers for guiding cancer therapy.
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Affiliation(s)
| | | | - Soner Koc
- Seven Bridges Genomics (United States), United States
| | - Yvonne A Evrard
- Frederick National Laboratory for Cancer Research, Frederick, MD, United States
| | | | | | - Kurt W Evans
- The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Dali Li
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Lawrence V Rubinstein
- National Institutes of Health, National Cancer Institute, Bethesda, MD, United States
| | - Alana L Welm
- University of Utah, Salt Lake City, UT, United States
| | - Dennis A Dean
- Seven Bridges Genomics (United States), Charlestown, MA, United States
| | - Anuj Srivastava
- The Jackson Lab for Genomic Medicine, Farmington, CT, United States
| | | | - Min Jin Ha
- Graduate School of Public Health, Yonsei University, Seoul, Seodaemun-gu, Korea (South), Republic of
| | - Huiqin Chen
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Xuelin Huang
- The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Kaushik Varadarajan
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jing Wang
- The University of Texas MD Anderson Cancer Center, ´Houston, TX, United States
| | - Jack A Roth
- The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
| | - Bryan E Welm
- University of Utah, Salt Lake City, UT, United States
| | - Ramaswamy Govindan
- Washington University in St. Louis School of Medicine, St Louis, MO, United States
| | - Li Ding
- Washington University School of Medicine in St. Louis, St Louis, MO, United States
| | - Salma Kaochar
- Baylor College of Medicine, Houston, TX, United States
| | | | | | | | - Michael A Davies
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | - Ryan C Fields
- Washington University in St. Louis School of Medicine, St. Louis, MO, United States
| | | | - J Chuck Harrell
- Virginia Commonwealth University, Richmond, VA, United States
| | | | - Jeffrey H Chuang
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, United States
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DiPeri TP, Zhao M, Evans KW, Varadarajan K, Moss T, Scott S, Kahle MP, Byrnes CC, Chen H, Lee SS, Halim AB, Hirai H, Wacheck V, Kwong LN, Rodon J, Javle M, Meric-Bernstam F. Convergent MAPK pathway alterations mediate acquired resistance to FGFR inhibitors in FGFR2 fusion-positive cholangiocarcinoma. J Hepatol 2024; 80:322-334. [PMID: 37972659 DOI: 10.1016/j.jhep.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/29/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND & AIMS There is a knowledge gap in understanding mechanisms of resistance to fibroblast growth factor receptor (FGFR) inhibitors (FGFRi) and a need for novel therapeutic strategies to overcome it. We investigated mechanisms of acquired resistance to FGFRi in patients with FGFR2-fusion-positive cholangiocarcinoma (CCA). METHODS A retrospective analysis of patients who received FGFRi therapy and underwent tumor and/or cell-free DNA analysis, before and after treatment, was performed. Longitudinal circulating tumor DNA samples from a cohort of patients in the phase I trial of futibatinib (NCT02052778) were assessed. FGFR2-BICC1 fusion cell lines were developed and secondary acquired resistance mutations in the mitogen-activated protein kinase (MAPK) pathway were introduced to assess their effect on sensitivity to FGFRi in vitro. RESULTS On retrospective analysis of 17 patients with repeat sequencing following FGFRi treatment, new FGFR2 mutations were detected in 11 (64.7%) and new alterations in MAPK pathway genes in nine (52.9%) patients, with seven (41.2%) patients developing new alterations in both the FGFR2 and MAPK pathways. In serially collected plasma samples, a patient treated with an irreversible FGFRi tested positive for previously undetected BRAF V600E, NRAS Q61K, NRAS G12C, NRAS G13D and KRAS G12K mutations upon progression. Introduction of a FGFR2-BICC1 fusion into biliary tract cells in vitro sensitized the cells to FGFRi, while concomitant KRAS G12D or BRAF V600E conferred resistance. MEK inhibition was synergistic with FGFRi in vitro. In an in vivo animal model, the combination had antitumor activity in FGFR2 fusions but was not able to overcome KRAS-mediated FGFRi resistance. CONCLUSIONS These findings suggest convergent genomic evolution in the MAPK pathway may be a potential mechanism of acquired resistance to FGFRi. CLINICAL TRIAL NUMBER NCT02052778. IMPACT AND IMPLICATIONS We evaluated tumors and plasma from patients who previously received inhibitors of fibroblast growth factor receptor (FGFR), an important receptor that plays a role in cancer cell growth, especially in tumors with abnormalities in this gene, such as FGFR fusions, where the FGFR gene is fused to another gene, leading to activation of cancer cell growth. We found that patients treated with FGFR inhibitors may develop mutations in other genes such as KRAS, and this can confer resistance to FGFR inhibitors. These findings have several implications for patients with FGFR2 fusion-positive tumors and provide mechanistic insight into emerging MAPK pathway alterations which may serve as a therapeutic vulnerability in the setting of acquired resistance to FGFRi.
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Affiliation(s)
- Timothy P DiPeri
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Ming Zhao
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Kurt W Evans
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Kaushik Varadarajan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Tyler Moss
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Stephen Scott
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Michael P Kahle
- Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Charnel C Byrnes
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Huiqin Chen
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Sunyoung S Lee
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | | | | | | | - Lawrence N Kwong
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston TX, United States; Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | - Jordi Rodon
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, United States
| | | | - Funda Meric-Bernstam
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, United States; Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, United States.
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DiPeri TP, Kong K, Varadarajan K, Karp DD, Ajani JA, Pant S, Press MF, Piha-Paul SA, Dumbrava EE, Meric-Bernstam F. Discordance of HER2 Expression and/or Amplification on Repeat Testing. Mol Cancer Ther 2023; 22:976-984. [PMID: 37339271 PMCID: PMC10751575 DOI: 10.1158/1535-7163.mct-22-0630] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/02/2022] [Revised: 02/21/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
We sought to assess discordance of HER2 status in patients with HER2-amplified/expressing solid tumors who underwent reevaluation of HER2 status. Patients with metastatic solid tumors and HER2 expression by IHC or amplification by FISH/next-generation sequencing on local testing underwent central HER2 IHC/FISH testing with either archival or fresh biopsies and were evaluated for discordance in HER2 status. 70 patients (12 cancer types) underwent central HER2 reevaluation, including 57 (81.4%) with a new biopsy. In 30 patients with HER2 3+ on local IHC, 21 (70.0%) were 3+, 5 (16.7%) were 2+, 2 (6.7%) were 1+, and 2 (6.7%) had 0 HER2 expression on central IHC. In 15 patients whose cancers were 2+ on local IHC, 2 (13.3%) were 3+, 5 (33.3%) were 2+, 7 (46.7%) were 1+, and 1 (6.7%) had 0 HER2 expression on central IHC. HER2 discordance was seen in 16 of 52 (30.8%) of patients with HER2 overexpression/amplification who underwent a new image-guided biopsy. Discordance was observed in 10 (33.3%) of 30 patients who received intervening HER2-targeted therapy and in 6 (23.8%) of 22 patients who did not. In the 8 patients who had central HER2 assessment from the same archival block used for local testing, none were discordant. Discordance of HER2 status is common in patients with tumors previously identified as HER2-expressing, especially in patients with HER2 2+ tumors. Repeat biomarker evaluation may have value when considering HER2-targeted therapies.
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Affiliation(s)
- Timothy P. DiPeri
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Kathleen Kong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Kaushik Varadarajan
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Daniel D. Karp
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Jaffer A. Ajani
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Shubham Pant
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Michael F. Press
- Department of Pathology and Norris Comprehensive Cancer Center, University of Southern California, Keck School of Medicine, Los Angeles CA, 90007
| | - Sarina A. Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Ecaterina E. Dumbrava
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
| | - Funda Meric-Bernstam
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston TX, 77030
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Bosnyák E, Kamson DO, Guastella AR, Varadarajan K, Robinette NL, Kupsky WJ, Muzik O, Michelhaugh SK, Mittal S, Juhász C. Molecular imaging correlates of tryptophan metabolism via the kynurenine pathway in human meningiomas. Neuro Oncol 2015; 17:1284-92. [PMID: 26092774 DOI: 10.1093/neuonc/nov098] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/06/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Increased tryptophan metabolism via the kynurenine pathway (KP) is a key mechanism of tumoral immune suppression in gliomas. However, details of tryptophan metabolism in meningiomas have not been elucidated. In this study, we evaluated in vivo tryptophan metabolism in meningiomas and compared it with gliomas using α-[(11)C]-methyl-L-tryptophan (AMT)-PET. We also explored expression patterns of KP enzymes in resected meningiomas. METHODS Forty-seven patients with MRI-detected meningioma (n = 16) and glioma (n = 31) underwent presurgical AMT-PET scanning. Tumoral AMT uptake and tracer kinetic parameters (including K and k3' evaluating unidirectional uptake and trapping, respectively) were measured, correlated with meningioma grade, and compared between meningiomas and gliomas. Patterns of KP enzyme expression were assessed by immunohistochemistry in all meningiomas. RESULTS Meningioma grade showed a positive correlation with AMT k3' tumor/cortex ratio (r = 0.75, P = .003), and this PET parameter distinguished grade I from grade II/III meningiomas with 92% accuracy. Kinetic AMT parameters could differentiate meningiomas from both low-grade gliomas (97% accuracy by k3' ratios) and high-grade gliomas (83% accuracy by K ratios). Among 3 initial KP enzymes (indoleamine 2,3-dioxygenase 1/2, and tryptophan 2,3-dioxygenase 2 [TDO2]), TDO2 showed the strongest immunostaining, particularly in grade I meningiomas. TDO2 also showed a strong negative correlation with AMT k3' ratios (P = .001). CONCLUSIONS PET imaging of tryptophan metabolism can provide quantitative imaging markers for differentiating grade I from grade II/III meningiomas. TDO2 may be an important driver of in vivo tryptophan metabolism in these tumors. These results can have implications for pharmacological targeting of the KP in meningiomas.
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Affiliation(s)
- Edit Bosnyák
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - David O Kamson
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Anthony R Guastella
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Kaushik Varadarajan
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Natasha L Robinette
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - William J Kupsky
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Otto Muzik
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Sharon K Michelhaugh
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Sandeep Mittal
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
| | - Csaba Juhász
- Department of Pediatrics, Wayne State University, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Department of Neurology, Wayne State University, Detroit, Michigan (C.J.); Department of Neurosurgery, Wayne State University, Detroit, Michigan (A.R.G., K.V., S.K.M., S.M.); Department of Oncology, Wayne State University, Detroit, Michigan (A.R.G., S.M.); Department of Radiology, Wayne State University, , Detroit, Michigan (N.L.R., O.M.); Department of Pathology, Wayne State University, Detroit, Michigan (W.J.K.); PET Center, Children's Hospital of Michigan, Detroit, Michigan (E.B., D.O.K., O.M., C.J.); Karmanos Cancer Institute, Detroit, Michigan (N.L.R., W.J.K., S.M., C.J.)
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Michelhaugh S, Guastella A, Varadarajan K, Polin L, Bollig-Fischer A, Sarkar F, Mittal S. PM-11 * DEVELOPMENT OF A HUMAN MENINGIOMA MOUSE XENOGRAFT MODEL WITH THE SPONTANEOUSLY IMMORTAL CELL LINE KCI-MENG1. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou268.11] [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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Kamson DO, Lee TJ, Varadarajan K, Robinette NL, Muzik O, Chakraborty PK, Snyder M, Barger GR, Mittal S, Juhász C. Clinical significance of tryptophan metabolism in the nontumoral hemisphere in patients with malignant glioma. J Nucl Med 2014; 55:1605-10. [PMID: 25189339 DOI: 10.2967/jnumed.114.141002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [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: 12/17/2022] Open
Abstract
UNLABELLED α-(11)C-methyl-L-tryptophan (AMT) PET allows evaluation of brain serotonin synthesis and can also track upregulation of the immunosuppressive kynurenine pathway in tumor tissue. Increased AMT uptake is a hallmark of World Health Organization grade III-IV gliomas. Our recent study also suggested decreased frontal cortical AMT uptake in glioma patients contralateral to the tumor. The clinical significance of extratumoral tryptophan metabolism has not been established. In the present study, we investigated clinical correlates of tryptophan metabolic abnormalities in the nontumoral hemisphere of glioma patients. METHODS Standardized AMT uptake values (SUVs) and the uptake rate constant of AMT (K [mL/g/min], a measure proportional to serotonin synthesis in nontumoral gray matter) were quantified in the frontal and temporal cortex and thalamus in the nontumoral hemisphere in 77 AMT PET scans of 66 patients (41 men, 25 women; mean age ± SD, 55 ± 15 y) with grade III-IV gliomas. These AMT values were determined before treatment in 35 and after treatment in 42 patients and were correlated with clinical variables and survival. RESULTS AMT uptake in the thalamus showed a moderate age-related increase before treatment (SUV, r = 0.39, P = 0.02) but decrease after treatment (K, r = -0.33, P = 0.057). Women had higher thalamic SUVs before treatment (P = 0.037) and higher thalamic (P = 0.013) and frontal cortical K values (P = 0.023) after treatment. In the posttreatment glioma group, high thalamic SUVs and high thalamocortical SUV ratios were associated with short survival in Cox regression analysis. The thalamocortical ratio remained strongly prognostic (P < 0.01) when clinical predictors, including age, glioma grade, and time since radiotherapy, were entered in the regression model. Long interval between radiotherapy and posttreatment AMT PET as well as high radiation dose affecting the thalamus were associated with lower contralateral thalamic or cortical AMT uptake values. CONCLUSION These observations provide evidence for altered tryptophan uptake in contralateral cortical and thalamic brain regions in glioma patients after initial therapy, suggesting treatment effects on the serotonergic system. Low thalamic tryptophan uptake appears to be a strong, independent predictor of long survival in patients with previous glioma treatment.
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Affiliation(s)
- David O Kamson
- PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan Department of Pediatrics, Wayne State University, Detroit, Michigan
| | - Tiffany J Lee
- PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan
| | - Kaushik Varadarajan
- PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan
| | - Natasha L Robinette
- Department of Radiology, Wayne State University, Detroit, Michigan Karmanos Cancer Institute, Detroit, Michigan
| | - Otto Muzik
- PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan Department of Pediatrics, Wayne State University, Detroit, Michigan Department of Radiology, Wayne State University, Detroit, Michigan Department of Neurology, Wayne State University, Detroit, Michigan
| | - Pulak K Chakraborty
- PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan Department of Radiology, Wayne State University, Detroit, Michigan
| | | | - Geoffrey R Barger
- Karmanos Cancer Institute, Detroit, Michigan Department of Neurology, Wayne State University, Detroit, Michigan
| | - Sandeep Mittal
- Karmanos Cancer Institute, Detroit, Michigan Department of Neurosurgery, Wayne State University, Detroit, Michigan; and Department of Oncology, Wayne State University, Detroit, Michigan
| | - Csaba Juhász
- PET Center and Translational Imaging Laboratory, Children's Hospital of Michigan, Detroit, Michigan Department of Pediatrics, Wayne State University, Detroit, Michigan Karmanos Cancer Institute, Detroit, Michigan Department of Neurology, Wayne State University, Detroit, Michigan
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