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Lopes CDH, Antonacio FF, Moraes PMG, Asprino PF, Galante PAF, Jardim DL, de Macedo MP, Sandoval RL, Katz A, de Castro G, Achatz MI. The Clinical and Molecular Profile of Lung Cancer Patients Harboring the TP53 R337H Germline Variant in a Brazilian Cancer Center: The Possible Mechanism of Carcinogenesis. Int J Mol Sci 2023; 24:15035. [PMID: 37894716 PMCID: PMC10606350 DOI: 10.3390/ijms242015035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
In southern and southeastern Brazil, the TP53 founder variant c.1010G>A (R337H) has been previously documented with a prevalence of 0.3% within the general population and linked to a heightened incidence of lung adenocarcinomas (LUADs). In the present investigation, we cover clinical and molecular characterizations of lung cancer patients from the Brazilian Li-Fraumeni Syndrome Study (BLISS) database. Among the 175 diagnosed malignant neoplasms, 28 (16%) were classified as LUADs, predominantly occurring in females (68%), aged above 50 years, and never-smokers (78.6%). Significantly, LUADs manifested as the initial clinical presentation of Li-Fraumeni Syndrome in 78.6% of cases. Molecular profiling was available for 20 patients, with 14 (70%) revealing EGFR family alterations. In total, 23 alterations in cancer driver genes were identified, comprising 7 actionable mutations and 4 linked to resistance against systemic treatments. In conclusion, the carriers of TP53 R337H demonstrate a predisposition to LUAD development. Furthermore, our results indicate that environmental pollution potentially impacts the carcinogenesis of lung tumors in the carriers of TP53 R337H.
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Affiliation(s)
- Carlos D. H. Lopes
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Fernanda F. Antonacio
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Priscila M. G. Moraes
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Paula F. Asprino
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Pedro A. F. Galante
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Denis L. Jardim
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
- Oncoclínicas, São Paulo 04543-906, Brazil
| | - Mariana P. de Macedo
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Renata L. Sandoval
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Artur Katz
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Gilberto de Castro
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
| | - Maria Isabel Achatz
- Hospital Sirio Libanes, São Paulo 01308-050, Brazil; (F.F.A.); (P.M.G.M.); (P.F.A.); (P.A.F.G.); (D.L.J.); (M.P.d.M.); (R.L.S.); (A.K.); (G.d.C.J.)
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Gutierrez K, Glanzner WG, de Macedo MP, Rissi VB, Dicks N, Bohrer RC, Baldassarre H, Agellon LB, Bordignon V. Cell Cycle Stage and DNA Repair Pathway Influence CRISPR/Cas9 Gene Editing Efficiency in Porcine Embryos. Life (Basel) 2022; 12:life12020171. [PMID: 35207459 PMCID: PMC8876063 DOI: 10.3390/life12020171] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/21/2022] Open
Abstract
CRISPR/Cas9 technology is a powerful tool used for genome manipulation in different cell types and species. However, as with all new technologies, it still requires improvements. Different factors can affect CRISPR/Cas efficiency in zygotes, which influence the total cost and complexity for creating large-animal models for research. This study evaluated the importance of zygote cell cycle stage between early-injection (within 6 h post activation/fertilization) versus late-injection (14–16 h post activation/fertilization) when the CRISPR/Cas9 components were injected and the inhibition of the homologous recombination (HR) pathway of DNA repair on gene editing, embryo survival and development on embryos produced by fertilization, sperm injection, somatic cell nuclear transfer, and parthenogenetic activation technologies. Injections at the late cell cycle stage decreased embryo survival (measured as the proportion of unlysed embryos) and blastocyst formation (68.2%; 19.3%) compared to early-stage injection (86.3%; 28.8%). However, gene editing was higher in blastocysts from late-(73.8%) vs. early-(63.8%) injected zygotes. Inhibition of the HR repair pathway increased gene editing efficiency by 15.6% in blastocysts from early-injected zygotes without compromising embryo development. Our finding shows that injection at the early cell cycle stage along with HR inhibition improves both zygote viability and gene editing rate in pig blastocysts.
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Affiliation(s)
- Karina Gutierrez
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
| | - Werner G. Glanzner
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
| | - Mariana P. de Macedo
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
| | - Vitor B. Rissi
- Department of Agriculture, Biodiversity and Forests, Federal University of Santa Catarina, Curitibanos 89520-000, Brazil;
| | - Naomi Dicks
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
| | - Rodrigo C. Bohrer
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
| | - Hernan Baldassarre
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
| | - Luis B. Agellon
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada
- Correspondence: (L.B.A.); (V.B.)
| | - Vilceu Bordignon
- Department of Animal Science, McGill University, Sainte-Anne-de-Bellevue, QC H9X 3V9, Canada; (K.G.); (W.G.G.); (M.P.d.M.); (N.D.); (R.C.B.); (H.B.)
- Correspondence: (L.B.A.); (V.B.)
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Ferst JG, Glanzner WG, Gutierrez K, de Macedo MP, Ferreira R, Gasperin BG, Duggavathi R, Gonçalves PB, Bordignon V. Supplementation of oleic acid, stearic acid, palmitic acid and β-hydroxybutyrate increase H3K9me3 in endometrial epithelial cells of cattle cultured in vitro. Anim Reprod Sci 2021; 233:106851. [PMID: 34560342 DOI: 10.1016/j.anireprosci.2021.106851] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
There is growing evidence that greater than homeostatic blood concentrations of nonesterified fatty acids (NEFAs) and β-hydroxybutyrate (BHBA) have negative consequences on dairy cow's fertility, but effects on cell homeostasis in the reproductive system is not completely understood. In this study, lipids accumulation, reactive oxygen species (ROS) concentrations, abundance of gene transcripts, and immunofluorescence signal of H3K4me3 and H3K9me3 were evaluated in endometrial epithelial cells of cattle cultured with NEFAs (Oleic (OA), Stearic (SA) and Palmitic (PA) acids), BHBA, NEFAs + BHBA or each of the three NEFAs alone. The cellular lipids were in greater concentrations as a result of NEFAs + BHBA, NEFAs, SA or OA supplementation, but not by BHBA or PA. The ROS concentrations were greater when there were treatments with NEFAs + BHBA, NEFAs or BHBA. The relative mRNA abundance for genes involved in the regulation of apoptosis (XIAP), glucose transport (GLUT3), and DNA methylation (DNMT1) were greater when there were NEFAs + BHBA, but not NEFAs, BHBA, OA, SA or PA treatments. The immunofluorescence signal for H3K9me3 was greater when there were NEFAs + BHBA, NEFAs or PA, but not by BHBA, OA or SA treatments. These findings indicate that NEFAs and BHBA have an additive effect on endometrial cells of cattle by altering epigenetic markers and the expression of genes controlling important cellular pathways. Furthermore, there was cellular lipid accumulation and increased H3K9me3 in cultured bovine endometrial cells that was mainly induced by OA and PA treatments, respectively.
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Affiliation(s)
- Juliana G Ferst
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Federal University of Santa Maria, Santa Maria, RS, Brazil; Department of Animal Science, McGill University, Saint-Anne-de-Bellevue, QC, Canada.
| | - Werner G Glanzner
- Department of Animal Science, McGill University, Saint-Anne-de-Bellevue, QC, Canada.
| | - Karina Gutierrez
- Department of Animal Science, McGill University, Saint-Anne-de-Bellevue, QC, Canada.
| | - Mariana P de Macedo
- Department of Animal Science, McGill University, Saint-Anne-de-Bellevue, QC, Canada.
| | - Rogério Ferreira
- Department of Animal Production, Santa Catarina State University, Lages, SC, Brazil.
| | - Bernardo G Gasperin
- Department of Animal Pathology, Federal University of Pelotas, Capão do Leão, RS, Brazil.
| | - Raj Duggavathi
- Department of Animal Science, McGill University, Saint-Anne-de-Bellevue, QC, Canada.
| | - Paulo Bayard Gonçalves
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Federal University of Santa Maria, Santa Maria, RS, Brazil; Molecular and Integrative Physiology of Reproduction Laboratory, MINT, Federal University of Pampa, Uruguaiana, RS, Brazil.
| | - Vilceu Bordignon
- Department of Animal Science, McGill University, Saint-Anne-de-Bellevue, QC, Canada.
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Dicks N, Gutierrez K, Currin L, de Macedo MP, Glanzner WG, Mondadori RG, Michalak M, Agellon LB, Bordignon V. Tauroursodeoxycholic acid/TGR5 signaling promotes survival and early development of glucose-stressed porcine embryos†. Biol Reprod 2021; 105:76-86. [PMID: 33889948 PMCID: PMC8256098 DOI: 10.1093/biolre/ioab072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/24/2021] [Accepted: 04/12/2021] [Indexed: 01/21/2023] Open
Abstract
Conditions of impaired energy and nutrient homeostasis, such as diabetes and obesity, are associated with infertility. Hyperglycemia increases endoplasmic reticulum stress as well as oxidative stress and reduces embryo development and quality. Oxidative stress also causes deoxyribonucleic acid damage, which impairs embryo quality and development. The natural bile acid tauroursodeoxycholic acid reduces endoplasmic reticulum stress and rescues developmentally incompetent late-cleaving embryos, as well as embryos subjected to nuclear stress, suggesting the endoplasmic reticulum stress response, or unfolded protein response, and the genome damage response are linked. Tauroursodeoxycholic acid acts via the Takeda-G-protein-receptor-5 to alleviate nuclear stress in embryos. To evaluate the role of tauroursodeoxycholic acid/Takeda-G-protein-receptor-5 signaling in embryo unfolded protein response, we used a model of glucose-induced endoplasmic reticulum stress. Embryo development was impaired by direct injection of tauroursodeoxycholic acid into parthenogenetically activated oocytes, whereas it was improved when tauroursodeoxycholic acid was added to the culture medium. Attenuation of the Takeda-G-protein-receptor-5 precluded the positive effect of tauroursodeoxycholic acid supplementation on development of parthenogenetically activated and fertilized embryos cultured under standard conditions and parthenogenetically activated embryos cultured with excess glucose. Moreover, attenuation of tauroursodeoxycholic acid/Takeda-G-protein-receptor-5 signaling induced endoplasmic reticulum stress, oxidative stress and cell survival genes, but decreased expression of pluripotency genes in parthenogenetically activated embryos cultured under excess glucose conditions. These data suggest that Takeda-G-protein-receptor-5 signaling pathways link the unfolded protein response and genome damage response. Furthermore, this study identifies Takeda-G-protein-receptor-5 signaling as a potential target for mitigating fertility issues caused by nutrient excess-associated blastomere stress and embryo death.
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Affiliation(s)
- Naomi Dicks
- Department of Animal Science, McGill University, Quebec, Canada
| | | | - Luke Currin
- Department of Animal Science, McGill University, Quebec, Canada
| | | | | | - Rafael G Mondadori
- Department of Animal Science, McGill University, Quebec, Canada
- ReproPel, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Marek Michalak
- Department of Biochemistry, University of Alberta, Edmonton, Alberta, Canada
| | - Luis B Agellon
- School of Human Nutrition, McGill University, Quebec, Canada
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Bertolli E, Calsavara VF, de Macedo MP, Pinto CAL, Duprat Neto JP. Development and validation of a Brazilian nomogram to assess sentinel node biopsy positivity in melanoma. Tumori 2020; 107:440-445. [PMID: 33143554 DOI: 10.1177/0300891620969827] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although well-established, sentinel node biopsy (SNB) for melanoma is not free from controversies and sometimes it can be questionable if SNB should be considered even for patients who meet the criteria for the procedure. Mathematical tools such as nomograms can be helpful and give more precise answers for both clinicians and patients. We present a nomogram for SNB positivity that has been internally validated. METHODS Retrospective analysis of patients who underwent SNB from 2000 to 2015 in a single institution. Single logistic regressions were used to identify variables that were associated to SNB positivity. All variables with a p value < 0.05 were included in the final model. Overall performance, calibration, and discriminatory power of the final multiple logistic regression model were all assessed. Internal validation of the multiple logistic regression model was performed via bootstrap analysis based on 1000 replications. RESULTS Site of primary lesion, Breslow thickness, mitotic rate, histologic regression, lymphatic invasion, and Clark level were statistically related to SNB positivity. After internal validation, a good performance was observed as well as an adequate power of discrimination (area under the curve 0.751). CONCLUSIONS We have presented a nomogram that can be helpful and easily used in daily practice for assessing SNB positivity.
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Affiliation(s)
- Eduardo Bertolli
- Skin Cancer Department, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Vinicius F Calsavara
- Statistics and Epidemiology Department, A.C. Camargo Cancer Center, São Paulo, Brazil
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Gelatti ACZ, Cordeiro de Lima VC, Freitas H, Werutsky G, Gaiger AM, Klock C, Viola PP, Shiang C, de Macedo MP, Lopes LF, De Marchi P, Albino da Silva EC, Moura F, Borges G, Zaffaroni F, Nunes Filho PR, Araujo LH, Mascarenhas E, Mathias C, Barrios C, Zukin M. Real-World Prevalence of PD-L1 Expression Among Tumor Samples From Patients With Non-Small-Cell Lung Cancer. Clin Lung Cancer 2020; 21:e511-e515. [PMID: 32389509 DOI: 10.1016/j.cllc.2020.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 09/28/2019] [Revised: 02/15/2020] [Accepted: 04/03/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION We analyzed the prevalence of non-small-cell lung cancer (NSCLC) with a programmed cell death ligand 1 (PD-L1) tumor proportion score (TPS) of ≥ 50% and compared the results with the existing data from clinical trials and databases from other countries. MATERIALS AND METHODS The Latin American Cooperative Oncology Group and Grupo Brasileiro de Oncologia Torácica performed a retrospective, cross-sectional study from August 2017 to April 2018. PD-L1 expression was collected from pathology reports from 5 laboratories in Brazil. All tests were sponsored by the pharmaceutical industry on request from the treating medical oncologist. PD-L1 expression was assessed by immunohistochemistry. The variables were summarized as absolute and relative frequencies or the median and interquartile range. Pearson's χ2 test was used to compare the TPS categories stratified by sex, age, and histologic type. All analyses were performed with SAS, version 9.4, and were deemed statistically significant at P < .05. RESULTS A total of 1512 patients were included in the present study. Their median age was 66 years. Most patients were men (56.02%), and the most common histologic type was adenocarcinoma (58.04%); 109 tumors (11.31%) had EGFR mutations and 34 (3.64%) had ALK gene rearrangements. Overall, 56.54% had a PD-L1 TPS < 1%, 25.63% a TPS of 1% to 49%, and 17.83% a TPS of ≥ 50%. The factors associated with PD-L1 expression were histologic type (with adenocarcinoma samples having a greater proportion of TPS < 1%) and the laboratory that performed the test. CONCLUSION The prevalence of high PD-L1 expression among the Brazilian NSCLC samples was lower than previously described in other countries, which could affect the number of patients who might be candidates for immunotherapy alone.
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Affiliation(s)
- Ana C Z Gelatti
- Grupo Oncoclínicas, Porto Alegre, Brazil; Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Latin American Cooperative Oncology Group, Porto Alegre, Brazil.
| | - Vladmir C Cordeiro de Lima
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; A. C. Camargo Cancer Center, São Paulo, Brazil
| | | | - Gustavo Werutsky
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Latin American Cooperative Oncology Group, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | | | | | - Giuliano Borges
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Centro de Novos Tratamentos, Itajaí, Brazil
| | | | | | - Luiz H Araujo
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Instituto Nacional de Câncer, Rio De Janeiro, Brazil
| | - Eldsamira Mascarenhas
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Núcleo de Oncologia da Bahia, Salvador, Brazil
| | - Clarissa Mathias
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Núcleo de Oncologia da Bahia, Salvador, Brazil
| | - Carlos Barrios
- Grupo Oncoclínicas, Porto Alegre, Brazil; Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Latin American Cooperative Oncology Group, Porto Alegre, Brazil
| | - Mauro Zukin
- Grupo Brasileiro de Oncologia Torácica, Porto Alegre, Brazil; Américas Centro de Oncologia, Rio De Janeiro, Brazil
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Mitra A, Andrews MC, Roh W, Macedo MPD, Reuben A, Carapeto F, Wang F, Reddy SM, Wani K, Spencer C, Miller J, Schalck A, Little LD, Sakellariou-Thompson DA, Gumbs C, Hwu WJ, Bernatchez C, Zhang J, Hwu P, Navin N, Sharma P, Allison JP, Wargo J, Lazar AJ, Futreal PA. Abstract 3776: Spatially resolved immunogenomic analyses reveal diverse sub tumoral microenvironments in the context of melanoma immunotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3776] [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
Sustained periods of apparent clinical benefit despite lack of objective response are well known in a subpopulation of advanced melanoma patients. Inter-individual heterogeneity in response of separate tumors is common, characterizing complex overall response patterns. The molecular and cellular dynamics facilitating such long-term survival and heterogeneous response is poorly understood, particularly in the era of exposure to multiple potentially active therapies. We studied an exceptional case of long-term survival in a patient with non-responding metastatic melanoma in order to characterize the clonal and microenvironmental factors active across 3 time points.
We performed immunogenomic analyses of 3 metachronous tumors, including a systemic therapy-naïve mass, 67 intratumor sub-regions of a non-responding mass during PD-1 inhibitor therapy, and a post-PD-1 inhibitor mass. We profiled samples using whole exome sequencing, RNA-sequencing (RNA-seq), immunohistochemistry (IHC), and T cell receptor sequencing. Longitudinal, spatial, and cross-modal analyses were performed.
Longitudinal analyses identified mutations in several genes known to be associated with targeted or immune therapy resistance affecting distinct metastases. Genomic intratumoral heterogeneity (ITH) was primarily driven by subclonal copy number alterations that showed evidence of spatially-distinct evolution which may be in response to selective pressures at the tumor margin. RNA-seq revealed an unexpectedly high degree of ITH characterized by limited group-level gene or pathway associations with physical or immune characteristics of each site. Spatially-distinct pockets of immune activation and suppression were observed throughout the PD-1 inhibitor resistant metastasis despite a largely immune-excluded phenotype seen on IHC. A specific T cell Vβ CDR3 rearrangement was identified as dominant and recurrent not only across multiple spatial points within a single tumor mass, but also across metachronous tumors spanning the patient’s disease course. Immunophenotyping of the T cell population with single-cell RNA-seq suggested repeated T-cell priming events leading to the persistence of both activated and exhausted T cells bearing the same TCR-β at any given time.
Our findings highlight an unexpected level of genomic and immune heterogeneity in metastatic melanoma tumors of a long-term surviving patient. The observed degree of ITH across local tumor microenvironments reiterates the inherent limitations to identifying robust and reproducible predictive biomarkers of therapy response based on limited physical sampling of tumors. Further spatiotemporal analysis of metastatic lesions in the context of immune checkpoint blockade will be required to determine how the mechanisms driving convergent microenvironmental phenotypes may be harnessed for therapeutic gain.
Citation Format: Akash Mitra, Miles C. Andrews, Whijae Roh, Mariana P. de Macedo, Alexandre Reuben, Fernando Carapeto, Feng Wang, Sangeetha M. Reddy, Khalida Wani, Christine Spencer, John Miller, Aislyn Schalck, Latasha D. Little, Donald A. Sakellariou-Thompson, Curtis Gumbs, Wen-Jen Hwu, Chantale Bernatchez, Jianhua Zhang, Patrick Hwu, Nicholas Navin, Padmanee Sharma, James P. Allison, Jennifer Wargo, Alexander J. Lazar, Philip A. Futreal. Spatially resolved immunogenomic analyses reveal diverse sub tumoral microenvironments in the context of melanoma immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3776.
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Affiliation(s)
- Akash Mitra
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | - Feng Wang
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Khalida Wani
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - John Miller
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Aislyn Schalck
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Curtis Gumbs
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Wen-Jen Hwu
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jianhua Zhang
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Patrick Hwu
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nicholas Navin
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Padmanee Sharma
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jennifer Wargo
- 1The University of Texas MD Anderson Cancer Center, Houston, TX
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Fischer GM, Jalali A, Kircher DA, Lee WC, McQuade JL, Haydu LE, Joon AY, Reuben A, de Macedo MP, Carapeto FCL, Yang C, Srivastava A, Ambati CR, Sreekumar A, Hudgens CW, Knighton B, Deng W, Ferguson SD, Tawbi HA, Glitza IC, Gershenwald JE, Vashisht Gopal YN, Hwu P, Huse JT, Wargo JA, Futreal PA, Putluri N, Lazar AJ, DeBerardinis RJ, Marszalek JR, Zhang J, Holmen SL, Tetzlaff MT, Davies MA. Molecular Profiling Reveals Unique Immune and Metabolic Features of Melanoma Brain Metastases. Cancer Discov 2019; 9:628-645. [PMID: 30787016 PMCID: PMC6497554 DOI: 10.1158/2159-8290.cd-18-1489] [Citation(s) in RCA: 192] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/08/2019] [Accepted: 02/12/2019] [Indexed: 12/24/2022]
Abstract
There is a critical need to improve our understanding of the pathogenesis of melanoma brain metastases (MBM). Thus, we performed RNA sequencing on 88 resected MBMs and 42 patient-matched extracranial metastases; tumors with sufficient tissue also underwent whole-exome sequencing, T-cell receptor sequencing, and IHC. MBMs demonstrated heterogeneity of immune infiltrates that correlated with prior radiation and post-craniotomy survival. Comparison with patient-matched extracranial metastases identified significant immunosuppression and enrichment of oxidative phosphorylation (OXPHOS) in MBMs. Gene-expression analysis of intracranial and subcutaneous xenografts, and a spontaneous MBM model, confirmed increased OXPHOS gene expression in MBMs, which was also detected by direct metabolite profiling and [U-13C]-glucose tracing in vivo. IACS-010759, an OXPHOS inhibitor currently in early-phase clinical trials, improved survival of mice bearing MAPK inhibitor-resistant intracranial melanoma xenografts and inhibited MBM formation in the spontaneous MBM model. The results provide new insights into the pathogenesis and therapeutic resistance of MBMs. SIGNIFICANCE: Improving our understanding of the pathogenesis of MBMs will facilitate the rational development and prioritization of new therapeutic strategies. This study reports the most comprehensive molecular profiling of patient-matched MBMs and extracranial metastases to date. The data provide new insights into MBM biology and therapeutic resistance.See related commentary by Egelston and Margolin, p. 581.This article is highlighted in the In This Issue feature, p. 565.
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MESH Headings
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Biomarkers, Tumor/metabolism
- Brain Neoplasms/drug therapy
- Brain Neoplasms/immunology
- Brain Neoplasms/metabolism
- Brain Neoplasms/secondary
- Cohort Studies
- Disease Models, Animal
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphocytes, Tumor-Infiltrating/immunology
- Melanoma/drug therapy
- Melanoma/immunology
- Melanoma/metabolism
- Melanoma/pathology
- Metabolic Flux Analysis
- Metabolome
- Mice
- Mice, Inbred C57BL
- Mice, Nude
- Oxidative Phosphorylation
- Sequence Analysis, RNA/methods
- Tumor Cells, Cultured
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Grant M Fischer
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ali Jalali
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - David A Kircher
- Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Won-Chul Lee
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer L McQuade
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lauren E Haydu
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Aron Y Joon
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alexandre Reuben
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Fernando C L Carapeto
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chendong Yang
- Children's Medical Research Institute, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Anuj Srivastava
- Department of Computational Sciences, The Jackson Lab for Genomic Medicine, Farmington, Connecticut
| | - Chandrashekar R Ambati
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, Texas
- Advanced Technology Core, Alkek Center for Molecular Discovery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Arun Sreekumar
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, Texas
- Advanced Technology Core, Alkek Center for Molecular Discovery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Courtney W Hudgens
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Barbara Knighton
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wanleng Deng
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sherise D Ferguson
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hussein A Tawbi
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Isabella C Glitza
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Gershenwald
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Y N Vashisht Gopal
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Patrick Hwu
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jason T Huse
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jennifer A Wargo
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - P Andrew Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nagireddy Putluri
- Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, Texas
- Advanced Technology Core, Alkek Center for Molecular Discovery, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Alexander J Lazar
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ralph J DeBerardinis
- Children's Medical Research Institute, The University of Texas Southwestern Medical Center, Dallas, Texas
- Howard Hughes Medical Institute, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joseph R Marszalek
- Institute for Applied Cancer Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jianjun Zhang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sheri L Holmen
- Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah
- Department of Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Michael T Tetzlaff
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Davies
- Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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9
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Bridi A, Bertolin K, Rissi VB, Mujica LKS, Glanzner WG, de Macedo MP, Comim FV, Gonçalves PBD, Antoniazzi AQ. Parthenogenetic bovine embryos secrete type I interferon capable of stimulating ISG15 in luteal cell culture. Anim Reprod 2018; 15:1268-1277. [PMID: 34221141 PMCID: PMC8203113 DOI: 10.21451/1984-3143-ar2018-0095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 11/08/2022] Open
Abstract
Interferon tau (IFNT) is the pregnancy recognition signal in ruminants and is secreted by
trophoblast cells. Paracrine action in the endometrium is well established by inhibiting
luteolytic pulses of prostaglandin F2 alpha. Recently, endocrine action was documented
in the corpus luteum, blood cell and liver. It was hypothesized that conditioned medium (CM)
obtained from days 7, 9 and 12 parthenogenetic embryos alters luteal cell gene expression.
The aim was to establish a bovine mixed luteal cell culture to evaluate cellular response associated
to interferon stimulated genes, steroidogenesis and apoptosis. Conditioned medium was
obtained from Days 7, 9 and 12 parthenogenetic (PA) embryos culture. Moreover, antiviral
assay was performed on CM from Days 7, 9 and 12 to verify Type I interferon activity. Luteal cell
culture was validated by steroidogenic and apoptotic genes (CYP11A1
, HSD3B1, BAX, BCL2, AKT and
XIAP mRNA expression), and concentration of progesterone as endpoint. Luteal
cell culture was treated with interferon alpha (IFNA) and CM from parthenogenetic embryos.
Antiviral assay revealed Type I interferon activity on CM from embryos increasing on Days
9 and 12. ISG15 mRNA was greater in the mixed luteal cells culture treated
with 1, 10 and 100ng/ml of interferon alpha (IFNA) and also on Days 7, 9 and 12 CM treatments.
Concentration of progesterone was not altered in luteal cell culture regardless of treatments.
Steroidogenic and apoptotic genes were similar among groups in luteal cell culture treated
with different doses of IFNA or CM from PA embryos. In conclusion, parthenogenetic embryo-derived
CM has antiviral activity, luteal cell culture respond to Type I interferon by expressing
IGS15. These data indicate this model can be used for IFNT endocrine signaling studies.
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Affiliation(s)
- Alessandra Bridi
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Kalyne Bertolin
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Vitor B Rissi
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Lady K S Mujica
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Werner G Glanzner
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Mariana P de Macedo
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Fabio V Comim
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Paulo B D Gonçalves
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Alfredo Q Antoniazzi
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Department of Large Animal Clinical Science, Federal University of Santa Maria, Santa Maria, RS, Brazil
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10
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de Macedo MP, Glanzner WG, Rissi VB, Gutierrez K, Currin L, Baldassarre H, Bordignon V. A fast and reliable protocol for activation of porcine oocytes. Theriogenology 2018; 123:22-29. [PMID: 30273737 DOI: 10.1016/j.theriogenology.2018.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 06/19/2018] [Revised: 08/10/2018] [Accepted: 09/23/2018] [Indexed: 12/29/2022]
Abstract
Oocyte activation is physiologically triggered by the sperm during fertilization, however, production of porcine embryos by somatic cell nuclear transfer (SCNT), intracytoplasmic sperm injection (ICSI) or parthenogenetic activation (PA) requires artificial oocyte activation. Although effective protocols for artificial oocyte activation have been developed, current protocols require long exposures to non-specific inhibitors, which do not mimic the physiological process and may have detrimental consequences for embryo development. This study attempted to mimic the physiological activation events induced by fertilization, through the manipulation of Ca2+ and Zn2+ levels, and protein kinase C (PKC) as well as cyclin dependent kinase 1 (CDK1) activities, with the aim of developing an improved protocol for activation of porcine oocytes. In the first experiment, matured oocytes were exposed to ionomycin (Ion) for 5 min, and then treated with a specific CDK1 inhibitor (RO-3306) and/or PKC activator (OAG) for different time intervals. The highest rate of pronuclear (PN) formation (58.8%) was obtained when oocytes were treated with PKCa + CDK1i for 4 h. Second, PN formation and embryo development were evaluated in oocytes exposed for different times to a Zn2+ chelator (TPEN) following Ion treatment. This revealed that 15 min was the minimal exposure time to TPEN required to maximise oocyte activation and embryo development. Next, we observed that treatment with PKCa + CDK1i for 4 h after TPEN for 15 min decreased embryo development compared to TPEN alone. Lastly, we compared the efficiency of the Ion (5 min) plus TPEN (15 min) protocol (IT-20) with a control protocol used in our laboratory (CT-245) for production of PA, SCNT and ICSI embryos. In PA embryos, IT-20 resulted in higher cleavage (72% vs 49.2%) and blastocyst from cleaved embryos (65.5% vs 46.2%) compared to CT-245. In ICSI embryos, higher PN rates were obtained with the IT-20 protocol compared with CT-245 and the non-activated (N-A) group. Moreover, the two protocols were equally efficient for activation of SCNT embryos. Based on these findings, we propose that IT-20 is a fast and effective protocol for activation of porcine oocytes.
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Affiliation(s)
- Mariana P de Macedo
- Department of Animal Science, McGill University, Sainte-Anne de Bellevue, Quebec, Canada
| | - Werner G Glanzner
- Department of Animal Science, McGill University, Sainte-Anne de Bellevue, Quebec, Canada
| | - Vitor B Rissi
- Laboratory of Biotechnology and Animal Reproduction - BioRep, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Karina Gutierrez
- Department of Animal Science, McGill University, Sainte-Anne de Bellevue, Quebec, Canada
| | - Luke Currin
- Department of Animal Science, McGill University, Sainte-Anne de Bellevue, Quebec, Canada
| | - Hernan Baldassarre
- Department of Animal Science, McGill University, Sainte-Anne de Bellevue, Quebec, Canada
| | - Vilceu Bordignon
- Department of Animal Science, McGill University, Sainte-Anne de Bellevue, Quebec, Canada.
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11
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Marques MC, C Ribeiro HS, Costa WL, de Jesus VHF, de Macedo MP, Diniz AL, Godoy AL, Farias IC, Aguiar S, Riechelmann RSP, S Begnami MDF, Coimbra FJF. Is primary sidedness a prognostic factor in patients with resected colon cancer liver metastases (CLM)? J Surg Oncol 2018; 117:858-863. [PMID: 29611198 DOI: 10.1002/jso.25048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 02/21/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Recent studies have suggested that sidedness of origin from colorectal adenocarcinomas is a predictor of survival, however the impact of this factor in patients with resected colon cancer liver metastases (CLM) is not clear. So, in this study, we compared clinic and pathologic characteristics and long-term survival of patients with resected CLM according to the primary tumor location. METHODS This is a retrospective analyzes of a prospective database. Patients with resected CLM from 1998 to 2012 were included. Right colon included tumors from cecum to middle transverse colon, and left colon included tumors from splenic flexure to sigmoid. RESULTS One hundred fifty-one patients were included, 27 right colon and 124 left colon. In the latter group, there were more patients with synchronous disease (67.7 × 6.2%, P = 0.026) and a higher CEA (22.0 × 11.7 ng/mL, P = 0.001). However, K-Ras mutation was more frequent in right sided tumors (75.0 × 24.1%, P = 0.001). There was no difference in long term survival in both groups in this series even when adjusted for the confounding variables. CONCLUSION Sidedness do not seem to be a predictor of long term survival in patients with resected colon cancer liver metastases.
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Affiliation(s)
- Márcio C Marques
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Héber S C Ribeiro
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Wílson L Costa
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | - Mariana P de Macedo
- Anatomic Pathology Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Alessandro L Diniz
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - André L Godoy
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Igor C Farias
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | - Samuel Aguiar
- Pelvic Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | - Felipe J F Coimbra
- Abdominal Surgery Department, AC Camargo Cancer Center, São Paulo, SP, Brazil
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12
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Brandão PHDM, Bertolli E, Doria-Filho E, Santos Filho IDAO, de Macedo MP, Pinto CAL, Duprat Neto JP. In transit sentinel node drainage as a prognostic factor for patients with cutaneous melanoma. J Surg Oncol 2018; 117:864-867. [PMID: 29484669 DOI: 10.1002/jso.25023] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/26/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Minor basin or in transit node drainage can be found in patients with cutaneous melanoma who undergo sentinel node biopsy. Its clinical impact is still unclear. Our objective is to evaluate clinical outcomes in patients who presented with in transit sentinel node (ITN) drainage. MATERIAL AND METHODS Retrospective analysis of patients who underwent sentinel node biopsy (SNB) in a single Brazilian institution between 2000 and 2015. RESULTS Our cohort comprised 1223 SNB. There were 64 patients (5.2%) with ITN. Melanoma of the limbs (OR 10.61, P < 0.0001) and acral subtype (OR 3.49, P < 0.0001) were associated with ITN drainage. Among these 64 patients, 14 (21.9%) had a positive SNB. The ITN was positive for metastases in five patients, four in a popliteal basin and one on the trunk. Regarding completion node dissection (CND), two patients had positive non-sentinel nodes (NSN), both in major basins. In patients who developed recurrence, time to recurrence was shorter (mean time 18 vs 31.4 months, P = 0.001) and time to death was shorter (mean time 31.6 vs 40 months, P = 0.039) in those who had ITN drainage. CONCLUSION ITN drainage was associated with earlier recurrences and deaths from melanoma.
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Affiliation(s)
- Paulo H D M Brandão
- Surgical Oncology Medical Residence Program, AC Camargo Cancer Center, São Paulo, Brazil
| | - Eduardo Bertolli
- Skin Cancer Department, AC Camargo Cancer Center, São Paulo, Brazil
| | - Eduardo Doria-Filho
- Surgical Oncology Medical Residence Program, AC Camargo Cancer Center, São Paulo, Brazil
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13
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Blumetti TP, Scope A, de Macedo MP, Ferreira JB, Gomes EE, Enokihara MY, Pinto CA, Nascimento MM, Rezze GG, Braga JC. Dermoscopic and Reflectance Confocal Microscopy Findings in Extra-genital HPV16-associated Pigmented Squamous Cell Carcinoma in situ. Acta Derm Venereol 2016; 96:836-7. [PMID: 26976508 DOI: 10.2340/00015555-2399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Tatiana P Blumetti
- Cutaneous Oncology Department, AC Camargo Cancer Center, Rua Professor Antonio Prudente, 211, São Paulo, Brazil.
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