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Vo NTP, Nam TU, Jeong MW, Kim JS, Jung KH, Lee Y, Ma G, Gu X, Tok JBH, Lee TI, Bao Z, Oh JY. Autonomous self-healing supramolecular polymer transistors for skin electronics. Nat Commun 2024; 15:3433. [PMID: 38653966 DOI: 10.1038/s41467-024-47718-2] [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: 12/05/2023] [Accepted: 04/10/2024] [Indexed: 04/25/2024] Open
Abstract
Skin-like field-effect transistors are key elements of bio-integrated devices for future user-interactive electronic-skin applications. Despite recent rapid developments in skin-like stretchable transistors, imparting self-healing ability while maintaining necessary electrical performance to these transistors remains a challenge. Herein, we describe a stretchable polymer transistor capable of autonomous self-healing. The active material consists of a blend of an electrically insulating supramolecular polymer with either semiconducting polymers or vapor-deposited metal nanoclusters. A key feature is to employ the same supramolecular self-healing polymer matrix for all active layers, i.e., conductor/semiconductor/dielectric layers, in the skin-like transistor. This provides adhesion and intimate contact between layers, which facilitates effective charge injection and transport under strain after self-healing. Finally, we fabricate skin-like self-healing circuits, including NAND and NOR gates and inverters, both of which are critical components of arithmetic logic units. This work greatly advances practical self-healing skin electronics.
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Affiliation(s)
- Ngoc Thanh Phuong Vo
- Department of Chemical Engineering (Integrated Engineering Program), Kyung Hee University, Yongin, Gyeonggi, 17104, Korea
| | - Tae Uk Nam
- Department of Chemical Engineering (Integrated Engineering Program), Kyung Hee University, Yongin, Gyeonggi, 17104, Korea
| | - Min Woo Jeong
- Department of Chemical Engineering (Integrated Engineering Program), Kyung Hee University, Yongin, Gyeonggi, 17104, Korea
| | - Jun Su Kim
- Department of Chemical Engineering (Integrated Engineering Program), Kyung Hee University, Yongin, Gyeonggi, 17104, Korea
| | - Kyu Ho Jung
- Department of Chemical Engineering (Integrated Engineering Program), Kyung Hee University, Yongin, Gyeonggi, 17104, Korea
| | - Yeongjun Lee
- Department of Chemical Engineering, Stanford University, Stanford, CA, 94305-5025, USA
- Department of Brain and Cognitive Sciences, KAIST, Daejeon, 34141, Korea
| | - Guorong Ma
- School of Polymer Science and Engineering, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Xiaodan Gu
- School of Polymer Science and Engineering, University of Southern Mississippi, Hattiesburg, MS, 39406, USA
| | - Jeffrey B-H Tok
- Department of Chemical Engineering, Stanford University, Stanford, CA, 94305-5025, USA
| | - Tae Il Lee
- Department of Materials Science and Engineering, Gachon University, Seong-nam, Gyeonggi, 13120, Korea.
| | - Zhenan Bao
- Department of Chemical Engineering, Stanford University, Stanford, CA, 94305-5025, USA.
| | - Jin Young Oh
- Department of Chemical Engineering (Integrated Engineering Program), Kyung Hee University, Yongin, Gyeonggi, 17104, Korea.
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Jung KH, Kim HJ, Park W, Lim MJ, Kang T, Kang MJ, Kim KB, Ahn HS. Incidence, survival, and risk of cardiovascular events in adult inflammatory myopathies in South Korea: a nationwide population-based study. Scand J Rheumatol 2020; 49:323-331. [PMID: 32286141 DOI: 10.1080/03009742.2019.1707281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Epidemiological studies on inflammatory myopathies (IMs) show widely variable results, and studies on Asians are lacking. Despite emerging interest in the cardiovascular disease (CVD) risk associated with IMs, the prevalence of CVD in IM patients and its impact on mortality remain unclear. We conducted a nationwide, population-based study on the incidence, mortality, and associated major CVD events of IMs in the Republic of Korea over 11 years. METHOD Using the nationwide, population-based National Health Insurance claims database and the Rare Intractable Disease registration programme, we estimated incidence, mortality, and CVD occurrence. Survival was examined using the Kaplan-Meier method. Mortality rate in IMs with CVD was analysed by Cox proportional hazards regression. RESULTS There were 3014 incident cases, 640 of whom died during the study period. The mean annual incidence was 7.16/106. Dermatomyositis (DM) and polymyositis (PM) had 5 year survival rates of 76.8% and 79.3%, respectively. Cardiovascular events occurred in 155 patients and 40.6% of IM patients with CVD died. Acute myocardial infarction in men had the highest risk of any CVD event in both DM [standardized incidence ratio (SIR) 4.2, 95% confidence interval (95% CI) 2.4-7.2] and PM (SIR 3.5, 95% CI 1.8-7.0). Haemorrhagic stroke had the highest hazard ratio (HR) in both DM (HR 2.31, 95% CI 1.13-4.70) and PM patients (HR 2.10, 95% CI 1.03-4.27) compared with the general population with CVD. CONCLUSION We found persistently low incidence, poor survival, and high major CVD incidence in IMs, and increased mortality in IMs with CVD.
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Affiliation(s)
- K H Jung
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University , Incheon, Republic of Korea
| | - H J Kim
- Department of Preventive Medicine, College of Medicine, Korea University , Seoul, Republic of Korea
| | - W Park
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University , Incheon, Republic of Korea
| | - M J Lim
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inha University , Incheon, Republic of Korea
| | - T Kang
- Health Insurance Policy Research Institute, National Health Institute Service , Wonju, Republic of Korea
| | - M J Kang
- Department of Public Health, Graduate School, Korea University , Seoul, Republic of Korea
| | - K-B Kim
- Department of Public Health, Graduate School, Korea University , Seoul, Republic of Korea
| | - H S Ahn
- Department of Preventive Medicine, College of Medicine, Korea University , Seoul, Republic of Korea
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Park JH, Jung KH, Vithayathil S, Jia D, Kaipparettu BA. Abstract P2-02-11: Combinational treatment of biguanides and fatty acid β-oxidation inhibitor in triple-negative breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-02-11] [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
Among breast cancers (BCs), the driver pathways and therapeutic targets are still poorly understood for triple negative (TN) BCs. Advances in cancer metabolism research over the last decade have enhanced our understanding on metabolic reprogramming in cancer therapy. We have previously shown that metabolic reprogramming to fatty acid β-oxidation (FAO) is a major energy pathway in metastatic TNBC. Moreover, we reported that FAO regulates c-Src, one of the frequently upregulated oncopathways in TNBC via autophosphorylation of Src at Y419. Since FAO inhibitors alone cannot effectively control the tumor progression in TNBC, suitable combination therapies with other metabolic targets are necessary. Recently increasing evidences show that anti-diabetic biguanides have attractive anticancer effect in various cancer types including BC. However, its significance as an anticancer drug is not well established due to parallel metabolic pathways that support tumor growth.
Phenformin, a biguanide derivative similar to metformin, has a greater potency than metformin. Like metformin, phenformin also inhibits mitochondrial electron transport chain (ETC) through complex I inhibition. In addition, biguanides lead to the activation of AMPK, which plays a key role in insulin signaling and energy sensing. Importantly, AMPK is an upstream regulator of FAO pathway because it can phosphorylate ACC to activate FAO. Considering the dependency of TNBC to FAO, we evaluated the therapeutic significance of the combination of biguanides(ETC inhibitors) and FAO inhibitors in TNBC progression and metastasis. We hypothesize that blocking both 'arms' of the pathway can provide more pronounced and durable responses in TNBCs. Our different in vitro and in vivo studies using TNBC cell line and PDX models suggest that the combination of both inhibitors can provide better therapeutic significance in metastatic TNBCs. This is a rationale and cost-effective metabolic approach to manage the currently non-targetable metastatic TNBCs. Further investigation into the clinical effectiveness of this combination may provide better treatment opportunities for TNBC patients.
Citation Format: Park JH, Jung KH, Vithayathil S, Jia D, Kaipparettu BA. Combinational treatment of biguanides and fatty acid β-oxidation inhibitor in triple-negative breast cancers [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 P2-02-11.
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Affiliation(s)
- JH Park
- Baylor College of Medicine, Houston, TX; Center for Theoretical Biological Physics, Rice University, Houston, TX; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
| | - KH Jung
- Baylor College of Medicine, Houston, TX; Center for Theoretical Biological Physics, Rice University, Houston, TX; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
| | - S Vithayathil
- Baylor College of Medicine, Houston, TX; Center for Theoretical Biological Physics, Rice University, Houston, TX; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
| | - D Jia
- Baylor College of Medicine, Houston, TX; Center for Theoretical Biological Physics, Rice University, Houston, TX; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
| | - BA Kaipparettu
- Baylor College of Medicine, Houston, TX; Center for Theoretical Biological Physics, Rice University, Houston, TX; Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX
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Sim SH, Park IH, Jung KH, Kim SB, Ahn JH, Lee KH, Im SA, Im YH, Park YH, Sohn JH, Kim YJ, Lee S, Kim HJ, Chae YS, Park KH, Nam BH, Lee KS, Ro J. Abstract P6-17-23: Randomized phase II study of lapatinib plus vinorelbine versus vinorelbine in patients with HER2 positive metastatic breast cancer progressed after lapatinib and trastuzumab treatment. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-17-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The continuum of anti-HER2 agents is regarded as a standard strategy for HER2 positive metastatic breast cancer patients who had progressed disease with anti-HER2 agent- containing treatments. However, there has been lack of data on which agents should be continued and how long continuous anti-HER2 therapies would be effective. This study was aimed to evaluate the efficacy of lapatinib plus vinorelbine in HER2 positive metastatic breast cancer patients who had progressed on both trastuzumab and lapatinib treatments.
Methods
A total of 149 patients were randomly assigned to lapatinib with vinorelbine (LV) (n=75; laptinib, 1000mg daily ; vinorelbine 20mg/m2 D1,D8 q3w) or vinorelbine alone (V) (n=74; 30mg/m2 D1,D8 q3w). The stratification factors were followings; 1) visceral metastasis, 2) previous response to lapatinib treatment, CR+PR vs. SD ≥ 12 weeks. The primary endpoint was progression free survival (PFS) rate at 18 weeks. The secondary endpoints were objective response rate (ORR), PFS, and overall survival (OS).
Results :
Both arms were well balanced in various clinical factors. The median number of previous anti-HER2 therapies were 2 (range 2-5). There was no significant difference in PFS rate at 18 weeks between LV and V arms (44.0% vs 36.5%, p=0.44). ORR was 19.7% in LV arm and 16.9% in V arm (p=0.881). PFS and OS did not differ between two arms (LV vs V; median PFS, 16weeks vs 12 weeks, HR= 0.86, 95% CI 0.61-1.22, p=0.41; median OS, 15.0 months vs 18.9 months, HR= 1.07, 95% CI 0.72-1.58, p=0.72). In subgroup analysis, there was no difference in PFS and OS between two arms according to previous response to lapatinib (median PFS, CR+PR vs. SD ≥ 12 weeks, 12.1weeks vs.17.4 weeks; HR= 1.242, 95% CI 0.881-1.751, p=0.215; median OS, 14.9 months vs. 19.4 months; HR= 1.179, 95% CI 0.797-1.744, p=0.41). Most common adverse events in both arms were neutropenia which was more often observed in V arm (55% vs 73%, p=0.03). Overall, the profiles of adverse events were similar in both arms and all were manageable.
Conclusion
Lapatinib plus vinorelbine treatment was tolerable, however, it did not demonstrate the clinical benefits compared to vinorelbine alone in HER2 positive metastatic breast cancer patients after progression on both trastuzumab and lapatinib.
Citation Format: Sim SH, Park IH, Jung KH, Kim S-B, Ahn J-H, Lee K-H, Im S-A, Im Y-H, Park YH, Sohn JH, Kim YJ, Lee S, Kim H-J, Chae YS, Park K-H, Nam B-H, Lee KS, Ro J. Randomized phase II study of lapatinib plus vinorelbine versus vinorelbine in patients with HER2 positive metastatic breast cancer progressed after lapatinib and trastuzumab treatment [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 P6-17-23.
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Affiliation(s)
- SH Sim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - IH Park
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - KH Jung
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - S-B Kim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - J-H Ahn
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - K-H Lee
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - S-A Im
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - Y-H Im
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - YH Park
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - JH Sohn
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - YJ Kim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - S Lee
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - H-J Kim
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - YS Chae
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - K-H Park
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - B-H Nam
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - KS Lee
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
| | - J Ro
- National Cancer Center, Goyang, Republic of Korea; Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Yonsei University, College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea; Korea University, Seoul, Republic of Korea; Research Institute & Hospital, National Cancer Center, Goyang, Republic of Korea; Seoul National University Bundang Hospital, Bundang, Republic of Korea; Chung-Ang University, College of Medicine, Seoul, Republic of Korea; Dong-A University, College of Medicine, Busan, Republic of Korea; Kyungpook National University, College of Medicine, Daegu, Republic of Korea
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Kim JY, Lee EJ, Park KH, Im SA, Kim SB, Sohn SH, Lee KS, Chae YS, Lee KH, Kim JH, Im YH, Kim TY, Lee KH, Ahn JH, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH, Park YH. Abstract P3-11-07: Exploratory biomarker analysis from a phase II, multicenter, randomized trial of eribulin plus gemcitabine(EG) versus paclitaxel plus gemcitabine(PG) as first-line chemotherapy for human epidermal growth factor receptor 2 (HER2)- negative metastatic breast cancer(MBC): Korean cancer study group trial (KCSG BR13-11). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-11-07] [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 : A phase II, multicenter, randomized clinical trial of the comparison between eribulin plus gemcitabine (EG) and paclitaxel plus gemcitabine (PG) as first-line chemotherapy for patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) found EG was less neurotoxic, but had similar efficacy of PG. In this study, we performed exploratory biomarker analysis of the impact of genetic alterations on the efficacy according to EG and PG chemotherapy.
Methods : This biomarker study was conducted using tumor samples from 40patients. When tissue collection was possible after disease progression, we performed paired sample analysis. Tumor DNA and RNA were extracted from formalin-fixed, paraffin-embedded tissues. To perform targeted deep sequencing, we used CancerScanTM, a 375 cancer gene panel. And we performed an nCounter expression assay for gene expression analysis using 730 PanCancer panel and 730 Immune panel.
Results: In total, we obtained 44 tissue samples from 40 patients. Twenty two patients were assigned in EG arm and 18 patients were in PG arm. Thirty-eight were at baseline and six after disease progression. Gene expression assay were performed in 44 tissue samples but only 31 samples were possible to be targeted deep sequencing.
We performed differently expressed gene(DEG) analysis for detecting the association between level of gene expression and disease progression. In this analysis, high expression of CCNE1, TGFB4 and BAMBI and low expression of DDB2, CD14 and SHC3 were associated with disease progression among 730 PanCancer panel genes (p<0.05, respectively). In terms of immune panel genes, most of immune related genes were highly expressed in a group without disease progression compared with that with disease progression. Only 2 genes, C8G and CD24 were highly expressed in a group with disease progression. Paired sample analysis showed that expression levels of THBS4 and CD27 decreased after disease progression while those of CCNE2 and FGFR4 increased.
In targeted deep sequencing, FAT3 (42.3%) was most frequently mutated gene followed by PKHD1, PIK3CA and TP53. Among mutated genes, EWSR1 mutation and upstream mutation of ETV1 were associated with disease progression, respectively (p<0.05, respectively). In mutation signature analysis, signature 1 (S, age related), S3(homologous recombination deficiency, HRD), S6 (mismatch repair, MMR), S20(MMR) and S21(microsatellite instability, MSI) were enriched in this population. Mutation signature 3 related to short disease free survival (p=0.0026).
Conclusion: In gene expression analysis, high expression of TGF-B signaling pathway related genes was associated with disease progression while high expression of immune related genes were related to prolonged disease free survival. In mutation analysis, EWSR1 and ETV1 mutations indicated short disease free interval and HRD mutation signature was also related to poor prognosis.
Citation Format: Kim J-Y, Lee EJ, Park KH, Im S-A, Kim S-B, Sohn SH, Lee KS, Chae YS, Lee KH, Kim JH, Im Y-H, Kim T-Y, Lee K-H, Ahn J-H, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH, Park YH. Exploratory biomarker analysis from a phase II, multicenter, randomized trial of eribulin plus gemcitabine(EG) versus paclitaxel plus gemcitabine(PG) as first-line chemotherapy for human epidermal growth factor receptor 2 (HER2)- negative metastatic breast cancer(MBC): Korean cancer study group trial (KCSG BR13-11) [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 P3-11-07.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - EJ Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - S-A Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - S-B Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SH Sohn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KS Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - YS Chae
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - JH Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - T-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - K-H Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - J-H Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - GM Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - IH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SJ Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - HS Han
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - SH Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - KH Jung
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Seoul National University Hospital, Cancer Research Institute, Seoul National University, College of Medicine, Seoul, Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Yonsei University College of Medicine, Seoul, Korea; Center for Breast Cancer, National Cancer Center, Goyang, Korea; Kyungpook National University Medical Center, Daegu, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Kim J, Jo WK, Kim KY, Kim BJ, Lee SB, Lee HJ, Yu JH, Kim HJ, Chung IY, Ko BS, Kim SB, Jung KH, Ahn JH, Chang S, Lee JW, Son BH, Ahn SH. Abstract P4-01-11: Genomic alterations of cell-free DNA in early breast cancer patients with recurrence. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-01-11] [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
Cell-free DNA (cfDNA), as a non-invasive strategy, provides substantial benefit to overcome tumor heterogeneity. Surveillance of recurrence after standard treatment in early breast cancer (BC) using cfDNA, enables to detect minimal residual disease (MRD), also to identify genomic alterations driving recurrences. We aimed to assess the role of cfDNA in detecting MRD by investigating genomic alterations of 1)primary, recurred tumor and 2)cfDNA at time of recurrence using deep targeted sequencing. Fifty-four early BC patients were enrolled prospectively between 2014 and 2017 at time of recurrence. Median disease free interval was 28.5 months (rage 6.2-49.8). 62.7% (32/51) were hormone receptor (HR) positive (28 HRpos/HER2neg, 4 HRpos/HER2pos), 11.8% (6/51) were HRneg/HER2pos and 25.5% (13/51) were triple negative BCs. 59.3% (32/54) patients developed loco-regional recurrence (15 local recurrence only, 13 regional only, 4 with both) and distant metastasis was observed among 40.7% (22/54) patients. Cell-free DNA was extracted from 5cc blood at time of recurrence. Deep targeted sequencing was performed using customized NGS panel –encompassing 426 cancer-related target coding region, 242 fusion and amplification-related region- of cfDNA and FFPE(formalin fixed paraffin embedded) tumor samples archived from surgical resection or biopsy. Deep targeted sequencing data was successfully performed in 72.1% (31/43) plasma samples and sequencing yield was significantly lower when stored for more than 2yrs (46.2% vs 83.3%).
Mutations of cfDNA and tumor (primary, recurred) were analyzed. Mean sequencing depth of cfDNA and FFPE were x425.7 and x777.6 respectively. Median number of pathogenic mutations found in primary tumor, cfDNA and recurred tumor were 27(range 12-99), 25(range 8-85) and 9(range 0-23). Among mutations found in primary tumor, 27.4% were shared mutations (range 8.1%-72.7%) with recurred tumor and 26.1% were shared mutations (range 4.7%-69.2%) observed in cfDNA sample. Among mutations found in recurred tumor, 40.9% were observed in cfDNA (range 17.7-87.5%). In primary tumor, median number of mutations with allelic fraction (MAF)>10% were 12 (range 4-21) and at least one mutation was found in cfDNA at time of recurrence. Among mutations with MAF>10%, 59.4% and 69.1% were found in cfDNA and recurred tumor. Known oncogenic mutations of PIK3CA, TP53, GATA3, AKT1, ESR1, RELN, ERBB2, ERBB3, BRCA1 mutation were found. PIK3CA gene (p.H1047R) was found in two cases both in primary tumor and cfDNA at recurrence (MAF 11.4% vs 5.3% and 12.3% vs 15.4%) suggesting de novo driver mutation. One patient developed regional recurrence during adjuvant aromatase inhibitor with ESR1 V392I mutation in both cfDNA and recurred tumor (MAF 48.1 and 54.5%), while another patient's recurred tumor during aromatase inhibitor harbored ESR1 D538G mutation exclusively in recurred tumor with MAF <1%. Both patients had no ESR1 hotpot mutation in primary tumor.
Our data showed sequencing yield of 83.3% in plasma samples within 2yr. Pathogenic mutations in primary tumor, especially when MAF>10%, half of them was observed in cfDNA at time of recurrence. ESR1 mutation should be included in cfDNA surveillance for patients undergoing endocrine therapy even absent in primary tumor.
Citation Format: Kim J, Jo WK, Kim KY, Kim BJ, Lee SB, Lee HJ, Yu JH, Kim HJ, Chung IY, Ko BS, Kim S-B, Jung KH, Ahn JH, Chang S, Lee JW, Son BH, Ahn SH. Genomic alterations of cell-free DNA in early breast cancer patients with recurrence [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 P4-01-11.
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Affiliation(s)
- J Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - WK Jo
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KY Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SB Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JH Yu
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - IY Chung
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BS Ko
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-B Kim
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KH Jung
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Chang
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JW Lee
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - BH Son
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SH Ahn
- Asan Medical Center, Seoul, Republic of Korea; Macrogen Inc, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Jung KH, Park JH, Sirupangi T, Jia D, Gandhi N, Pudakalakatti S, Elswood J, Porter W, Putluri N, Zhang XHF, Chen X, Bhattacharya PK, Creighton CJ, Lewis MT, Rosen JM, Wong LJC, Das GM, Osborne CK, Rimawi MF, Kaipparettu BA. Abstract P2-02-14: Metabolic regulation and drug resistance in c-Src activated triple negative breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-02-14] [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
c-Src (Src) is a proto-oncogene involved in signaling that culminates in the control of multiple biological functions. Src is also one of the most frequently upregulated pathways in triple negative breast cancer (TNBC). Dysregulation of Src has been detected in TNBC and is strongly associated with tumor metastasis and poor prognosis. However, even after promising preclinical studies, Src inhibitors did not show major clinical advantage in unselected TNBC populations. We have previously published that metastatic TNBC has high energy-dependency to mitochondrial fatty acid beta-oxidation (FAO) and FAO activates Src by inducing autophosphorylation at Y419. However, our recent analysis suggests that as observed with the Src inhibitors, TNBC tumors treated with FAO inhibitors also develop drug-resistance and continue tumor growth. Evaluation of their drug resistance mechanism revealed that while short-term inhibition of FAO or Src induces autophagic and apoptotic cell deaths, long-term inhibition results in autophagy-mediated drug resistance and survival. Further analyses suggest that FAO and Src inhibitors activate mitogen-activated protein (MAP) kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) pathway via the induction of cellular reactive oxygen species (ROS) in TNBC. Activated MEK/ERK then induces survival pathways for drug resistance and tumor survival. Validation of in vitro findings using in vivo TNBC models confirmed that combination of FAO/Src inhibitors with MEK/ERK inhibitors can provide significant benefit to overcome the therapeutic resistance of TNBC. These findings open-up new therapeutic opportunities to manage TNBC patients with currently non-targetable metastatic tumors.
Citation Format: Jung KH, Park JH, Sirupangi T, Jia D, Gandhi N, Pudakalakatti S, Elswood J, Porter W, Putluri N, Zhang XH-F, Chen X, Bhattacharya PK, Creighton CJ, Lewis MT, Rosen JM, Wong L-JC, Das GM, Osborne CK, Rimawi MF, Kaipparettu BA. Metabolic regulation and drug resistance in c-Src activated triple negative 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 P2-02-14.
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Affiliation(s)
- KH Jung
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - JH Park
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - T Sirupangi
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - D Jia
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - N Gandhi
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - S Pudakalakatti
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - J Elswood
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - W Porter
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - N Putluri
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - XH-F Zhang
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - X Chen
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - PK Bhattacharya
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - CJ Creighton
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - MT Lewis
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - JM Rosen
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - L-JC Wong
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - GM Das
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - CK Osborne
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - MF Rimawi
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
| | - BA Kaipparettu
- Baylor College of Medicine, Houston; Center for Theoretical Biological Physics, Rice University, Houston; Roswell Park Cancer Institute, Buffalo; MD Anderson Cancer Center, The University of Texas, Houston; Veterinary Integrative Biosciences, Texas A&M University, College Station; Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston; Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston
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Kim JY, Lee E, Park K, Jung HH, Park WY, Lee KH, Sohn JH, Lee KS, Jung KH, Kim JH, Lee KH, Im SA, Park YH. Abstract P2-09-21: Molecular alterations and poziotinib, a pan-HER inhibitor efficacy in human epidermal growth factor receptor 2(HER2) positive breast cancers: Combined exploratory biomarker analysis from phase II clinical trial of poziotinib for refractory HER2 positive breast cancer(BC) patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-21] [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: Poziotinib is a novel, pan-HER kinase inhibitor which showed potent anti-tumor activities through irreversible inhibition of HER family tyrosine kinases in preclinical and early clinical studies. Recent the open-label, multicenter phase II trial of poziotinib monotherapy evaluated that poziotinib is a new promising option for patients with HER2-positive metastatic BC who have failed more than two HER2 targeted therapy (NCT02418689). We evaluated genetic profiles of HER2-positive metastatic BC and investigated potential biomarkers of poziotinib for HER2-positive metastatic BC (MBC). Methods: All participants were diagnosed as HER2-positive BCs according to American Society of Clinical Oncology/College of American Pathologists HER2 guideline and provided tissue specimens that would be possible to extract DNA and RNA for next generation sequencing. We performed targeted deep sequencing with a customized 381 cancer gene panel (CancerSCAN™) and analyzed the relationship among the sequencing data, immunohistochemistry and clinical outcome.
Results: From Apr 2015 to Feb 2016, 106 patients were enrolled in the trial from 7 institutes in Korea. Of 106 patients, biomarker data were available for 79 patients. TP53 was the most frequently mutated gene (70.8%) followed by PIK3CA (45.6%). HER2 single nucleotide variant (SNV) was detected in 13 BCs (16.5%) and HER3 SNV was in 9 (11.4%). The score of HER2 immunohistochemistry (IHC) was 3+ in 68 BCs and 2+ with positive in situ hybridization in 11 BCs. In copy number variant (CNV) analysis, HER2 amplification (86.1%) was most frequently observed and followed by CDK12 amplification (58.2%) and APOBEC3B deletion (30.4%). IHC score of HER2 was positively correlated to copy number (CN) of HER2 (P=0.001) but 11 breast cancer tissue did not have copy number amplification of HER2 (13.9%) (Six of HER2 IHC score 2+ and 5 of 3+). The median progression free survival (PFS) was 4.04 months (95% CI, 2.96 - 4.40) for patients who treated with poziotinib in this study. PIK3CA activating mutations were associated with short PFS compared to wild type (WT) and other SNVs (Median PFS of activating mutations vs. WT and others: 2.66 vs. 4.40 (months), P=0.009). HER2 CN amplification was positively correlated to duration of PFS (Median PFS of no amplification vs. 4 ≤ CN < 16 vs. 16 ≤ CN: 2.56 vs. 3.02 vs. 4.86 (months), P=0.032). HER2 SNVs prolonged duration of PFS without statistical significance (Median PFS of HER2 SNVs vs. WT: 4.24 vs. 3.19 (months), P=0.114), but 10 of 13 BCs with HER2 SNV (76.9%) had clinical benefit from poziotinib and 5 BCs (38.5%) had durable response more than 6 months. Conclusion: In this biomarker analysis, SNV of HER2 was frequently observed in HER2 positive MBCs and HER2 CN amplification was detected not in all. High CN amplification of HER2 derived longer PFS than those with low CN. To contrary to this, activating PIK3CA mutations shorten PFS compared to those with WT. In addition, HER2 SNVs might be a potential biomarker of poziotinib in HER2-positive MBC. Further functional study would be warranted.
Citation Format: Kim J-Y, Lee E, Park K, Jung HH, Park W-Y, Lee K-H, Sohn JH, Lee KS, Jung KH, Kim J-H, Lee KH, Im S-A, Park YH. Molecular alterations and poziotinib, a pan-HER inhibitor efficacy in human epidermal growth factor receptor 2(HER2) positive breast cancers: Combined exploratory biomarker analysis from phase II clinical trial of poziotinib for refractory HER2 positive breast cancer(BC) patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-21.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - E Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - K-H Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - JH Sohn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KS Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - J-H Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KH Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - S-A Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
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9
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Rajamanickam S, Park JH, Bates K, Timilsina S, Eedunuri VK, Onyeagucha B, Subbarayalu P, Abdelfattah N, Jung KH, Favours E, Mohammad TA, Chen HIH, Vadlamudi RK, Chen Y, Kaipparettu BA, Arbiser JL, Rao MK. Abstract P6-06-04: Targeting replication stress in triple negative breast cancer treatment regimen: An emerging approach. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-06-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Triple-negative breast cancers (TNBCs) represent aggressive heterogeneous subtype of breast cancer with poor clinical outcome. TNBCs have been reported to have high levels of replication stress due to i) various oncogene activations (C-myc or EGFR) ii) germline BRCA mutations iii) “BRCAness” in the absence of BRCA mutations in sporadic TNBCs. Replication stress is known to cause genomic instability, promote tumorigenesis and plays a critical role in therapy resistance in TNBCs. Therefore, targeting replication stress has emerged as an effective approach for better TNBC treatment through further downregulation of the remaining checkpoints to induce catastrophic failure of TNBC cells proliferation. Herein, we evaluated the anticancer efficacy of Carbazole Blue (CB), a synthetic analogue of Carbazole, on TNBC cells growth and progression. Our results demonstrated that CB inhibits short and long term viability of TNBC (MDA-MB-231, MDA-MB-468 and BT549) cells in a dose dependent manner without affecting normal mammary epithelial (MCF-10A) cells. In addition, CB treatment significantly reduced proliferation of TNBC cells, as evidenced by the BrdU proliferation assay. Consistent with this, our results further demonstrated that CB treatment induced G1/S cell cycle arrest and apoptosis in TNBCs. Importantly, systemic delivery of CB using nanoparticle-based delivery approach suppressed breast cancer growth without inducing toxicity, in preclinical orthotopic xenograft and PDX mouse models of TNBC. Furthermore, our gene microarray analysis revealed that CB treatment modulates the expression and activity of several genes known to be involved in DNA replication (CDC6, CDT1, MCMs, Claspin, POLE and PCNA) and associated DNA repair machinery such as (XRCC3, Exo1 and RAD51), which play pivotal roles in replication stress. Our results for the first time highlight the potential use of CB as a novel and potent therapeutic agent for treating TNBCs. As exploiting replication stress to treat cancer is gaining major interest, compound/s that may induce replication stress and inhibit DNA repair ability of cancer cells, has immense translational potential.
Citation Format: Rajamanickam S, Park JH, Bates K, Timilsina S, Eedunuri VK, Onyeagucha B, Subbarayalu P, Abdelfattah N, Jung KH, Favours E, Mohammad TA, Chen H-IH, Vadlamudi RK, Chen Y, Kaipparettu BA, Arbiser JL, Rao MK. Targeting replication stress in triple negative breast cancer treatment regimen: An emerging approach [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-06-04.
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Affiliation(s)
- S Rajamanickam
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - JH Park
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - K Bates
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - S Timilsina
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - VK Eedunuri
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - B Onyeagucha
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - P Subbarayalu
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - N Abdelfattah
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - KH Jung
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - E Favours
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - TA Mohammad
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - H-IH Chen
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - RK Vadlamudi
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - Y Chen
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - BA Kaipparettu
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - JL Arbiser
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
| | - MK Rao
- UT Health San Antonio, San Antonio, TX; Baylor College of Medicine, Houston, TX; Emory University School of Medicine, Atlanta, GA, Ukraine
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10
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Park JH, Jung KH, Sirupangi T, Vithayathil S, Jin F, Putluri V, Piyarathna DWB, Yotnda P, Bhat VB, Sreekumar A, Lewis MT, Coarfa C, Putluri N, Creighton CJ, Wong LJC, Kaipparettu BA. Abstract P6-01-07: Mitochondria-nuclear communication regulates epithelial-mesenchymal transition and metastasis in triple negative breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-01-07] [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
For triple negative breast cancer (TNBC), the driver pathways are still poorly understood. Advances in cancer metabolism research over the last decade have enhanced and modified our understanding on Warburg effect. It is now known that mitochondria in tumors are not always defective in their ability to carry out oxidative phosphorylation. Instead, in proliferating cells, mitochondrial energy pathways are reprogrammed to meet the challenges of macromolecular synthesis and to escape from apoptosis. Tumor initiating cells (TICs) maintain cancer stem cell properties and are known to play significant role in TNBC metastasis. Mitochondrial retrograde regulation (MRR) is a bidirectional communication between mitochondria and nucleus. MRR is triggered by mitochondrial functional demands and it responds in a continuous manner to change metabolic needs of the cell. Using transmitochondrial cybrid (cybrid) technology, we generated different cybrid models under common nuclear backgrounds of benign breast epithelium or TNBC. Mitochondria from cells with different cancer potential such as benign breast epithelium, moderately metastatic and highly metastatic breast cancer cell lines were studied under the common nuclear background to understand MRR-regulated TIC properties and cancer pathways. Using genomic, metabolomic, and proteomic approaches, we confirmed the significance of mitochondrial character in the regulation of epithelial mesenchymal transition (EMT), TIC and metastatic properties. Altogether, our results suggest that MRR is critical in TNBC TIC character and stemness.
Citation Format: Park JH, Jung KH, Sirupangi T, Vithayathil S, Jin F, Putluri V, Piyarathna DWB, Yotnda P, Bhat VB, Sreekumar A, Lewis MT, Coarfa C, Putluri N, Creighton CJ, Wong L-JC, Kaipparettu BA. Mitochondria-nuclear communication regulates epithelial-mesenchymal transition and metastasis in triple negative 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 P6-01-07.
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Affiliation(s)
- JH Park
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - KH Jung
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - T Sirupangi
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - S Vithayathil
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - F Jin
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - V Putluri
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - DWB Piyarathna
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - P Yotnda
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - VB Bhat
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - A Sreekumar
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - MT Lewis
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - C Coarfa
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - N Putluri
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - CJ Creighton
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - L-JC Wong
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
| | - BA Kaipparettu
- Baylor College of Medicine, Houston, TX; Dan L. Duncan Cancer Center-Biostatistics, Baylor College of Medicine, Houston, TX; Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, TX; Agilent Technologies, Wilmington, DE
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11
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Park K, Woo M, Kim JE, Ahn JH, Jung KH, Kim SB. Abstract P1-02-14: Circulating cell-free DNA (CFD) measured by a simple fluorescent assay to predict relapse in triple negative breast cancer patients receiving neoadjuvant chemotherapy: A biomarker substudy of prospective observational study (NCT02001519, NCT02001506). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-02-14] [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: Prior technique to measure cell free DNA(CFD) is labor-intensive and expensive, while, recently developed fluorescent CFD assay is more simple and convenient.The aim of this study was to evaluate the role of CFD measured by a fluorescent assay as a biomarker of patients with triple negative breast cancer (TNBC) received neoadjuvant chemotherapy
Methods: We prospectively enrolled patients with TNBC, clinical stage II or III (T>1.5cm or lymph node > 1.5cm), who were scheduled for neoadjuvant chemotherapy. Patients received 4 cycles of adriamycin 60 mg/m2 plus cyclophosphamide 600 mg/m2 (AC) followed by 4 cycles of cisplatin or docetaxel, and surgery. Plasma samples were obtained from patients before initial chemotherapy (baseline-CFD) and after 4 cycles of AC neoadjuvant chemotherapy (AC-CFD).
Results: This study included 72 patients who met the inclusion criteria. The mean levels of baseline-CFD and AC-CFD were 239±68 ng/mL and 210±66 ng/mL, respectively, and the CFD level was significantly decreased after AC chemotherapy.( p=0.001) The baseline-CFD was not associated with initial tumor characteristics. (T stage 1-2 vs. 3, p=0.313; N stage 0 vs. 1-3, p=0.317) There was no statistically significant difference between patients with response (CR or PR) to AC chemotherapy and those without response in terms of baseline-CFD, AC-CFD, and change of CFD between two values. (p=0.814, p=0.839, p=0.927) With 33.6 months of median follow up, there were 18 cases of relapse. Relapsed group showed numerically higher level of baseline-CFD, although it was not statistically significant. (relapse, 259 ng/mL; non-relapse, 233 ng/mL; p=0.161) We performed a ROC curve analysis of baseline-CFD for relapse, and found an area under the curve of 0.62 (95% CI, 0.46-0.78) at 222 ng/mL. Patients with baseline-CFD above 222 showed higher relapses than those below 222. (HR, 2.75; 95% CI, 0.96-7.84; p = 0.059)
Conclusions: The baseline-CFD obtained using a simple and convenient fluorescent assay could predict relapse, suggesting baseline-CFD as a potential biomarker for risk stratification of TNBC.
Citation Format: Park K, Woo M, Kim JE, Ahn J-H, Jung KH, Kim S-B. Circulating cell-free DNA (CFD) measured by a simple fluorescent assay to predict relapse in triple negative breast cancer patients receiving neoadjuvant chemotherapy: A biomarker substudy of prospective observational study (NCT02001519, NCT02001506) [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 P1-02-14.
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Affiliation(s)
- K Park
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Medical Oncology and Hematology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - M Woo
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Medical Oncology and Hematology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - JE Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Medical Oncology and Hematology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - J-H Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Medical Oncology and Hematology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - KH Jung
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Medical Oncology and Hematology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Medical Oncology and Hematology, Pusan National University Yangsan Hospital, Yangsan, Korea
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12
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Park YH, Im SA, Sohn JH, Lee KS, Chae YS, Lee KH, Kim JH, Im YH, Ahn JS, Kim TY, Lee KH, Kim SB, Ahn JH, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH. Abstract OT1-01-12: A phase II, multicenter, randomized trial of eribulin plus gemcitabine (EG) vs. paclitaxel plus gemcitabine (PG) in patients with HER2-negative metastatic breast cancer as first-line chemotherapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-01-12] [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
Background: Metastatic breast cancer (MBC) is an incurable disease and is needed to improve effective chemotherapy. Paclitaxel plus Gemcitabine (PG) combination chemotherapy is one of the preferred chemotherapeutic regimens for patients with MBC, and was found to be proper as a maintenance chemotherapy regimen with survival benefit and feasible toxicity profile. Eribulin mesylate is a non-taxane inhibitor of microtubule dynamics of the halichondrin class of antineoplastic drugs. A recent pooled analysis of two phase II studies with eribulin showed improved overall survival in in various patient subgroups with advanced/metastatic breast cancer who had previously received an anthracycline and a taxane. Furthermore, eribulin may have rational benefit compared with paclitaxel in terms of neurotoxicity. Therefore, Eribulin plus Gemcitabine (EG) combination chemotherapy may have less neurotoxocity comparing to PG.
Trial Design: Prospective randomized phase 2, open-label, two-arm, multi-center study comparing EG chemotherapy with PG chemotherapy for patients with HER-2 negative MBC as first-line chemotherapy.
Eligibility Criteria: Histologically confirmed breast cancer patients, at least 19 years of age, with no prior history of chemotherapy for metastatic, recurrent breast cancer with evaluable lesions (as per RECIST, 1.1) who have adequate hematologic, renal, and hepatic function. Patients either may or may not have a prior anthracycline containing regimen. Prior hormonal therapy as a treatment of metastatic disease is allowed.
Specific Aims:
The primary efficacy endpoint of the trial is Progression-Free Survival (PFS). The secondary efficacy endpoints are: Time to Treatment Failure (TTF); Overall Survival (OS); neuropathic scale (FACT for Taxane QOL assessment); toxicity; duration of response; Objective Response Rate (ORR); Clinical Benefit Rate. The exploratory endpoint of the study includes pharmacogenetic profile.
Statistical Methods:
The initial sample size of the present study was determined based on the data derived from a previous trial on PG maintenance chemotherapy design; 6-month PFS is 70% for PG chemotherapy. This design was hypothesized that EG chemotherapy would not be inferior to PG chemotherapy. Thus, estimated PFS for each arm is 70%. Based on this estimate, we would plan to recruit a total of 100 patients (50 per arm). Considering drop-out rate of 10%, total 112 MBC patients planned to be enrolled.
Present Accrual and Target Accrual:Enrollment has been completed as of March, 2016 with a target enrollment of 112 patients.
Contact information:Kyung Hae Jung MD, Ph.D. khjung@amc.seoul.kr
ClinicalTrials.gov Identifier: NCT02263495.
Citation Format: Park YH, Im S-A, Sohn JH, Lee KS, Chae YS, Lee KH, Kim J-H, Im Y-H, Ahn JS, Kim T-Y, Lee K-H, Kim S-B, Ahn J-H, Kim GM, Park IH, Lee SJ, Han HS, Kim SH, Jung KH. A phase II, multicenter, randomized trial of eribulin plus gemcitabine (EG) vs. paclitaxel plus gemcitabine (PG) in patients with HER2-negative metastatic breast cancer as first-line chemotherapy [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 OT1-01-12.
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Affiliation(s)
- YH Park
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - S-A Im
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - JH Sohn
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - KS Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - YS Chae
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - KH Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - J-H Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - Y-H Im
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - JS Ahn
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - T-Y Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - K-H Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - S-B Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - J-H Ahn
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - GM Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - IH Park
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - SJ Lee
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - HS Han
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - SH Kim
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
| | - KH Jung
- Samsung Medical Center; Seoul National University Hospital; Yonsei Cancer Center; National Cancer Center; Kyungpook National University Medical Center; Chungbuk National University Hospital; Seoul National University Bundang Hospital; Asan Medical Center
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Park KH, Lee S, Park JH, Kang SY, Kim HY, Park IH, Park YH, Im YH, Lee HJ, Park S, Lee SI, Jung KH, Kim YS, Seo JH. A randomized, multi-center, open-label, phase III study of once-per-cycle DA-3031, a pegylated G-CSF, in comparison with daily filgrastim in patients receiving TAC chemotherapy for breast cancer. Support Care Cancer 2016; 25:505-511. [PMID: 27709313 DOI: 10.1007/s00520-016-3429-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 09/26/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE This multi-center, randomized, phase III study was conducted to demonstrate the non-inferiority of DA-3031 compared with daily filgrastim in patients during the first cycle of chemotherapy for breast cancer in terms of the duration of severe neutropenia (DSN). METHODS Seventy-four patients with breast cancer who were receiving combination chemotherapy with docetaxel, doxorubicin, and cyclophosphamide (TAC) were enrolled. All participants were randomized to receive either daily subcutaneous injections of filgrastim 100 μg/m2/day for up to 10 days or a single subcutaneous injection of DA-3031 at fixed doses of 6 mg on day 2 of each chemotherapy cycle. RESULTS The mean duration of grade 4 (G4) neutropenia in cycle 1 was 2.08 ± 0.85 days for the filgrastim group and 2.28 ± 1.14 days for the DA-3031 group. The difference between groups was 0.2 ± 1.10 days (95 % confidence interval (CI) = -0.26, 0.66), which supported non-inferiority. No statistically significant differences were observed in nadir absolute neutrophil count (ANC) (154.34/mm3 and 161.75/mm3 for the filgrastim and DA-3031 groups, respectively; P = 0.8414) or in time to ANC recovery (10.03 ± 0.75 and 9.83 ± 1.56 days in the filgrastim and DA-3031 groups, respectively; P = 0.0611) during cycle 1. Serious AEs occurred in six (15.8 %) patients receiving filgrastim and in ten (27.8 %) patients receiving DA-3031; however, none was determined to be related to the study drug. CONCLUSIONS DA-3031 and daily filgrastim are similar in regard to DSN and safety in breast cancer patients receiving TAC chemotherapy.
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Affiliation(s)
- K H Park
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, 73 Inchonro, Sungbuk-Gu, Seoul, 02481, South Korea
| | - S Lee
- Division of Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - J H Park
- Division of Oncology/Hematology, Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan, South Korea
| | - S Y Kang
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - H Y Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Pyeongchon, Anyang-si, Gyeonggi-do, South Korea
| | - I H Park
- Center for Breast Cancer and Center for Clinical Trials, National Cancer Center, Goyang-si, South Korea
| | - Y H Park
- Division of Hematology/Oncology, Department of Internal Medicine, Samsung Medical Center, Seoul, South Korea
| | - Y H Im
- Division of Hematology/Oncology, Department of Internal Medicine, Samsung Medical Center, Seoul, South Korea
| | - H J Lee
- Product Development HQ, Dong-A ST, Seoul, South Korea
| | - S Park
- Division of Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University College of Medicine, Seoul, South Korea
| | - S I Lee
- Division of Oncology/Hematology, Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - K H Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Y S Kim
- Division of Oncology/Hematology, Department of Internal Medicine, Kosin University Gospel Hospital, Busan, South Korea
| | - Jae Hong Seo
- Division of Oncology/Hematology, Department of Internal Medicine, Korea University College of Medicine, 73 Inchonro, Sungbuk-Gu, Seoul, 02481, South Korea.
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14
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Kim TY, Ahn JH, Yoon JH, Sohn JH, Kim GM, Lee KH, Park YH, Koh SJ, Lee SE, Chae Y, Lee KS, Lee KE, Won HS, Kim JH, Jeong J, Park KH, Cho EK, Im YH, Im SA, Jung KH. Abstract P1-09-09: Role of endocrine therapy in premenopausal patients with hormone receptor-positive metastatic breast cancer, compared with postmenopausal patients: Diachronic analyses from nationwide cohort in Korea (KCSG BR 14-07). Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-09-09] [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
Endocrine therapy (E) has a major role in treatment of hormone receptor (HR)-positive metastatic breast cancer (MBC). However, in contrast to western countries, premenopausal patients (PRE) more prevalent (50% of all breast cancer patients) and have less options of E than postmenopausal patients (POST) in Korea where the use of LHRH agonist in combination aromatase inhibitors (AIs) in PRE is restricted. Recently we have been successfully established nationwide cohort for the patients MBC (575 patients from 26 institutes). This study was designed to evaluate the role of E especially in PRE.
Methods
The patients with MBC were prospectively or retrospectively enrolled between September 2014 and May 2015. Only menopausal status-confirmed patients (296) were analyzed. Postmenopause was defined, based on NCCN guideline. Total duration of treatment was defined as the time from start day of any first treatment to end of any last treatment. Total duration of E was defined as the sum of time duration of each E. Overall survival was calculated from the start day of any treatment for MBC to any causes of death. This work is supported by National Strategic Coordinating Center for Clinical Research (H110C2020).
Results
A total of 296 patients with HR-positive MBC were analyzed [PRE, 169 (57.1%) and POST, 127 (42.9%)]. Except age (mean 44 and 60 years), baseline characteristics including in pathology, HER2 status, initial pathologic stage, de novo metastasis versus recurrence, surgery and adjuvant treatment (chemotherapy, endocrine therapy and radiotherapy) were well balanced. 92 (54.4%) of PRE and 77 (60.6%) of POST received at least one or more E through all treatment course. 41 (24.2%) of PRE and 44 (34.6%) received E as 1st-line treatment (p=0.034). Among PRE who received 1st-line of E, 30 (71.4%) and 9 (21.4%) of PRE received 2nd- and 3rd-line E. 20 (45.4%) and 10 (22.7%) of POST received 2nd- and 3rd- or more line of E. Most of PRE (54%) received tamoxifen+/-goserelin and 32% of PRE received AIs along with ovarian suppression. 71% of POST received AIs. As initial treatment, E was more frequently used in POST than in PRE (34.6% and 24.3%, p=0.053). Overall survival (OS) of all patients was 18.2 months (95% CI, 14.8-21.5). There was no difference in OS between PRE (17.8 months, 10.9-24.8) and POST (18.5 months, 95% CI, 13.2-23.9) (P=0.337). No difference of OS was observed (E, 18.1 moths, 95% CI, 13.0-23.3; chemotherapy 21.2 moths, 95% CI, 16.8-25.5), regardless of initial treatment. Total duration of treatment of PRE and POST were 15.2 and 13.6 months, respectively with no significant difference (p=0.389). PRE (8.3 moths, 95% CI,5.7-10.8) showed the trend toward longer duration of E in comparison with POST (5.5 moths, 95% CI,4.4-6.7), however the difference did not reach statistical significance (p=0.051).
Conclusion
E was more commonly used as 1st-line therapy in POST than in PRE. Although PRE had limited options of E, E was used in long duration of treatment especially in PRE. These findings suggested that E had a role in treatment for PRE with HR-positive MBC and could be used in treatment for PRE with good efficacy.
Citation Format: Kim T-Y, Ahn J-H, Yoon JH, Sohn JH, Kim GM, Lee KH, Park YH, Koh S-J, Lee SE, Chae Y, Lee KS, Lee KE, Won HS, Kim JH, Jeong J, Park KH, Cho EK, Im Y-H, Im S-A, Jung KH. Role of endocrine therapy in premenopausal patients with hormone receptor-positive metastatic breast cancer, compared with postmenopausal patients: Diachronic analyses from nationwide cohort in Korea (KCSG BR 14-07). [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 P1-09-09.
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Affiliation(s)
- T-Y Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - J-H Ahn
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - JH Yoon
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - JH Sohn
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - GM Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KH Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - YH Park
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - S-J Koh
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - SE Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - Y Chae
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KS Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KE Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - HS Won
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - JH Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - J Jeong
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KH Park
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - EK Cho
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - Y-H Im
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - S-A Im
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
| | - KH Jung
- Seoul National University Hospital, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Republic of Korea; Yonsei University College of Medicine, Kwangju, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Samsung Medical Center, Seoul; Ulsan University Hospital, Ulsan; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu, Republic of Korea; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea
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Yoon JA, Yoo C, Lee HJ, Kim KP, Kim J, Ahn JH, Jung KH, Gong G, Kim SB. Abstract P3-07-34: Predictive role of stromal tumor infiltrating lymphocytes (TILs) in patients with metastatic HER2-positive breast cancer (BC) treated with trastuzumab. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-34] [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:Prognostic significance of stromal TILs in metastatic BC has been suggested in various BC subtypes. However, predictive role of stromal TILs for the efficacy of trastuzumab has not been established in patients with HER2-positive BC. This study was performed to evaluate whether the stromal TILs are associated with the efficacy of trastuzumab in patients with metastatic HER2-positve BC.
Method:Between June 2006 and March 2013, a total of 60 women with recurrent or metastatic HER2-positive BC treated with trastuzumab were included in this retrospective analysis. In these patients, trastuzumab was administered either as single agent or combination with taxanes. Stromal TILs were assessed using immunohistochemistry in surgical specimen (n=39, 65%) and biopsy specimen of metastatic lesion (n=21, 35%) by the academic pathologist (HJL). Primary endpoint of this study was progression-free survival (PFS), and secondary endpoints were response rate and overall survival (OS).
Result:Median age was 54 year old (range, 36-76), and all patients had invasive ductal carcinoma. Hormone receptor was positive in 34 patients (57%) and 18 patients (30%) initially presented with metastatic disease. Nine patients (15%) received cytotoxic chemotherapy without trastuzumab before the administration of trastuzumab. Patients were grouped according to the TILs (< 10% [n=50] and >10% [n=10]), and there was no significant difference in age (p=0.68), histologic grade (p=1.00), metastatic sites (p>0.05), and number of lines of chemotherapy before the administration of trastuzumab(p=0.33) among patients with low and high stromal TILs. High TILs were more common in hormone receptor (HR)-negative tumor compared with HR–positive tumor (31% vs 6%; p=0.02). In overall, median PFS and OS were 15.0 months (95% CI, 9.7-20.2) and 35.0 months (95% CI, 29.8-40.2), respectively. Median PFS in patients with high stromal TILs were numerically longer than that in those with low TILs (22.0 months [95% CI, 9.6-34.4] vs 14.0 months [95% CI, 9.6-18.4]; p=0.057). There was no difference in response rates (p=0.43) and OS (p=0.94) according to the stromal TILs. FcR genotype was not significantly correlated with objective response rate, PFS and OS.
Conclusion:This study suggests that the stromal TILs might be associated with the clinical outcomes of HER2-targeted therapy in patients with metastatic HER2-positive BC. Our finding should be validated in future studies based on a large sample size.
Keywords: Breast cancer, tumor infiltrating lymphocyte. Trastzumab, HER2.
Citation Format: Yoon JA, Yoo C, Lee HJ, Kim K-P, Kim J, Ahn J-H, Jung KH, Gong G, Kim S-B. Predictive role of stromal tumor infiltrating lymphocytes (TILs) in patients with metastatic HER2-positive breast cancer (BC) treated with trastuzumab. [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 P3-07-34.
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Affiliation(s)
- JA Yoon
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - C Yoo
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - HJ Lee
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - K-P Kim
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - J Kim
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - J-H Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - KH Jung
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - G Gong
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
| | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Song-pa gu, Korea
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16
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Kim JE, Ahn JH, Jung KH, Lee HJ, Gong GY, Lee EM, Ha EJ, Son BH, Ahn SH, Ahn SD, Kim HH, Shin HJ, Kim SB. Abstract P1-14-15: A randomized phase lll trial of neoadjuvant sequential chemotherapy with 4 cycles of adriamycin plus cyclophosphamide followed by 4 cycles of docetaxel (AC4-D4) versus shorter 3 cycles of FEC followed by 3 cycles of docetaxel (FEC3-D3) in node-positive breast cancer (Neo-Shorter): First report of efficacy & toxicity profile. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-14-15] [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 addition of a taxane to anthracycline-based chemotherapy provided an improved outcome in neoadjuant setting. Two neoadjuvant chemotherapy with 4 cycles of AC followed by 4 cycles of docetaxel (AC4-D4) and 3 cycles of FEC followed by 3 cycles of docetaxel (FEC3-D3) are widely used. Short duration of chemotherapy, 6 cycles rather than 8 cycles might be an attractive approach.
Methods: This is a randomized, single-center, prospective, parallel group, comparative phase III trial (NCT02001506). Patients (pts) with breast cancer of clinically stage II or III, or sized 1.5 cm with histologically proven lymph-node involvement were included. Pts were stratified according to hormone receptor and HER2 expression status and randomized to AC4-D4 and 3 cycles of FEC3-D3 treatment. The primary endpoint was pathological complete response, defined as the absence of invasive disease in the breast and axillary lymph nodes, analyzed by intention to treat.
Results: At the time of submission, a total of 207 pts were enrolled; 1 pt failed screening; 25 pts dropped out (5 pts in AC4-D4 arm and 2 pts in FEC3-D3 arm discontinue treatment due to progressive disease); 39 pts are still receiving neoadjuvant chemotherapy; 142 pts, who received surgery, were included for this analysis. In AC4-D4 arm, among 64 pts, 57 pts achieved clinical response (6 complete response [CR] and 51 partial response [PR]) and among them 9 pts achieved pathologic complete response [pCR]. In FEC3-D3 arm, among 78 pts, 66 pts achieved clinical response (7 CR and 59 PR) and among them 11 pts achieved pCR. Addition of docetaxel increased clinical response in both arms. The most common adverse event was febrile neutropenia. Without prophylactic G-CSF, grade ≥3 febrile neutropenia (FN) occurred 23/661 cycles (3.5%) in AC4-D4 arm and 23/552 cycles (4.2%) in FEC3-D3 arm, respectively. Grade 3 and 4 toxicities other than FN were reported at expected levels in both groups. Sixty-one severe adverse events were reported; 33 (including 23 FN) in AC4-D4 arm and 28 (including 23 FN) in FEC3-D3 arm.
Conclusion: Compared to AC4-D4, shorter duration of FEC3-D3 neoadjuvant chemotherapy showed similar efficacy of pCR rate of 14.0% (versus 14.1% in AC4-D4 arm). The most common and important adverse event was febrile neutropenia in both arms. Updated study findings will be provided.
Citation Format: Kim JE, Ahn J-H, Jung KH, Lee HJ, Gong G-Y, Lee E-M, Ha EJ, Son B-H, Ahn S-H, Ahn SD, Kim H-H, Shin HJ, Kim S-B. A randomized phase lll trial of neoadjuvant sequential chemotherapy with 4 cycles of adriamycin plus cyclophosphamide followed by 4 cycles of docetaxel (AC4-D4) versus shorter 3 cycles of FEC followed by 3 cycles of docetaxel (FEC3-D3) in node-positive breast cancer (Neo-Shorter): First report of efficacy & toxicity profile. [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 P1-14-15.
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Affiliation(s)
- JE Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J-H Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KH Jung
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - G-Y Gong
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - E-M Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - EJ Ha
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - B-H Son
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-H Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SD Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H-H Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - HJ Shin
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim TY, Sohn JH, Kim SB, Yoon JH, Kim GM, Lee KH, Koh SJ, Park YH, Lee SE, Chae Y, Lee KS, Lee KE, Won HS, Kim JH, Jeong J, Park KH, Cho EK, Im YH, Im SA, Jung KH. Abstract P6-10-03: Does participation in clinical trials influence on survival in patients with metastatic breast cancer? Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-10-03] [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
Recently, many clinical trials (TRIAL) especially incorporated with molecular-targeted agents are being conducted in treatment for breast cancer worldwide. However, the relation of participating clinical trials with survival has not been actively studied. This study was designed to evaluate whether participation in clinical trials could improve overall survival (OS) or not in patients with metastatic breast cancer (MBC), compared with conventional treatment.
Method
Korean Cancer Study Group (KCSG) has successfully established Nationwide Cohort in KOREA to conduct diachronic analysis (KCSG BR 14-07). Clinical data for patients with MBC were collected from this Cohort. OS was defined as the time duration from first diagnosis of metastasis to any cause of death. This work is supported by National Strategic Coordinating Center for Clinical Research (H110C2020).
Results
A total of 575 patients with metastatic breast from 26 institutes in KOREA cancer MBC were consequently enrolled between September 2014 and May 2015. 156 (27.1%) of patients were enrolled to at least one or more clinical trials and 419 patients received only conventional treatment (CONV). Age, hormone status, HER2 status, initial pathologic stage, metastasis versus recurrence, adjuvant treatment, ECOG performance status (PS) (0, 1 vs 2 or more) were similar between TRIAL and CONV. 30% of trials were associated with HER2-targeted agents. As initial treatment, chemotherapy was more frequently used in TRIAL (85.9%) than in CONV (79.0%) (P=0.038). Number of regimens of chemotherapy was greater in TRIAL (2.9+/-1.8) than CONV (2.1+/-1.6) (P<0.001). Number of regimens of endocrine therapy (E) was similar between TRIAL (1.4+/-0.6) and CONV (1.5+/-0.7) (P=0.474). Overall survival of all patients was 16.2 months (95% CI, 14.1-18.1). TRIAL showed significant prolongation of survival, compared with CONV [21.1 (95% CI, 17.7-24.6) vs 15.1 months (95% CI, 13.1-17.2); P=0.005]. The differences in OS was constantly observed in HER2-positive [23.8 (16.7-30.9) vs 17.2 months (95% CI, 12.4-21.9); P=0.018] and Triple-negative [15.4 (10.5-20.3) vs 12.0 months (95% CI, 10.2-13.8); P=0.025]. In multivariate analysis, initial metastasis, hormone status, ECOG PS did not influence on OS between TRIAL and CONV (P=0.849)
Conclusion
Participating in clinical trials could be associated with prolongation of survival. This results constantly maintained in HER2-positive and triple-negative MBC. These findings suggested that clinical trials are useful for the patients with MBC, even if the patients do not complete the standard treatment.
Citation Format: Kim T-Y, Sohn JH, Kim S-B, Yoon JH, Kim GM, Lee KH, Koh S-J, Park YH, Lee SE, Chae Y, Lee KS, Lee KE, Won HS, Kim JH, Jeong J, Park KH, Cho EK, Im Y-H, Im S-A, Jung KH. Does participation in clinical trials influence on survival in patients with metastatic breast cancer?. [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 P6-10-03.
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Affiliation(s)
- T-Y Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - JH Sohn
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - S-B Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - JH Yoon
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - GM Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - KH Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - S-J Koh
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - YH Park
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - SE Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Y Chae
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - KS Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - KE Lee
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - HS Won
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - JH Kim
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - J Jeong
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - KH Park
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - EK Cho
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Y-H Im
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - S-A Im
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - KH Jung
- Seoul National University Hospital, Seoul, Republic of Korea; Asan Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Seoul, Republic of Korea; Division of Breast-Endocrine Surgery, Chonnam National Univ. Hwasun Hospital, Kwangju, Republic of Korea; Yonsei University College of Medicine, Seoul, Republic of Korea; Chungbuk National University Hospital, Cheongju, Republic of Korea; Ulsan University Hospital, Ulsan, Republic of Korea; Dong-A University Hospital, Pusan, Republic of Korea; Kyungpook National University Hospital, Daegu; Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea; Ewha Womans University Hospital, Seoul, Republic of Korea; Uijeongbu St. Mary's Hospital, Uijeongbu, Republic of Korea; Seoul National University Bundang Hospital, Sungnam, Republic of Korea; Gangnam Severance Hospital, Seoul, Republic of Korea; Korea University Anam Hospital, Seoul, Republic of Korea; Gachon University Gil Medical Center, Incheon, Republic of Korea
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Park YH, Jung KH, Sohn JH, Lee KS, Lee KH, Kim JH, Kim JY, Jung J, Han H, Park WY, Im SA. Abstract OT3-01-10: A prospective, open-label, single-arm, multi-center, phase II exploratory study to evaluate the efficacy and safety of poziotinib (NOV120101) in patients with HER2-positive metastatic breast cancer who have received at least two prior HER2-directed regimens. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot3-01-10] [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: Poziotinib is a novel, oral, irreversible pan-HER inhibitor that has shown promising clinical activity in Phase 1 studies of patients (pts) with advance HER2 positive breast cancer who have failed at least 2 prior lines of HER2-directed therapy. A Phase 2 study of poziotinib was initiated in Korea in March 2015 in pts with HER2+ metastatic breast cancer. This phase 2 study is designed to seek accelerated approval for poziotinib for the treatment of metastatic breast cancer in Korea.
Trial Design: Prospective Phase 2, open-label, single-arm, multi-center study in pts with recurrent, Stage IV breast cancer with HER2-overexpression who had received at least 2 prior HER2-directed regimens
Eligibility Criteria: Histologically confirmed breast cancer patients, at least 19 years of age, with confirmed HER2 positive evaluable tumors (per RECIST, 1.1) who have adequate hematologic, renal, and hepatic function and have failed at least two HER2-directed regimens that included a taxane-containing anticancer chemotherapy, with a life expectancy of at least 12 weeks.
Specific Aims: The Primary Efficacy Endpoint of the study was Progression-Free Survival (PFS). The Secondary Efficacy Endpoints included: PFS rate at 12 weeks post-dose; Objective Response Rate (ORR) including Complete Response (CR) and Partial Response (PR) rates; Disease Control Rate (DCR) including CR, PR, and Stable Disease (SD); Duration of Disease Control; Overall Survival (OS); Time to Progression (TTP); Time to Objective Response and Duration of Objective Response. The Exploratory Endpoints included: Population Pharmacokinetic (PK) Profile and Exploratory Genomic and Biomarker Analyses.
Statistical Methods: In the randomized, multicenter, 2-arm, open-label study of trastuzumab emtansine (TH3RESA18), the median PFS was shown to be 3.3 months in subjects with optimal treatment per Investigator's Choice. This ongoing study with poziotinib expects a median PFS of 4.5 months based on data from a previous Phase 1 study of poziotinib (NOV120101). Based on the following assumptions, a 5% one-sided significance level, and 80% power, and 2 months of accrual and 12 months of follow-up, 66 subjects will be required. Accounting for a 10% drop-out rate, a total of 74 subjects will be recruited into this ongoing Phase 2 study.
Present Accrual and Target Accrual: 17 patients enrolled as of May 20, 2015 with a total target enrollment of 74 patients
Contact information:
ClinicalTrials.gov Identifier: NCT02418689.
Citation Format: Park Y-H, Jung KH, Sohn JH, Lee KS, Lee KH, Kim J-H, Kim J-Y, Jung J, Han H, Park W-Y, Im S-A. A prospective, open-label, single-arm, multi-center, phase II exploratory study to evaluate the efficacy and safety of poziotinib (NOV120101) in patients with HER2-positive metastatic breast cancer who have received at least two prior HER2-directed regimens. [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 OT3-01-10.
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Affiliation(s)
- Y-H Park
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - KH Jung
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - JH Sohn
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - KS Lee
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - KH Lee
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - J-H Kim
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - J-Y Kim
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - J Jung
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - H Han
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - S-A Im
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
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Halder D, Mandal C, Lee BH, Lee JS, Choi MR, Chai JC, Lee YS, Jung KH, Chai YG. PCDHB14- and GABRB1-like nervous system developmental genes are altered during early neuronal differentiation of NCCIT cells treated with ethanol. Hum Exp Toxicol 2015; 34:1017-27. [PMID: 25566775 DOI: 10.1177/0960327114566827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 01/08/2023]
Abstract
Ethanol (EtOH) exposure during embryonic development causes dysfunction of the central nervous system (CNS). Here, we examined the effects of chronic EtOH on gene expression during early stages of neuronal differentiation. Human embryonic carcinoma (NCCIT) cells were differentiated into neuronal precursors/lineages in the presence or absence of EtOH and folic acid. Gene expression profiling and pathway analysis demonstrated that EtOH deregulates many genes and pathways that are involved in early brain development. EtOH exposure downregulated several important genes, such as PCDHB14, GABRB1, CTNND2, NAV3, RALDH1, and OPN5, which are involved in CNS development, synapse assembly, synaptic transmission, and neurotransmitter receptor activity. GeneGo pathway analysis revealed that the deregulated genes mapped to disease pathways that were relevant to fetal alcohol spectrum disorders (FASD, such as neurotic disorders, epilepsy, and alcohol-related disorders). In conclusion, these findings suggest that the impairment of the neurological system or suboptimal synapse formation resulting from EtOH exposure could underlie the neurodevelopmental disorders in individuals with FASD.
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Affiliation(s)
- D Halder
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - C Mandal
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - B H Lee
- Department of Psychiatry, Gangnam Eulji Hospital, Eulji University, Seoul, Republic of Korea KARF Hospital, the Korean Alcohol Research Foundation, Goyang, Republic of Korea
| | - J S Lee
- KARF Hospital, the Korean Alcohol Research Foundation, Goyang, Republic of Korea
| | - M R Choi
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - J C Chai
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - Y S Lee
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea
| | - K H Jung
- Institute of Natural Science and Technology, Hanyang University, Ansan, Republic of Korea
| | - Y G Chai
- Department of Molecular and Life Sciences, Hanyang University, Ansan, Republic of Korea Department of Nanobiotechnology, Hanyang University, Seoul, Republic of Korea
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Lee HJ, Seo AN, Kim EJ, Jang MH, Kim YJ, Kim JH, Kim SW, Ryu HS, Park IA, Im SA, Gong G, Jung KH, Kim HJ, Park SY. Prognostic and predictive values of EGFR overexpression and EGFR copy number alteration in HER2-positive breast cancer. Br J Cancer 2014; 112:103-11. [PMID: 25349977 PMCID: PMC4453607 DOI: 10.1038/bjc.2014.556] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/23/2014] [Accepted: 10/02/2014] [Indexed: 12/24/2022] Open
Abstract
Background: Epidermal growth factor receptor (EGFR) is overexpressed in a subset of human epidermal growth factor receptor 2 (HER2)-positive breast cancers, and coexpression of HER2 and EGFR has been reported to be associated with poor clinical outcome. Moreover, interaction between HER2 and EGFR has been suggested to be a possible basis for trastuzumab resistance. Methods: We analysed the clinical significance of EGFR overexpression and EGFR gene copy number alterations in 242 HER2-positive primary breast cancers. In addition, we examined the correlations between EGFR overexpression, trastuzumab response and clinical outcome in 447 primary, and 112 metastatic HER2-positive breast cancer patients treated by trastuzumab. Results: Of the 242 primary cases, the level of EGFR overexpression was 2+ in 12.7% and 3+ in 11.8%. High EGFR gene copy number was detected in 10.3%. Epidermal growth factor receptor overexpression was associated with hormone receptor negativity and high Ki-67 proliferation index. In survival analyses, EGFR overexpression, but not high EGFR copy number, was associated with poor disease-free survival in all patients, and in the subgroup not receiving adjuvant trastuzumab. In 447 HER2-positive primary breast cancer patients treated with adjuvant trastuzumab, EGFR overexpression was also an independent poor prognostic factor. However, EGFR overexpression was not associated with trastuzumab response, progression-free survival or overall survival in the metastatic setting. Conclusions: Epidermal growth factor receptor overexpression, but not high EGFR copy number, is a poor prognostic factor in HER2-positive primary breast cancer. Epidermal growth factor receptor overexpression is a predictive factor for trastuzumab response in HER2-positive primary breast cancer, but not in metastatic breast cancer.
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Affiliation(s)
- H J Lee
- 1] Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea [2] Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-746, Korea
| | - A N Seo
- Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea
| | - E J Kim
- Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea
| | - M H Jang
- Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea
| | - Y J Kim
- 1] Department of Medical Oncology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea [2] Department of Medical Oncology, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
| | - J H Kim
- 1] Department of Medical Oncology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea [2] Department of Medical Oncology, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
| | - S-W Kim
- 1] Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea [2] Department of Surgery, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
| | - H S Ryu
- Department of Pathology, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
| | - I A Park
- Department of Pathology, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
| | - S-A Im
- Department of Medical Oncology, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
| | - G Gong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-746, Korea
| | - K H Jung
- Department of Medical Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-746, Korea
| | - H J Kim
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-746, Korea
| | - S Y Park
- 1] Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi 463-707, Korea [2] Department of Pathology, Seoul National University College of Medicine, 28 Yeongon-dong, Jongno-gu, Seoul 110-799, Korea
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Kim JK, Jung KH, Jang JH, Huh DS. Hydrophobic interaction-mediated reversible adsorption–desorption of nanoparticles in the honeycomb-patterned thermoresponsive poly(N-isopropylamide) hydrogel surface. Polym Bull (Berl) 2014. [DOI: 10.1007/s00289-014-1129-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Park IH, Lee KS, Im SA, Jung KH, Park KH, Im YH, Lee S, Kim YJ, Kim HJ, Lee S, Lee MH, Kim TY, Lee KH, Kim SB, Ahn JH, Nam BH, Ro J. Abstract OT3-1-08: The PROCEED trial KCSG BR11-01: Phase III multicenter randomized open label study of irinotecan plus capecitabine versus capecitabine in patients previously treated with anthracycline and taxane for HER2 negative metastatic breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-ot3-1-08] [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: Most patients with metastatic breast cancer (MBC) experience disease progression after being treated with an anthracycline or taxane. Irinotecan, a semisynthetic agent derived from the natural alkaloid camptothecin is metabolized to the active metabolite SN-38 which targets topoisomerase I leading to single and double strand DNA breaks. Irinotecan as a single agent demonstrated tumor activity with an objective response rate ranging from 5 to 23% in patients with MBC refractory to taxane and anthracycline. Irinotecan increased the activity of 5-FU, the active metabolite of capecitabine, and overcomes the negative effect of thymidylate synthase overexpression, which is the main target of an active metabolite of 5-FU. A phase II study that evaluated the efficacy and safety of irinotecan and capecitabin combination (IX) showed that the median progression free survival (PFS) was 7.6 months (95% CI, 5.0-10.2months), and the median OS was 22.6 months (95% CI, 15.4 – 29.8 months) with good tolerability in anthracycline and taxane pretreated MBC patients. Based on these results, we planned to conduct a multicenter, randomized phase III study which assesses the efficacy of irinotecan and capecitabine combination therapy compared with capecitabine alone in patients with anthracycline and taxane resistant MBC.
Methods: In this trial, patients with HER2 normal tumor who previously received anthracycline and taxane based chemotherapies are enrolled. Eligible patients are randomly assigned in a 1:1 ratio to receive irinotecan plus capecitabine or capecitabine alone. The primary end point of this trial is PFS and a total number of accrual patients will be 222. Randomization is done using a random block size permutation method and stratified by hormone receptor status (negative vs. positive), first line vs. ≥second lines, visceral metastasis (negative vs. positive). Patients receive irinotecan at 80 mg/m2 on day 1 and 8 every 3 weeks and capecitabine 1000mg/m2 bid from day 1 to day 14 every 3 weeks. In control arm, patients receive capecitabine 1250mg/m2 bid from day 1 to day 14 every 3 weeks. Response will be assessed using RECIST1.1 criteria and toxicity will be graded according to NCI-CTCAE 4.0 criteria. Study Status: A total of 107 patients consented for the study since June 2011, and accrual is ongoing. Clinical trial information: NCT01501669.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT3-1-08.
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Affiliation(s)
- IH Park
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - KS Lee
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - S-A Im
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - KH Jung
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - KH Park
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - Y-H Im
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - S Lee
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - YJ Kim
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - H-J Kim
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - S Lee
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - MH Lee
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - T-Y Kim
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - K-H Lee
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - S-B Kim
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - J-H Ahn
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - B-H Nam
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
| | - J Ro
- National Cancer Center, Korea; Seoul National University Hospital, Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Korea University Anam Hospital; Samsung Medical Center, Sungkyunkwan University School of Medicine; Yonsei University College of Medicine; Seoul National University Bundang Hospital, Seoul National University College of Medicine; Chung-Ang University College of Medicine; Dong-A University College of Medicine; Inha University College of Medicine
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Choi YJ, Bae JW, Kim HJ, Kang SY, Park YH, Lee S, Jung KH, Oh HS, Choi IS, Lee KH, Lee SE, Park KH. Abstract P6-05-17: A study of investigating biologic markers of anti-tumor effects of zoledronic acid and taxane-based chemotherapy for metastatic breast cancer in bone: A prospective, multi-center, non-randomized study (BEAT-ZO) (KCSG BR10-13). Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p6-05-17] [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
Introduction
Currently the predictive factors for taxane(T)-zoledronic acid(ZA) combination therapy in breast cancer patient with bone metastasis have not been established except tumor biology. The aim of this study is to investigate potential biologic markers of anti-tumor effects of and T-ZA for metastatic breast cancer(MBC) in bone.
Methods
Patients(pts) with MBC in bone being treated with docetaxel or paclitaxel based chemotherapy and ZA for the first time in metastatic setting were enrolled. Blood samples were collected serially at baseline, after 2 cycles to examine markers for angiogenesis(VEGF, VEGFR2, FGF-2, PDGF-AA), immune modulation (IL-2, IFN-γ, MCP-2, IL-10, TGF-β, IL-12, TNF-α, IL-17, IL-6) and apoptosis (TRAIL).
Results
Of enrolled total 58 pts, 31 pts (median age 49; ECOG 0-1 96.8%; menopause 58.1%; invasive ductal carcinoma 92.9%; ER-(+) 77.4%; HER2-(+) 35.5%; visceral metastasis 35.5%) were included in this preliminary analysis.
Fifteen pts received docetaxel-based chemotherapy and the remainder were treated with paclitaxel-based chemotherapy. Median 6 (range: 1 – 23) cycles per pt were administered. In per-protocol analysis, overall RR was 55.6% [95% CI: 37.3 – 72.4]. After the median follow-up of 13.67 months(mo.), median PFS was 9.13 mths [95% CI: 3.25 – 15.02]. Osteonecrosis of the jaw was reported in only one patient (3.2%).
In the baseline biomarker analysis, the pts with triple-negative breast cancer (TNBC) showed significantly higher VEGF level than hormone (+) or HER-2 (+) pts (518.7 vs 151.6 and 179.2 pg/ml, p = 0.041). Median baseline TRAIL was significantly higher in the postmenopausal women than the premenopausal women (52.0 vs 32.0 pg/ml, p = 0.038).
For the group as a whole, there was a borderline significant reduction in median serum MCP-2 level (41.4 to 34.1 pg/ml, p = 0.066) and an increasing tendency in median serum TRAIL level (44.7 to 54.5 pg/ml, p = 0.080) after 2 cycles of treatment. Median percentage reduction in serum VEGF in the TNBC group was -50.0% compared with +37.7% in others (p = 0.099). Median changes in MCP-2 was -36.4% in hormone (+) group compared with +7.6% in others (p = 0.008).
The pts who were progression free at 6 mths showed significant increase in median TNF-α after 2cycles of treatment, while the pts who experienced disease progression within 6 mths showed significant decrease in TNF-α level (p = 0.028) and there was a similar tendency in TRAIL level (p = 0.157).
The pts with increase of serum TNF-α or TRAIL levels from baseline showed significant improvement of PFS comparing the pts with no change or decrease of TNF-α and TRAIL levels (13.3 vs 5.93 mths, p = 0.012).
We are planning to perform additional analysis. The significance of serum TGF-β level on prognosis and the data of the remainder will be presented on the poster.
Conclusion
In this study, baseline levels and changes of biomarkers suggest potentially relevant interactions between menopausal status, tumor biology and treatment. Especially, TNF-α and TRAIL may be potential early marker for zoledronic acid and taxane-based chemotherapy for MBC in bone. Larger studies are needed to validate these complex interactions.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-05-17.
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Affiliation(s)
- YJ Choi
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - JW Bae
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - HJ Kim
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - SY Kang
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - YH Park
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - S Lee
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - KH Jung
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - H-S Oh
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - IS Choi
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - K-H Lee
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - S-E Lee
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
| | - KH Park
- Korea University College of Medicine, Seoul, Republic of Korea; Chung-Ang University Hospital; Severance Hospital, Yonsei University College of Medicine; Ajou University School of Medicine; Samsung Medical Center, Sungkyunkwan University School of Medicine; Asan Medical Center, University of Ulsan College of Medicine; Gangneung Asan Hospital, University of Ulsan College of Medicine; Seoul Municipal Boramae Hospital, Seoul National University College of Medicine; Cancer Research Institute, Seoul National University; Dong-A Medical Center
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Lee HJ, Seo AN, Kim EJ, Jang MH, Suh KJ, Ryu HS, Kim YJ, Kim JH, Im SA, Gong G, Park IA, Jung KH, Park SY. Abstract P1-08-38: HER2 heterogeneity affects trastuzumab responses and survival in patients with HER2-postive metastatic breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-08-38] [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
Purpose: Heterogeneity of HER2 gene amplification is found in a subset of breast cancers. However, it is not known whether breast cancers with heterogeneous HER2 amplification respond differently to HER2-targeted therapy than those with homogeneous amplification. In this study, we investigated the relationship between HER2 heterogeneity and trastuzumab resistance and clinical outcomes in patients with HER2-positive metastatic breast cancer.
Patients and methods: We studied tumor tissues from 127 patients with HER2-positive metastatic breast cancers who had received trastuzumab-based chemotherapy. Regional and genetic heterogeneity of HER2 amplification was determined in three different areas of each tumor by immunohistochemistry (IHC) and silver in situ hybridization. We also assessed the overall levels of HER2 amplification, and the proportion of tumor cells with a HER2/CEP17 ratio >2.2 or HER2 overexpression (IHC score of 3+). HER2status including HER2 heterogeneity was correlated with trastuzumab responses and survival of the patients.
Results: HER2regional and genetic heterogeneity was confirmed in 7.8% and 3.6% of cases, respectively. Poor response to trastuzumab was associated with overall low-level amplification, HER2regional heterogeneity, HER2/CEP17 ratio >2.2 in <80% of tumor cells, and HER2 IHC score of 3+ in <75% of tumor cells. In survival analyses, low-level HER2 amplification, HER2regional heterogeneity, and HER2/CEP17 ratio >2.2 in <80% of tumor cells were associated with shorter time to progression and lower overall survival in univariate and multivariate analyses.
Conclusion: Accurate assessment of HER2 status including HER2 heterogeneity is important in predicting trastuzumab responses and outcomes in patients with HER2-positive metastatic breast cancer.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-08-38.
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Affiliation(s)
- HJ Lee
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - AN Seo
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - EJ Kim
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - MH Jang
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - KJ Suh
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - HS Ryu
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - YJ Kim
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - JH Kim
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - S-A Im
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - G Gong
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - IA Park
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - KH Jung
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
| | - SY Park
- Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea; Seoul National University Bundang Hospital; Seoul National University Hospital; Seoul National University College of Medicine; Asan Medical Center, University of Ulsan College of Medicine
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Kim SY, S Hong Y, K Shim E, Kong SY, Shin A, Baek JY, Jung KH. S-1 plus irinotecan and oxaliplatin for the first-line treatment of patients with metastatic colorectal cancer: a prospective phase II study and pharmacogenetic analysis. Br J Cancer 2013; 109:1420-7. [PMID: 23963147 PMCID: PMC3776990 DOI: 10.1038/bjc.2013.479] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/09/2013] [Accepted: 07/29/2013] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND S-1 is an oral fluoropyrimidine that mimics infusional 5-fluorouracil. The aim of this phase II trial was to explore the clinical efficacy of the triplet regimen TIROX, which consists of S-1, irinotecan and oxaliplatin. METHODS Forty-two chemo-naive patients with metastatic colorectal cancer (mCRC) were planned to be enrolled and be treated with irinotecan 150 mg m(-2) followed by oxaliplatin 85 mg m(-2) on day 1 and S-1 80 mg m(-2) per day from day 1 to 14 every 3 weeks. Polymorphisms in the UGT1A1, UGT1A6, UGT1A7 and CYP2A6 genes were analysed. RESULTS Between July 2007 and February 2008, 43 patients were enrolled. An objective response was noted in 29 patients (67.4%, 95% confidence interval: 53.4-81.4), of which 2 achieved durable complete responses. The median progression-free survival was 10.0 months and the median overall survival was 19.2 months. Significant grade 3 or 4 adverse events were neutropenia (45.2%), febrile neutropenia (9.5%), diarrhoea (7.1%) and vomiting (9.5%). Increased gastrointestinal toxicities were associated with the presence of UGT1A6*2 or UGT1A7*3 and an improved tumour response was noted in those without variant alleles of CYP2A6 or UGT1A1*60. CONCLUSION The combination of S-1, irinotecan and oxaliplatin showed favourable efficacy and tolerability in untreated patients with mCRC.
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Affiliation(s)
- S Y Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - Y S Hong
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul 138-736, Korea
| | - E K Shim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - S-Y Kong
- Department of Laboratory Medicine, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - A Shin
- Molecular Epidemiology Branch, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - J Y Baek
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 410-769, Korea
| | - K H Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul 138-736, Korea
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Hong HP, Jung KH, Kim JH, Kwon KH, Lee CJ, Yun KN, Min NK. Percolated pore networks of oxygen plasma-activated multi-walled carbon nanotubes for fast response, high sensitivity capacitive humidity sensors. Nanotechnology 2013; 24:085501. [PMID: 23376938 DOI: 10.1088/0957-4484/24/8/085501] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report on the preparation of capacitive-type relative humidity sensors incorporating plasma-activated multi-wall carbon nanotube (p-MWCNT) electrodes and on their performance compared with existing commercial technology. Highly open porous conductive electrodes, which are almost impossible to obtain with conventional metal electrodes, are fabricated by spray-depositing MWCNT networks on a polyimide layer. Oxygen plasma activation of the MWCNTs is also explored to improve the water adsorption of the MWCNT films, by introducing oxygen-containing functional groups on the CNT surface. Polyimide humidity sensors with optimized p-MWCNT network electrodes exhibit exceptionally fast response times (1.5 for adsorption and 2 s for desorption) and high sensitivity (0.75 pF/% RH). These results may be partially due to their percolated pore structure being more accessible for water molecules, expending the diffusion of moisture to the polyimide sensing film, and partially due to the oxygenated surface of p-MWCNT films, allocating more locations for adsorption or attraction of water molecules to contribute to the sensitivity.
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Affiliation(s)
- H P Hong
- Department of Control and Instrumentation Engineering, Korea University, Jochiwon 339-700, Korea
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Yun YH, Lee MK, Park SM, Kim YA, Lee WJ, Lee KS, Choi JS, Jung KH, Do YR, Kim SY, Heo DS, Kim HT, Park SR. Effect of complementary and alternative medicine on the survival and health-related quality of life among terminally ill cancer patients: a prospective cohort study. Ann Oncol 2013; 24:489-494. [PMID: 23110809 DOI: 10.1093/annonc/mds469] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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: 10/07/2023] Open
Abstract
BACKGROUND We evaluated whether complementary and alternative medicine (CAM) use influenced outcomes [survival and health-related quality of life (HRQOL)] of cancer patients whose condition had just been judged terminal. PATIENTS AND METHODS From July 2005 to October 2006, we conducted a prospective cohort study of 481 terminally ill cancer patients at 11 university hospitals and the National Cancer Center in Korea. We assessed how the use of CAM affected HRQOL and survival. RESULTS In a follow-up of 481 patients and 163.8 person-years, we identified 466 deceased cases. On multivariate analyses, CAM users did not have better survival compared with nonusers [adjusted hazard ratio (aHR), 0.91; 95% confidence interval (CI) 0.74-1.10]. Among mind-body interventions, prayer showed significantly worse survival (aHR, 1.56; 95% CI, 1.00-2.43). Clinically, CAM users reported significantly worse cognitive functioning (-11.6 versus -1.3; P < 0.05) and fatigue (9.9 versus -1.0; P < 0.05) than nonusers. Compared with nonusers in subgroup analysis, users of alternative medical treatments, prayer, vitamin supplements, mushrooms, or rice and cereal reported clinically significant worse changes in some HRQOL subscales. CONCLUSION While CAM did not provide any definite survival benefit, CAM users reported clinically significant worse HRQOLs.
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Affiliation(s)
- Y H Yun
- Cancer Research Institute, Seoul National University Hospital and College of Medicine, Seoul.
| | - M K Lee
- Research Institute and Hospital, National Cancer Center, Goyang
| | - S M Park
- Department of Family Medicine, Seoul National University Hospital and College of Medicine, Seoul
| | - Y A Kim
- Research Institute and Hospital, National Cancer Center, Goyang
| | - W J Lee
- Research Institute and Hospital, National Cancer Center, Goyang
| | - K S Lee
- Research Institute and Hospital, National Cancer Center, Goyang
| | - J S Choi
- Department of Oncology, Gangneung Asan Hospital, Gangneung
| | - K H Jung
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - Y R Do
- Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu
| | - S Y Kim
- Department of Internal Medicine, Chungnam University School of Medicine, Daejeon
| | - D S Heo
- Department of Internal Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - H T Kim
- Research Institute and Hospital, National Cancer Center, Goyang
| | - S R Park
- Research Institute and Hospital, National Cancer Center, Goyang
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Jo JC, Kang MJ, Ahn JH, Jung KH, Kim JE, Gong G, Kim HH, Ahn SD, Kim SS, Son BH, Ahn SH, Kim SB. Abstract P3-12-05: Clinical features and outcomes of leptomeningeal metastasis in patients with breast cancer: a single center experience. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-12-05] [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: Leptomeningeal metastasis (LM) is one of the major problems in managing metastatic breast cancer because of LM typically carries a devastating prognosis and often represents a terminal event. We analyzed the clinical features and outcomes of LM in patients with breast cancer.
Methods: We retrospectively reviewed the medical records of patients who were diagnosed with LM from breast cancer between 2002 and 2012 at Asan Medical Center.
Results: Of the 95 LM patients by cytologically proven (n = 81) or radiologically diagnosed (n = 14), 57 (60%) had an ECOG performance status (PS) ≥ 3, and the median age was 47 years (range, 26–72 years). The patients were diagnosed with LM after a median of 10.3 months (95% CI, 5.5–15.0 months) from the time of diagnosis of metastatic breast cancer. LM was present in 2 patients at the time of initial diagnosis. Twenty-three patients (24.2%) had isolated CNS metastasis, and 6 (6.3%) had only LM without any detectable metastasis sites. At the time of diagnosis of LM, 46 patients (48.4%) presented with coincidental failure of systemic disease control. Seventy-eight patients (82.1%) underwent intrathecal chemotherapy (methotrexate; n=78, thiotepa; n=11), resulting in one-third of cytologic negative conversion (n = 26), and 41 (43.2%) received systemic chemotherapy. The overall median survival time was 3.3 months (95% CI, 2.5–4.2 months) and 7.8% of the patients survived for more than 1 year. Overall survival tended to be better in patients who achieved cytologic negative conversion to intrathecal chemotherapy than those did not (median 4.5 months versus 3.2 months, P = 0.241). Overall survival was not different according to subtypes; hormone receptor (+), HER2 (+), and triple negative (median 3.6 months, 3.3 months, and 3.2 months, P = 0.937). Multivariate analysis demonstrated that ECOG PS ≥ 3 (HR = 2.09, 95% CI 1.21–3.58, P = 0.007), coincidental failure of systemic disease control at LM (HR = 3.01, 95% CI 1.76–5.15, P < 0.001), and systemic chemotherapy after LM (HR = 0.40, 95% CI 0.24–0.68, P = 0.001) were independent factors associated with survival.
Conclusions: The prognosis for patients with LM from breast cancer was still poor. Systemic chemotherapy in addition to intrathecal chemotherapy might confer a survival benefit, even after the detection of LM.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-12-05.
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Affiliation(s)
- J-C Jo
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - MJ Kang
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-H Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - KH Jung
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - JE Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - G Gong
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - HH Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SD Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SS Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - BH Son
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SH Ahn
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-B Kim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee SD, Kim TH, Kim DY, Baek JY, Kim SY, Chang HJ, Park SC, Park JW, Oh JH, Jung KH. Lymph node ratio is an independent prognostic factor in patients with rectal cancer treated with preoperative chemoradiotherapy and curative resection. Eur J Surg Oncol 2012; 38:478-83. [PMID: 22465588 DOI: 10.1016/j.ejso.2012.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 02/26/2012] [Accepted: 03/05/2012] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To evaluate the prognostic effect of lymph node ratio (LNR) in patients with locally advanced rectal cancer who were treated with curative resection after preoperative chemoradiotherapy (CRT). METHODS Between October 2001 and December 2007, 519 patients who had undergone curative resection of primary rectal cancer after preoperative CRT were enrolled. Of these, 154 patients were positive for lymph node (LN) metastasis and were divided into three groups according to the LNR (≤ 0.15 [n=80], 0.16-0.3 [n=44], >0.3 [n=30]) to evaluate the prognostic effect on overall survival (OS) and disease-free survival (DFS). RESULTS LNR (≤ 0.15, 0.16-0.3, and >0.3) was significantly associated with 5-year OS (90.3%, 75.1%, and 45.1%; p<0.001) and DFS (66.7%, 55.8%, and 21.9%; p<0.001) rates. In a multivariate analysis, LNR (≤ 0.15, 0.16-0.3, and >0.3) was a significant independent prognostic factor for OS (hazard ratios [HRs], 1, 3.609, and 8.197; p<0.001) and DFS (HRs, 1, 1.699, and 3.960; p<0.001). LNR had a prognostic impact on OS and DFS in patients with <12 harvested LNs, as well as in those with ≥ 12 harvested LNs (p<0.05). CONCLUSION LNR was a significant independent prognostic predictor for OS and DFS in patients with locally advanced rectal cancer who were treated with curative resection after preoperative CRT.
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Affiliation(s)
- S D Lee
- Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea
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Kim SJ, Yoon DW, Lee EJ, Hur GY, Jung KH, Lee SY, Lee SY, Shin C, Shim JJ, In KH, Kang KH, Yoo SH, Kim JH. Carotid atherosclerosis in patients with untreated chronic obstructive pulmonary disease. Int J Tuberc Lung Dis 2012; 15:1265-70, i. [PMID: 21943856 DOI: 10.5588/ijtld.10.0680] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is associated with systemic inflammation. OBJECTIVE To evaluate carotid artery intima-media thickness (IMT), high sensitivity C-reactive protein (hsCRP) and their correlation in newly diagnosed untreated patients with COPD. DESIGN Post-bronchodilator spirometry, carotid artery IMT and blood tests were measured in patients with COPD (COPD group). Age, sex, body mass index, smoking status and smoking amount were compared with matched healthy subjects (non-COPD group). Participants taking medications and/or with a history of hypertension, diabetes mellitus, dyslipidaemia, COPD or cardiovascular disease were excluded. RESULTS A total of 126 patients (COPD group 42, non-COPD group 84) were enrolled. The IMT and hsCRP of the COPD group were significantly higher than in the non-COPD group (P < 0.05). The decrease in the forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratio and FEV(1) was significantly correlated with an increase in the hsCRP and IMT (P < 0.05); there was no correlation between the IMT and hsCRP (P = 0.152). CONCLUSION In newly diagnosed untreated patients with COPD, the carotid artery IMT and hsCRP were significantly higher than in healthy subjects. These findings suggest that systemic inflammation may play a potential role in preclinical atherosclerosis in COPD.
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Affiliation(s)
- S J Kim
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
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Koo DH, Ahn JH, Yoon DH, Kim SB, Lee HJ, Kong KY, Son BH, Ahn SH, Jung KH. P5-13-11: PTEN and Tau-Protein Expression: Predictive Value of Poor Response to Trastuzumab Plus Paclitaxel in Patients with HER2−Positive Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-13-11] [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
Backgrounds: Trastuzumab-based chemotherapy has been an active treatment in patients (pts) with HER2−positive breast cancer; however, primary and secondary resistance has occurred in pts treated with trastuzumab (H) alone or in combination with chemotherapy. Material and Methods: Biomarkers were searched using tissue microarrays (TMA) in the HER2−positive breast cancer pts treated with H and paclitaxel (P) combination chemotherapy between October 2004 and August 2010. Tumor blocks of 101 pts were analyzed for VEGF, IGF-1R, p-Akt, beta-III tubulin, CD44, Tau-protein, p27 and PTEN by immunohistochemical (IHC) analysis. Eight biomarkers were assessed to investigate the correlation with the clinical outcomes, including response rate (RR), progression free survival (PFS), and overall survival (OS).
Results: With a median follow-up duration of 21.7 months (range, 9.1−55.2 months), 101 pts received H+P chemotherapy in neoadjuvant setting (n=36, 35.6%) and recurrent or metastatic setting (n=65, 64.4%). Median age was 48 (range, 19–83 years), and the majority of pts (n=95, 94.1%) had good performance status. Premenopausal pts and hormone receptor-negative pts were 48 (47.5%) and 52 (51.5%), respectively. The median cycle of H+P chemotherapy was six (range, H 1–43; P 1–21). Overall RR was 68.3% (n=69) including complete response with 7 pts, and PFS and OS were significantly longer in pts responsive to H+P chemotherapy compared with non-responsive patients (PFS, p=0.001; OS, p=0.015). Although VEGF, IGF-1R, p-Akt, beta-III tubulin, CD44, p27 and PTEN status by IHC were not significantly associated with response to H+P chemotherapy, Tau-protein showed a trend of association without statistical significance (RR, 46.2% vs. 71.6%, p=0.066). Among 13 pts with high Tau protein expression, 9 pts with both high Tau-protein and low PTEN level showed statistically significant lower RR compared with other 92 pts (22.2% vs. 72.8%; p=0.002). None of the biomarkers was related to PFS and OS in pts with recurrent or metastatic disease, and to pathologic complete response in pts after H+P chemotherapy as neoadjuvant therapy.
Conclusion: Our data showed that both low PTEN level and high Tauprotein expression were significantly associated with poor response to H+P chemotherapy in patients with HER2−positive breast cancer.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-13-11.
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Affiliation(s)
- DH Koo
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - J-H Ahn
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - DH Yoon
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-B Kim
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - HJ Lee
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - KY Kong
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - BH Son
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - SH Ahn
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - KH Jung
- 1Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kil IS, Jung KH, Nam WS, Park JW. Attenuated mitochondrial NADP+-dependent isocitrate dehydrogenase activity enhances EGCG-induced apoptosis. Biochimie 2011; 93:1808-15. [DOI: 10.1016/j.biochi.2011.06.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 06/21/2011] [Indexed: 02/05/2023]
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Kim HJ, Gong KY, Jung KH, Kim SB, Lee JW, Ahn SH. Abstract P1-01-08: Lymph Node Ratio as an Alternative to pN Staging in Node Positive Breast Cancer: A report from the Korean Breast Cancer Society. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p1-01-08] [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: To compare the lymph node ratio(LNR) and pN staging as a prognostic predictor and find out high risk subgroup which can not predict prognosis using pN staging.
Patients and Methods: Using information from two large databases, including Korean nationwide registry, we compared the survival using LNR and pN stage parameters by Cox regression analysis. Moreover survival data were analysed according to age subgroups and intrinsic subtypes. Results: In an analysis of 2264 node positive patients from single institution, adjusted cancer specific mortality risks of low (≥0.20), intermediate (>0.20 and ≥0.65) and high risk (>0.65) LNR groups were 1(reference), 1.9 (95%CI, 1.6 to 2.4), 4.6(95%CI, 3.6 to 5.8). The difference of mortality risk between LNR parameters were wider than that of N1, N2 and N3 in DFS, CSS, OS. In contrast to LNR risk categories, survival curve in pN1 and pN2 overlapped in the patients below 35 years old. Survival curve in pN1 and pN2 also overlapped in patients in her2/neu enriched as well as triple negative subtype. These finding were validated by an analysis of nationwide registry data on 15488 node positive patients. The patients who had N1 and LNR2-3 disease showed poor DFS (HR 1.7 95% CI 1.4 to 2.2) and CSS (HR 1.6, 95% CI 1.1 to 2.2) compared with the patients who had N2 and LNR1 disease. Conclusion: LNR define breast cancer prognosis more adequate than the pN categories especially high risk breast cancer like young age, her2/neu enriched and triple negative intrinsic subtype. It is more reasonable that treatment decision like radiotherapy might be depend on the LNR than pN staging. We argue that LNR should be considered as an alternative to pN staging.
Figures available in online version.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-08.
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Affiliation(s)
- HJ Kim
- Asan Medical Center, Seoul, Korea
| | - KY Gong
- Asan Medical Center, Seoul, Korea
| | - KH Jung
- Asan Medical Center, Seoul, Korea
| | - S-B Kim
- Asan Medical Center, Seoul, Korea
| | - JW Lee
- Asan Medical Center, Seoul, Korea
| | - SH. Ahn
- Asan Medical Center, Seoul, Korea
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Jung KH, Park JW. Suppression of mitochondrial NADP(+)-dependent isocitrate dehydrogenase activity enhances curcumin-induced apoptosis in HCT116 cells. Free Radic Res 2010; 45:431-8. [PMID: 21110780 DOI: 10.3109/10715762.2010.540574] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Curcumin is a polyphenol derived from the plant Curcuma longa that induces apoptotic cell death in malignant cancer cell lines. It has been shown previously that mitochondrial NADP(+)-dependent isocitrate dehydrogenase (IDPm) plays an essential role in defense against oxidative stress by supplying NADPH for antioxidant systems. This study demonstrates that curcumin decreased the activity of IDPm, both as a purified enzyme and in cultured cells. It also shows that curcumin-induced apoptosis in the colon cancer cell line HCT116 is significantly enhanced by suppression of IDPm activity. Transfection of HCT116 cells with an IDPm small interfering RNA (siRNA) markedly decreased activity of IDPm, enhancing cellular susceptibility to curcumin-induced apoptosis, as reflected by DNA fragmentation, cellular redox status, mitochondria dysfunction and modulation of apoptotic marker proteins. Together, these results suggest that application of curcumin together with IDPm siRNA may be an effective combination modality in the treatment of cancer.
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Affiliation(s)
- Kyu Ho Jung
- School of Life Sciences and Biotechnology, College of Natural Sciences, Kyungpook National University, Taegu 702-701, Korea
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Shin HJ, Kim HH, Ahn JH, Kim SB, Jung KH, Gong G, Son BH, Ahn SH. Comparison of mammography, sonography, MRI and clinical examination in patients with locally advanced or inflammatory breast cancer who underwent neoadjuvant chemotherapy. Br J Radiol 2010; 84:612-20. [PMID: 21081579 DOI: 10.1259/bjr/74430952] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine the relative accuracies of mammography, sonography, MRI and clinical examination in predicting residual tumour size and pathological response after neoadjuvant chemotherapy for locally advanced or inflammatory breast cancer. Each prediction method was compared with the gold standard of surgical pathology. METHODS 43 patients (age range, 25-62 years; mean age, 42.7 years) with locally advanced or inflammatory breast cancer who had been treated by neoadjuvant chemotherapy were enrolled prospectively. We compared the predicted residual tumour size and the predicted response on imaging and clinical examination with residual tumour size and response on pathology. Statistical analysis was performed using weighted kappa statistics and intraclass correlation coefficients (ICC). RESULTS The ICC values between predicted tumour size and pathologically determined tumour size were 0.65 for clinical examination, 0.69 for mammography, 0.78 for sonography and 0.97 for MRI. Agreement between the response predictions at mid-treatment and the responses measured by pathology had kappa values of 0.28 for clinical examination, 0.32 for mammography, 0.46 for sonography and 0.68 for MRI. Agreement between the final response predictions and the responses measured by pathology had kappa values of 0.43 for clinical examination, 0.44 for mammography, 0.50 for sonography and 0.82 for MRI. CONCLUSION Predictions of response and residual tumour size made on MRI were better correlated with the assessments of response and residual tumour size made upon pathology than were predictions made on the basis of clinical examination, mammography or sonography. Thus, the evaluation of predicted response using MRI could provide a relatively sensitive early assessment of chemotherapy efficacy.
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Affiliation(s)
- H J Shin
- Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Songpa-Gu, Seoul, Korea
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Lee KJ, Moon JY, Choi HK, Kim HO, Hur GY, Jung KH, Lee SY, Kim JH, Shin C, Shim JJ, In KH, Yoo SH, Kang KH, Lee SY. Immune regulatory effects of simvastatin on regulatory T cell-mediated tumour immune tolerance. Clin Exp Immunol 2010; 161:298-305. [PMID: 20491794 DOI: 10.1111/j.1365-2249.2010.04170.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Statins are potent inhibitors of hydroxyl-3-methylglutaryl co-enzyme A (HMG-CoA) reductase, and have emerged as potential anti-cancer agents based on preclinical evidence. In particular, compelling evidence suggests that statins have a wide range of immunomodulatory properties. However, little is known about the role of statins in tumour immune tolerance. Tumour immune tolerance involves the production of immunosuppressive molecules, such as interleukin (IL)-10, transforming growth factor (TGF)-beta and indoleamine-2,3-dioxygenase (IDO) by tumours, which induce a regulatory T cell (T(reg)) response. In this study, we investigated the effect of simvastatin on the production of IL-10, TGF-beta and IDO production and the proliferation of T(regs) using several cancer cell lines, and Lewis lung cancer (3LL) cells-inoculated mouse tumour model. Simvastatin treatment resulted in a decrease in the number of cancer cells (3LL, A549 and NCI-H292). The production of the immune regulatory markers IL-10, TGF-beta in 3LL and NCI-H292 cells increased after treatment with simvastatin. The expression of IDO and forkhead box P3 (FoxP3) transcription factor was also increased in the presence of simvastatin. In a murine 3LL model, there were no significant differences in tumour growth rate between untreated and simvastatin-treated mice groups. Therefore, while simvastatin had an anti-proliferative effect, it also exhibited immune tolerance-promoting properties during tumour development. Thus, due to these opposing actions, simvastatin had no net effect on tumour growth.
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Affiliation(s)
- K J Lee
- Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Hwang SY, Cho SH, Cho DY, Lee M, Choo J, Jung KH, Maeng JH, Chai YG, Yoon WJ, Lee EK. Time-lapse, single cell based confocal imaging analysis of caspase activation and phosphatidylserine flipping during cellular apoptosis. Biotech Histochem 2010; 86:181-7. [DOI: 10.3109/10520291003648367] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Bae HJ, Song JH, Noh JH, Kim JK, Jung KH, Eun JW, Xie HJ, Ryu JC, Ahn YM, Kim SY, Lee SH, Yoo NJ, Lee JY, Park WS, Nam SW. Low frequency mutation of the Ephrin receptor A3 gene in hepatocellular carcinoma. Neoplasma 2009; 56:331-4. [PMID: 19469653 DOI: 10.4149/neo_2009_04_331] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
EphA3 is a component of the Eph/ephrin tyrosine kinase system, which participates in vasculature development. This receptor/ligand system is associated with various signaling pathways related to cell growth and viability, cytoskeletal organization, cell migration, and anti-apoptosis. Accumulated evidence suggests that aberrant regulation of EphA3 and its genetic alterations are implicated in the development and progression of various cancers. However, despite a high incidence of EphA3 over-expression, no such investigation has been performed in hepatocellular carcinoma. Thus, we investigated genetic alterations of the EphA3 gene in 73 cases of hepatocellular carcinoma by single-strand conformational polymorphism and sequencing. One novel D219V missense mutation was found in the extracellular domain of EphA3, and two genetic alterations in the intracellular sterile-alpha-motif (SAM) domain of EphA3 appeared to be polymorphisms. Although the functional assessments of this mutant are incomplete, it is believed that this novel EphA3 mutation may contribute to the development of hepatocellular carcinoma.
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Affiliation(s)
- H J Bae
- Department of Pathology, Microdissection Genomics Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Xie HJ, Bae HJ, Noh JH, Eun JW, Kim JK, Jung KH, Ryu JC, Ahn YM, Kim SY, Lee SH, Yoo NJ, Lee JY, Park WS, Nam SW. Mutational analysis of JAK1 gene in human hepatocellular carcinoma. Neoplasma 2009; 56:136-40. [PMID: 19239328 DOI: 10.4149/neo_2009_02_136] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
UNLABELLED The <em>Janus kinase 1</em> (JAK1) gene encodes a cytoplasmic tyrosine kinase that is noncovalently associated with a variety of cytokine receptors and plays a nonredundant role in cell proliferation, survival, and differentiation. The mutated forms of JAK1 often altered the activation of JAK1 and then changed the activation of JAK1/STAT pathways, and this may contribute to cancer development and progression. Thus, to investigate whether genetic mutations of JAK1 gene are associated in hepatocellular carcinoma (HCC) progression, we analyzed genetic alterations of JAK1 gene in 84 human HCCs by single-strand conformational polymorphism (SSCP) and direct sequencing. Of 24 exons of JAK1 gene, 12 exons were previously reported to have mutations, we searched genetic alteration of JAK1 in these exons. Overall, one missense mutation (1.2%) was found. In addition, 12 cases (14%) were found to have single nucleotide polymorphism (14%) in exon 14. Taken together, we found one novel missense mutation of JAK1 gene in hepatocellular carcinomas with some polymorphisms. Although the functional assessment of this novel mutant remains to be completed, JAK1 mutation may contribute to the tumor development in liver cancer. KEYWORDS JAK1 gene, hepatocellular carcinoma, mutation.
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Affiliation(s)
- H J Xie
- Department of Pathology, Microdisection Genomic Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Lim SB, Jeong SY, Choi HS, Sohn DK, Hong CW, Jung KH, Chang HJ, Park JG, Choi IJ, Kim CG. Synchronous gastric cancer in primary sporadic colorectal cancer patients in Korea. Int J Colorectal Dis 2008; 23:61-5. [PMID: 17724601 DOI: 10.1007/s00384-007-0366-z] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2007] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Colorectal cancer has been reported to be the malignancy most frequently associated with gastric cancer in Korea. The aim of this study was to define the frequency and clinical characteristics of synchronous gastric cancer detected at preoperative esophagogastroduodenoscopy (EGD) in colorectal cancer patients. MATERIALS AND METHODS This prospective study analyzed the EGD results from 1,542 consecutive colorectal cancer patients who underwent surgery from January 2003 to December 2005 at the Center for Colorectal Cancer, National Cancer Center, Korea. RESULTS Of the 1,542 cases, 1,155 (74.9%) underwent EGD at our center and 387 underwent EGD at other hospitals within 6 months before surgery. Of the 1,542 cases, synchronous gastric cancers were detected in 31 cases (2.0%). Of these 31 cases, 26 had early gastric cancer (EGC; 83.9%) and 5 had advanced gastric cancer. Ten (38.5%) of the 26 EGC cases were managed using endoscopic mucosal resection. Compared to colorectal cancer patients without synchronous gastric cancer, the group of patients with synchronous gastric cancer was older (65.5+/-9.6 vs 58.4+/-11.3 years, p=0.001) and had a greater proportion of males (77.4 vs 59.4%, p=0.043). CONCLUSION This study found that 2% of Korean sporadic colorectal cancer patients had synchronous gastric cancer. A preoperative EGD for colorectal cancer patients is likely to greatly assist in the diagnosis of synchronous gastric cancer at an early stage and the implementation of appropriate minimally invasive treatment.
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Affiliation(s)
- S B Lim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Korea
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Park JW, Sohn DK, Han KS, Hong CW, Chang HJ, Jung KH, Kim DY, Lim SB, Choi HS, Jeong SY. Endoscopic treatment of completely occluding anastomotic web using incision and ballooning after dye injection. Endoscopy 2007; 39 Suppl 1:E102-3. [PMID: 17440859 DOI: 10.1055/s-2006-945145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J W Park
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
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Kim SJ, Suk MH, Choi HMA, Kimm KC, Jung KH, Lee SY, Lee SY, Kim JH, Shin C, Shim JJ, In KH, Kang KH, Yoo SH. The local prevalence of COPD by post-bronchodilator GOLD criteria in Korea. Int J Tuberc Lung Dis 2006; 10:1393-8. [PMID: 17167958] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD) is a disease characterised by not fully reversible airflow limitation. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) committee decided to diagnose COPD using post-bronchodilator spirometry values. We aimed to examine the prevalence and risk factors of COPD in Ansan, an industrialised city of Korea, by using the post-bronchodilator GOLD criteria. We then investigated the implications of brenchodilation on the prevalence of COPD. DESIGN A total of 3642 participants in the Korean Health and Genome Study were interviewed about age, income, smoking status and respiratory symptoms and completed pulmonary function tests, including postbronchodilator spirometry. RESULTS COPD prevalence by post-bronchodilator spirometry was 3.7% (134/3642), which was significantly different from that estimated using pre-bronchodilator criteria (7.7%, 282/3642). Exclusion of subjects with significant bronchodilator response (BDR) significantly lowered the prevalence of COPD to 3.3% (117/3572), compared with including subjects with post-bronchodilatory residual obstruction with significant BDR. Prevalence was associated with old age, smoking history, male sex and respiratory symptoms. CONCLUSION COPD prevalence by post-bronchodilator GOLD criteria was 3.7%, which was much lower than that of pre-bronchodilator criteria. The bronchodilator reversibility test substantially affects estimations of COPD prevalence.
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Affiliation(s)
- S J Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan 425-707, Republic of Korea.
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Jung KH, Kil SY, Choi IK, Seo JH, Shin C, Kim YS, Kim JH. Interstitial lung diseases in patients treated with oxaliplatin, 5-fluorouracil and leucovorin (FOLFOX). Int J Tuberc Lung Dis 2006; 10:1181-2. [PMID: 17044215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
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Kim DW, Lim SB, Kim DY, Kim TH, Jung KH, Kim DH, Chang HJ, Sohn DK, Hong CW, Choi HS, Jeong SY, Park JG. Pre-operative chemo-radiotherapy improves the sphincter preservation rate in patients with rectal cancer located within 3 cm of the anal verge. Eur J Surg Oncol 2006; 32:162-7. [PMID: 16289718 DOI: 10.1016/j.ejso.2005.10.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2005] [Accepted: 10/13/2005] [Indexed: 12/17/2022]
Abstract
AIMS To evaluate whether pre-operative chemo-radiotherapy (CRT) improves the sphincter preservation rate for distal rectal cancers within 3 cm of the anal verge. METHODS Between January 2001 and December 2004, 49 patients underwent surgery with or without pre-operative CRT for primary rectal adenocarcinoma within 3 cm of the anal verge. Clinical data were retrospectively reviewed, including stage workups, surgical records and pathology records to determine sphincter preservation rate and the factors influencing sphincter preservation. RESULTS Of 49 patients with rectal tumours within 3 cm of the anal verge, 31 underwent pre-operative CRT followed by surgery (CRT group), and 18 underwent surgery alone (non-CRT group). Sphincter preservation was possible in 11 of 31 CRT patients, and only one of 18 non-CRT patients (p=0.036). The factors most influencing sphincter preservation were reduction in tumour size (p=0.005) and downstaging (p=0.001) following pre-operative CRT. CONCLUSION We could observe that sphincter preservation was improved in CRT group with statistical significance when compared to non-CRT group in our study patients with rectal cancer within 3 cm of the anal verge.
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Affiliation(s)
- D-W Kim
- Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 809 Madu-1-dong, Ilsan-gu, Goyang, Gyeonggi 411-769, South Korea
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Ha E, Yim SV, Jung KH, Yoon SH, Zheng LT, Kim MJ, Hong SJ, Choe BK, Baik HH, Chung JH, Kim JW. Topiramate stimulates glucose transport through AMP-activated protein kinase-mediated pathway in L6 skeletal muscle cells. Pharmacogenomics J 2006; 6:327-32. [PMID: 16415917 DOI: 10.1038/sj.tpj.6500366] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The use of topiramate (TPM) in the treatment of binge-eating disorder, bulimia nervosa, and antipsychotic-induced weight gain has recently increased, however, the exact molecular basis for its effects on body weight reduction and improved glucose homeostasis, is yet to be elucidated. Here we investigated the effect and signaling pathway of TPM on glucose uptake in L6 rat skeletal muscle cells, which account for >70% of glucose disposal in the body. Intriguingly, we found that TPM (10 microM) stimulated the rate of glucose uptake up to twofold increase. And TPM-stimulated glucose transport was inhibited with the overexpression of dominant-negative form of AMP-activated protein kinase (AMPK), an important mediator in glucose transport, implicating that AMPK-mediated pathway is involved. The TPM-stimulated glucose transport was blocked by SB203580, a specific inhibitor of AMPK downstream mediator, p38 mitogen-activated protein kinase (MAPK) protein. LY294002, an inhibitor of phosphatidylinositol (PI) 3-kinase, which is another crucial mediator in independent glucose transport pathway, did not inhibit TPM-stimulated glucose transport. We also found that TPM increased the phosphorylation level of AMPK and p38 MAPK, whereas no effect on the activity of PI 3-kinase of TPM, when assessed by PI 3-kinase assay, was observed. These results together suggest that TPM stimulates glucose transport, not via PI 3-kinase mediated, but via AMPK-mediated pathway in skeletal muscle cells, thereby contributing to the body weight regulation and glucose homeostasis.
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Affiliation(s)
- E Ha
- Department of Biochemistry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Govorunova EG, Jung KH, Sineshchekov OA. [Phototaxis of the green algae: the new class of rhodopsin receptors]. Biofizika 2004; 49:278-93. [PMID: 15129628] [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: 04/29/2023]
Abstract
Photomotility behavior in green flagellate algae is mediated by rhodopsin-like receptors, which was initially suggested on the basis of physiological evidence. The cascade of rapid Ca(2+)-dependent electrical responses in the plasma membrane plays a key role in the signal transduction chain during both phototaxis and the photophobic response. The photoreceptor current through the plasma membrane is the earliest detectable event upon photoexcitation of the photoreceptors. Analysis of this current revealed that it consists of at least two components with different characteristics. Genes encoding two archaeal-type rhodopsins (type I rhodopsins) were recently identified in the genome of Chlamydomonas reinhardtii and named (Chlamydomonas Sensory Rhodopsins A and B CSRA and CSRB). The measurements of photoelectric and motor responses in genetic transformants of C. reinhardtii enriched in each of these receptor proteins showed that the two components of the photoreceptor current are mediated by the two rhodopsins, and that both CSRA and CSRB are involved in phototaxis and the photophobic response. The CSRA-mediated current dominates at high light intensities and contributes primarily to the photophobic response. The CSRB-initiated transduction involves an efficient amplification cascade and mediates the highly sensitive phototaxis at low light intensities. CSRA and CSRB expressed heterologously in oocytes of Xenopus laevis act as light-gated proton channels, although it is unclear whether this channel activity plays a functional role in the initiation of motor responses and/or occurs in the native system.
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Affiliation(s)
- E G Govorunova
- Biology Department, Lomonosov Moscow State University, Moscow, 119899 Russia
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Jang TJ, Min SK, Bae JD, Jung KH, Lee JI, Kim JR, Ahn WS. Expression of cyclooxygenase 2, microsomal prostaglandin E synthase 1, and EP receptors is increased in rat oesophageal squamous cell dysplasia and Barrett's metaplasia induced by duodenal contents reflux. Gut 2004; 53:27-33. [PMID: 14684572 PMCID: PMC1773937 DOI: 10.1136/gut.53.1.27] [Citation(s) in RCA: 50] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIM It is known that bile acids can induce mucosal injury, stimulate cell proliferation, and promote tumorigenesis. A large body of genetic and biochemical evidence indicate that the biosynthetic pathway of prostaglandin E2 (PGE2) may play an important role in human and rodent tumours. Therefore, we examined the expression pattern of cyclooxygenase 1 (COX-1), COX-2, and microsomal prostaglandin E synthase 1 (mPGES-1), as well as EP receptor subtypes in rat oesophageal lesions induced by duodenal contents reflux. METHODS Oesophagoduodenal anastomosis was performed in rats to induce duodenal contents reflux. We examined histological changes and expression of COX-1, COX-2, mPGES-1, and EP receptor subtypes in the oesophagus by immunohistochemistry and reverse transcription-polymerase chain reaction. RESULTS Normal control oesophageal tissues showed COX-1 expression in subepithelial stromal cells, including endothelial cells and muscular cells, and did not reveal expression of COX-2 or mPGES-1. In the case of squamous cell lesions, immunoreactivity of COX-1 was similar to that of normal lesions, and COX-2 was maximally expressed around the vascular papillae of tissues showing dysplasia and surrounding epithelial layer and basal layer. mPGES-1 was highly expressed in stromal cells with COX-2 expression. In the case of Barrett's oesophagus, COX-2 and mPGES-1 were predominantly in subepithelial stromal cells. mRNA levels of COX-2, mPGES-1, EP2, EP3, and EP4 were higher in the experimental groups than in controls. CONCLUSIONS We suggest that the biosynthetic pathway of PGE2 may play an important role in oesophageal squamous cell dysplasia and glandular metaplasia induced by duodenal contents reflux.
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Affiliation(s)
- T J Jang
- Department of Pathology, Dongguk University College of Medicine, Kyongju, Kyongbuk, Korea.
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Chang HM, Jung KH, Kim TY, Kim WS, Yang HK, Lee KU, Choe KJ, Heo DS, Bang YJ, Kim NK. A phase III randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil and mitomycin C versus 5-fluorouracil alone in curatively resected gastric cancer. Ann Oncol 2002; 13:1779-85. [PMID: 12419751 DOI: 10.1093/annonc/mdf302] [Citation(s) in RCA: 32] [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: 11/14/2022] Open
Abstract
BACKGROUND A phase III single-center randomized trial was performed in order to determine whether the addition of mitomycin C (MMC) and/or doxorubicin to 5-fluorouracil (5-FU) as adjuvant chemotherapy could influence survival in patients with curatively resected gastric cancer. PATIENTS AND METHODS A total of 416 patients who had undergone curative resection for stage IB-IIIB gastric adenocarcinoma were stratified according to the stage and type of surgery, and then randomized to receive one of the three chemotherapy regimens, 5-FU alone (F) or 5-FU and MMC (FM) or 5-FU, doxorubicin and MMC (FAM) within 5 weeks after surgery. RESULTS Of 416 patients registered, 395 (133 in F, 131 in FM and 131 in FAM) were assessable. Median follow-up duration was 91 months. Five-year overall survival rates were 67.2% for F, 67.0% for FM and 66.7% for FAM (P = 0.97). Five-year disease-free survival rates were 62.1% for F, 63.3% for FM and 62.5% for FAM (P = 0.83). Hematological toxicities were more frequent in the FM and FAM groups, whereas stomatitis was more common in the F group. CONCLUSIONS Compared with adjuvant 5-FU alone, the addition of MMC and/or doxorubicin to 5-FU did not influence survival in patients with resected gastric cancer.
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Affiliation(s)
- H M Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Abstract
Halophilic archaea, such as Halobacterium salinarum and Natronobacterium pharaonis, alter their swimming behavior by phototaxis responses to changes in light intensity and color using visual pigment-like sensory rhodopsins (SRs). In N. pharaonis, SRII (NpSRII) mediates photorepellent responses through its transducer protein, NpHtrII. Here we report the expression of fusions of NpSRII and NpHtrII and fusion hybrids with eubacterial cytoplasmic domains and analyze their function in vivo in haloarchaea and in eubacteria. A fusion in which the C terminus of NpSRII is connected by a short flexible linker to NpHtrII is active in phototaxis signaling for H. salinarum, showing that the fusion does not inhibit functional receptor-transducer interactions. We replaced the cytoplasmic portions of this fusion protein with the cytoplasmic domains of Tar and Tsr, chemotaxis transducers from enteric eubacteria. Purification of the fusion protein from H. salinarum and Tar fusion chimera from Escherichia coli membranes shows that the proteins are not cleaved and exhibit absorption spectra characteristic of wild-type membranes. Their photochemical reaction cycles in H. salinarum and E. coli membranes, respectively, are similar to those of native NpSRII in N. pharaonis. These fusion chimeras mediate retinal-dependent phototaxis responses by Escherichia coli, establishing that the nine-helix membrane portion of the receptor-transducer complex is a modular functional unit able to signal in heterologous membranes. This result confirms a current model for SR-Htr signal transduction in which the Htr transducers are proposed to interact physically and functionally with their cognate sensory rhodopsins via helix-helix contacts between their transmembrane segments.
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Affiliation(s)
- K H Jung
- Department of Microbiology and Molecular Genetics, University of Texas-Houston Medical School, Houston, Texas 77030, USA
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