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Laillet J, Monnet P, Goldfarb L, Belkhir R, Robert C. Secondary hypertrophic osteoarthropathy revealing a metastatic melanoma. Eur J Cancer 2023; 192:113247. [PMID: 37625239 DOI: 10.1016/j.ejca.2023.113247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 08/27/2023]
Affiliation(s)
- J Laillet
- Dermatology Department, Gustave Roussy Institute, Villejuif, France
| | - P Monnet
- Dermatology Department, Gustave Roussy Institute, Villejuif, France
| | - L Goldfarb
- Nuclear Medicine Department, Centre Hospitalier Fréderic Joliot, CEA, Orsay, France
| | - R Belkhir
- Rheumatology Department, FHU CARE, AP-HP-Hôpital Bicêtre, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - C Robert
- Dermatology Department, Gustave Roussy Institute, Villejuif, France; Gustave Roussy and Paris Saclay University, Villejuif, France.
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2
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Iep A, Chawki MB, Goldfarb L, Nguyen L, Brulon V, Comtat C, Lebon V, Besson FL. Relevance of 18F-DOPA visual and semi-quantitative PET metrics for the diagnostic of Parkinson disease in clinical practice: a machine learning-based inference study. EJNMMI Res 2023; 13:13. [PMID: 36780091 PMCID: PMC9925664 DOI: 10.1186/s13550-023-00962-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/02/2023] [Indexed: 02/14/2023] Open
Abstract
PURPOSE To decipher the relevance of visual and semi-quantitative 6-fluoro-(18F)-L-DOPA (18F-DOPA) interpretation methods for the diagnostic of idiopathic Parkinson disease (IPD) in hybrid positron emission tomography (PET) and magnetic resonance imaging. MATERIAL AND METHODS A total of 110 consecutive patients (48 IPD and 62 controls) with 11 months of median clinical follow-up (reference standard) were included. A composite visual assessment from five independent nuclear imaging readers, together with striatal standard uptake value (SUV) to occipital SUV ratio, striatal gradients and putamen asymmetry-based semi-quantitative PET metrics automatically extracted used to train machine learning models to classify IPD versus controls. Using a ratio of 70/30 for training and testing sets, respectively, five classification models-k-NN, LogRegression, support vector machine, random forest and gradient boosting-were trained by using 100 times repeated nested cross-validation procedures. From the best model on average, the contribution of PET parameters was deciphered using the Shapley additive explanations method (SHAP). Cross-validated receiver operating characteristic curves (cv-ROC) of the most contributive PET parameters were finally estimated and compared. RESULTS The best machine learning model (k-NN) provided final cv-ROC of 0.81. According to SHAP analyses, visual PET metric was the most important contributor to the model overall performance, followed by the minimum between left and right striatal to occipital SUV ratio. The 10-time cv-ROC curves of visual, min SUVr or both showed quite similar performance (mean area under the ROC of 0.81, 0.81 and 0.79, respectively, for visual, min SUVr or both). CONCLUSION Visual expert analysis remains the most relevant parameter to predict IPD diagnosis at 11 months of median clinical follow-up in 18F-FDOPA. The min SUV ratio appears interesting in the perspective of simple semi-automated diagnostic workflows.
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Affiliation(s)
- Alex Iep
- Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France.
| | - Mohammad B. Chawki
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Lucas Goldfarb
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Loc Nguyen
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Vincent Brulon
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
| | - Claude Comtat
- grid.460789.40000 0004 4910 6535 Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale BioMaps, SHFJ, Université Paris Saclay, Orsay, France
| | - Vincent Lebon
- grid.460789.40000 0004 4910 6535 Inserm, CNRS, CEA, Laboratoire d’Imagerie Biomédicale Multimodale BioMaps, SHFJ, Université Paris Saclay, Orsay, France
| | - Florent L. Besson
- grid.414044.10000 0004 0630 1867Nuclear Medicine Department, Service Hospitalier Frédéric Joliot SHFJ-CEA, Orsay, France
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Duclos V, Iep A, Gomez L, Goldfarb L, Besson FL. PET Molecular Imaging: A Holistic Review of Current Practice and Emerging Perspectives for Diagnosis, Therapeutic Evaluation and Prognosis in Clinical Oncology. Int J Mol Sci 2021; 22:4159. [PMID: 33923839 PMCID: PMC8073681 DOI: 10.3390/ijms22084159] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 04/03/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 02/06/2023] Open
Abstract
PET/CT molecular imaging has been imposed in clinical oncological practice over the past 20 years, driven by its two well-grounded foundations: quantification and radiolabeled molecular probe vectorization. From basic visual interpretation to more sophisticated full kinetic modeling, PET technology provides a unique opportunity to characterize various biological processes with different levels of analysis. In clinical practice, many efforts have been made during the last two decades to standardize image analyses at the international level, but advanced metrics are still under use in practice. In parallel, the integration of PET imaging with radionuclide therapy, also known as radiolabeled theranostics, has paved the way towards highly sensitive radionuclide-based precision medicine, with major breakthroughs emerging in neuroendocrine tumors and prostate cancer. PET imaging of tumor immunity and beyond is also emerging, emphasizing the unique capabilities of PET molecular imaging to constantly adapt to emerging oncological challenges. However, these new horizons face the growing complexity of multidimensional data. In the era of precision medicine, statistical and computer sciences are currently revolutionizing image-based decision making, paving the way for more holistic cancer molecular imaging analyses at the whole-body level.
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Affiliation(s)
- Valentin Duclos
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
| | - Alex Iep
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
| | - Léa Gomez
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
| | - Lucas Goldfarb
- Service Hospitalier Frédéric Joliot-CEA, 91401 Orsay, France;
| | - Florent L. Besson
- Department of Biophysics and Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris Saclay, Assistance Publique-Hôpitaux de Paris, CHU Bicêtre, 94270 Le Kremlin-Bicêtre, France; (V.D.); (A.I.); (L.G.)
- Université Paris Saclay, CEA, CNRS, Inserm, BioMaps, 91401 Orsay, France
- School of Medicine, Université Paris Saclay, 94720 Le Kremlin-Bicêtre, France
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4
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Seban RD, Assie JB, Giroux-Leprieur E, Massiani MA, Soussan M, Bonardel G, Chouaid C, Playe M, Goldfarb L, Duchemann B, Girard N, Champion L. FDG-PET biomarkers associated with long-term benefit from first-line immunotherapy in patients with advanced non-small cell lung cancer. Ann Nucl Med 2020; 34:968-974. [PMID: 33070295 DOI: 10.1007/s12149-020-01539-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 10/07/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine FDG-PET biomarkers associated with long-term benefit (LTB) and survival in advanced non-small cell lung cancer (NSCLC) patients receiving first-line immunotherapy. METHODS In this multicenter study, we retrospectively analyzed advanced NSCLC patients with a PD-L1 tumor proportion score (TPS) ≥ 50%, who underwent FDG-PET/CT before first-line pembrolizumab, received from August 2017 to September 2019. Parameters extracted were SUVmax, SUVmean, TMTV (total metabolic tumor volume) and TLG (total lesion glycolysis). LTB was defined as objective (complete or partial) response or stable disease as best overall response, maintained for ≥ 12 months. A multivariate prediction model was developed using logistic regression for LTB and Cox models for progression-free survival (PFS) and overall survival (OS). RESULTS On the 63 eligible patients, with a median follow-up of 13.4 (range, 1.5-29.1) months, 17 (27%) had LTB. Median PFS and OS were 7.7 months (95%CI 5.0-10.5) and 12.1 months (95%CI 8.6-15.6). In multivariate analyses, high TMTV (> 84cm3) and high tumor SUVmean (> 10.1) remained independent factors for predicting LTB (OR 0.2; p = 0.03 and OR 3.7; p = 0.04) and PFS (HR 2.2; p = 0.02 and HR 0.5; p = 0.045). High TMTV was significantly associated with poor OS (HR 3.1; p = 0.03). No association was observed between tumor SUVmax or TLG and clinical outcomes. CONCLUSIONS In patients with advanced NSCLC and PD-L1 TPS ≥ 50%, baseline low TMTV and high tumor SUVmean correlate with survival and LTB from upfront pembrolizumab. Beyond the initial staging, FDG-PET/CT scan could provide relevant biomarkers associated with clinical outcomes that should be taken into account when considering first-line treatment options.
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Affiliation(s)
- Romain-David Seban
- Department of Nuclear Medicine, Institut Curie, Saint-Cloud, 92210, Saint-Cloud, France.
| | - Jean-Baptiste Assie
- Department of Pneumology, Paris-Est University, Centre Hospitalier Inter-Communal de Créteil, Inserm U955, UPEC, IMRB, Équipe CEpiA, Créteil, France
- Centre de Recherche Des Cordeliers, Inserm, Functional Genomics of Solid Tumors Laboratory, Sorbonne Université, Université de Paris, 75006, Paris, France
| | - Etienne Giroux-Leprieur
- Department of Respiratory Diseases and Thoracic Oncology, APHP, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | | | - Michael Soussan
- Department of Nuclear Medicine, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Gérald Bonardel
- Department of Nuclear Medicine, Centre Cardiologique du Nord, Saint-Denis, France
| | - Christos Chouaid
- Department of Pneumology, Paris-Est University, Centre Hospitalier Inter-Communal de Créteil, Inserm U955, UPEC, IMRB, Équipe CEpiA, Créteil, France
| | - Margot Playe
- Department of Nuclear Medicine, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Lucas Goldfarb
- Department of Nuclear Medicine, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Boris Duchemann
- Department of Medical Oncology, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Nicolas Girard
- Institut du Thorax Curie Montsouris, Institut Curie, Paris, France
| | - Laurence Champion
- Department of Nuclear Medicine, Institut Curie, Saint-Cloud, 92210, Saint-Cloud, France
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Popescu M, Lazaridou I, Goldfarb L, Zumelzu C, Heidelberger V, Aljundi M, Laroche L, Caux F, Maubec E. Hypoacousie induite par les anti-PD-1 associée à une réaction granulomateuse. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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6
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Cǎlugǎreanu A, Rompteaux P, Bohelay G, Goldfarb L, Barrau V, Cucherousset N, Heidelberger V, Nault JC, Ziol M, Caux F, Maubec E. Late onset of nivolumab-induced severe gastroduodenitis and cholangitis in a patient with stage IV melanoma. Immunotherapy 2019; 11:1005-1013. [PMID: 31304833 DOI: 10.2217/imt-2019-0077] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Antiprogramed cell death-1 protein agents represent a therapeutic approach based on stimulating the host's immune response through blockade of immune checkpoints, inhibitory pathways that dampen the physiological peripheral T-cell immune response and are essential for maintaining self-tolerance. We describe the late onset of severe gastroduodenitis and cholangitis in a nivolumab-treated, metastatic melanoma patient in complete remission. Positron-emission tomography with computed tomography scans showed diffuse fluorodeoxyglucose (FDG) uptake in the stomach preceding upper digestive tract symptoms. Hence, positron-emission tomography with computed tomography might as well be a useful tool for early diagnosis of subclinical gastric toxicity as recently shown for colitis. Furthermore, physicians must be aware and remain vigilant to antiprogramed cell death-1 protein-related digestive toxicity that may appear very late during treatment.
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Affiliation(s)
- Andreea Cǎlugǎreanu
- Dermatology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (APHP), Bobigny, France
| | - Pierre Rompteaux
- Hepatogastroenterology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bobigny, France
| | - Gérôme Bohelay
- Hepatogastroenterology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bobigny, France.,Paris 13 University, Bobigny, France
| | - Lucas Goldfarb
- Nuclear Medicine Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bobigny, France
| | - Vincent Barrau
- Radiology Department, Centre Cardiologique du Nord, Saint-Denis, France
| | - Nahla Cucherousset
- Pathology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bobigny, France
| | - Valentine Heidelberger
- Dermatology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (APHP), Bobigny, France
| | - Jean-Charles Nault
- Hepatology Department, Jean-Verdier Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bondy, & Inserm UMR-1162, Génomique Fonctionnelle des Tumeurs Solides, Université Paris-Descartes, Université Paris-Diderot, Université Paris 13, Labex Immuno-Oncology, Paris, France
| | - Marianne Ziol
- Department of Pathology and Center of biological resources (BB-0033-00027), Hôpital Jean-Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bondy, France
| | - Frédéric Caux
- Dermatology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (APHP), Bobigny, France.,Hepatogastroenterology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bobigny, France
| | - Eve Maubec
- Dermatology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris (APHP), Bobigny, France.,Hepatogastroenterology Department, Avicenne Hospital, Hôpitaux Universitaires Paris-Seine-Saint-Denis, APHP, Bobigny, France
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Popinat G, Cousse S, Goldfarb L, Becker S, Gardin I, Salaün M, Thureau S, Vera P, Guisier F, Decazes P. Sub-cutaneous Fat Mass measured on multislice computed tomography of pretreatment PET/CT is a prognostic factor of stage IV non-small cell lung cancer treated by nivolumab. Oncoimmunology 2019; 8:e1580128. [PMID: 31069139 DOI: 10.1080/2162402x.2019.1580128] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/11/2018] [Accepted: 01/07/2019] [Indexed: 12/26/2022] Open
Abstract
Introduction: Our aim was to explore the prognostic value of anthropometric parameters in patients treated with nivolumab for stage IV non-small cell lung cancer (NSCLC). Methods: We retrospectively included 55 patients with NSCLC treated by nivolumab with a pretreatment 18FDG positron emission tomography coupled with computed tomography (PET/CT). Anthropometric parameters were measured on the CT of PET/CT by in-house software (Anthropometer3D) allowing an automatic multi-slice measurement of Lean Body Mass (LBM), Fat Body Mass (FBM), Muscle Body Mass (MBM), Visceral Fat Mass (VFM) and Sub-cutaneous Fat Mass (SCFM). Clinical and tumor parameters were also retrieved. Receiver operator characteristics (ROC) analysis was performed and overall survival at 1 year was studied using Kaplan-Meier and Cox analysis. Results: FBM and SCFM were highly correlated (ρ = 0.99). In ROC analysis, only FBM, SCFM, VFM, body mass index (BMI) and metabolic tumor volume (MTV) had an area under the curve (AUC) significantly higher than 0.5. In Kaplan-Meier analysis using medians as cut-offs, prognosis was worse for patients with low SCFM (<5.69 kg/m2; p = 0.04, survivors 41% vs 75%). In Cox univariate analysis using continuous values, BMI (HR = 0.84, p= 0.007), SCFM (HR = 0.75, p = 0.003) and FBM (HR = 0.80, p= 0.004) were significant prognostic factors. In multivariate analysis using clinical parameters (age, gender, WHO performance status, number prior regimens) and SCFM, only SCFM was significantly associated with poor survival (HR = 0.75, p = 0.006). Conclusions: SCFM is a significant prognosis factor of stage IV NSCLC treated by nivolumab.
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Affiliation(s)
- Geoffrey Popinat
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France
| | - Stéphanie Cousse
- Department of Pulmonology, Thoracic Oncology, and Respiratory Intensive Care, Rouen University Hospital, Rouen, France
| | - Lucas Goldfarb
- Department of Nuclear Medicine, Hôpital Avicenne, Bobigny, France
| | - Stéphanie Becker
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France.,Faculty of Medicine, University of Rouen, Rouen, France
| | - Isabelle Gardin
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France.,Faculty of Medicine, University of Rouen, Rouen, France
| | - Mathieu Salaün
- Department of Pulmonology, Thoracic Oncology, and Respiratory Intensive Care, Rouen University Hospital, Rouen, France.,Faculty of Medicine, University of Rouen, Rouen, France
| | - Sébastien Thureau
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France.,Faculty of Medicine, University of Rouen, Rouen, France.,Department of Radiotherapy and Oncology, Henri Becquerel Cancer Center, Rouen, France
| | - Pierre Vera
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France.,Faculty of Medicine, University of Rouen, Rouen, France
| | - Florian Guisier
- Department of Pulmonology, Thoracic Oncology, and Respiratory Intensive Care, Rouen University Hospital, Rouen, France
| | - Pierre Decazes
- Department of Nuclear Medicine, Henri Becquerel Cancer Center, Rouen, France.,Faculty of Medicine, University of Rouen, Rouen, France
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Goldfarb L, Duchemann B, Chouahnia K, Zelek L, Soussan M. Monitoring anti-PD-1-based immunotherapy in non-small cell lung cancer with FDG PET: introduction of iPERCIST. EJNMMI Res 2019; 9:8. [PMID: 30694399 PMCID: PMC6890907 DOI: 10.1186/s13550-019-0473-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/07/2019] [Indexed: 02/07/2023] Open
Abstract
Background Immunotherapy represents a new therapeutic approach in non-small cell lung carcinoma (NSCLC) with the potential for prolonged benefits. Because of the systemic nature and heterogeneity of tumoral diseases, as well as the immune restoration process induced by immunotherapy, the assessment of therapeutic efficacy is challenging, and the role of FDG PET is not well established. We evaluated the potential of FDG PET to monitor NSCLC patients treated with a checkpoint inhibitor. Results This was a retrospective analysis of 28 NSCLC patients treated with nivolumab, a programmed cell death 1 (PD-1) blocker. All patients underwent a PET scan before treatment (SCAN-1) and another scan 2 months later (SCAN-2). Disease progression was assessed by immune PET Response Criteria in Solid Tumors (iPERCIST), which was adapted from PERCIST; and the immune Response Evaluation Criteria in Solid Tumors (iRECIST). iPERCIST is a dual-time-point evaluation of “unconfirmed progressive metabolic disease” (UPMD) status at SCAN-2. UPMD at SCAN-2 was re-evaluated after 4 weeks with SCAN-3 to confirm PMD. Patients with complete/partial metabolic response (CMR or PMR) or stable metabolic disease (SMD) at SCAN-2 or -3 were considered responders. Patients with UPMD confirmed at SCAN-3 were considered non-responders. The Kaplan-Meier method was used to estimate survival. At SCAN-2, we found 9/28 cases of PMR, 4/28 cases of SMD, 2/28 cases of CMR, and 13/28 cases of UPMD. Four of the 13 UPMD patients were classified as responders at SCAN-3 (PMR n = 1, SMD n = 3). The remaining nine UPMD patients were classified as non-responders due to clinical degradation, and treatment was stopped. The median follow-up was 16.7 months [3.6–32.2]. Responders continued treatment for a mean of 10.7 months [3.8–26.3]. Overall survival was longer for responders than that for non-responders (19.9 vs. 3.6 months, log rank p = 0.0003). The 1-year survival rates were 94% for responders and 11% for non-responders. A comparison with iRECIST showed reclassification in 39% (11/28) of patients with relevant additional prognostic information. Conclusions iPERCIST dual-time-point evaluation might be a powerful tool for evaluating anti-PD-1-based immunotherapy, with the ability to identify patients who can benefit most from treatment. The prognostic value of iPERCIST criteria should be confirmed in large prospective multicentric studies. Electronic supplementary material The online version of this article (10.1186/s13550-019-0473-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lucas Goldfarb
- Department of Nuclear Medicine, Paris 13 University, APHP, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France
| | - Boris Duchemann
- Department of Oncology, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Kader Chouahnia
- Department of Oncology, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Laurent Zelek
- Department of Oncology, Paris 13 University, APHP, Hôpital Avicenne, Bobigny, France
| | - Michael Soussan
- Department of Nuclear Medicine, Paris 13 University, APHP, Hôpital Avicenne, 125 rue de Stalingrad, 93000, Bobigny, France. .,IMIV, CEA, Inserm, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France.
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Goldfarb L, Duchemann B, Chouahnia K, Gomez L, Pop G, Zelek L, Soussan M. FDG-PET in the assessment of metabolic response in patients with NSCLC treated with nivolumab: Preliminary results. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20554 Background: Immunotherapy becomes a standard treatment in non-small-cell lung carcinoma (NSCLC), locally advanced or metastatic, after prior chemotherapy. Because of systemic involvement and heterogeneity of the tumoral disease, methods of assessment are complex and the role of PET-FDG is not well established. The objective of the present study is to describe the results of FDG-PET in the evaluation of patients with NSCLC treated with checkpoint inhibitor (OPDIVO®, Nivolumab) in our academic center. Methods: A retrospective analysis of FDG-PET’s data was performed in 16 patients (performance status: 1), with NSCLC (13 adenocarcinoma, 2 squamous cell carcinoma and 1 large cell neuroendocrine carcinoma) and progression after at least one line of treatment, and treated with Nivolumab. All patients had an FDG-PET before and at 2 months (M2) of treatment. Patients showing progression at M2 had a third PET at M3 to confirm disease progression. Disease responses were assessed according to PERCIST criteria. Patients were considered as responders to Nivolumab treatment, if the treatment was pursued at least 6 months, or as non-responders if the treatment was pursued less than 6 months. Pseudoprogression was defined as a disease progression at M2, which was not confirmed on FDG-PET control at M3. Results: Assessment by FDG-PET after 2 months of treatment showed 8/16 partial metabolic responses (PMR), 6/16 progressive diseases (PD), 1/16 stable disease (SD) and 1/16 complete metabolic response (CMR). Among the patients with PMR, SD or CMR at M2 (n = 10), 90% (9/10) were considered as responders and 10% (1/10) as non-responder. Nivolumab was discontinued in patients with PD. One patient showed a pseudo progression at M2 (PMR at M3), and was eventually classified as non-responder. Conclusions: These results show an association between the metabolic response at M2 and the continuation of the treatment with Nivolumab in NSCLC patients. 90% of patients with early metabolic response showed a sustained response with Nivolumab. FDG-PET could be helpful in the therapeutic strategy of these patients and deserves to be assessed in prospective trials including a cost/benefit evaluation.
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Affiliation(s)
- Lucas Goldfarb
- Department of Nuclear Medicine, Hôpital Avicenne, APHP, Bobigny, France
| | - Boris Duchemann
- Department of Oncology, Hôpital Avicenne, APHP, Paris, France
| | | | - Lea Gomez
- Department of Nuclear Medicine, Hôpital Avicenne, APHP, Bobigny, France
| | - Gabriel Pop
- Department of Nuclear Medicine, Hôpital Avicenne, APHP, Bobigny, France
| | - Laurent Zelek
- Department of Oncology, Hôpital Avicenne, APHP, Bobigny, France
| | - Michael Soussan
- Department of Nuclear Medicine, Hôpital Avicenne, APHP, Bobigny, France
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Dominguez Rubio R, Martinez A, Poza J, García Bragado F, Jericó I, van der Ven P, Fürst D, Romero N, Goldfarb L, Olivé M. Intranuclear protein aggregation in myofibrillar myopathies. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Goldfarb L. The Benefits of Automatic Inhibition. J Vis 2013. [DOI: 10.1167/13.9.646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Zhao J, Goldfarb L, Turk-Browne NB. When numbers and statistics collide: Competition between numerosity perception and statistical learning. J Vis 2013. [DOI: 10.1167/13.9.1087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Goldfarb L, Treisman A. Counting multidimensional objects - implications for the neural synchrony theory. J Vis 2012. [DOI: 10.1167/12.9.1164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Reid WV, Chen D, Goldfarb L, Hackmann H, Lee YT, Mokhele K, Ostrom E, Raivio K, Rockström J, Schellnhuber HJ, Whyte A. Earth System Science for Global Sustainability: Grand Challenges. Science 2010; 330:916-7. [PMID: 21071651 DOI: 10.1126/science.1196263] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- W V Reid
- David and Lucile Packard Foundation, Los Altos, CA 94022, USA.
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15
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Goldfarb L, Treisman A. How is quantity bound to specific objects? J Vis 2010. [DOI: 10.1167/9.8.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Fischer D, Kley RA, Strach K, Meyer C, Sommer T, Eger K, Rolfs A, Meyer W, Pou A, Pradas J, Heyer CM, Grossmann A, Huebner A, Kress W, Reimann J, Schröder R, Eymard B, Fardeau M, Udd B, Goldfarb L, Vorgerd M, Olivé M. Distinct muscle imaging patterns in myofibrillar myopathies. Neurology 2008; 71:758-65. [PMID: 18765652 DOI: 10.1212/01.wnl.0000324927.28817.9b] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare muscle imaging findings in different subtypes of myofibrillar myopathies (MFM) in order to identify characteristic patterns of muscle alterations that may be helpful to separate these genetic heterogeneous muscular disorders. METHODS Muscle imaging and clinical findings of 46 patients with MFM were evaluated (19 desminopathy, 12 myotilinopathy, 11 filaminopathy, 1 alphaB-crystallinopathy, and 3 ZASPopathy). The data were collected retrospectively in 43 patients and prospectively in 3 patients. RESULTS In patients with desminopathy, the semitendinosus was at least equally affected as the biceps femoris, and the peroneal muscles were never less involved than the tibialis anterior (sensitivity of these imaging criteria to detect desminopathy in our cohort 100%, specificity 95%). In most of the patients with myotilinopathy, the adductor magnus showed more alterations than the gracilis muscle, and the sartorius was at least equally affected as the semitendinosus (sensitivity 90%, specificity 93%). In filaminopathy, the biceps femoris and semitendinosus were at least equally affected as the sartorius muscle, and the medial gastrocnemius was more affected than the lateral gastrocnemius. The semimembranosus mostly showed more alterations than the adductor magnus (sensitivity 88%, specificity 96%). Early adult onset and cardiac involvement was most often associated with desminopathy. In patients with filaminopathy, muscle weakness typically beginning in the 5th decade of life was mostly pronounced proximally, while late adult onset (>50 years) with distal weakness was more often present in myotilinopathy. CONCLUSIONS Muscle imaging in combination with clinical data may be helpful for separation of distinct myofibrillar myopathy subtypes and in scheduling of genetic analysis.
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Affiliation(s)
- D Fischer
- Department of Neurology, University Hospital Basel, Switzerland.
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18
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Fischer D, Kley RA, Strach K, Meyer C, Sommer T, Eger K, Rolfs A, Meyer W, Pou A, Pradas J, Heyer CM, Grossmann A, Huebner A, Kress W, Reimann J, Schröder R, Eymard B, Fardeau M, Udd B, Goldfarb L, Vorgerd M, Olivé M. Distinct muscle imaging patterns in myofibrillar myopathies. Neurology 2008. [PMID: 18765652 DOI: 10.1212/01.wnl.0000324927.28817.9b.pmid:18765652;pmcid:pmc2583436] [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] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE To compare muscle imaging findings in different subtypes of myofibrillar myopathies (MFM) in order to identify characteristic patterns of muscle alterations that may be helpful to separate these genetic heterogeneous muscular disorders. METHODS Muscle imaging and clinical findings of 46 patients with MFM were evaluated (19 desminopathy, 12 myotilinopathy, 11 filaminopathy, 1 alphaB-crystallinopathy, and 3 ZASPopathy). The data were collected retrospectively in 43 patients and prospectively in 3 patients. RESULTS In patients with desminopathy, the semitendinosus was at least equally affected as the biceps femoris, and the peroneal muscles were never less involved than the tibialis anterior (sensitivity of these imaging criteria to detect desminopathy in our cohort 100%, specificity 95%). In most of the patients with myotilinopathy, the adductor magnus showed more alterations than the gracilis muscle, and the sartorius was at least equally affected as the semitendinosus (sensitivity 90%, specificity 93%). In filaminopathy, the biceps femoris and semitendinosus were at least equally affected as the sartorius muscle, and the medial gastrocnemius was more affected than the lateral gastrocnemius. The semimembranosus mostly showed more alterations than the adductor magnus (sensitivity 88%, specificity 96%). Early adult onset and cardiac involvement was most often associated with desminopathy. In patients with filaminopathy, muscle weakness typically beginning in the 5th decade of life was mostly pronounced proximally, while late adult onset (>50 years) with distal weakness was more often present in myotilinopathy. CONCLUSIONS Muscle imaging in combination with clinical data may be helpful for separation of distinct myofibrillar myopathy subtypes and in scheduling of genetic analysis.
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Affiliation(s)
- D Fischer
- Department of Neurology, University Hospital Basel, Switzerland.
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19
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Fischer D, Olive M, Kley R, Strach K, Hübner A, Udd B, Fardeau M, Goldfarb L, Studer A, Weber M. Identification of first Swiss desminopathy families using systematic muscle imaging in myofibrillar myopathies. Clin Neurophysiol 2008. [DOI: 10.1016/j.clinph.2007.09.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Fischer D, Kley R, Strach K, Huebner A, Kress W, Udd B, Schroeder R, Eymard B, Fardeau M, Goldfarb L, Vorgerd M, Olivé M. C.P.4.02 Muscle imaging differentiates primary desminopathies from myofibrillar myopathies. Neuromuscul Disord 2007. [DOI: 10.1016/j.nmd.2007.06.392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Coates S, Chinnery P, Goldfarb L, Birchall D, Fawcett P. Myotilinopathy – A report on four UK patients. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2007.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Kostareva A, Gudkova A, Sjoberg G, Kiselev I, Moiseeva O, Karelkina E, Goldfarb L, Schlyakhto E, Sejersen T. Desmin mutations in a St. Petersburg cohort of cardiomyopathies. Acta Myol 2006; 25:109-15. [PMID: 17626518] [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: 05/16/2023]
Abstract
Several desmin mutations have been described over the past few years in patients with dilated and restrictive cardiomyopathy, often in association with distal myopathy. However, the role of desmin mutations as a cause of various types of cardiomyopathy is still undetermined. The aim of this study was to analyse the frequency of desmin mutations in patients with cardiomyopathy identified and diagnosed in the St. Petersburg area of Russia. We screened 98 patients with dilated, 40 with hypertrophic and 4 with restrictive cardiomyopathy. All exons of the desmin gene were amplified by PCR and studied by sequencing. Two out of 98 patients showed the presence of desmin gene mutations, not previously described in dilated cardiomyopathy. A novel IVS2-2A-->G splice site mutation, presumably causing skipping of exon 3, was detected in a case of familial right ventricular dilated cardiomyopathy. An A213V mutation was associated with a case of late onset dilated cardiomyopathy. No desmin mutations were found in patients with hypertrophic or restrictive cardiomyopathy. Desmin mutations should be considered a relatively rare cause of dilated cardiomyopathy in this specific geographic area.
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Affiliation(s)
- A Kostareva
- Department of Woman and Child Health, and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden
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23
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Shatunov A, Jankovic J, Elble R, Sambuughin N, Singleton A, Hallett M, Goldfarb L. A variant in the HS1-BP3 gene is associated with familial essential tremor. Neurology 2005; 65:1995; author reply 1995. [PMID: 16380635 DOI: 10.1212/01.wnl.0000200984.10076.e5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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24
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D'Amico A, Benedetti S, Petrini S, Sambuughin N, Boldrini R, Menditto I, Ferrari M, Verardo M, Goldfarb L, Bertini E. Major myofibrillar changes in early onset myopathy due to de novo heterozygous missense mutation in lamin A/C gene. Neuromuscul Disord 2005; 15:847-50. [PMID: 16288872 DOI: 10.1016/j.nmd.2005.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [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: 06/14/2005] [Revised: 09/07/2005] [Accepted: 09/14/2005] [Indexed: 11/18/2022]
Abstract
Mutations in the lamin A/C gene (LMNA) have been associated with neuromuscular diseases and more complex syndromes, involving bone and adipose tissue. We report on a case of early onset myopathy due to a heterozygous LMNA mutation in exon 9, characterized by the presence of a marked number of cytoplasmic bodies with extensive myofibrillar abnormalities and Z-disk disruption in skeletal muscle. This case suggests there is a need to increase the list of genes to be screened in patients with myofibrillar myopathy.
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Affiliation(s)
- A D'Amico
- Unit of Molecular Medicine and Pathology, Department of Laboratory Medicine, Bambino Gesu' Children's Research Hospital, Rome, Italy
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25
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Schmoltner AM, Talukdar RK, Warren RF, Mellouki A, Goldfarb L, Gierczak T, McKeen SA, Ravishankara AR. Rate coefficients for reactions of several hydrofluorocarbons with hydroxyl and oxygen atom(1D) and their atmospheric lifetimes. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100137a023] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Goudeau B, Dagvadorj A, Rodrigues-Lima F, Nédellec P, Casteras-Simon M, Perret E, Langlois S, Goldfarb L, Vicart P. Structural and functional analysis of a new desmin variant causing desmin-related myopathy. Hum Mutat 2001; 18:388-96. [PMID: 11668632 DOI: 10.1002/humu.1210] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [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: 11/11/2022]
Abstract
Desmin-related myopathy is a familial or sporadic disease characterized by skeletal muscle weakness and cardiomyopathy as well as the presence of intracytoplasmic aggregates of desmin-reactive material in the muscle cells. Previously, two kinds of deletions and eight missense mutations have been identified in the desmin gene and proven to be responsible for the disorder. The present study was conducted to determine structural and functional defects in a pathogenic desmin variant that caused a disabling disorder in an isolated case presenting with distal and proximal limb muscle weakness and cardiomyopathy. We identified a novel heterozygous Q389P desmin mutation located at the C-terminal part of the rod domain as the causative mutation in this case. Transfection of desmin cDNA containing the patient's mutation into C2.7, MCF7, and SW13 cells demonstrated that the Q389P mutant is incapable of constructing a functional intermediate filament network and has a dominant negative effect on filament formation. We conclude that Q389P mutation is the molecular event leading to the development of desmin-related myopathy.
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MESH Headings
- Adult
- Amino Acid Motifs
- Amino Acid Sequence
- Animals
- Base Sequence
- Cardiomyopathies/complications
- Cardiomyopathies/genetics
- Cardiomyopathies/physiopathology
- Cell Line
- Crystallins/genetics
- DNA Mutational Analysis
- Desmin/chemistry
- Desmin/genetics
- Desmin/metabolism
- Genes, Dominant/genetics
- Genetic Variation/genetics
- Humans
- Intermediate Filaments/metabolism
- Intermediate Filaments/pathology
- Male
- Mice
- Middle Aged
- Molecular Sequence Data
- Muscle Weakness/complications
- Muscle Weakness/genetics
- Muscle Weakness/physiopathology
- Mutation, Missense/genetics
- Myopathies, Structural, Congenital/complications
- Myopathies, Structural, Congenital/genetics
- Myopathies, Structural, Congenital/physiopathology
- Protein Structure, Tertiary
- Sequence Alignment
- Structure-Activity Relationship
- Tumor Cells, Cultured
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Affiliation(s)
- B Goudeau
- Laboratoire Cytosquelette et Développement, UMR CNRS 7000, Faculté de Médecine, Paris, France
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27
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Goebel HH, Halbig LE, Goldfarb L, Schober R, Albani M, Neuen-Jacob E, Voit T. Reducing body myopathy with cytoplasmic bodies and rigid spine syndrome: a mixed congenital myopathy. Neuropediatrics 2001; 32:196-205. [PMID: 11571700 DOI: 10.1055/s-2001-17374] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
At the age of five years a male child started to develop a progressive rigid spine, torsion scoliosis, and flexion contractures of his elbows, knees, hips, and ankles owing to severe proximal and distal muscle weakness. He had three muscle biopsies from three different muscles at ages 7, 11, and 14 years, respectively. Myopathologically, these muscle tissues contained numerous inclusions which, at the ultrastructural level, turned out to be reducing bodies and cytoplasmic bodies, often in close spatial proximity. Similar histological inclusions, although not further identified by histochemistry and electron microscopy, were seen in his maternal grandmother's biopsied muscle tissue who had developed weakness of the legs and hands after the age of 50 years. The patient's parents were healthy, but the mother's quadriceps muscle showed an increased spectrum of muscle fibre diameters. Our patient, thus, had a neuromuscular disorder, perhaps familial, presenting as a mixed congenital myopathy, i.e., reducing body myopathy with cytoplasmic bodies, of which the morphological lesions could be consistently documented over several years in his different limb muscles. While other mixed congenital myopathies had shown cores and rods, both related to sarcomeres and thus possibly morphogenetically related, cytoplasmic bodies thought to be related to Z-bands and reducing bodies dissimilar to any muscle fibre constituent do not share any common denominator. Therefore, we suggest that this neuromuscular disorder may be a unique mixed congenital myopathy, either sporadic or genetic. In the latter case, the transmission pattern suggested X-linked recessive inheritance, but an autosomal-dominant transmission with variable penetrance could not be ruled out.
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MESH Headings
- Adult
- Aged
- Child, Preschool
- Disease Progression
- Female
- Genetic Predisposition to Disease
- Humans
- Inclusion Bodies/pathology
- Lordosis/genetics
- Male
- Muscle, Skeletal/pathology
- Myopathies, Structural, Congenital/classification
- Myopathies, Structural, Congenital/diagnosis
- Myopathies, Structural, Congenital/genetics
- Myositis, Inclusion Body/congenital
- Myositis, Inclusion Body/diagnosis
- Myositis, Inclusion Body/genetics
- Myositis, Inclusion Body/pathology
- Pedigree
- Spinal Muscular Atrophies of Childhood/diagnosis
- Syndrome
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Affiliation(s)
- H H Goebel
- Department of Neuropathology, Medical Center, Johannes Gutenberg University, Mainz, Germany.
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28
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Sivakumar K, Vasconcelos O, Goldfarb L, Dalakas MC. Late-onset muscle weakness in partial phosphofructokinase deficiency: a unique myopathy with vacuoles, abnormal mitochondria, and absence of the common exon 5/intron 5 junction point mutation. Neurology 1996; 46:1337-42. [PMID: 8628478 DOI: 10.1212/wnl.46.5.1337] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 02/01/2023] Open
Abstract
Three patients (ages 51, 59, and 79) from two generations of an Ashkenazi Jewish family had partial (33% activity) phosphofructokinase (PFK) deficiency that presented with fixed muscle weakness after the age of 50 years. MR spectroscopy revealed accumulation of phosphomonoesters during exercise. Muscle biopsy showed a vacuolar myopathy with increased autophagic activity and several ragged-red and cytochrome c oxidase-negative fibers. The older patient, age 79 at biopsy, had several necrotic fibers. Electron microscopy revealed subsarcolemmal and intermyofibrillar glycogen accumulation and proliferation of mitochondria with paracrystalline inclusions, probably related to reduced availability of energy due to impaired glycolysis. The common point mutation of exon 5/intron 5 junction seen in Jewish Ashkenazi patients with PFK deficiency was excluded. We conclude that late-onset fixed muscle weakness occurs in partial PFK deficiency and it may represent the end result of continuing episodes of muscle fiber destruction. Partial enzyme deficiency in two successive generations suggests a unique molecular mechanism.
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Affiliation(s)
- K Sivakumar
- Neuromuscular Diseases Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
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29
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McDowell D, Galanter M, Goldfarb L, Lifshutz H. Spirituality and the treatment of the dually diagnosed: an investigation of patient and staff attitudes. J Addict Dis 1996; 15:55-68. [PMID: 8704001 DOI: 10.1300/j069v15n02_05] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Spirituality is a neglected area of study and research in the treatment of addictions. The role of spirituality in the treatment of the dually diagnosed has received particularly scant attention. One hundred and one patients on an in-patient dual-diagnosis unit, as well as the 31 members of the nursing staff who treat them were surveyed. Patients and staff were questioned about their spiritual beliefs and what was the role of spirituality in the patients' recovery from addiction. Staff were questioned about their own spirituality and what they think the patients' level of spirituality is. In addition the staff were asked what they think the patients' view of spiritually is. Results indicate that the patients and staff are equally spiritually oriented. The patients view spirituality as essential to their recovery and value spiritual programming in their treatment more than some concrete items. The nursing staff underestimated both the patients' level of spirituality and this importance placed on spiritual issues. The authors suggest that more attention should be given by staff to spirituality in the treatment of this population.
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Affiliation(s)
- D McDowell
- Division of Substance Abuse, College of Physicians & Surgeons, Columbia University, USA
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30
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Abstract
OBJECTIVE To evaluate the efficacy of buspirone hydrochloride, a serotonin (5-hydroxytryptamine1A) agonist, in treating patients with cerebellar ataxia. DESIGN Open-label study in which 20 patients (14 with cerebellar cortical atrophy and six with olivopontocerebellar atrophy) received buspirone hydrochloride, up to 60 mg/d, for 8 weeks. SETTING Research hospital. MAIN OUTCOME MEASURES Clinical, physiological, and psychological assessment. RESULTS Nine patients with mild or moderate cerebellar dysfunction who completed the study showed significant improvement in clinical and self-assessment ratings, but not in a motor performance test, posturography (data were incomplete), State-Trait Anxiety Inventory, and Beck Depression Inventory. Seven patients with severe cerebellar dysfunction who completed the study had no improvement on any measure. CONCLUSIONS Buspirone may be effective in treating mild to moderate cerebellar ataxia. A double-blind study of the efficacy of buspirone in cerebellar ataxia is warranted.
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Affiliation(s)
- J S Lou
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Md, USA
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31
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Novoradovsky A, Tsai SJ, Goldfarb L, Peterson R, Long JC, Goldman D. Mitochondrial aldehyde dehydrogenase polymorphism in Asian and American Indian populations: detection of new ALDH2 alleles. Alcohol Clin Exp Res 1995; 19:1105-10. [PMID: 8561277 DOI: 10.1111/j.1530-0277.1995.tb01587.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Genetic deficiency of the mitochondrial aldehyde dehydrogenase (ALDH2) is frequent in Asian peoples where it is an important factor negatively regulating drinking behavior. To obtain additional information on gene geography of known ALDH2 alleles, and look for new variants, ALDH2 genes were evaluated in a Chinese population from Taiwan, a Yakut population of Siberia, and in five North American Indian populations. A novel approach based on a single-strand conformation polymorphism assay, and polymerase chain reaction-directed mutagenesis was developed for genotyping. In the Taiwan Chinese population, the ALDH2(2) allele frequency was 0.319 +/- 0.025, and this allele was not detected in the Yakut population nor in the five North American Indian populations. However, a new allele, ALDH2(3), was detected in Pima Indians at a frequency of 0.044 +/- 0.022, and this allele was also observed in 1 of 49 Pueblo samples. ALDH2(3) is a silent transition 1464 G-->A, and it possibly has a wide distribution among North American Indians. A new subtype of the ALDH2(2) allele, designated as ALDH2(2Taiwan), was found in 1 of 174 Chinese from Taiwan. ALDH2(2Taiwan) is characterized by two G-->A transitions at bases 1486 and 1510, resulting in Glu-->Lys substitutions at both the 479 and 487 positions. Thus, this second nonconservative ALDH2 substitution occurs within the sequence of the already inactive ALDH2(2) allele.
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Affiliation(s)
- A Novoradovsky
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland 20892, USA
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32
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Haltia M, Viitanen M, Sulkava R, Ala-Hurula V, Poyhonen M, Goldfarb L, Brown P, Levy E, Houlden H, Crook R. Chromosome 14-encoded Alzheimer's disease: genetic and clinicopathological description. Ann Neurol 1994; 36:362-7. [PMID: 8080244 DOI: 10.1002/ana.410360307] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A family of Finnish descent with very-early-onset Alzheimer's disease has been identified. Genetic analysis of this family eliminated the amyloid precursor protein gene as the pathogenic locus, but strongly implicated a locus on chromosome 14q23.4 between D14S52 and D14S55. The early age at onset of the disease (average, 36 years; range, 35-39 years), the rapid progression, and the early and prominent myoclonus, while they appear to be frequent findings in the chromosome 14-encoded form of Alzheimer's disease, raised the clinical suspicion of prion disease. However, sequencing the prion gene-coding region of 2 affected members of the pedigree failed to show any abnormality. Apart from the presence of modest cortical vacuolar change, the pathological features of our index patient appeared typical of Alzheimer's disease with abundant senile plaques immunoreactive with beta-amyloid, but not with prion protein antibodies.
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Affiliation(s)
- M Haltia
- Department of Pathology, University of Helsinki, Finland
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33
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Ranum LP, Chung MY, Banfi S, Bryer A, Schut LJ, Ramesar R, Duvick LA, McCall A, Subramony SH, Goldfarb L. Molecular and clinical correlations in spinocerebellar ataxia type I: evidence for familial effects on the age at onset. Am J Hum Genet 1994; 55:244-52. [PMID: 8037204 PMCID: PMC1918367] [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: 01/28/2023] Open
Abstract
The spinocerebellar ataxias are a group of debilitating neurodegenerative diseases for which a clinical classification system has proved unreliable. We have recently isolated the gene for spinocerebellar ataxia type 1 (SCA1) and have shown that the disease is caused by an expanded, unstable, CAG trinucleotide repeat within an expressed gene. Normal alleles have a size range of 19-36 repeats, while SCA1 alleles have 42-81 repeats. In this study, we examined the frequency and variability of the SCA1 repeat expansion in 87 kindreds with diverse ethnic backgrounds and dominantly inherited ataxia. All nine families for which linkage to the SCA1 region of 6p had previously been established showed repeat expansion, while 3 of the remaining 78 showed a similar abnormality. For 113 patients from the families with repeat expansion, inverse correlations between CAG repeat size and both age at onset and disease duration were observed. Repeat size accounted for 66% of the variation in age at onset in these patients. After correction for repeat size, interfamilial differences in age at onset remained significant, suggesting that additional genetic factors affect the expression of the SCA1 gene product.
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Affiliation(s)
- L P Ranum
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis
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Saunders AM, Schmader K, Breitner JC, Benson MD, Brown WT, Goldfarb L, Goldgaber D, Manwaring MG, Szymanski MH, McCown N. Apolipoprotein E epsilon 4 allele distributions in late-onset Alzheimer's disease and in other amyloid-forming diseases. Lancet 1993; 342:710-1. [PMID: 8103823 DOI: 10.1016/0140-6736(93)91709-u] [Citation(s) in RCA: 394] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The frequency of the allele for apolipoprotein E type 4 (epsilon 4) is increased in late-onset familial and sporadic Alzheimer's disease (AD). We have examined epsilon 4 frequencies in four distinct, normal, elderly control groups and, most importantly, in patients with amyloid-forming diseases whose epsilon 4 distributions were not previously known (Creutzfeldt-Jakob disease, familial amyloidotic polyneuropathy, Down's syndrome). There were no differences between any of these controls and published control series, cementing the relevance of epsilon 4 for late-onset AD. The increase in late-onset AD was confirmed in two new series.
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Affiliation(s)
- A M Saunders
- Bryan Alzheimer's Disease Research Center, Division of Neurology, Duke University Medical Center, Durham, NC 27710
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Abstract
Previous research has suggested that women with a negative emotional orientation toward sexuality (i.e., erotophobia) have difficulty learning and retaining sexually relevant material such as contraceptive information. It has been hypothesized that these women become aroused by this material and that this arousal interferes with their ability to learn it. The importance of this issue led us to conduct the current study. Erotophobic and erotophilic women viewed presentations about contraception while their physiological responses were being monitored. In addition, they were tested on the information contained in the presentation before, immediately after, and again 4-6 weeks after the presentation. The results indicated that the erotophobic women knew less contraceptive information before the presentation and were more aroused by the presentation. This arousal, however, did not interfere with retention of the material. These results are discussed in terms of individual differences in reactions to sexual material and the ability to learn, retain, and use contraceptive information.
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Abstract
Previous research has suggested that women with a negative emotional orientation toward sexuality (i.e., erotophobia) have difficulty learning and retaining sexually relevant material such as contraceptive information. It has been hypothesized that these women become aroused by this material and that this arousal interferes with their ability to learn it. The importance of this issue led us to conduct the current study. Erotophobic and erotophilic women viewed presentations about contraception while their physiological responses were being monitored. In addition, they were tested on the information contained in the presentation before, immediately after, and again 4-6 weeks after the presentation. The results indicated that the erotophobic women knew less contraceptive information before the presentation and were more aroused by the presentation. This arousal, however, did not interfere with retention of the material. These results are discussed in terms of individual differences in reactions to sexual material and the ability to learn, retain, and use contraceptive information.
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Rolo A, Krinsky LW, Abramson H, Goldfarb L. Preliminary method for study of LSD with children. Int J Neuropsychiatry 1965; 1:552-5. [PMID: 5886534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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