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Köbel M, Kang EY, Lee S, Terzic T, Karnezis AN, Ghatage P, Woo L, Lee CH, Meagher NS, Ramus SJ, Gorringe KL. Infiltrative pattern of invasion is independently associated with shorter survival and desmoplastic stroma markers FAP and THBS2 in mucinous ovarian carcinoma. Histopathology 2024; 84:1095-1110. [PMID: 38155475 DOI: 10.1111/his.15128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023]
Abstract
AIMS Mucinous ovarian carcinoma (MOC) is a rare ovarian cancer histotype with generally good prognosis when diagnosed at an early stage. However, MOC with the infiltrative pattern of invasion has a worse prognosis, although to date studies have not been large enough to control for covariables. Data on reproducibility of classifying the invasion pattern are limited, as are molecular correlates for infiltrative invasion. We hypothesized that the invasion pattern would be associated with an aberrant tumour microenvironment. METHODS AND RESULTS Four subspecialty pathologists assessed interobserver reproducibility of the pattern of invasion in 134 MOC. Immunohistochemistry on fibroblast activation protein (FAP) and THBS2 was performed on 98 cases. Association with survival was tested using Cox regression. The average interobserver agreement for the infiltrative pattern was moderate (kappa 0.60, agreement 86.3%). After reproducibility review, 24/134 MOC (18%) were determined to have the infiltrative pattern and this was associated with a higher risk of death, independent of FIGO stage, grade, and patient age in a time-dependent manner (hazard ratio [HR] = 10.2, 95% confidence interval [CI] 3.0-34.5). High stromal expression of FAP and THBS2 was more common in infiltrative MOC (FAP: 60%, THBS2: 58%, both P < 0.001) and associated with survival (multivariate HR for FAP: 1.5 [95% CI 1.1-2.1] and THBS2: 1.91 [95% CI 1.1-3.2]). CONCLUSIONS The pattern of invasion should be included in reporting for MOC due to the strong prognostic implications. We highlight the histological features that should be considered to improve reproducibility. FAP and THBS2 are associated with infiltrative invasion in MOC.
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Affiliation(s)
- Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Sandra Lee
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Tatjana Terzic
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Centre, Calgary, AB, Canada
| | - Antony N Karnezis
- Department of Pathology and Laboratory Medicine, University of California Davis, Sacramento, CA, USA
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lawrence Woo
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada
| | - Nicola S Meagher
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Susan J Ramus
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Kylie L Gorringe
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Vic., Australia
- Peter MacCallum Cancer Centre, Melbourne, Vic., Australia
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Martell K, McIntyre JB, Abedin T, Kornaga EN, Chan AMY, Enwere E, Köbel M, Dean ML, Phan T, Ghatage P, Lees-Miller SP, Doll CM. Prevalence and Prognostic Significance of PIK3CA Mutation and CNV Status and Phosphorylated AKT Expression in Patients With Cervical Cancer Treated With Primary Surgery. Int J Gynecol Pathol 2024; 43:158-170. [PMID: 37668363 DOI: 10.1097/pgp.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
Currently, there are limited and conflicting reports on the prognostic utility of PIK3CA and associated pathway markers for cervical cancers treated with primary surgical management. Moreover, current studies are lacking complete characterization of adjuvant treatment with RT and/or chemotherapy. We aimed to document the prevalence, clinicopathologic, adjuvant treatment details, and prognostic value of PI3K/AKT pathway mutations and copy number variation and phosphorylated AKT status in patients with cervical cancers treated with primary surgery. A clinicopathologic review was performed on a retrospective cohort of 185 patients with cervical cancer, treated with primary surgery at a single tertiary institution. Next-generation sequencing and digital PCR was used to determine PI3K/AKT pathway mutational status and PIK3CA copy number variation, respectively, and fluorescent immunohistochemistry measured phosphorylated AKT expression. In all, 179 of 185 (96.8%) of tumors were successfully sequenced; 48 (26.8%) were positive for PI3K/AKT pathway mutations-the majority (n=37, 77.1%) PIK3CA mutations. PIK3CA mutation was associated with pathologically positive lymph nodes [12 (32%) vs. 22 (16%); P =0.022] and indication for postoperative chemoradiotherapy [17 (45.9%) vs. 32 (22.5%); P =0.004]. On multivariable analysis, PIK3CA status was not associated with overall survival ( P =0.103) or progression-free survival ( P =0.240) at 5 yrs, nor was PIK3CA copy number variation status. phosphorylated AKT ≤ median significantly predicted for progression-free survival [multivariable hazard ratio 0.39 (0.17-0.89; P =0.025)] but not overall survival ( P =0.087). The correlation of PIK3CA with pathologic positive lymph node status yet lack of association with survival outcomes may be due to the use of adjuvant postoperative therapy. PIK3CA assessment before radical hysterectomy may help identify patients with a higher risk of node-positive disease.
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Kang EY, Terzic T, Ghatage P, Woo L, Gorringe KL, Karnezis AN, Lee CH, Köbel M. TP53 as a Diagnostic Aid in the Distinction of Ovarian Mucinous Borderline Tumors From Mucinous Carcinoma. Int J Gynecol Pathol 2024; 43:111-122. [PMID: 37406453 DOI: 10.1097/pgp.0000000000000967] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Ovarian mucinous borderline tumors (MBTs) are clinically managed as benign neoplasms while the management of ovarian mucinous carcinomas (MC) is dependent on tumor stage. Despite the standardization of sampling of ovarian mucinous neoplasms, limited interobserver reproducibility between MBT and MC persists. Based on our recent finding that abnormal TP53 expression is associated with unfavorable outcome in MBT, we hypothesized that TP53 status might improve the reproducible distinction of MBT from MC. A virtual slide set of 85 consecutive ovarian mucinous neoplasms received at a single institution, with each case represented by 3 full sections, were reviewed by 3 pathologists in 2 iterations. The initial assessment was based solely on morphologic review, while the second iteration was performed with knowledge of TP53 status. The reproducibility of a trinary categorization (MBT, MBT with intraepithelial carcinoma [IEC], MC) significantly improved from a κ of 0.60 based on the initial morphologic assessment to a κ of 0.76 (t-test, P =0.0042) after consideration of TP53 immunohistochemistry (IHC) results. Six out of 85 patients died of disease, and in 2 of them, at least 1 pathologist assessed MBT with IEC and not MC even after integration of TP53 IHC. With the integration of TP53 IHC, substantial interobserver agreement for MBT and MC can be reached, particularly in cases with an uncertain degree of confluent growth. TP53 IHC can also be used to highlight and support the presence of IEC in MBT, however, discordances remained in 2 cases with adverse outcome.
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Kommoss FK, Lee CH, Tessier-Cloutier B, Gilks CB, Stewart CJ, von Deimling A, Köbel M. Mesonephric-like adenocarcinoma harbours characteristic copy number variations and a distinct DNA methylation signature closely related to mesonephric adenocarcinoma of the cervix. J Pathol 2024; 262:4-9. [PMID: 37850576 DOI: 10.1002/path.6217] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/09/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023]
Abstract
Mesonephric-like adenocarcinoma (MLA) of the female genital tract is an uncommon histotype that can arise in both the endometrium and the ovary. The exact cell of origin and histogenesis currently remain unknown. Here, we investigated whole genome DNA methylation patterns and copy number variations (CNVs) in a series of MLAs in the context of a large cohort of various gynaecological carcinoma types. CNV analysis of 19 MLAs uncovered gains of chromosomes 1q (18/19, 95%), 10 (15/19, 79%), 12 (14/19, 74%), and 2 (10/19, 53%), as well as loss of chromosome 1p (7/19, 37%). Gains of chromosomes 1q, 10, and 12 were also identified in the majority of mesonephric adenocarcinomas of the uterine cervix (MAs) as well as subsets of endometrioid carcinomas (ECs) and low-grade serous carcinomas of the ovary (LGSCs) but only in a minority of serous carcinomas of the uterine corpus (USCs), clear cell carcinomas (CCCs), and tubo-ovarian high-grade serous carcinomas (HGSCs). While losses of chromosome 1p together with gains of chromosome 1q were also identified in both MA and LGSC, gains of chromosome 2 were almost exclusively identified in MLA and MA. Unsupervised hierarchical clustering and t-SNE analysis of DNA methylation data (Illumina EPIC array) identified a co-clustering for MLAs and MAs, which was distinct from clusters of ECs, USCs, CCCs, LGSCs, and HGSCs. Group-wise comparisons confirmed a close epigenetic relationship between MLA and MA. These findings, in conjunction with the established histological and immunophenotypical overlap, suggest bona fide mesonephric differentiation, and support a more precise terminology of mesonephric-type adenocarcinoma instead of MLA in these tumours. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Felix Kf Kommoss
- Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | | | - C Blake Gilks
- Department of Laboratory Medicine and Pathology, University of British Columbia, Vancouver, BC, Canada
| | - Colin Jr Stewart
- Department of Anatomical Pathology, King Edward Memorial Hospital, Subiaco, WA, Australia
- School for Women's and Infants' Health, University of Western Australia, Perth, WA, Australia
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital and CCU Neuropathology DKFZ, Heidelberg, Germany
| | - Martin Köbel
- Department of Laboratory Medicine and Pathology, University of Calgary, Calgary, AB, Canada
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Tessier-Cloutier B, Kommoss FKF, Kolin DL, Němejcová K, Smith D, Pors J, Stewart CJR, McCluggage WG, Foulkes WD, von Deimling A, Köbel M, Lee CH. Dedifferentiated and Undifferentiated Ovarian Carcinoma: An Aggressive and Molecularly Distinct Ovarian Tumor Characterized by Frequent SWI/SNF Complex Inactivation. Mod Pathol 2024; 37:100374. [PMID: 37925057 DOI: 10.1016/j.modpat.2023.100374] [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: 08/06/2023] [Revised: 10/17/2023] [Accepted: 10/28/2023] [Indexed: 11/06/2023]
Abstract
Dedifferentiated and undifferentiated ovarian carcinomas (DDOC/UDOC) are rare neoplasms defined by the presence of an undifferentiated carcinoma. In this study, we detailed the clinical, pathological, immunohistochemical, and molecular features of a series of DDOC/UDOC. We collected a multi-institutional cohort of 23 DDOC/UDOC and performed immunohistochemistry for core switch/sucrose nonfermentable (SWI/SNF) complex proteins (ARID1A, ARID1B, SMARCA4, and SMARCB1), mismatch repair (MMR) proteins, and p53. Array-based genome-wide DNA methylation and copy number variation analyses were performed on a subset of cases with comparison made to a previously reported cohort of undifferentiated endometrial carcinoma (UDEC), small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), and tubo-ovarian high-grade serous carcinoma (HGSC). The age of all 23 patients with DDOC/UDOC ranged between 22 and 71 years (with an average age of 50 years), and a majority of them presented with extraovarian disease (16/23). Clinical follow-up was available for 19 patients. Except for 2 patients, the remaining 17 patients died from disease, with rapid disease progression resulting in mortality within a year in stage II-IV settings (median disease-specific survival of 3 months). Eighteen of 22 cases with interpretable immunohistochemistry results showed loss of expression of core SWI/SNF protein(s) that are expected to result in SWI/SNF complex inactivation as 10 exhibited coloss of ARID1A and ARID1B, 7 loss of SMARCA4, and 1 loss of SMARCB1. Six of 23 cases were MMR-deficient. Two of 20 cases exhibited mutation-type p53 immunoreactivity. Methylation profiles showed coclustering of DDOC/UDOC with UDEC, which collectively were distinct from SCCOHT and HGSC. However, DDOC/UDOC showed an intermediate degree of copy number variation, which was slightly greater, compared with SCCOHT but much less compared with HGSC. Overall, DDOC/UDOC, like its endometrial counterpart, is highly aggressive and is characterized by frequent inactivation of core SWI/SNF complex proteins and MMR deficiency. Its molecular profile overlaps with UDEC while being distinct from SCCOHT and HGSC.
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Affiliation(s)
- Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Felix K F Kommoss
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - David L Kolin
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Kristýna Němejcová
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - DuPreez Smith
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer Pors
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, British Columbia, Canada
| | - Colin J R Stewart
- Department of Pathology, King Edward Memorial Hospital, Perth, Australia
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - William D Foulkes
- Departments of Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Andreas von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany; CCU Neuropathology, German Cancer Center (DKFZ), Heidelberg, Germany
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
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Huvila J, Thompson EF, Vanden Broek J, Lum A, Senz J, Leung S, Gilks CB, Köbel M, McAlpine JN, Jamieson A. Subclonal p53 immunostaining in the diagnosis of endometrial carcinoma molecular subtype. Histopathology 2023; 83:880-890. [PMID: 37580913 DOI: 10.1111/his.15029] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/26/2023] [Accepted: 07/30/2023] [Indexed: 08/16/2023]
Abstract
AIMS The significance of subclonal expression of p53 (abrupt transition from wild-type to mutant-pattern staining) is not well understood, and the arbitrary diagnostic cut-off of 10% between NSMP and p53abn molecular subtypes of endometrial carcinoma (EC) has not been critically assessed. Our aim was to characterise subclonal p53 and discrepant p53 expression/TP53 sequencing results in EC and assess their clinical significance. METHODS AND RESULTS Subclonal p53 immuostaining on whole sections from 957 ECs was recorded. Agreement between TP53 mutational assessment and p53 immunostaining was evaluated. Subclonal p53 IHC staining was seen in 4.0% (38 of 957) of cases, with 23 of 957 (2.4%) showing mutant-pattern p53 staining in ≥10% of tumour cells. It was most commonly seen in POLEmut (nine of 65, 14%) and MMRd (13 of 274, 4.7%) EC ('multiple classifier' ECs), where subclonal p53 staining does not impact the molecular subtype diagnosis. Excluding POLEmut and MMRd EC, 11 of 957 (1.1%) showed ≥10% subclonal p53 from which four patients died of disease, while there were no deaths due to disease in the five patients with <10% mutant-pattern p53 staining. Agreement between p53 immunostaining and TP53 sequencing was 92.6%; most of the discrepant results were in the ultramutated POLEmut or hypermutated MMRd ECs. In NSMP and p53abn EC the agreement between IHC and sequencing was 95.8%. CONCLUSIONS Subclonal p53 staining ≥10% is present in only 1.1% of EC after excluding 'multiple classifier' ECs. The cut-off of ≥10% subclonal p53 staining identified patients at increased risk of dying from EC, supporting its use to diagnose p53abn molecular subtype.
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Affiliation(s)
- Jutta Huvila
- Department of Pathology, Turku University Hospital, University of Turku, Turku, Finland
| | - Emily F Thompson
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Jamie Vanden Broek
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Amy Lum
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Janine Senz
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Samuel Leung
- Department of Molecular Oncology, University of British Columbia, Vancouver, BC, Canada
| | - C Blake Gilks
- Department of Pathology, University of British Columbia, Vancouver, BC, Canada
| | - Martin Köbel
- Department of Pathology, University of Calgary, Calgary, AB, Canada
| | - Jessica N McAlpine
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Amy Jamieson
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of British Columbia, Vancouver, BC, Canada
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Zoet G, Tucker DR, Orr NL, Alotaibi FT, Liu YD, Noga H, Köbel M, Yong PJ. Standardized protocol for quantification of nerve bundle density as a biomarker for endometriosis. Front Reprod Health 2023; 5:1297986. [PMID: 38098984 PMCID: PMC10720898 DOI: 10.3389/frph.2023.1297986] [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: 09/20/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction We propose a standardized protocol for measurement of nerve bundle density in endometriosis as a potential biomarker, including in deep endometriosis (DE), ovarian endometriomas (OMA) and superficial peritoneal endometriosis (SUP). Methods This was a prospective cohort of surgically excised endometriosis samples from Dec 1st 2013 and Dec 31st 2017 at a tertiary referral center for endometriosis in Vancouver, BC, Canada. Surgical data were available from linked patient registry. Protein gene product 9.5 (PGP9.5) was used to identify nerve bundles on immunohistochemistry. PGP9.5 nerve bundles were counted visually. To calculate nerve bundle density, PGP9.5 nerve bundle count was divided by the tissue surface area (total on the slide). All samples were assessed using NHS Elements software for semi-automated measurement of the tissue surface area. For a subset of samples, high power fields (HPFs) were also counted as manual measurement of the tissue surface area. Intraclass correlation was used to assess intra observer and inter observer reliability. Generalized linear mixed model (GLMM) with random intercepts only was conducted to assess differences in PGP9.5 nerve bundle density by endometriosis type (DE, OMA, SUP). Results In total, 236 tissue samples out of 121 participants were available for analysis in the current study. Semi-automated surface area measurement could be performed in 94.5% of the samples and showed good correlation with manually counted HPFs (Spearman's rho = 0.781, p < 0.001). To assess intra observer reliability, 11 samples were assessed twice by the same observer; to assess inter observer reliability, 11 random samples were blindly assessed by two observers. Intra observer reliability and inter observer reliability for nerve bundle density were excellent: 0.979 and 0.985, respectively. PGP9.5 nerve bundle density varied among samples and no nerve bundles could be found in 24.6% of the samples. GLMM showed a significant difference in PGP9.5 nerve bundle density between the different endometriosis types (X2 = 87.6, P < 0.001 after adjusting for hormonal therapy, with higher density in DE and SUP in comparison to OMA). Conclusion A standardized protocol is presented to measure PGP9.5 nerve bundle density in endometriosis, which may serve as a biomarker reflecting local neurogenesis in the endometriosis microenvironment.
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Affiliation(s)
- Gerbrand Zoet
- Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Dwayne R. Tucker
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- University of British Columbia Endometriosis and Pelvic Pain Laboratory, Vancouver, BC, Canada
| | - Natasha L. Orr
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- University of British Columbia Endometriosis and Pelvic Pain Laboratory, Vancouver, BC, Canada
| | - Fahad T. Alotaibi
- University of British Columbia Endometriosis and Pelvic Pain Laboratory, Vancouver, BC, Canada
- Department of Physiology, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Yang Doris Liu
- University of British Columbia Endometriosis and Pelvic Pain Laboratory, Vancouver, BC, Canada
| | - Heather Noga
- University of British Columbia Endometriosis and Pelvic Pain Laboratory, Vancouver, BC, Canada
- Women’s Health Research Institute, Vancouver, BC, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul J. Yong
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- University of British Columbia Endometriosis and Pelvic Pain Laboratory, Vancouver, BC, Canada
- Women’s Health Research Institute, Vancouver, BC, Canada
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Saner FAM, Takahashi K, Budden T, Pandey A, Ariyaratne D, Zwimpfer TA, Meagher NS, Fereday S, Twomey L, Pishas KI, Hoang T, Bolithon A, Traficante N, Alsop K, Christie EL, Kang EY, Nelson GS, Ghatage P, Lee CH, Riggan MJ, Alsop J, Beckmann MW, Boros J, Brand AH, Brooks-Wilson A, Carney ME, Coulson P, Courtney-Brooks M, Cushing-Haugen KL, Cybulski C, El-Bahrawy MA, Elishaev E, Erber R, Gayther SA, Gentry-Maharaj A, Blake Gilks C, Harnett PR, Harris HR, Hartmann A, Hein A, Hendley J, Hernandez BY, Jakubowska A, Jimenez-Linan M, Jones ME, Kaufmann SH, Kennedy CJ, Kluz T, Koziak JM, Kristjansdottir B, Le ND, Lener M, Lester J, Lubiński J, Mateoiu C, Orsulic S, Ruebner M, Schoemaker MJ, Shah M, Sharma R, Sherman ME, Shvetsov YB, Singh N, Rinda Soong T, Steed H, Sukumvanich P, Talhouk A, Taylor SE, Vierkant RA, Wang C, Widschwendter M, Wilkens LR, Winham SJ, Anglesio MS, Berchuck A, Brenton JD, Campbell I, Cook LS, Doherty JA, Fasching PA, Fortner RT, Goodman MT, Gronwald J, Huntsman DG, Karlan BY, Kelemen LE, Menon U, Modugno F, Pharoah PD, Schildkraut JM, Sundfeldt K, Swerdlow AJ, Goode EL, DeFazio A, Köbel M, Ramus SJ, Bowtell DDL, Garsed DW. Concurrent RB1 loss and BRCA-deficiency predicts enhanced immunological response and long-term survival in tubo-ovarian high-grade serous carcinoma. medRxiv 2023:2023.11.09.23298321. [PMID: 37986741 PMCID: PMC10659507 DOI: 10.1101/2023.11.09.23298321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Background Somatic loss of the tumour suppressor RB1 is a common event in tubo-ovarian high-grade serous carcinoma (HGSC), which frequently co-occurs with alterations in homologous recombination DNA repair genes including BRCA1 and BRCA2 (BRCA). We examined whether tumour expression of RB1 was associated with survival across ovarian cancer histotypes (HGSC, endometrioid (ENOC), clear cell (CCOC), mucinous (MOC), low-grade serous carcinoma (LGSC)), and how co-occurrence of germline BRCA pathogenic variants and RB1 loss influences long-term survival in a large series of HGSC. Patients and methods RB1 protein expression patterns were classified by immunohistochemistry in epithelial ovarian carcinomas of 7436 patients from 20 studies participating in the Ovarian Tumor Tissue Analysis consortium and assessed for associations with overall survival (OS), accounting for patient age at diagnosis and FIGO stage. We examined RB1 expression and germline BRCA status in a subset of 1134 HGSC, and related genotype to survival, tumour infiltrating CD8+ lymphocyte counts and transcriptomic subtypes. Using CRISPR-Cas9, we deleted RB1 in HGSC cell lines with and without BRCA1 mutations to model co-loss with treatment response. We also performed genomic analyses on 126 primary HGSC to explore the molecular characteristics of concurrent homologous recombination deficiency and RB1 loss. Results RB1 protein loss was most frequent in HGSC (16.4%) and was highly correlated with RB1 mRNA expression. RB1 loss was associated with longer OS in HGSC (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.66-0.83, P = 6.8 ×10-7), but with poorer prognosis in ENOC (HR 2.17, 95% CI 1.17-4.03, P = 0.0140). Germline BRCA mutations and RB1 loss co-occurred in HGSC (P < 0.0001). Patients with both RB1 loss and germline BRCA mutations had a superior OS (HR 0.38, 95% CI 0.25-0.58, P = 5.2 ×10-6) compared to patients with either alteration alone, and their median OS was three times longer than non-carriers whose tumours retained RB1 expression (9.3 years vs. 3.1 years). Enhanced sensitivity to cisplatin (P < 0.01) and paclitaxel (P < 0.05) was seen in BRCA1 mutated cell lines with RB1 knockout. Among 126 patients with whole-genome and transcriptome sequence data, combined RB1 loss and genomic evidence of homologous recombination deficiency was correlated with transcriptional markers of enhanced interferon response, cell cycle deregulation, and reduced epithelial-mesenchymal transition in primary HGSC. CD8+ lymphocytes were most prevalent in BRCA-deficient HGSC with co-loss of RB1. Conclusions Co-occurrence of RB1 loss and BRCA mutation was associated with exceptionally long survival in patients with HGSC, potentially due to better treatment response and immune stimulation.
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Affiliation(s)
- Flurina A. M. Saner
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Kazuaki Takahashi
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Timothy Budden
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Skin Cancer and Ageing Lab, Cancer Research United Kingdom Manchester Institute, The University of Manchester, Manchester, UK
| | - Ahwan Pandey
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | | | - Nicola S. Meagher
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Laura Twomey
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Kathleen I. Pishas
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Therese Hoang
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Adelyn Bolithon
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Kathryn Alsop
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth L. Christie
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Gregg S. Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Marjorie J. Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jessica Boros
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Alison H. Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | | | - Michael E. Carney
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Penny Coulson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Madeleine Courtney-Brooks
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kara L. Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Mona A. El-Bahrawy
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Hammersmith Hospital, London, UK
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Simon A. Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
- Department of Women’s Cancer, Elizabeth Garrett Anderson Institute for Women’s Health, University College London, London, UK
| | - C. Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul R. Harnett
- The University of Sydney, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
| | - Holly R. Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Joy Hendley
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - AOCS Group
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | | | - Michael E. Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Scott H. Kaufmann
- Division of Oncology Research, Department of Oncology, Mayo Clinic, Rochester, MN, USA
| | - Catherine J. Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Tomasz Kluz
- Department of Gynecology and Obstetrics, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | | | - Björg Kristjansdottir
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
| | - Nhu D. Le
- Cancer Control Research, BC Cancer Agency, Vancouver, BC, Canada
| | - Marcin Lener
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | | | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Minouk J. Schoemaker
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Mark E. Sherman
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | | | - Naveena Singh
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - T. Rinda Soong
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
- Section of Gynecologic Oncology Surgery, North Zone, Alberta Health Services, Edmonton, Alberta, Canada
| | - Paniti Sukumvanich
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Aline Talhouk
- British Columbia’s Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Sarah E. Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Robert A. Vierkant
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Stacey J. Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Michael S. Anglesio
- British Columbia’s Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - James D. Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Ian Campbell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Linda S. Cook
- Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Renée T. Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Marc T. Goodman
- Cancer Prevention and Control Program, Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - David G. Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- British Columbia’s Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Beth Y. Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Linda E. Kelemen
- Division of Acute Disease Epidemiology, South Carolina Department of Health & Environmental Control, Columbia, SC, USA
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Women’s Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
| | - Paul D.P. Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Joellen M. Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
| | - Anthony J. Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Ellen L. Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Anna DeFazio
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Susan J. Ramus
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - David D. L. Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Dale W. Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
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9
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Köbel M, Yang RZ, Kang EY, Al-Shamma Z, Cook LS, Kinloch M, Carey MS, Hopkins L, Nelson GS, McManus KJ, Vizeacoumar FS, Vizeacoumar FJ, Freywald A, Fu Y, Reuss DE, Lee CH. Survey of NF1 inactivation by surrogate immunohistochemistry in ovarian carcinomas. Gynecol Oncol 2023; 178:80-88. [PMID: 37820398 DOI: 10.1016/j.ygyno.2023.09.016] [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: 08/15/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Inhibition of the MAPK pathway by MEK inhibitors (MEKi) is currently a therapeutic standard in several cancer types, including ovarian low-grade serous carcinoma (LGSC). A common MAPK pathway alteration in tubo-ovarian high-grade serous carcinoma (HGSC) is the genomic inactivation of neurofibromin 1 (NF1). The primary objectives of our study were to survey the prevalence of NF1 inactivation in the principal ovarian carcinoma histotype as well as to evaluate its associations with clinico-pathological parameters and key biomarkers including BRCA1/2 status in HGSC. METHODS A recently commercialized NF1 antibody (clone NFC) was orthogonally validated on an automated immunohistochemistry (IHC) platform and IHC was performed on tissue microarrays containing 2140 ovarian carcinoma cases. Expression was interpreted as loss/inactivated (complete or subclonal) versus normal/retained. RESULTS Loss of NF1 expression was detected in 250/1429 (17.4%) HGSC including 11% with subclonal loss. Survival of NF1-inactivated HGSC patients was intermediate between favorable BRCA1/2 mutated HGSC and unfavorable CCNE1 high-level amplified HGSC. NF1 inactivation was mutually exclusive with CCNE1 high-level amplifications, co-occurred with RB1 loss and occurred at similar frequencies in BRCA1/2 mutated versus wild-type HGSC. NF1 loss was found in 21/286 (7.3%) endometrioid carcinomas with a favorable prognostic association (p = 0.048), and in 4/64 (5.9%) LGSC, mutually exclusive with other driver events. CONCLUSIONS NF1 inactivation occurs in a significant subset of BRCA1/2 wild-type HGSC and a subset of LGSC. While the functional effects of NF1 inactivation need to be further characterized, this signifies a potential therapeutic opportunity to explore targeting NF1 inactivation in these tumors.
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Affiliation(s)
- Martin Köbel
- Department of Pathology, University of Calgary, Calgary, Alberta, Canada.
| | - Rui Zhe Yang
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eun Young Kang
- Department of Pathology, University of Calgary, Calgary, Alberta, Canada
| | - Zainab Al-Shamma
- Department of Pathology, University of Calgary, Calgary, Alberta, Canada
| | - Linda S Cook
- Department of CSPH-Epidemiology, University of Colorado-Anschutz, Aurora, CO, USA
| | - Mary Kinloch
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mark S Carey
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Hopkins
- Division of Oncology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada; Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kirk J McManus
- Department of Biochemistry & Medical Genetics, University of Manitoba, Winnipeg, Manitoba, Canada; Paul Albrechtsen Research Institute CancerCare, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Frederick S Vizeacoumar
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Franco J Vizeacoumar
- Division of Oncology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada; Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada
| | - Andrew Freywald
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - YangXin Fu
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - David E Reuss
- Department of Neuropathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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10
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Fullerton RE, Martell K, Khanolkar R, Phan T, Banerjee RN, Meyer T, Traptow L, Köbel M, Ghatage P, Doll CM. Impact of Immune, Inflammatory, and Nutritional Indices on Outcome in Patients with Cervical Cancer Treated with Definitive (Chemo)radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e513. [PMID: 37785604 DOI: 10.1016/j.ijrobp.2023.06.1772] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Systemic immune, inflammatory, and nutritional indices have been shown to be prognostic for outcome across a range of tumor sites. However, a comprehensive analysis of these markers in patients with cervical cancer treated with definitive (chemo)radiotherapy [(C)RT] has not been performed. We hypothesized that systemic immune, inflammatory, and nutritional indices may be associated with progression free survival (PFS) and overall survival (OS) in patients undergoing definitive (C)RT for cervical cancer. MATERIALS/METHODS Patients with cervical cancer treated with definitive (C)RT from 1999 - 2015 were identified from a single cancer institution's retrospective clinicopathological database. Pre-treatment immune, inflammatory, and nutritional parameters were collected, and indices derived. Systemic immune-inflammation index (SII) = neutrophil count x platelet count / lymphocyte count(10^9/L); PLR = platelet count / lymphocyte count(10^9/L), NLR = neutrophil count / lymphocyte count (10^9/L); MLR = monocyte count / lymphocyte count (10^9/L); albumin to alkaline phosphatase ratio (AAPR) = serum albumin level (g/L)/alkaline phosphatase level (U/L) and prognostic nutritional index (PNI) = serum albumin (g/L) + 5 x lymphocyte count (10^9/L). Univariate analysis was first performed on each parameter as continuous variables for PFS and OS. For variables with statistically significant associations, ROC curves were analyzed to determine if an optimal cut point could be established for each outcome. Common cut points were then defined for each variable. PFS and OS were analyzed by the Kaplan-Meier method and the Log-Rank test. Multivariate analysis was performed using Cox regression with covariates of tumor stage, histology, and age. P-values of <0.05 were considered statistically significant. RESULTS A total of 196 patients were identified; median follow-up 7 years. 131 (67%) had stage I-II and 65 (33%) stage III-IV disease. 187 (95%) received CRT and 9 (5%) RT alone. Higher SII (≤700 vs >700; p = 0.01), higher PLR (≤ 250 vs >250; p<0.001) and higher NLR (≤ 5 vs >5; p = 0.003) were associated with worse PFS. Higher SII [≤700 vs >700: 5y OS 74.9 vs 55.8; p = 0.02], higher PLR [≤ 250 vs >250: 5y OS 69.9% vs 42.0%; p<0.001] and higher NLR [≤ 5 vs >5: 5y OS 65.3% vs 51.0%; p = 0.01] were associated with worse OS. MLR, AAPR and PNI were not associated with outcome on univariate analysis. On multivariate analysis, SII and PLR were independently associated with both PFS [SII: HR 1.647 (CI 1.029-2.639), p = 0.038; PLR: HR 2.301 (95% CI 1.507 - 3.512), p = <0.001], and OS [SII: HR 1.649 (95% CI 1.009-2.696), p = 0.046; PLR: HR 2.212 (95% CI 1.416-3.455), p<0.001]; NLR did not remain statistically significant. CONCLUSION SII and PLR, but not nutritional indices, were independently associated with PFS and OS in patients with cervical cancer treated with definitive (C)RT. Further evaluation of these systemic immune and inflammatory indices in a validation set will be required to better define their clinical utility.
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Affiliation(s)
- R E Fullerton
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - K Martell
- Department of Oncology, Division of Radiation Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada
| | - R Khanolkar
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - T Phan
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - R N Banerjee
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - T Meyer
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Division of Medical Physics, University of Calgary, Calgary, AB, Canada
| | - L Traptow
- Department of Radiation Therapy, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - P Ghatage
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
| | - C M Doll
- Department of Oncology, University of Calgary, Calgary, AB, Canada
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11
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Fullerton RE, Martell K, Khanolkar R, Phan T, Banerjee RN, Meyer T, Traptow L, Köbel M, Ghatage P, Doll CM. Hypomagnesemia and Survival in Patients with Cervical Cancer Treated with Definitive Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e513-e514. [PMID: 37785605 DOI: 10.1016/j.ijrobp.2023.06.1773] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Hypomagnesemia is a common side effect of platinum-based chemotherapy regimens. Although there are data reporting that hypomagnesemia is associated with worse survival in patients receiving platinum-based chemotherapy or chemoradiotherapy (CRT), this has not been documented in patients with cervical cancer treated with definitive CRT. We hypothesized that in patients with cervical cancer undergoing definitive CRT, on-treatment hypomagnesemia would be associated with longer treatment duration and worse cancer-specific survival (CSS). MATERIALS/METHODS Patients with cervical cancer treated with definitive CRT from 1999 to 2015 were identified from a single cancer center's clinicopathologic database. Lowest on-treatment magnesium value was recorded and categorized as per Common Terminology Criteria for Adverse Events (CTCAE) v5.0 grading (grade 1: <0.7 - 0.5 mmol/L, grade 2: <0.5 - 0.4 mmol/L, grade 3: <0.4-0.3 mmol/L, and grade 4 <0.3 mmol/L). Grade 0 was defined as ≥ 0.7 mmol/L. Treatment duration was defined as the number of days between the first day of radiotherapy until the last day of pelvic treatment (either brachytherapy or pelvic external beam radiotherapy boost). Prolonged treatment was considered as any treatment duration greater than 63 days. CSS for patients with either grade 0-1 or grade ≥ 2 CTCAE v5.0 magnesium toxicity was estimated using the Kaplan-Meier method, and the Peto & Peto modification to the generalized Gehan-Wilcoxon was used to determine statistical significance between groups. Associations with prolonged treatment duration was explored using logistic regression. P-values of <0.05 were considered statistically significant. RESULTS A total of 186 patients were identified; median follow-up was 7 (IQR 2-11) years. 125 (67%) had stage I-II disease and 61 (33%) stage III-IV. Median treatment duration was 51 (IQR 48-57) days. All patients received concurrent weekly cisplatin-based chemotherapy with RT: the majority (n = 133; 72%) received 5 or 6 cycles. 147 (79%) patients received routine IV magnesium infusion with their chemotherapy and 173 (93%) received routine IV mannitol. During treatment the highest CTCAE v5.0 magnesium toxicity score was grade 0-1 in 158 (85%) and grade ≥ 2 in 28 (15%). Magnesium grade ≥ 2 was associated with worse 5-year CSS [grade 0-1: 5yr CSS 67.2%, (95% CI 60.1-75.1); grade ≥ 2: 5yr CSS 50%, (95% CI 34.5-72.4); p = 0.039]. Magnesium status was not associated with an increase in treatment duration [OR 1.465 (95% CI 0.3177 - 6.753); p = 0.625]. CONCLUSION On-treatment hypomagnesemia ≥ grade 2 (CTCAE v5.0) was associated with worse CSS but did not predict longer treatment duration. This is the first study that shows a detrimental survival impact of on-treatment hypomagnesemia in this patient population. These findings highlight the need to ensure adequate monitoring, support and correction of magnesium during definitive CRT.
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Affiliation(s)
- R E Fullerton
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - K Martell
- Department of Oncology, Division of Radiation Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, AB, Canada
| | - R Khanolkar
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - T Phan
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - R N Banerjee
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - T Meyer
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Division of Medical Physics, University of Calgary, Calgary, AB, Canada
| | - L Traptow
- Department of Radiation Therapy, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - M Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - P Ghatage
- Department of Oncology, University of Calgary, Calgary, AB, Canada; Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
| | - C M Doll
- Department of Oncology, University of Calgary, Calgary, AB, Canada
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12
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Wong NKY, Llaurado Fernandez M, Kommoss FKF, Praveen Kumar P, Kim H, Liu J, Zhang G, Coatham M, Lin YY, Haegert AM, Volik S, Le Bihan S, Collins CC, Fu Y, Postovit LM, von Deimling A, Wu R, Xue H, Wang Y, Köbel M, Carey MS, Lee CH. Establishment and validation of preclinical models of SMARCA4-inactivated and ARID1A/ARID1B co-inactivated dedifferentiated endometrial carcinoma. Gynecol Oncol 2023; 176:162-172. [PMID: 37556934 DOI: 10.1016/j.ygyno.2023.07.016] [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: 06/08/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Dedifferentiated endometrial cancer (DDEC) is an uncommon and clinically highly aggressive subtype of endometrial cancer characterized by genomic inactivation of SWItch/Sucrose Non-Fermentable (SWI/SNF) complex protein. It responds poorly to conventional systemic treatment and its rapidly progressive clinical course limits the therapeutic windows to trial additional lines of therapies. This underscores a pressing need for biologically accurate preclinical tumor models to accelerate therapeutic development. METHODS DDEC tumor from surgical samples were implanted into immunocompromised mice for patient-derived xenograft (PDX) and cell line development. The histologic, immunophenotypic, genetic and epigenetic features of the patient tumors and the established PDX models were characterized. The SMARCA4-deficienct DDEC model was evaluated for its sensitivity toward a KDM6A/B inhibitor (GSK-J4) that was previously reported to be effective therapy for other SMARCA4-deficient cancer types. RESULTS All three DDEC models exhibited rapid growth in vitro and in vivo, with two PDX models showing spontaneous development of metastases in vivo. The PDX tumors maintained the same undifferentiated histology and immunophenotype, and exhibited identical genomic and methylation profiles as seen in the respective parental tumors, including a mismatch repair (MMR)-deficient DDEC with genomic inactivation of SMARCA4, and two MMR-deficient DDECs with genomic inactivation of both ARID1A and ARID1B. Although the SMARCA4-deficient cell line showed low micromolecular sensitivity to GSK-J4, no significant tumor growth inhibition was observed in the corresponding PDX model. CONCLUSIONS These established patient tumor-derived models accurately depict DDEC and represent valuable preclinical tools to gain therapeutic insights into this aggressive tumor type.
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Affiliation(s)
- Nelson K Y Wong
- Department of Experimental Therapeutics, BC Cancer, Vancouver, British Columbia, Canada
| | | | - Felix K F Kommoss
- Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Pooja Praveen Kumar
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | - Hannah Kim
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Jiahui Liu
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Guihua Zhang
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Mackenzie Coatham
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Yen-Yi Lin
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Anne M Haegert
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Stanislav Volik
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | | | - Colin C Collins
- Vancouver Prostate Centre, Vancouver, British Columbia, Canada
| | - Yangxin Fu
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Lynne M Postovit
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital and CCU Neuropathology DKFZ, Heidelberg, Germany
| | - Rebecca Wu
- Department of Experimental Therapeutics, BC Cancer, Vancouver, British Columbia, Canada
| | - Hui Xue
- Department of Experimental Therapeutics, BC Cancer, Vancouver, British Columbia, Canada
| | - Yuzhuo Wang
- Department of Experimental Therapeutics, BC Cancer, Vancouver, British Columbia, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, Alberta, Canada
| | - Mark S Carey
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Department of Laboratory Medicine and Pathology, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
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Heinze K, Cairns ES, Thornton S, Harris B, Milne K, Grube M, Meyer C, Karnezis AN, Fereday S, Garsed DW, Leung SC, Chiu DS, Moubarak M, Harter P, Heitz F, McAlpine JN, DeFazio A, Bowtell DD, Goode EL, Pike M, Ramus SJ, Pearce CL, Staebler A, Köbel M, Kommoss S, Talhouk A, Nelson BH, Anglesio MS. The Prognostic Effect of Immune Cell Infiltration Depends on Molecular Subtype in Endometrioid Ovarian Carcinomas. Clin Cancer Res 2023; 29:3471-3483. [PMID: 37339172 PMCID: PMC10472107 DOI: 10.1158/1078-0432.ccr-22-3815] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/14/2023] [Accepted: 06/14/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE Endometrioid ovarian carcinoma (ENOC) is the second most-common type of ovarian carcinoma, comprising 10%-20% of cases. Recently, the study of ENOC has benefitted from comparisons to endometrial carcinomas including defining ENOC with four prognostic molecular subtypes. Each subtype suggests differential mechanisms of progression, although tumor-initiating events remain elusive. There is evidence that the ovarian microenvironment may be critical to early lesion establishment and progression. However, while immune infiltrates have been well studied in high-grade serous ovarian carcinoma, studies in ENOC are limited. EXPERIMENTAL DESIGN We report on 210 ENOC, with clinical follow-up and molecular subtype annotation. Using multiplex IHC and immunofluorescence, we examine the prevalence of T-cell lineage, B-cell lineage, macrophages, and populations with programmed cell death protein 1 or programmed death-ligand 1 across subtypes of ENOC. RESULTS Immune cell infiltrates in tumor epithelium and stroma showed higher densities in ENOC subtypes with known high mutation burden (POLEmut and MMRd). While molecular subtypes were prognostically significant, immune infiltrates were not (overall survival P > 0.2). Analysis by molecular subtype revealed that immune cell density was prognostically significant in only the no specific molecular profile (NSMP) subtype, where immune infiltrates lacking B cells (TILB minus) had inferior outcome (disease-specific survival: HR, 4.0; 95% confidence interval, 1.1-14.7; P < 0.05). Similar to endometrial carcinomas, molecular subtype stratification was generally superior to immune response in predicting outcomes. CONCLUSIONS Subtype stratification is critical for better understanding of ENOC, in particular the distribution and prognostic significance of immune cell infiltrates. The role of B cells in the immune response within NSMP tumors warrants further study.
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Affiliation(s)
- Karolin Heinze
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Evan S. Cairns
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Shelby Thornton
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
- Molecular and Cellular Immunology Core (MCIC), Deeley Research Centre, BC Cancer, Victoria, Canada
| | - Bronwyn Harris
- Molecular and Cellular Immunology Core (MCIC), Deeley Research Centre, BC Cancer, Victoria, Canada
| | - Katy Milne
- Molecular and Cellular Immunology Core (MCIC), Deeley Research Centre, BC Cancer, Victoria, Canada
| | - Marcel Grube
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Charlotte Meyer
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Anthony N. Karnezis
- Department of Pathology and Laboratory, UC Davis Medical Center, Sacramento, California
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Dale W. Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Samuel C.Y. Leung
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Derek S. Chiu
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Malak Moubarak
- Kliniken Essen Mitte, Department of Gynecology and Gynecologic Oncology, Essen, Germany
| | - Philipp Harter
- Kliniken Essen Mitte, Department of Gynecology and Gynecologic Oncology, Essen, Germany
| | - Florian Heitz
- Kliniken Essen Mitte, Department of Gynecology and Gynecologic Oncology, Essen, Germany
- Department for Gynecology with the Center for Oncologic Surgery Charité Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jessica N. McAlpine
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - David D.L. Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Ellen L. Goode
- Mayo Clinic, Department of Health Science Research, Division of Epidemiology, Rochester, Minnesota
| | - Malcolm Pike
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan J. Ramus
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales Sydney, Sydney, Australia
- Multidisciplinary Ovarian Cancer Outcomes Group (Consortium)
| | - C. Leigh Pearce
- Multidisciplinary Ovarian Cancer Outcomes Group (Consortium)
- School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Annette Staebler
- Institute of Pathology, University Hospital of Tübingen, Tübingen, Germany
| | - Martin Köbel
- Department of Pathology, University of Calgary, Calgary, Alberta, Canada
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Aline Talhouk
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
| | - Brad H. Nelson
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
- Molecular and Cellular Immunology Core (MCIC), Deeley Research Centre, BC Cancer, Victoria, Canada
- Multidisciplinary Ovarian Cancer Outcomes Group (Consortium)
| | - Michael S. Anglesio
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
- OVCARE - British Columbia's Gynecological Cancer Research Program, BC Cancer, Vancouver General Hospital, and the University of British Columbia, Vancouver, British Columbia, Canada
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14
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Jamieson A, Huvila J, Chiu D, Thompson EF, Scott S, Salvador S, Vicus D, Helpman L, Gotlieb W, Kean S, Samouelian V, Köbel M, Kinloch M, Parra-Herran C, Offman S, Grondin K, Irving J, Lum A, Senz J, Leung S, McConechy MK, Plante M, Kommoss S, Huntsman DG, Talhouk A, Gilks CB, McAlpine JN. Corrigendum to "Grade and Estrogen Receptor Expression Identify a Subset of No Specific Molecular Profile Endometrial Carcinomas at a Very Low Risk of Disease-Specific Death": [Modern Pathology 36 (2023) 100085]. Mod Pathol 2023; 36:100212. [PMID: 37182372 DOI: 10.1016/j.modpat.2023.100212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Amy Jamieson
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jutta Huvila
- Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland
| | - Derek Chiu
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily F Thompson
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Scott
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Dalhousie University, Halifax, Canada
| | - Shannon Salvador
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McGill University, Montreal, Canada
| | - Danielle Vicus
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Toronto, Toronto, Canada
| | - Limor Helpman
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McMaster University, Hamilton, Ontario, Canada
| | - Walter Gotlieb
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McGill University, Montreal, Canada
| | - Sarah Kean
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Manitoba, Winnipeg, Canada
| | - Vanessa Samouelian
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Montreal, Montreal, Quebec, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mary Kinloch
- Department of Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Saul Offman
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Katherine Grondin
- Department of Pathology, Laval University, Quebec City, Quebec, Canada
| | - Julie Irving
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amy Lum
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janine Senz
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samuel Leung
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Marie Plante
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Laval University, Quebec City, Quebec, Canada
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - David G Huntsman
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada; Imagia Canexia Health, Inc., Vancouver, British Columbia, Canada
| | - Aline Talhouk
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Blake Gilks
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jessica N McAlpine
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
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15
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Fu Z, Brooks MM, Irvin S, Jordan S, Aben KKH, Anton-Culver H, Bandera EV, Beckmann MW, Berchuck A, Brooks-Wilson A, Chang-Claude J, Cook LS, Cramer DW, Cushing-Haugen KL, Doherty JA, Ekici AB, Fasching PA, Fortner RT, Gayther SA, Gentry-Maharaj A, Giles GG, Goode EL, Goodman MT, Harris HR, Hein A, Kaaks R, Kiemeney LA, Köbel M, Kotsopoulos J, Le ND, Lee AW, Matsuo K, McGuire V, McLaughlin JR, Menon U, Milne RL, Moysich KB, Pearce CL, Pike MC, Qin B, Ramus SJ, Riggan MJ, Rothstein JH, Schildkraut JM, Sieh W, Sutphen R, Terry KL, Thompson PJ, Titus L, van Altena AM, White E, Whittemore AS, Wu AH, Zheng W, Ziogas A, Taylor SE, Tang L, Songer T, Wentzensen N, Webb PM, Risch HA, Modugno F. Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis. J Natl Cancer Inst 2023; 115:539-551. [PMID: 36688720 PMCID: PMC10165492 DOI: 10.1093/jnci/djad011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/10/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The role of ovulation in epithelial ovarian cancer (EOC) is supported by the consistent protective effects of parity and oral contraceptive use. Whether these factors protect through anovulation alone remains unclear. We explored the association between lifetime ovulatory years (LOY) and EOC. METHODS LOY was calculated using 12 algorithms. Odds ratios (ORs) and 95% confidence intervals (CIs) estimated the association between LOY or LOY components and EOC among 26 204 control participants and 21 267 case patients from 25 studies. To assess whether LOY components act through ovulation suppression alone, we compared beta coefficients obtained from regression models with expected estimates assuming 1 year of ovulation suppression has the same effect regardless of source. RESULTS LOY was associated with increased EOC risk (OR per year increase = 1.014, 95% CI = 1.009 to 1.020 to OR per year increase = 1.044, 95% CI = 1.041 to 1.048). Individual LOY components, except age at menarche, also associated with EOC. The estimated model coefficient for oral contraceptive use and pregnancies were 4.45 times and 12- to 15-fold greater than expected, respectively. LOY was associated with high-grade serous, low-grade serous, endometrioid, and clear cell histotypes (ORs per year increase = 1.054, 1.040, 1.065, and 1.098, respectively) but not mucinous tumors. Estimated coefficients of LOY components were close to expected estimates for high-grade serous but larger than expected for low-grade serous, endometrioid, and clear cell histotypes. CONCLUSIONS LOY is positively associated with nonmucinous EOC. Differences between estimated and expected model coefficients for LOY components suggest factors beyond ovulation underlie the associations between LOY components and EOC in general and for non-HGSOC.
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Affiliation(s)
- Zhuxuan Fu
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Maria Mori Brooks
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Sarah Irvin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Susan Jordan
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Katja K H Aben
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Hoda Anton-Culver
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Elisa V Bandera
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-European Metropolitan Region of Nuremberg (EMN), Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Linda S Cook
- Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Daniel W Cramer
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kara L Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jennifer A Doherty
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Arif B Ekici
- Institute of Human Genetics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-European Metropolitan Region of Nuremberg (EMN), Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Marc T Goodman
- Cancer Prevention and Control Program, Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-European Metropolitan Region of Nuremberg (EMN), Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lambertus A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Joanne Kotsopoulos
- Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Nhu D Le
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Alice W Lee
- Department of Health Science, California State University, Fullerton, Fullerton, CA, USA
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Valerie McGuire
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - John R McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Malcolm C Pike
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Department of Population Health and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Bo Qin
- Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Susan J Ramus
- School of Clinical Medicine, University of New South Wales Medicine and Health, University of New South Wales Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Marjorie J Riggan
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Joseph H Rothstein
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Weiva Sieh
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca Sutphen
- Epidemiology Center, College of Medicine, University of South Florida, Tampa, FL, USA
| | - Kathryn L Terry
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Epidemiology Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Pamela J Thompson
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Linda Titus
- Muskie School of Public Policy, Public Health, Portland, ME, USA
| | - Anne M van Altena
- Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Emily White
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Alice S Whittemore
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Anna H Wu
- Department of Population Health and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Argyrios Ziogas
- Department of Medicine, Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA
| | - Sarah E Taylor
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lu Tang
- Department of Biostatistics, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Thomas Songer
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Penelope M Webb
- The School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - AOCS Group
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Harvey A Risch
- Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Francesmary Modugno
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Women’s Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
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Köbel M, Kang E, Weir A, Rambau PF, Lee C, Nelson GS, Ghatage P, Meagher NS, Riggan MJ, Alsop J, Anglesio MS, Beckmann MW, Bisinotto C, Boisen M, Boros J, Brand AH, Brooks‐Wilson A, Carney ME, Coulson P, Courtney‐Brooks M, Cushing‐Haugen KL, Cybulski C, Deen S, El‐Bahrawy MA, Elishaev E, Erber R, Fereday S, Fischer A, Gayther SA, Barquin‐Garcia A, Gentry‐Maharaj A, Gilks CB, Gronwald H, Grube M, Harnett PR, Harris HR, Hartkopf AD, Hartmann A, Hein A, Hendley J, Hernandez BY, Huang Y, Jakubowska A, Jimenez‐Linan M, Jones ME, Kennedy CJ, Kluz T, Koziak JM, Lesnock J, Lester J, Lubiński J, Longacre TA, Lycke M, Mateoiu C, McCauley BM, McGuire V, Ney B, Olawaiye A, Orsulic S, Osorio A, Paz‐Ares L, Ramón y Cajal T, Rothstein JH, Ruebner M, Schoemaker MJ, Shah M, Sharma R, Sherman ME, Shvetsov YB, Singh N, Steed H, Storr SJ, Talhouk A, Traficante N, Wang C, Whittemore AS, Widschwendter M, Wilkens LR, Winham SJ, Benitez J, Berchuck A, Bowtell DD, Candido dos Reis FJ, Campbell I, Cook LS, DeFazio A, Doherty JA, Fasching PA, Fortner RT, García MJ, Goodman MT, Goode EL, Gronwald J, Huntsman DG, Karlan BY, Kelemen LE, Kommoss S, Le ND, Martin SG, Menon U, Modugno F, Pharoah PDP, Schildkraut JM, Sieh W, Staebler A, Sundfeldt K, Swerdlow AJ, Ramus SJ, Brenton JD. p53 and ovarian carcinoma survival: an Ovarian Tumor Tissue Analysis consortium study. J Pathol Clin Res 2023; 9:208-222. [PMID: 36948887 PMCID: PMC10073933 DOI: 10.1002/cjp2.311] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 03/24/2023]
Abstract
Our objective was to test whether p53 expression status is associated with survival for women diagnosed with the most common ovarian carcinoma histotypes (high-grade serous carcinoma [HGSC], endometrioid carcinoma [EC], and clear cell carcinoma [CCC]) using a large multi-institutional cohort from the Ovarian Tumor Tissue Analysis (OTTA) consortium. p53 expression was assessed on 6,678 cases represented on tissue microarrays from 25 participating OTTA study sites using a previously validated immunohistochemical (IHC) assay as a surrogate for the presence and functional effect of TP53 mutations. Three abnormal expression patterns (overexpression, complete absence, and cytoplasmic) and the normal (wild type) pattern were recorded. Survival analyses were performed by histotype. The frequency of abnormal p53 expression was 93.4% (4,630/4,957) in HGSC compared to 11.9% (116/973) in EC and 11.5% (86/748) in CCC. In HGSC, there were no differences in overall survival across the abnormal p53 expression patterns. However, in EC and CCC, abnormal p53 expression was associated with an increased risk of death for women diagnosed with EC in multivariate analysis compared to normal p53 as the reference (hazard ratio [HR] = 2.18, 95% confidence interval [CI] 1.36-3.47, p = 0.0011) and with CCC (HR = 1.57, 95% CI 1.11-2.22, p = 0.012). Abnormal p53 was also associated with shorter overall survival in The International Federation of Gynecology and Obstetrics stage I/II EC and CCC. Our study provides further evidence that functional groups of TP53 mutations assessed by abnormal surrogate p53 IHC patterns are not associated with survival in HGSC. In contrast, we validate that abnormal p53 IHC is a strong independent prognostic marker for EC and demonstrate for the first time an independent prognostic association of abnormal p53 IHC with overall survival in patients with CCC.
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Affiliation(s)
- Martin Köbel
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| | - Eun‐Young Kang
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
| | - Ashley Weir
- School of Clinical MedicineUNSW Medicine and Health, University of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer Program, Lowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
| | - Peter F Rambau
- Department of Pathology and Laboratory MedicineUniversity of Calgary, Foothills Medical CenterCalgaryABCanada
- Pathology DepartmentCatholic University of Health and Allied Sciences‐BugandoMwanzaTanzania
| | - Cheng‐Han Lee
- Department of Pathology and Laboratory MedicineUniversity of AlbertaEdmontonABCanada
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of MedicineUniversity of CalgaryCalgaryABCanada
| | - Nicola S Meagher
- School of Clinical MedicineUNSW Medicine and Health, University of NSW SydneySydneyNew South WalesAustralia
- The Daffodil CentreThe University of Sydney, a Joint Venture with Cancer Council NSWSydneyNew South WalesAustralia
| | - Marjorie J Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic OncologyDuke University Medical CenterDurhamNCUSA
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Michael S Anglesio
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBCCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British Columbia, BC Cancer, and Vancouver General HospitalVancouverBCCanada
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Christiani Bisinotto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Michelle Boisen
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Jessica Boros
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Alison H Brand
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | | | - Michael E Carney
- Department of Obstetrics and Gynecology, John A. Burns School of MedicineUniversity of HawaiiHonoluluHIUSA
| | - Penny Coulson
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Madeleine Courtney‐Brooks
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Kara L Cushing‐Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattleWAUSA
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Suha Deen
- Department of HistopathologyNottingham University Hospitals NHS Trust, Queen's Medical CentreNottinghamUK
| | - Mona A El‐Bahrawy
- Department of Metabolism, Digestion and ReproductionImperial College London, Hammersmith HospitalLondonUK
| | - Esther Elishaev
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Sian Fereday
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - AOCS Group
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- QIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Anna Fischer
- Institute of Pathology and Neuropathology, Tuebingen University HospitalTuebingenGermany
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | | | - Aleksandra Gentry‐Maharaj
- MRC Clinical Trials UnitInstitute of Clinical Trials & Methodology, University College LondonLondonUK
| | - C Blake Gilks
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Helena Gronwald
- Department of Propaedeutics, Physical Diagnostics and Dental PhysiotherapyPomeranian Medical UniversitySzczecinPoland
| | - Marcel Grube
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Paul R Harnett
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
- Crown Princess Mary Cancer CentreWestmead HospitalSydneyNew South WalesAustralia
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWAUSA
| | - Andreas D Hartkopf
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
- Department of Gynecology and ObstetricsUniversity Hospital of UlmUlmGermany
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen‐EMN, Friedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Joy Hendley
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Brenda Y Hernandez
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Yajue Huang
- Department of Laboratory Medicine and Pathology, Mayo ClinicRochesterMNUSA
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
- Independent Laboratory of Molecular Biology and Genetic DiagnosticsPomeranian Medical UniversitySzczecinPoland
| | | | - Michael E Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Catherine J Kennedy
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Tomasz Kluz
- Department of Gynecology and ObstetricsInstitute of Medical Sciences, Medical College of Rzeszow UniversityRzeszówPoland
| | | | - Jaime Lesnock
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCAUSA
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Teri A Longacre
- Department of PathologyStanford University School of MedicineStanfordCAUSA
| | - Maria Lycke
- Department of Obstetrics and GynecologyInstitute of Clinical Science, Sahlgrenska University Hospital, University of GothenburgGothenburgSweden
| | | | - Bryan M McCauley
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo ClinicRochesterMNUSA
| | - Valerie McGuire
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCAUSA
| | - Britta Ney
- Institute of Pathology and Neuropathology, Tuebingen University HospitalTuebingenGermany
| | - Alexander Olawaiye
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCAUSA
| | - Ana Osorio
- Genetics Service, Fundación Jiménez DíazMadridSpain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
| | - Luis Paz‐Ares
- H12O‐CNIO Lung Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO)MadridSpain
- Oncology DepartmentHospital Universitario 12 de OctubreMadridSpain
| | | | - Joseph H Rothstein
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNYUSA
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Minouk J Schoemaker
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic OncologyWestmead HospitalSydneyNew South WalesAustralia
| | - Mark E Sherman
- Department of Health Sciences Research, Mayo ClinicJacksonvilleFLUSA
| | - Yurii B Shvetsov
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Naveena Singh
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyUniversity of AlbertaEdmontonABCanada
- Section of Gynecologic Oncology Surgery, North Zone, Alberta Health ServicesEdmontonABCanada
| | - Sarah J Storr
- Nottingham Breast Cancer Research CentreBiodiscovery Institute, University of NottinghamNottinghamUK
| | - Aline Talhouk
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBCCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British Columbia, BC Cancer, and Vancouver General HospitalVancouverBCCanada
| | - Nadia Traficante
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo ClinicRochesterMNUSA
| | - Alice S Whittemore
- Department of Epidemiology and Population HealthStanford University School of MedicineStanfordCAUSA
- Department of Biomedical Data ScienceStanford University School of MedicineStanfordCAUSA
| | | | - Lynne R Wilkens
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluHIUSA
| | - Stacey J Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo ClinicRochesterMNUSA
| | - Javier Benitez
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO)MadridSpain
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic OncologyDuke University Medical CenterDurhamNCUSA
| | - David D Bowtell
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Ian Campbell
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Linda S Cook
- Epidemiology, School of Public HealthUniversity of ColoradoAuroraCOUSA
- Community Health Sciences, University of CalgaryCalgaryABCanada
| | - Anna DeFazio
- The Daffodil CentreThe University of Sydney, a Joint Venture with Cancer Council NSWSydneyNew South WalesAustralia
- Centre for Cancer ResearchThe Westmead Institute for Medical Research, University of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health SciencesUniversity of UtahSalt Lake CityUTUSA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐Nuremberg, University Hospital ErlangenErlangenGermany
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)HeidelbergGermany
- Department of Research, Cancer Registry of NorwayOsloNorway
| | - María J García
- Computational Oncology Group, Structural Biology Programme, Spanish National Cancer Research Centre (CNIO)MadridSpain
| | - Marc T Goodman
- Cancer Prevention and Control Program, Cedars‐Sinai Cancer, Cedars‐Sinai Medical CenterLos AngelesCAUSA
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo ClinicRochesterMNUSA
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - David G Huntsman
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBCCanada
- Department of Molecular Oncology, BC Cancer Research CentreVancouverBCCanada
| | - Beth Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCAUSA
| | - Linda E Kelemen
- Division of Acute Disease Epidemiology, South Carolina Department of Health & Environmental ControlColumbiaSCUSA
| | - Stefan Kommoss
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Nhu D Le
- Cancer Control Research, BC Cancer AgencyVancouverBCCanada
| | - Stewart G Martin
- Nottingham Breast Cancer Research CentreBiodiscovery Institute, University of NottinghamNottinghamUK
| | - Usha Menon
- MRC Clinical Trials UnitInstitute of Clinical Trials & Methodology, University College LondonLondonUK
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPAUSA
- Department of EpidemiologyUniversity of Pittsburgh School of Public HealthPittsburghPAUSA
- Women's Cancer Research CenterMagee‐Womens Research Institute and Hillman Cancer CenterPittsburghPAUSA
| | - Paul DP Pharoah
- Centre for Cancer Genetic Epidemiology, Department of OncologyUniversity of CambridgeCambridgeUK
- Department of Computational Biomedicine, Cedars‐Sinai Medical CenterWest HollywoodCAUSA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaGAUSA
| | - Weiva Sieh
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNYUSA
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Annette Staebler
- Institute of Pathology and Neuropathology, Tuebingen University HospitalTuebingenGermany
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical ScienceSahlgrenska Center for Cancer Research, University of GothenburgGothenburgSweden
| | - Anthony J Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUK
| | - Susan J Ramus
- School of Clinical MedicineUNSW Medicine and Health, University of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer Program, Lowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of CambridgeCambridgeUK
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Wang C, Block MS, Cunningham JM, Sherman ME, McCauley BM, Armasu SM, Vierkant RA, Traficante N, Talhouk A, Ramus SJ, Pejovic N, Köbel M, Jorgensen BD, Garsed DW, Fereday S, Doherty JA, Ariyaratne D, Anglesio MS, Widschwendter M, Pejovic T, Bosquet JG, Bowtell DD, Winham SJ, Goode EL. Methylation Signature Implicated in Immuno-Suppressive Activities in Tubo-Ovarian High-Grade Serous Carcinoma. Cancer Epidemiol Biomarkers Prev 2023; 32:542-549. [PMID: 36790339 PMCID: PMC10073286 DOI: 10.1158/1055-9965.epi-22-0941] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/07/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Better understanding of prognostic factors in tubo-ovarian high-grade serous carcinoma (HGSC) is critical, as diagnosis confers an aggressive disease course. Variation in tumor DNA methylation shows promise predicting outcome, yet prior studies were largely platform-specific and unable to evaluate multiple molecular features. METHODS We analyzed genome-wide DNA methylation in 1,040 frozen HGSC, including 325 previously reported upon, seeking a multi-platform quantitative methylation signature that we evaluated in relation to clinical features, tumor characteristics, time to recurrence/death, extent of CD8+ tumor-infiltrating lymphocytes (TIL), gene expression molecular subtypes, and gene expression of the ATP-binding cassette transporter TAP1. RESULTS Methylation signature was associated with shorter time to recurrence, independent of clinical factors (N = 715 new set, hazard ratio (HR), 1.65; 95% confidence interval (CI), 1.10-2.46; P = 0.015; N = 325 published set HR, 2.87; 95% CI, 2.17-3.81; P = 2.2 × 10-13) and remained prognostic after adjustment for gene expression molecular subtype and TAP1 expression (N = 599; HR, 2.22; 95% CI, 1.66-2.95; P = 4.1 × 10-8). Methylation signature was inversely related to CD8+ TIL levels (P = 2.4 × 10-7) and TAP1 expression (P = 0.0011) and was associated with gene expression molecular subtype (P = 5.9 × 10-4) in covariate-adjusted analysis. CONCLUSIONS Multi-center analysis identified a novel quantitative tumor methylation signature of HGSC applicable to numerous commercially available platforms indicative of shorter time to recurrence/death, adjusting for other factors. Along with immune cell composition analysis, these results suggest a role for DNA methylation in the immunosuppressive microenvironment. IMPACT This work aids in identification of targetable epigenome processes and stratification of patients for whom tailored treatment may be most beneficial.
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Affiliation(s)
- Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | | | - Julie M. Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mark E. Sherman
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Bryan M. McCauley
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Sebastian M. Armasu
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Robert A. Vierkant
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Australian Ovarian Cancer Study Group
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research and Department of Gynaecological Oncology, Westmead Hospital, The University of Sydney, Sydney, New South Wales, Australia
| | - Aline Talhouk
- British Columbia’s Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Susan J. Ramus
- School of Clinical Medicine, Faculty of Medicine, University of NSW Sydney, Sydney, New South Wales, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | | | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Brooke D. Jorgensen
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Dale W. Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | | | - Michael S. Anglesio
- British Columbia’s Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Martin Widschwendter
- European Translational Oncology Prevention and Screening (EUTOPS) Institute, Universität Innsbruck, Hall in Tirol, Austria
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Jesus Gonzalez Bosquet
- Department of Obstetrics and Gynecologic, Division of Gynecologic Oncology, University of Iowa, Iowa City, IA, USA
| | - David D. Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Ellen L. Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
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Kang E, Weir A, Meagher NS, Farrington K, Nelson GS, Ghatage P, Lee C, Riggan MJ, Bolithon A, Popovic G, Leung B, Tang K, Lambie N, Millstein J, Alsop J, Anglesio MS, Ataseven B, Barlow E, Beckmann MW, Berger J, Bisinotto C, Bösmüller H, Boros J, Brand AH, Brooks‐Wilson A, Brucker SY, Carney ME, Casablanca Y, Cazorla‐Jiménez A, Cohen PA, Conrads TP, Cook LS, Coulson P, Courtney‐Brooks M, Cramer DW, Crowe P, Cunningham JM, Cybulski C, Darcy KM, El‐Bahrawy MA, Elishaev E, Erber R, Farrell R, Fereday S, Fischer A, García MJ, Gayther SA, Gentry‐Maharaj A, Gilks CB, Grube M, Harnett PR, Harrington SP, Harter P, Hartmann A, Hecht JL, Heikaus S, Hein A, Heitz F, Hendley J, Hernandez BY, Polo SH, Heublein S, Hirasawa A, Høgdall E, Høgdall CK, Horlings HM, Huntsman DG, Huzarski T, Jewell A, Jimenez‐Linan M, Jones ME, Kaufmann SH, Kennedy CJ, Khabele D, Kommoss FKF, Kruitwagen RFPM, Lambrechts D, Le ND, Lener M, Lester J, Leung Y, Linder A, Loverix L, Lubiński J, Madan R, Maxwell GL, Modugno F, Neuhausen SL, Olawaiye A, Olbrecht S, Orsulic S, Palacios J, Pearce CL, Pike MC, Quinn CM, Mohan GR, Rodríguez‐Antona C, Ruebner M, Ryan A, Salfinger SG, Sasamoto N, Schildkraut JM, Schoemaker MJ, Shah M, Sharma R, Shvetsov YB, Singh N, Sonke GS, Steele L, Stewart CJR, Sundfeldt K, Swerdlow AJ, Talhouk A, Tan A, Taylor SE, Terry KL, Tołoczko A, Traficante N, Van de Vijver KK, van der Aa MA, Van Gorp T, Van Nieuwenhuysen E, van‐Wagensveld L, Vergote I, Vierkant RA, Wang C, Wilkens LR, Winham SJ, Wu AH, Benitez J, Berchuck A, Candido dos Reis FJ, DeFazio A, Fasching PA, Goode EL, Goodman MT, Gronwald J, Karlan BY, Kommoss S, Menon U, Sinn H, Staebler A, Brenton JD, Bowtell DD, Pharoah PDP, Ramus SJ, Köbel M. CCNE1 and survival of patients with tubo-ovarian high-grade serous carcinoma: An Ovarian Tumor Tissue Analysis consortium study. Cancer 2023; 129:697-713. [PMID: 36572991 PMCID: PMC10107112 DOI: 10.1002/cncr.34582] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/14/2022] [Accepted: 09/30/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cyclin E1 (CCNE1) is a potential predictive marker and therapeutic target in tubo-ovarian high-grade serous carcinoma (HGSC). Smaller studies have revealed unfavorable associations for CCNE1 amplification and CCNE1 overexpression with survival, but to date no large-scale, histotype-specific validation has been performed. The hypothesis was that high-level amplification of CCNE1 and CCNE1 overexpression, as well as a combination of the two, are linked to shorter overall survival in HGSC. METHODS Within the Ovarian Tumor Tissue Analysis consortium, amplification status and protein level in 3029 HGSC cases and mRNA expression in 2419 samples were investigated. RESULTS High-level amplification (>8 copies by chromogenic in situ hybridization) was found in 8.6% of HGSC and overexpression (>60% with at least 5% demonstrating strong intensity by immunohistochemistry) was found in 22.4%. CCNE1 high-level amplification and overexpression both were linked to shorter overall survival in multivariate survival analysis adjusted for age and stage, with hazard stratification by study (hazard ratio [HR], 1.26; 95% CI, 1.08-1.47, p = .034, and HR, 1.18; 95% CI, 1.05-1.32, p = .015, respectively). This was also true for cases with combined high-level amplification/overexpression (HR, 1.26; 95% CI, 1.09-1.47, p = .033). CCNE1 mRNA expression was not associated with overall survival (HR, 1.00 per 1-SD increase; 95% CI, 0.94-1.06; p = .58). CCNE1 high-level amplification is mutually exclusive with the presence of germline BRCA1/2 pathogenic variants and shows an inverse association to RB1 loss. CONCLUSION This study provides large-scale validation that CCNE1 high-level amplification is associated with shorter survival, supporting its utility as a prognostic biomarker in HGSC.
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Affiliation(s)
- Eun‐Young Kang
- Department of Pathology and Laboratory MedicineUniversity of CalgaryFoothills Medical CenterCalgaryAlbertaCanada
| | - Ashley Weir
- School of Clinical MedicineUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer ProgramLowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
- The Walter and Eliza Hall Institute of Medical ResearchParkvilleVictoriaAustralia
| | - Nicola S. Meagher
- School of Clinical MedicineUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- The Daffodil CentreThe University of SydneyA Joint Venture With Cancer Council NSWSydneyNew South WalesAustralia
| | - Kyo Farrington
- Department of Pathology and Laboratory MedicineUniversity of CalgaryFoothills Medical CenterCalgaryAlbertaCanada
| | - Gregg S. Nelson
- Department of OncologyDivision of Gynecologic OncologyCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Prafull Ghatage
- Department of OncologyDivision of Gynecologic OncologyCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Cheng‐Han Lee
- Department of Pathology and Laboratory MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - Marjorie J. Riggan
- Department of Obstetrics and GynecologyDivision of Gynecologic OncologyDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Adelyn Bolithon
- Adult Cancer ProgramLowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
- School of Women's and Children's HealthFaculty of Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Gordana Popovic
- Stats CentralMark Wainwright Analytical CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Betty Leung
- Prince of Wales Clinical SchoolUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Katrina Tang
- Department of Anatomical PathologyPrince of Wales HospitalSydneyNew South WalesAustralia
| | - Neil Lambie
- Canterbury Health LaboratoriesChristchurchNew Zealand
| | - Joshua Millstein
- Division of BiostatisticsDepartment of Population and Public Health SciencesKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jennifer Alsop
- Department of OncologyCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Michael S. Anglesio
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British ColumbiaBC Cancerand Vancouver General HospitalVancouverBritish ColumbiaCanada
| | - Beyhan Ataseven
- Department of Gynecology and Gynecologic OncologyEvangelische Kliniken Essen‐Mitte (KEM)EssenGermany
- Department of Obstetrics and GynecologyLudwig Maximilian University MunichMunichGermany
| | - Ellen Barlow
- Gynaecological Cancer CentreRoyal Hospital for WomenSydneyNew South WalesAustralia
| | - Matthias W. Beckmann
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Jessica Berger
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Christiani Bisinotto
- Department of Gynecology and ObstetricsRibeirão Preto Medical SchoolUniversity of São PauloRibeirão PretoBrazil
| | - Hans Bösmüller
- Institute of Pathology and NeuropathologyTuebingen University HospitalTuebingenGermany
| | - Jessica Boros
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Alison H. Brand
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Angela Brooks‐Wilson
- Canada's Michael Smith Genome Sciences CentreBC CancerVancouverBritish ColumbiaCanada
| | - Sara Y. Brucker
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Michael E. Carney
- Department of Obstetrics and GynecologyJohn A. Burns School of MedicineUniversity of HawaiiHonoluluHawaiiUSA
| | - Yovanni Casablanca
- Uniformed Services of the Health Sciences Gynecologic Cancer Center of ExcellenceBethesdaMarylandUSA
| | | | - Paul A. Cohen
- Department of Gynaecological OncologySt John of God Subiaco HospitalSubiacoWestern AustraliaAustralia
- Division of Obstetrics and GynaecologyMedical SchoolUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Thomas P. Conrads
- Women's Health Integrated Research CenterInova Health SystemFalls ChurchVirginiaUSA
| | - Linda S. Cook
- EpidemiologySchool of Public HealthUniversity of ColoradoAuroraColoradoUSA
- Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Penny Coulson
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Madeleine Courtney‐Brooks
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Daniel W. Cramer
- Obstetrics and Gynecology Epidemiology CenterDepartment of Obstetrics and GynecologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Philip Crowe
- Prince of Wales Clinical SchoolUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- Department of SurgeryPrince of Wales Private HospitalRandwickNew South WalesAustralia
| | - Julie M. Cunningham
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Cezary Cybulski
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Kathleen M. Darcy
- Gynecologic Cancer Center of ExcellenceDepartment of Gynecologic Surgery and ObstetricsUniformed Services University of the Health SciencesWalter Reed National Military Medical CenterBethesdaMarylandUSA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, IncBethesdaMarylandUSA
| | - Mona A. El‐Bahrawy
- Department of Metabolism, Digestion and ReproductionImperial College LondonHammersmith HospitalLondonUK
| | - Esther Elishaev
- Department of PathologyUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Ramona Erber
- Institute of PathologyComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Rhonda Farrell
- Prince of Wales Private HospitalRandwickNew South WalesAustralia
| | - Sian Fereday
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Anna Fischer
- Institute of Pathology and NeuropathologyTuebingen University HospitalTuebingenGermany
| | - María J. García
- Computational Oncology GroupStructural Biology ProgrammeSpanish National Cancer Research Centre (CNIO)MadridSpain
| | - Simon A. Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics CoreCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | | | - C. Blake Gilks
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - AOCS Group
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- QIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Marcel Grube
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Paul R. Harnett
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
- Crown Princess Mary Cancer CentreWestmead HospitalSydneyNew South WalesAustralia
| | - Shariska Petersen Harrington
- Division of Gynecologic OncologyDepartment of Obstetrics and GynecologyThe University of Kansas Medical CenterKansas CityKansasUSA
| | - Philipp Harter
- Department of Gynecology and Gynecologic OncologyEvangelische Kliniken Essen‐Mitte (KEM)EssenGermany
- Department of Gynecology and Gynecological OncologyHSK, Dr. Horst‐Schmidt KlinikWiesbadenWiesbadenGermany
| | - Arndt Hartmann
- Institute of PathologyComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Jonathan L. Hecht
- Department of PathologyBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMassachusettsUSA
| | | | - Alexander Hein
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Florian Heitz
- Department of Gynecology and Gynecologic OncologyEvangelische Kliniken Essen‐Mitte (KEM)EssenGermany
- Department of Gynecology and Gynecological OncologyHSK, Dr. Horst‐Schmidt KlinikWiesbadenWiesbadenGermany
- Center for PathologyEvangelische Kliniken Essen‐MitteEssenGermany
| | - Joy Hendley
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | | | | | - Sabine Heublein
- Department of Obstetrics and GynecologyUniversity Hospital HeidelbergHeidelbergGermany
| | - Akira Hirasawa
- Department of Clinical Genomic MedicineGraduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayama UniversityOkayamaJapan
| | - Estrid Høgdall
- Department of PathologyHerlev HospitalUniversity of CopenhagenCopenhagenDenmark
| | - Claus K. Høgdall
- Department of GynaecologyRigshospitaletUniversity of CopenhagenCopenhagenDenmark
| | - Hugo M. Horlings
- Division of Molecular PathologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
| | - David G. Huntsman
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of Molecular OncologyBC Cancer Research CentreVancouverBritish ColumbiaCanada
| | - Tomasz Huzarski
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
- Department of Genetics and PathologyUniversity of Zielona GoraZielona GoraPoland
| | - Andrea Jewell
- Division of Gynecologic OncologyDepartment of Obstetrics and GynecologyThe University of Kansas Medical CenterKansas CityKansasUSA
| | | | - Michael E. Jones
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
| | - Scott H. Kaufmann
- Division of Oncology Research and Department of Molecular Pharmacology & Experimental TherapeuticsMayo ClinicRochesterMinnesotaUSA
| | - Catherine J. Kennedy
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Dineo Khabele
- Division of Gynecologic OncologyDepartment of Obstetrics and GynecologyWashington University in St. LouisSt. LouisMissouriUSA
| | | | - Roy F. P. M. Kruitwagen
- Department of Obstetrics and GynecologyMaastricht University Medical CentreMaastrichtThe Netherlands
- GROW – School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
| | - Diether Lambrechts
- Department of Human GeneticsLaboratory for Translational GeneticsKU LeuvenLeuvenBelgium
- VIB Center for Cancer BiologyVIBLeuvenBelgium
| | - Nhu D. Le
- Cancer Control ResearchBC Cancer AgencyVancouverBritish ColumbiaCanada
| | - Marcin Lener
- International Hereditary Cancer CenterDepartment of Genetics and PathologyPomeranian Medical University in SzczecinSzczecinPoland
| | - Jenny Lester
- David Geffen School of MedicineDepartment of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - Yee Leung
- Division of Obstetrics and GynaecologyFaculty of Health and Medical SciencesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
- Department of Gynaecological OncologyKing Edward Memorial HospitalSubiacoWestern AustraliaAustralia
- Australia New Zealand Gynaecological Oncology GroupCamperdownAustralia
| | - Anna Linder
- Department of Obstetrics and GynecologyInst of Clinical Science, Sahlgrenska Center for Cancer ResearchUniversity of GothenburgGothenburgSweden
| | - Liselore Loverix
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Jan Lubiński
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Rashna Madan
- Department of Pathology and Laboratory MedicineThe University of Kansas Medical CenterKansas CityKansasUSA
| | | | - Francesmary Modugno
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Department of EpidemiologyUniversity of Pittsburgh School of Public HealthPittsburghPennsylvaniaUSA
- Women's Cancer Research CenterMagee‐Womens Research Institute and Hillman Cancer CenterPittsburghPennsylvaniaUSA
| | - Susan L. Neuhausen
- Department of Population SciencesBeckman Research Institute of City of HopeDuarteCaliforniaUSA
| | - Alexander Olawaiye
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Siel Olbrecht
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Sandra Orsulic
- David Geffen School of MedicineDepartment of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - José Palacios
- Department of PathologyHospital Ramón y CajalInstituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)CIBERONCUniversidad de AlcaláMadridSpain
| | - Celeste Leigh Pearce
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Malcolm C. Pike
- Department of Epidemiology and BiostatisticsMemorial Sloan‐Kettering Cancer CenterNew YorkNew YorkUSA
- Department of Population Health and Public Health SciencesKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCaliforniaUSA
| | - Carmel M. Quinn
- The Health Precincts BiobankUNSW Biospecimen ServicesMark Wainwright Analytical CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Ganendra Raj Mohan
- Department of Gynaecological OncologySt John of God Subiaco HospitalSubiacoWestern AustraliaAustralia
- Department of Gynaecological OncologyKing Edward Memorial HospitalSubiacoWestern AustraliaAustralia
| | - Cristina Rodríguez‐Antona
- Hereditary Endocrine Cancer GroupSpanish National Cancer Research Center (CNIO)MadridSpain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
| | - Matthias Ruebner
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Andy Ryan
- MRC Clinical Trials UnitInstitute of Clinical Trials & MethodologyUniversity College LondonLondonUK
- Women's CancerInstitute for Women's HealthUniversity College LondonLondonUK
| | - Stuart G. Salfinger
- Department of Gynaecological OncologySt John of God Subiaco HospitalSubiacoWestern AustraliaAustralia
| | - Naoko Sasamoto
- Obstetrics and Gynecology Epidemiology CenterDepartment of Obstetrics and GynecologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Joellen M. Schildkraut
- Department of EpidemiologyRollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
| | | | - Mitul Shah
- Department of OncologyCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic OncologyWestmead HospitalSydneyNew South WalesAustralia
| | | | - Naveena Singh
- Department of PathologyBarts Health National Health Service TrustLondonUK
| | - Gabe S. Sonke
- Department of Medical OncologyThe Netherlands Cancer Institute ‐ Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Linda Steele
- Department of Population SciencesBeckman Research Institute of City of HopeDuarteCaliforniaUSA
| | - Colin J. R. Stewart
- School for Women's and Infants' HealthUniversity of Western AustraliaPerthAustralia
| | - Karin Sundfeldt
- Department of Obstetrics and GynecologyInst of Clinical Science, Sahlgrenska Center for Cancer ResearchUniversity of GothenburgGothenburgSweden
| | - Anthony J. Swerdlow
- Division of Genetics and EpidemiologyThe Institute of Cancer ResearchLondonUK
- Division of Breast Cancer ResearchThe Institute of Cancer ResearchLondonUK
| | - Aline Talhouk
- Department of Obstetrics and GynecologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- British Columbia's Gynecological Cancer Research Team (OVCARE)University of British ColumbiaBC Cancerand Vancouver General HospitalVancouverBritish ColumbiaCanada
| | - Adeline Tan
- Division of Obstetrics and GynaecologyFaculty of Health and Medical SciencesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
- Gynaepath WAClinipath (Sonic Healthcare)Osbourne ParkAustralia
| | - Sarah E. Taylor
- Division of Gynecologic OncologyDepartment of Obstetrics, Gynecology and Reproductive SciencesUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Kathryn L. Terry
- Obstetrics and Gynecology Epidemiology CenterDepartment of Obstetrics and GynecologyBrigham and Women's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
| | - Aleksandra Tołoczko
- Department of Genetics and PathologyPomeranian Medical UniversitySzczecinPoland
| | - Nadia Traficante
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Koen K. Van de Vijver
- Department of PathologyGhent University HospitalCancer Research Institute Ghent (CRIG)GhentBelgium
- Department of PathologyAntwerp University HospitalAntwerpBelgium
| | - Maaike A. van der Aa
- Department of ResearchNetherlands Comprehensive Cancer Organization (IKNL)UtrechtThe Netherlands
| | - Toon Van Gorp
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Els Van Nieuwenhuysen
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Lilian van‐Wagensveld
- Department of Obstetrics and GynecologyMaastricht University Medical CentreMaastrichtThe Netherlands
- GROW – School for Oncology and ReproductionMaastricht University Medical CenterMaastrichtThe Netherlands
- Department of ResearchNetherlands Comprehensive Cancer Organization (IKNL)UtrechtThe Netherlands
| | - Ignace Vergote
- Division of Gynecologic OncologyDepartment of Gynecology and ObstetricsLeuven Cancer InstituteLeuvenBelgium
| | - Robert A. Vierkant
- Department of Quantitative Health SciencesDivision of Clinical Trials and BiostatisticsMayo ClinicRochesterMinnesotaUSA
| | - Chen Wang
- Department of Quantitative Health SciencesDivision of Computational BiologyMayo ClinicRochesterMinnesotaUSA
| | | | - Stacey J. Winham
- Department of Quantitative Health SciencesDivision of Computational BiologyMayo ClinicRochesterMinnesotaUSA
| | - Anna H. Wu
- Department of Population Health and Public Health SciencesKeck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCaliforniaUSA
| | - Javier Benitez
- Centre for Biomedical Network Research on Rare Diseases (CIBERER)Instituto de Salud Carlos IIIMadridSpain
- Human Genetics GroupSpanish National Cancer Research Centre (CNIO)MadridSpain
| | - Andrew Berchuck
- Department of Obstetrics and GynecologyDivision of Gynecologic OncologyDuke University Medical CenterDurhamNorth CarolinaUSA
| | | | - Anna DeFazio
- The Daffodil CentreThe University of SydneyA Joint Venture With Cancer Council NSWSydneyNew South WalesAustralia
- Centre for Cancer ResearchThe Westmead Institute for Medical ResearchUniversity of SydneySydneyNew South WalesAustralia
- Department of Gynaecological OncologyWestmead HospitalSydneyNew South WalesAustralia
- Discipline of Obstetrics and GynaecologyThe University of SydneySydneyNew South WalesAustralia
| | - Peter A. Fasching
- Department of Gynecology and ObstetricsComprehensive Cancer Center Erlangen‐EMNFriedrich‐Alexander University Erlangen‐NurembergUniversity Hospital ErlangenErlangenGermany
| | - Ellen L. Goode
- Department of Quantitative Health SciencesDivision of EpidemiologyMayo ClinicRochesterMinnesotaUSA
| | - Marc T. Goodman
- Cancer Prevention and Control ProgramCedars‐Sinai CancerCedars‐Sinai Medical CenterLos AngelesCaliforniaUSA
| | - Jacek Gronwald
- Department of Genetics and PathologyInternational Hereditary Cancer CenterPomeranian Medical UniversitySzczecinPoland
| | - Beth Y. Karlan
- David Geffen School of MedicineDepartment of Obstetrics and GynecologyUniversity of California at Los AngelesLos AngelesCaliforniaUSA
| | - Stefan Kommoss
- Department of Women's HealthTuebingen University HospitalTuebingenGermany
| | - Usha Menon
- MRC Clinical Trials UnitInstitute of Clinical Trials & MethodologyUniversity College LondonLondonUK
| | - Hans‐Peter Sinn
- Institute of PathologyHeidelberg University HospitalHeidelbergGermany
| | - Annette Staebler
- Institute of Pathology and NeuropathologyTuebingen University HospitalTuebingenGermany
| | - James D. Brenton
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUK
| | - David D. Bowtell
- Peter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneParkvilleVictoriaAustralia
| | - Paul D. P. Pharoah
- Department of OncologyCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
- Department of Public Health and Primary CareCentre for Cancer Genetic EpidemiologyUniversity of CambridgeCambridgeUK
| | - Susan J. Ramus
- School of Clinical MedicineUNSW Medicine and HealthUniversity of NSW SydneySydneyNew South WalesAustralia
- Adult Cancer ProgramLowy Cancer Research CentreUniversity of NSW SydneySydneyNew South WalesAustralia
| | - Martin Köbel
- Department of Pathology and Laboratory MedicineUniversity of CalgaryFoothills Medical CenterCalgaryAlbertaCanada
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19
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Jamieson A, Huvila J, Chiu D, Thompson EF, Scott S, Salvador S, Vicus D, Helpman L, Gotlieb W, Kean S, Samouelian V, Köbel M, Kinloch M, Parra-Harran C, Offman S, Grondin K, Irving J, Lum A, Senz J, Leung S, McConechy MK, Plante M, Kommoss S, Huntsman DG, Talhouk A, Gilks CB, McAlpine JN. Grade and Estrogen Receptor Expression Identify a Subset of No Specific Molecular Profile Endometrial Carcinomas at a Very Low Risk of Disease-Specific Death. Mod Pathol 2023; 36:100085. [PMID: 36788084 DOI: 10.1016/j.modpat.2022.100085] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 10/06/2022] [Revised: 11/16/2022] [Accepted: 12/11/2022] [Indexed: 01/27/2023]
Abstract
Endometrial carcinoma (EC) can be divided into 4 prognostic molecular subtypes, and no specific molecular profile (NSMP) type is the most commonly occurring type (∼50%). Although described as having an intermediate to favorable prognosis, this subtype encompasses pathologically and molecularly diverse tumors. We aimed to identify factors associated with outcomes within the NSMP ECs that might be used to stratify prognosis and direct treatment. Clinicopathologic, immunohistochemical, and genetic features of a large series of NSMP EC were used to identify parameters that could identify the subset associated with a very favorable outcome (disease-specific death rate <5% at 5 years, termed low-risk NSMP). A total of 1110 NSMP ECs were profiled. In a univariate analysis, stage, grade, lymphovascular invasion, estrogen receptor (ER) and progesterone receptor (PR) expression, L1CAM overexpression, and mutations in PIK3CA were associated with disease-specific survival. Two critical features, grade and ER expression, identified a low-risk NSMP subset (grade 1-2, ER-positive [>1%], 84% of cases), which showed a 5-year disease-specific death rate of 1.6% across all stages and 1.4% within stage I. The remaining cases (high-risk NSMPs, grade 3, and/or ER-negative status) were responsible for most of the disease-specific deaths (disease-specific death rate at 5 years, 22.9%; hazard ratio compared with that of low-risk NSMPs: 16.3; 95% CI, 8.4-31.7). Within NSMP EC, the low-risk and high-risk categories were of prognostic significance independent of the stage on a multivariate analysis. Low-grade and ER-positive NSMP ECs are a homogeneous low-risk group associated with an exceptionally favorable prognosis in which de-escalation and/or endocrine therapy strategies can be applied. Grade 3 and/or ER-negative status identifies a high-risk NSMP subset, including rare high-grade histotypes (eg, clear cell, dedifferentiated, and mesonephric-like), responsible for most NSMP-related deaths. Subclassification of NSMPs allows for the category of low-risk EC molecular subtypes to be dramatically expanded because it now includes both POLEmut and the much more common low-risk NSMP EC.
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Affiliation(s)
- Amy Jamieson
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jutta Huvila
- Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland
| | - Derek Chiu
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily F Thompson
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephanie Scott
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Dalhousie University, Halifax, Canada
| | - Shannon Salvador
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McGill University, Montreal, Canada
| | - Danielle Vicus
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Toronto, Toronto, Canada
| | - Limor Helpman
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McMaster University, Hamilton, Ontario, Canada
| | - Walter Gotlieb
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, McGill University, Montreal, Canada
| | - Sarah Kean
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Manitoba, Winnipeg, Canada
| | - Vanessa Samouelian
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of Montreal, Montreal, Quebec, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mary Kinloch
- Department of Pathology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Saul Offman
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Katherine Grondin
- Department of Pathology, Laval University, Quebec City, Quebec, Canada
| | - Julie Irving
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amy Lum
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janine Senz
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samuel Leung
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Marie Plante
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Laval University, Quebec City, Quebec, Canada
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - David G Huntsman
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada; Imagia Canexia Health, Inc., Vancouver, British Columbia, Canada
| | - Aline Talhouk
- Department of Molecular Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Blake Gilks
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Jessica N McAlpine
- Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, University of British Columbia, Vancouver, British Columbia, Canada.
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20
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Weir A, Kang EY, Meagher NS, Nelson GS, Ghatage P, Lee CH, Riggan MJ, Gentry-Maharaj A, Ryan A, Singh N, Widschwendter M, Alsop J, Anglesio MS, Beckmann MW, Berger J, Bisinotto C, Boros J, Brand AH, Brenton JD, Brooks-Wilson A, Carney ME, Cunningham JM, Cushing-Haugen KL, Cybulski C, Elishaev E, Erber R, Fereday S, Fischer A, Paz-Ares L, Gayarre J, Gilks BC, Grube M, Harnett PR, Harris HR, Hartmann A, Hein A, Hendley J, Hernandez BY, Heublein S, Huang Y, Huzarski T, Jakubowska A, Jimenez-Linan M, Kennedy CJ, Kommoss FKF, Koziak JM, Kraemer B, Le ND, Lesnock J, Lester J, Lubiński J, Menkiszak J, Ney B, Olawaiye A, Orsulic S, Osorio A, Robles-Díaz L, Ruebner M, Shah M, Sharma R, Shvetsov YB, Steed H, Talhouk A, Taylor SE, Traficante N, Vierkant RA, Wang C, Wilkens LR, Winham SJ, Benitez J, Berchuck A, Bowtell DD, Candido Dos Reis FJ, Cook LS, DeFazio A, Doherty JA, Fasching PA, García MJ, Goode EL, Goodman MT, Gronwald J, Huntsman DG, Karlan BY, Kommoss S, Modugno F, Schildkraut JM, Sinn HP, Staebler A, Kelemen LE, Ford CE, Menon U, Pharoah PDP, Köbel M, Ramus SJ. Increased FOXJ1 protein expression is associated with improved overall survival in high-grade serous ovarian carcinoma: an Ovarian Tumor Tissue Analysis Consortium Study. Br J Cancer 2023; 128:137-147. [PMID: 36323878 DOI: 10.1038/s41416-022-02014-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 09/01/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Recently, we showed a >60% difference in 5-year survival for patients with tubo-ovarian high-grade serous carcinoma (HGSC) when stratified by a 101-gene mRNA expression prognostic signature. Given the varied patient outcomes, this study aimed to translate prognostic mRNA markers into protein expression assays by immunohistochemistry and validate their survival association in HGSC. METHODS Two prognostic genes, FOXJ1 and GMNN, were selected based on high-quality antibodies, correlation with protein expression and variation in immunohistochemical scores in a preliminary cohort (n = 134 and n = 80, respectively). Six thousand four hundred and thirty-four (FOXJ1) and 5470 (GMNN) formalin-fixed, paraffin-embedded ovarian neoplasms (4634 and 4185 HGSC, respectively) represented on tissue microarrays from the Ovarian Tumor Tissue Analysis consortium underwent immunohistochemical staining and scoring, then univariate and multivariate survival analysis. RESULTS Consistent with mRNA, FOXJ1 protein expression exhibited a linear, increasing association with improved overall survival in HGSC patients. Women with >50% expression had the most favourable outcomes (HR = 0.78, 95% CI 0.67-0.91, p < 0.0001). GMNN protein expression was not significantly associated with overall HSGC patient survival. However, HGSCs with >35% GMNN expression showed a trend for better outcomes, though this was not significant. CONCLUSION We provide foundational evidence for the prognostic value of FOXJ1 in HGSC, validating the prior mRNA-based prognostic association by immunohistochemistry.
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Affiliation(s)
- Ashley Weir
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Nicola S Meagher
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada
| | - Marjorie J Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Andy Ryan
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
- Women's Cancer, Institute for Women's Health, University College London, London, UK
| | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | | | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Michael S Anglesio
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jessica Berger
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Christiani Bisinotto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jessica Boros
- Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Alison H Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - Michael E Carney
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Julie M Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Kara L Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Fischer
- Institute of Pathology and Neuropathology, Tuebingen University Hospital, Tuebingen, Germany
| | - Luis Paz-Ares
- H12O-CNIO Lung Cancer Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Javier Gayarre
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Blake C Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marcel Grube
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - Paul R Harnett
- The University of Sydney, Sydney, NSW, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Joy Hendley
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | | | - Sabine Heublein
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Yajue Huang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Tomasz Huzarski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Department of Genetics and Pathology, University of Zielona Gora, Zielona Gora, Poland
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Independent Laboratory of Molecular Biology and Genetic Diagnostics, Szczecin, Poland
| | | | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Felix K F Kommoss
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Bernhard Kraemer
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - Nhu D Le
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Jaime Lesnock
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Britta Ney
- Institute of Pathology and Neuropathology, Tuebingen University Hospital, Tuebingen, Germany
| | - Alexander Olawaiye
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Raghwa Sharma
- Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, NSW, Australia
| | | | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
- Section of Gynecologic Oncology Surgery, North Zone, Alberta Health Services, Edmonton, AB, Canada
| | - Aline Talhouk
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
| | - Sarah E Taylor
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Nadia Traficante
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Robert A Vierkant
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | | | - Stacey J Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Javier Benitez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - David D Bowtell
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Linda S Cook
- Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Anna DeFazio
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, NSW, Australia
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - María J García
- Computational Oncology Group, Structural Biology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Marc T Goodman
- Cancer Prevention and Control Program, Cedars-Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - David G Huntsman
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Beth Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Stefan Kommoss
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - Francesmary Modugno
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Hans-Peter Sinn
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Annette Staebler
- Institute of Pathology and Neuropathology, Tuebingen University Hospital, Tuebingen, Germany
| | - Linda E Kelemen
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Caroline E Ford
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- School of Women's and Children's Health, Faculty of Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Susan J Ramus
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, NSW, Australia.
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia.
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21
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Meagher NS, Hamilton P, Milne K, Thornton S, Harris B, Weir A, Alsop J, Bisinoto C, Brenton JD, Brooks-Wilson A, Chiu DS, Cushing-Haugen KL, Fereday S, Garsed DW, Gayther SA, Gentry-Maharaj A, Gilks B, Jimenez-Linan M, Kennedy CJ, Le ND, Piskorz AM, Riggan MJ, Shah M, Singh N, Talhouk A, Widschwendter M, Bowtell DDL, Candido Dos Reis FJ, Cook LS, Fortner RT, García MJ, Harris HR, Huntsman DG, Karnezis AN, Köbel M, Menon U, Pharoah PDP, Doherty JA, Anglesio MS, Pike MC, Pearce CL, Friedlander ML, DeFazio A, Nelson BH, Ramus SJ. Profiling the immune landscape in mucinous ovarian carcinoma. Gynecol Oncol 2023; 168:23-31. [PMID: 36368129 PMCID: PMC10374276 DOI: 10.1016/j.ygyno.2022.10.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Mucinous ovarian carcinoma (MOC) is a rare histotype of ovarian cancer, with low response rates to standard chemotherapy, and very poor survival for patients diagnosed at advanced stage. There is a limited understanding of the MOC immune landscape, and consequently whether immune checkpoint inhibitors could be considered for a subset of patients. METHODS We performed multicolor immunohistochemistry (IHC) and immunofluorescence (IF) on tissue microarrays in a cohort of 126 MOC patients. Cell densities were calculated in the epithelial and stromal components for tumor-associated macrophages (CD68+/PD-L1+, CD68+/PD-L1-), T cells (CD3+/CD8-, CD3+/CD8+), putative T-regulatory cells (Tregs, FOXP3+), B cells (CD20+/CD79A+), plasma cells (CD20-/CD79a+), and PD-L1+ and PD-1+ cells, and compared these values with clinical factors. Univariate and multivariable Cox Proportional Hazards assessed overall survival. Unsupervised k-means clustering identified patient subsets with common patterns of immune cell infiltration. RESULTS Mean densities of PD1+ cells, PD-L1- macrophages, CD4+ and CD8+ T cells, and FOXP3+ Tregs were higher in the stroma compared to the epithelium. Tumors from advanced (Stage III/IV) MOC had greater epithelial infiltration of PD-L1- macrophages, and fewer PD-L1+ macrophages compared with Stage I/II cancers (p = 0.004 and p = 0.014 respectively). Patients with high epithelial density of FOXP3+ cells, CD8+/FOXP3+ cells, or PD-L1- macrophages, had poorer survival, and high epithelial CD79a + plasma cells conferred better survival, all upon univariate analysis only. Clustering showed that most MOC (86%) had an immune depleted (cold) phenotype, with only a small proportion (11/76,14%) considered immune inflamed (hot) based on T cell and PD-L1 infiltrates. CONCLUSION In summary, MOCs are mostly immunogenically 'cold', suggesting they may have limited response to current immunotherapies.
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Affiliation(s)
- Nicola S Meagher
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia; Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia; The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council New South Wales, Australia.
| | - Phineas Hamilton
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, BC, Canada
| | - Katy Milne
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, BC, Canada
| | - Shelby Thornton
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, BC, Canada
| | - Bronwyn Harris
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, BC, Canada
| | - Ashley Weir
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia; The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Christiani Bisinoto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - Derek S Chiu
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada
| | - Kara L Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Sian Fereday
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Dale W Garsed
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia; The University of Sydney, Sydney, New South Wales, Australia
| | - Nhu D Le
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Anna M Piskorz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Marjorie J Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC, USA
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK; Department of Anatomical Pathology, Vancouver General Hospital, Vancouver, Canada
| | - Aline Talhouk
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | | | - David D L Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Linda S Cook
- Epidemiology, School of Public Health, University of Colorado, Aurora, CO, USA; Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - María J García
- Computational Oncology Group, Structural Biology Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - David G Huntsman
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Usha Menon
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, London, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Jennifer A Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Michael S Anglesio
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, BC, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Malcolm C Pike
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Population Health and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Michael L Friedlander
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia; Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia; Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Anna DeFazio
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council New South Wales, Australia; Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia; The University of Sydney, Sydney, New South Wales, Australia
| | - Brad H Nelson
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, BC, Canada
| | - Susan J Ramus
- School of Clinical Medicine, UNSW Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia; Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia.
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22
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Patel H, Kishlyansky D, Köbel M, Alshamma Z, Glaze S, Ghaznavi S. Cervical small cell neuroendocrine carcinoma with ectopic ACTH secretion and acute pancreatitis. J Endocr Soc 2022. [DOI: 10.1210/jendso/bvac192] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Abstract
Ectopic Cushing’s Syndrome from a primary carcinoma of the cervix is an exceedingly rare phenomenon. The objective of this review is to describe our clinical case and summarize the clinical characteristics, investigations, and outcomes of all published cases.
We describe a previously healthy 39-year-old female presenting with abnormal uterine bleeding, leading to a diagnosis of stage IIIC1 small cell neuroendocrine carcinoma of the cervix, HPV-associated. She was treated with neoadjuvant chemotherapy, radical hysterectomy, adjuvant chemotherapy, and pelvic radiation. Unfortunately, she developed progressive disease with multifocal hepatic metastases and lesions in the para-aortic lymph nodes. Eighteen months after her initial diagnosis, she presented with severe Cushing’s Syndrome and acute pancreatitis, and died from a splenic artery pseudoaneurysm.
Literature review identified 10 published cases of ectopic ACTH secretion in the setting of carcinoma of the cervix. The mean age of presentation was 40. The majority (70%) occurred in the small cell neuroendocrine variant. In 80% of patients, Cushingoid features developed concomitantly or shortly after the discovery of metastatic disease; Cushingoid features included new-onset hypertension (30% of patients), hyperglycemia (50%), and hypokalemia (50%). All 10 patients died of the disease with a median survival of 2.5 months (range: 1 - 10 months) from the time of presentation with Cushing’s Syndrome.
Carcinoma of the cervix is a rare cause of ectopic Cushing’s Syndrome. Nevertheless, it should be considered as a source of ectopic ACTH secretion in all women, especially those presenting with gynecologic complaints. Despite surgical resection and systemic therapy, prognosis is poor.
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Affiliation(s)
- Harshil Patel
- Department of Internal Medicine, Cumming School of Medicine, University of Calgary; Calgary , Alberta , Canada
| | - David Kishlyansky
- Department of Internal Medicine, Cumming School of Medicine, University of Calgary; Calgary , Alberta , Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary. Alberta Precision Laboratories; Calgary , Alberta , Canada
| | - Zainab Alshamma
- Department of Pathology and Laboratory Medicine, University of Calgary. Alberta Precision Laboratories; Calgary , Alberta , Canada
| | - Sarah Glaze
- Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary , Calgary, AB
| | - Sana Ghaznavi
- Department of Internal Medicine, Cumming School of Medicine, University of Calgary; Calgary , Alberta , Canada
- Division of Endocrinology, Department of Medicine, Cumming School of Medicine, University of Calgary, Richmond Road Diagnostic and Treatment Centre , 1820 Richmond Road SW, Calgary, Alberta T2T 5C7 , Canada
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23
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Meagher NS, Gorringe KL, Wakefield M, Bolithon A, Pang CNI, Chiu DS, Anglesio MS, Mallitt KA, Doherty JA, Harris HR, Schildkraut JM, Berchuck A, Cushing-Haugen KL, Chezar K, Chou A, Tan A, Alsop J, Barlow E, Beckmann MW, Boros J, Bowtell DD, Brand AH, Brenton JD, Campbell I, Cheasley D, Cohen J, Cybulski C, Elishaev E, Erber R, Farrell R, Fischer A, Fu Z, Gilks B, Gill AJ, Gourley C, Grube M, Harnett PR, Hartmann A, Hettiaratchi A, Høgdall CK, Huzarski T, Jakubowska A, Jimenez-Linan M, Kennedy CJ, Kim BG, Kim JW, Kim JH, Klett K, Koziak JM, Lai T, Laslavic A, Lester J, Leung Y, Li N, Liauw W, Lim BW, Linder A, Lubiński J, Mahale S, Mateoiu C, McInerny S, Menkiszak J, Minoo P, Mittelstadt S, Morris D, Orsulic S, Park SY, Pearce CL, Pearson JV, Pike MC, Quinn CM, Mohan GR, Rao J, Riggan MJ, Ruebner M, Salfinger S, Scott CL, Shah M, Steed H, Stewart CJ, Subramanian D, Sung S, Tang K, Timpson P, Ward RL, Wiedenhoefer R, Thorne H, Cohen PA, Crowe P, Fasching PA, Gronwald J, Hawkins NJ, Høgdall E, Huntsman DG, James PA, Karlan BY, Kelemen LE, Kommoss S, Konecny GE, Modugno F, Park SK, Staebler A, Sundfeldt K, Wu AH, Talhouk A, Pharoah PD, Anderson L, DeFazio A, Köbel M, Friedlander ML, Ramus SJ. Gene-Expression Profiling of Mucinous Ovarian Tumors and Comparison with Upper and Lower Gastrointestinal Tumors Identifies Markers Associated with Adverse Outcomes. Clin Cancer Res 2022; 28:5383-5395. [PMID: 36222710 PMCID: PMC9751776 DOI: 10.1158/1078-0432.ccr-22-1206] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/22/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Advanced-stage mucinous ovarian carcinoma (MOC) has poor chemotherapy response and prognosis and lacks biomarkers to aid stage I adjuvant treatment. Differentiating primary MOC from gastrointestinal (GI) metastases to the ovary is also challenging due to phenotypic similarities. Clinicopathologic and gene-expression data were analyzed to identify prognostic and diagnostic features. EXPERIMENTAL DESIGN Discovery analyses selected 19 genes with prognostic/diagnostic potential. Validation was performed through the Ovarian Tumor Tissue Analysis consortium and GI cancer biobanks comprising 604 patients with MOC (n = 333), mucinous borderline ovarian tumors (MBOT, n = 151), and upper GI (n = 65) and lower GI tumors (n = 55). RESULTS Infiltrative pattern of invasion was associated with decreased overall survival (OS) within 2 years from diagnosis, compared with expansile pattern in stage I MOC [hazard ratio (HR), 2.77; 95% confidence interval (CI), 1.04-7.41, P = 0.042]. Increased expression of THBS2 and TAGLN was associated with shorter OS in MOC patients (HR, 1.25; 95% CI, 1.04-1.51, P = 0.016) and (HR, 1.21; 95% CI, 1.01-1.45, P = 0.043), respectively. ERBB2 (HER2) amplification or high mRNA expression was evident in 64 of 243 (26%) of MOCs, but only 8 of 243 (3%) were also infiltrative (4/39, 10%) or stage III/IV (4/31, 13%). CONCLUSIONS An infiltrative growth pattern infers poor prognosis within 2 years from diagnosis and may help select stage I patients for adjuvant therapy. High expression of THBS2 and TAGLN in MOC confers an adverse prognosis and is upregulated in the infiltrative subtype, which warrants further investigation. Anti-HER2 therapy should be investigated in a subset of patients. MOC samples clustered with upper GI, yet markers to differentiate these entities remain elusive, suggesting similar underlying biology and shared treatment strategies.
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Affiliation(s)
- Nicola S. Meagher
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia.,Corresponding Authors: Nicola S. Meagher, School of Clinical Medicine, The University of New South Wales, Sydney, NSW 2031, Australia. E-mail: ; and Susan J. Ramus, Level 2, Lowy Cancer Research Centre, UNSW Sydney NSW 2052, Australia. Phone: 61-9385-1720; E-mail:
| | - Kylie L. Gorringe
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Matthew Wakefield
- The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.,Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Adelyn Bolithon
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Chi Nam Ignatius Pang
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, New South Wales, Australia.,Bioinformatics Unit, Children's Medical Research Institute, Westmead, Sydney, Australia
| | - Derek S. Chiu
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Michael S. Anglesio
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kylie-Ann Mallitt
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Centre for Big Data Research in Health, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah
| | - Holly R. Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington.,Department of Epidemiology, University of Washington, Seattle, Washington
| | - Joellen M. Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina
| | - Kara L. Cushing-Haugen
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Ksenia Chezar
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada
| | - Angela Chou
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia.,Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | - Adeline Tan
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Crawley, Western Australia, Australia.,Western Women's Pathology, Western Diagnostic Pathology, Wembley, Western Australia, Australia
| | - Jennifer Alsop
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Ellen Barlow
- Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, New South Wales, Australia
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jessica Boros
- The University of Sydney, Sydney, New South Wales, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - David D.L. Bowtell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Alison H. Brand
- The University of Sydney, Sydney, New South Wales, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - James D. Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Ian Campbell
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Dane Cheasley
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Joshua Cohen
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Cezary Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Rhonda Farrell
- The University of Sydney, Sydney, New South Wales, Australia.,Prince of Wales Private Hospital, Randwick, New South Wales, Australia
| | - Anna Fischer
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Zhuxuan Fu
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania
| | - Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anthony J. Gill
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia.,Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,The University of Sydney, Sydney, New South Wales, Australia
| | | | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Scotland Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Marcel Grube
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Paul R. Harnett
- The University of Sydney, Sydney, New South Wales, Australia.,Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
| | - Arndt Hartmann
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Anusha Hettiaratchi
- The Health Precincts Biobank (formerly the Health Science Alliance Biobank), UNSW Biospecimen Services, Mark Wainwright Analytical Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Claus K. Høgdall
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tomasz Huzarski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.,Department of Genetics and Pathology, University of Zielona Góra, Zielona Góra, Poland
| | - Anna Jakubowska
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.,Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | | | - Catherine J. Kennedy
- The University of Sydney, Sydney, New South Wales, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Hoon Kim
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kayla Klett
- Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania
| | | | - Tiffany Lai
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Angela Laslavic
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Yee Leung
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Crawley, Western Australia, Australia.,Department of Gynaecological Oncology, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.,Australia New Zealand Gynaecological Oncology Group, Camperdown, New South Wales, Australia
| | - Na Li
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Winston Liauw
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Cancer Care Centre, St George Hospital, Sydney, New South Wales, Australia
| | - Belle W.X. Lim
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Anna Linder
- Department of Obstetrics and Gynecology, Inst of Clinical Science, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
| | - Jan Lubiński
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Sakshi Mahale
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Constantina Mateoiu
- Department of Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Simone McInerny
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Parham Minoo
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada
| | - Suzana Mittelstadt
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - David Morris
- St George and Sutherland Clinical School, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Sandra Orsulic
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Sang-Yoon Park
- Center for Gynecologic Cancer, National Cancer Center Institute for Cancer Control, Goyang, Republic of Korea
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - John V. Pearson
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Malcolm C. Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.,Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Carmel M. Quinn
- The Health Precincts Biobank (formerly the Health Science Alliance Biobank), UNSW Biospecimen Services, Mark Wainwright Analytical Centre, University of New South Wales Sydney, Sydney, New South Wales, Australia
| | - Ganendra Raj Mohan
- Department of Gynaecological Oncology, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.,Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia.,School of Medicine, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Jianyu Rao
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Marjorie J. Riggan
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Stuart Salfinger
- Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Clare L. Scott
- Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Victoria, Australia.,The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia.,Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Helen Steed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.,Section of Gynecologic Oncology Surgery, North Zone, Alberta Health Services, Edmonton, Alberta, Canada
| | - Colin J.R. Stewart
- School for Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia
| | | | - Soseul Sung
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Katrina Tang
- Department of Anatomical Pathology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Paul Timpson
- The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Robyn L. Ward
- The University of Sydney, Sydney, New South Wales, Australia
| | - Rebekka Wiedenhoefer
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Heather Thorne
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | | | - Paul A. Cohen
- Division of Obstetrics and Gynaecology, Medical School, University of Western Australia, Crawley, Western Australia, Australia.,Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Western Australia, Australia
| | - Philip Crowe
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Department of Surgery, Prince of Wales Private Hospital, Randwick, New South Wales, Australia
| | - Peter A. Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Jacek Gronwald
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Nicholas J. Hawkins
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - David G. Huntsman
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
| | - Paul A. James
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Parkville Familial Cancer Centre, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Beth Y. Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Linda E. Kelemen
- Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Gottfried E. Konecny
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Francesmary Modugno
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania.,Women's Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania.,Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Sue K. Park
- Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, South Korea
| | - Annette Staebler
- Institute of Pathology and Neuropathology, Tübingen University Hospital, Tübingen, Germany
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Inst of Clinical Science, Sahlgrenska Center for Cancer Research, University of Gothenburg, Gothenburg, Sweden
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California
| | - Aline Talhouk
- British Columbia's Gynecological Cancer Research Team (OVCARE), University of British Columbia, BC Cancer, and Vancouver General Hospital, Vancouver, British Columbia, Canada.,Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul D.P. Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom.,Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Lyndal Anderson
- The University of Sydney, Sydney, New South Wales, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
| | - Anna DeFazio
- The University of Sydney, Sydney, New South Wales, Australia.,Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia.,The Daffodil Centre, a joint venture with Cancer Council NSW, The University of Sydney, Sydney, New South Wales, Australia
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, Alberta, Canada
| | - Michael L. Friedlander
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Susan J. Ramus
- School of Clinical Medicine, Faculty of Medicine and Health, University of NSW Sydney, Sydney, New South Wales, Australia.,Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, New South Wales, Australia.,Corresponding Authors: Nicola S. Meagher, School of Clinical Medicine, The University of New South Wales, Sydney, NSW 2031, Australia. E-mail: ; and Susan J. Ramus, Level 2, Lowy Cancer Research Centre, UNSW Sydney NSW 2052, Australia. Phone: 61-9385-1720; E-mail:
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24
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Ji JX, Cochrane DR, Negri GL, Colborne S, Spencer Miko SE, Hoang LN, Farnell D, Tessier-Cloutier B, Huvila J, Thompson E, Leung S, Chiu D, Chow C, Ta M, Köbel M, Feil L, Anglesio M, Goode EL, Bolton K, Morin GB, Huntsman DG. The proteome of clear cell ovarian carcinoma. J Pathol 2022; 258:325-338. [PMID: 36031730 PMCID: PMC9649886 DOI: 10.1002/path.6006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 05/29/2022] [Revised: 08/05/2022] [Accepted: 08/26/2022] [Indexed: 01/19/2023]
Abstract
Clear cell ovarian carcinoma (CCOC) is the second most common subtype of epithelial ovarian carcinoma. Late-stage CCOC is not responsive to gold-standard chemotherapy and results in suboptimal outcomes for patients. In-depth molecular insight is urgently needed to stratify the disease and drive therapeutic development. We conducted global proteomics for 192 cases of CCOC and compared these with other epithelial ovarian carcinoma subtypes. Our results showed distinct proteomic differences in CCOC compared with other epithelial ovarian cancer subtypes including alterations in lipid and purine metabolism pathways. Furthermore, we report potential clinically significant proteomic subgroups within CCOC, suggesting the biologic plausibility of stratified treatment for this cancer. Taken together, our results provide a comprehensive understanding of the CCOC proteomic landscape to facilitate future understanding and research of this disease. © 2022 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Jennifer X Ji
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dawn R Cochrane
- Department of Molecular Oncology, BC Cancer Agency, Vancouver, BC, Canada
| | - Gian Luca Negri
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Shane Colborne
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Sandra E Spencer Miko
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Lynn N Hoang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - David Farnell
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jutta Huvila
- Department of Molecular Oncology, BC Cancer Agency, Vancouver, BC, Canada
- Department of Biomedicine, University of Turku, Turku, Finland
| | - Emily Thompson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Samuel Leung
- Genetic Pathology Evaluation Center, Vancouver, BC, Canada
| | - Derek Chiu
- Genetic Pathology Evaluation Center, Vancouver, BC, Canada
| | - Christine Chow
- Genetic Pathology Evaluation Center, Vancouver, BC, Canada
| | - Monica Ta
- Genetic Pathology Evaluation Center, Vancouver, BC, Canada
| | - Martin Köbel
- Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Lucas Feil
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Michael Anglesio
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Ellen L Goode
- Department of Health Science Research, Mayo Clinic, Rochester, MN, USA
| | - Kelly Bolton
- Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Gregg B Morin
- Canada's Michael Smith Genome Sciences Centre, BC Cancer Research Institute, University of British Columbia, Vancouver, BC, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, BC Cancer Agency, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
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25
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Bolton KL, Chen D, Corona de la Fuente R, Fu Z, Murali R, Köbel M, Tazi Y, Cunningham JM, Chan IC, Wiley BJ, Moukarzel LA, Winham SJ, Armasu SM, Lester J, Elishaev E, Laslavic A, Kennedy CJ, Piskorz A, Sekowska M, Brand AH, Chiew YE, Pharoah P, Elias KM, Drapkin R, Churchman M, Gourley C, DeFazio A, Karlan B, Brenton JD, Weigelt B, Anglesio MS, Huntsman D, Gayther S, Konner J, Modugno F, Lawrenson K, Goode EL, Papaemmanuil E. Molecular Subclasses of Clear Cell Ovarian Carcinoma and Their Impact on Disease Behavior and Outcomes. Clin Cancer Res 2022; 28:4947-4956. [PMID: 35816189 PMCID: PMC9777703 DOI: 10.1158/1078-0432.ccr-21-3817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/24/2022] [Accepted: 07/07/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To identify molecular subclasses of clear cell ovarian carcinoma (CCOC) and assess their impact on clinical presentation and outcomes. EXPERIMENTAL DESIGN We profiled 421 primary CCOCs that passed quality control using a targeted deep sequencing panel of 163 putative CCOC driver genes and whole transcriptome sequencing of 211 of these tumors. Molecularly defined subgroups were identified and tested for association with clinical characteristics and overall survival. RESULTS We detected a putative somatic driver mutation in at least one candidate gene in 95% (401/421) of CCOC tumors including ARID1A (in 49% of tumors), PIK3CA (49%), TERT (20%), and TP53 (16%). Clustering of cancer driver mutations and RNA expression converged upon two distinct subclasses of CCOC. The first was dominated by ARID1A-mutated tumors with enriched expression of canonical CCOC genes and markers of platinum resistance; the second was largely comprised of tumors with TP53 mutations and enriched for the expression of genes involved in extracellular matrix organization and mesenchymal differentiation. Compared with the ARID1A-mutated group, women with TP53-mutated tumors were more likely to have advanced-stage disease, no antecedent history of endometriosis, and poorer survival, driven by their advanced stage at presentation. In women with ARID1A-mutated tumors, there was a trend toward a lower rate of response to first-line platinum-based therapy. CONCLUSIONS Our study suggests that CCOC consists of two distinct molecular subclasses with distinct clinical presentation and outcomes, with potential relevance to both traditional and experimental therapy responsiveness. See related commentary by Lheureux, p. 4838.
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Affiliation(s)
- Kelly L. Bolton
- Washington University School of Medicine, St. Louis, Missouri
| | - Denise Chen
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | | | - Zhuxuan Fu
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | | | - Martin Köbel
- The University of Calgary, Calgary, Alberta, Canada
| | - Yanis Tazi
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | | | | | - Brian J. Wiley
- Washington University School of Medicine, St. Louis, Missouri
| | | | | | | | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Esther Elishaev
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Angela Laslavic
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Catherine J. Kennedy
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Anna Piskorz
- University of Cambridge, Cambridge, United Kingdom
| | | | - Alison H. Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Yoke-Eng Chiew
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Paul Pharoah
- University of Cambridge, Cambridge, United Kingdom
| | | | - Ronny Drapkin
- University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Anna DeFazio
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Beth Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | | | - Britta Weigelt
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | | | - David Huntsman
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Simon Gayther
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Jason Konner
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Francesmary Modugno
- University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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26
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Gilks CB, Selinger CI, Davidson B, Köbel M, Ledermann JA, Lim D, Malpica A, Mikami Y, Singh N, Srinivasan R, Vang R, Lax SF, McCluggage WG. Data Set for the Reporting of Ovarian, Fallopian Tube and Primary Peritoneal Carcinoma: Recommendations From the International Collaboration on Cancer Reporting (ICCR). Int J Gynecol Pathol 2022; 41:S119-S142. [PMID: 36305537 DOI: 10.1097/pgp.0000000000000908] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The move toward consistent and comprehensive surgical pathology reports for cancer resection specimens has been a key development in supporting evidence-based patient management and consistent cancer staging. The International Collaboration on Cancer Reporting (ICCR) previously developed a data set for reporting of the ovarian, fallopian tube and primary peritoneal carcinomas which was published in 2015. In this paper, we provide an update on this data set, as a second edition, that reflects changes in the 2020 World Health Organization (WHO) Classification of Female Genital Tumours as well as some other minor modifications. The data set has been developed by a panel of internationally recognized expert pathologists and a clinician and consists of "core" and "noncore" elements to be included in surgical pathology reports, with detailed commentary to guide users, including references. This data set replaces the widely used first edition, and will facilitate consistent and accurate case reporting, data collection for quality assurance and research, and allow for comparison of epidemiological and pathologic parameters between different populations.
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27
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Scott SA, Fernandez ML, Kim H, Elit L, Nourmoussavi M, Glaze S, Roberts L, Offman SL, Rahimi K, Lytwyn A, Sur M, Gilks CB, Matheson K, Köbel M, Dawson A, Tinker AV, Kwon JS, Hoskins P, Santos JL, Cheung A, Provencher D, Carey MS. Corrigendum to "Low-grade serous carcinoma (LGSC): A Canadian multicenter review of practice patterns and patient outcomes" [Gynecologic Oncology, Volume 157, Issue 1, April 2020, Pages 36-45]. Gynecol Oncol 2022; 167:399. [PMID: 37850594 DOI: 10.1016/j.ygyno.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stephanie A Scott
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Marta Llaurado Fernandez
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hannah Kim
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laurie Elit
- Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Melica Nourmoussavi
- Division of Gynecologic-Oncology, Centre Hospitalier de Université de Montréal (CHUM), Centre de recherche du CHUM, Montreal, Quebec, Canada
| | - Sarah Glaze
- Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Lesley Roberts
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Saul L Offman
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kurosh Rahimi
- Department of Pathology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Alice Lytwyn
- Department of Pathology and Molecular Medicine, Health Research Methods, Evaluation, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada
| | - Monalisa Sur
- Department of Pathology and Molecular Medicine, McMaster University and The Juravinski Hospital and Cancer Centre, Hamilton, Ontario, Canada
| | - C Blake Gilks
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kara Matheson
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amy Dawson
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anna V Tinker
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janice S Kwon
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul Hoskins
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer L Santos
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Cheung
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Diane Provencher
- Division of Gynecologic-Oncology, Centre Hospitalier de Université de Montréal (CHUM), Centre de recherche du CHUM, Montreal, Quebec, Canada
| | - Mark S Carey
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
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Praetorius TH, Leonova A, Lac V, Senz J, Tessier-Cloutier B, Nazeran TM, Köbel M, Grube M, Kraemer B, Yong PJ, Kommoss S, Anglesio MS. Molecular analysis suggests oligoclonality and metastasis of endometriosis lesions across anatomically defined subtypes. Fertil Steril 2022; 118:524-534. [PMID: 35715244 DOI: 10.1016/j.fertnstert.2022.05.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 11/16/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To investigate the heterogeneity of somatic cancer-driver mutations within patients and across endometriosis types. DESIGN A single-center cohort, retrospective study. SETTING Tertiary specialist-care center at a university hospital. PATIENT(S) Patients with surgically and histologically confirmed endometriosis of at least 2 anatomically distinct types (ovarian, deep infiltrating, and superficial). INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Specimens were analyzed for the presence or absence of somatic cancer-driver mutations using targeted panel sequencing with orthogonal validation using droplet digital polymerase chain reaction and mutation-surrogate immunohistochemistry. RESULT(S) It was found that 13 of 27 patients had informative somatic driver mutations in endometriosis lesions; of these 13 patients, 9 had identical mutations across distinct lesions. Endometriomas showed a higher mutational complexity, with functionally redundant driver mutations in the same gene and within the same lesions. CONCLUSION(S) Our data are consistent with clonality across endometriosis lesions, regardless of subtype. Further, the finding of redundancy in mutations within the same gene and lesions is consistent with endometriosis representing an oligoclonal disease with dissemination likely to consist of multiple epithelial clones traveling together. This suggests that the current anatomically defined classification of endometriosis does not fully recognize the etiology of the disease. A novel classification should consider genomic and other molecular features to promote personalized endometriosis diagnosis and care.
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Affiliation(s)
- Teresa H Praetorius
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany; British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada
| | - Anna Leonova
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada
| | - Vivian Lac
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada
| | - Janine Senz
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada
| | - Basile Tessier-Cloutier
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Tayyebeh M Nazeran
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada
| | - Marcel Grube
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Bernhard Kraemer
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Paul J Yong
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada; BC Women's Centre for Pelvic Pain & Endometriosis, BC Women's Hospital and Health Centre, Vancouver, Canada
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Michael S Anglesio
- British Columbia's Gynecological Cancer Research Program (OVCARE), University of British Columbia, Vancouver General Hospital, and BC Cancer, Vancouver, Canada; Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
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29
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Kommoss FKF, Chiang S, Köbel M, Koelsche C, Chang KTE, Irving JA, Dickson B, Thiryayi S, Rouzbahman M, Rasty G, von Deimling A, Lee CH, Turashvili G. Endometrial Stromal Sarcomas With BCOR Internal Tandem Duplication and Variant BCOR/BCORL1 Rearrangements Resemble High-grade Endometrial Stromal Sarcomas With Recurrent CDK4 Pathway Alterations and MDM2 Amplifications. Am J Surg Pathol 2022; 46:1142-1152. [PMID: 35499168 DOI: 10.1097/pas.0000000000001909] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The distinction between low-grade and high-grade endometrial stromal sarcomas (LGESS, HGESS) is increasingly defined by genetics. Recently, variant genomic alterations involving BCOR or BCORL1 have been reported in endometrial stromal sarcoma (ESS), although it remains unclear whether these justify a diagnosis of LGESS or HGESS. In this study, we describe clinicopathologic and molecular features of ESS with such alterations to help clarify their classification in the spectrum of ESS. We collected a cohort of 13 ESS harboring variant alteration involving BCOR (6 with internal tandem duplication, 1 with EP300::BCOR fusion, 1 with BCOR::LPP fusion) and BCORL1 ( 4 with JAZF1::BCORL1 fusion, 1 with EPC1::BCORL1 fusion). The median patient age at primary diagnosis was 51 years (range: 18 to 70 y). Median tumor size at primary diagnosis was 9.3 cm (range: 4.5 to 21 cm), and extrauterine disease spread (stage IIIB-C) was present in 27%. The tumors were composed of round to spindled cells with cellularity and cytologic atypia ranging from mild to marked and a median mitotic count of 18/10 HPFs (range: 2 to 85/10 HPFs). At least focally myopermeative growth was noted in 8/8 assessable cases. Of 12 patients with follow-up data (median: 25 mo), 4 patients died of disease and 3 were alive with recurrent disease. Unsupervised hierarchical clustering of DNA methylation data together with a large cohort of uterine mesenchymal tumors that included YWHAE::NUTM2 and Z C3H7B::BCOR HGESS and molecularly confirmed LGESS revealed a common methylation signature for all ESS with variant BCOR and BCORL1 alterations and HGESS with YWHAE::NUTM2 and ZC3H7B::BCOR gene fusion. Copy number analysis revealed amplifications of CDK4 and MDM2 , as well as homozygous deletions of CDKN2A/B and NF1 in a subset of tumors. Our results indicate that ESS with BCOR internal tandem duplication and variant BCOR and BCORL1 rearrangements clinically and molecularly resemble conventional HGESS.
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Affiliation(s)
| | - Sarah Chiang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Martin Köbel
- Department of Laboratory Medicine and Pathology, University of Calgary, Calgary
| | | | - Kenneth Tou-En Chang
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Republic of Singapore
| | - Julie A Irving
- Department of Laboratory Medicine, Pathology, and Medical Genetics, Royal Jubilee Hospital, Victoria, BC
| | - Brendan Dickson
- Department of Pathology and Laboratory Medicine, Sinai Health System and University of Toronto
| | - Sakinah Thiryayi
- Department of Pathology and Laboratory Medicine, Sinai Health System and University of Toronto
| | - Marjan Rouzbahman
- Department of Pathology, University Health Network, University of Toronto, Toronto
| | - Golnar Rasty
- Department of Laboratory Medicine, Markham Stouffville Hospital, Markham, ON, Canada
| | - Andreas von Deimling
- Neuropathology, Heidelberg University Hospital
- Clinical Cooperation Unit Neuropathology, DKFZ, Heidelberg, Germany
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB
| | - Gulisa Turashvili
- Department of Pathology and Laboratory Medicine, Sinai Health System and University of Toronto
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, GA
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30
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Meagher NS, Hamilton PT, Anglesio MS, Harris HR, Konecny GE, Schildkraut JM, Talhouk A, Friedlander ML, Pearce CL, Pike MC, Köbel M, Doherty JA, Goode EL, Nelson BH, DeFazio A, Ramus SJ. Multi-modal immune profiling of mucinous ovarian carcinoma: analysis from the Ovarian Tumor Tissue Analysis/Multidisciplinary Ovarian Cancer Outcomes Group consortia. The Journal of Immunology 2022. [DOI: 10.4049/jimmunol.208.supp.179.04] [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] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Mucinous ovarian carcinoma (MOC) is a rare histotype of ovarian cancer. Women with advanced disease (FIGO stage III/IV) have very poor outcomes, with 5-year survival of <20%. Little is known about the anti-tumor immune response in MOC, limiting potential immunotherapeutic options for patients.
Immune data from 3 platforms were analysed. A NanoString mRNA expression panel with 39 immune-related genes (n=60 MOC, n=4198 other ovarian histotypes), a NanoString mRNA plexset with PD-1, PD-L1 (n=241 MOC, n=115 upper and lower gastrointestinal (GI) cancers), and 2 multicolor immunofluorescence (mcIF) panels (n=121 MOC) for CD68, PD-L1, PD-1, CD8 and FOXP3. Data overlapped all platforms for 22 MOC. Immune marker expression by ovarian cancer histotype was measured. Uni- and multivariable Cox Proportional Hazards assessed overall survival (OS) within MOC. Hierarchical clustering looked for subgroups of patients based on co-expression of immune genes.
Compared to more common high-grade serous ovarian cancer (HGSC) and GI cancers, MOC were less immunologically active. High IGHM expression was associated with poorer OS (HR 1.31 (95% CI 1.02–1.69), p=0.033). High tumor densities of FOXP3 and PD-1 positive cells conferred poorer OS in a model with age, stage and site; however, these and PD-L1 and CD68 were associated with grade. The 39 gene NanoString and mcIF datasets revealed 4 clusters, roughly translating to immune cold, moderate and hot (groups 3,4). mcIF analysis revealed a subset with PD-L1 expression in the absence of T-regulatory cell infiltrates.
This study provides novel insights into the MOC immune landscape. Despite relatively low immune activity overall, immunotherapy could be explored for a subset of patients with MOC.
Supported by NSW Ministry of Health and UNSW Sydney, through the NSW Health PhD Scholarship Program 2017-2022; Translational Cancer Research Network top-up scholarship 2021
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Affiliation(s)
- Nicola S Meagher
- 1University of New South Wales, Australia
- 2School of Women’s and Children’s Health, University of New South Wales, Australia
| | | | - Michael S Anglesio
- 4British Columbia’s Gynecological Cancer Research Team (OVCARE), University of British Columbia, Canada
| | - Holly R Harris
- 5Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center
| | - Gottfried E Konecny
- 6Division of Hematology and Oncology and Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California at Los Angeles
| | | | - Aline Talhouk
- 4British Columbia’s Gynecological Cancer Research Team (OVCARE), University of British Columbia, Canada
| | | | - Celeste L Pearce
- 10Department of Epidemiology, University of Michigan School of Public Health, University of Michigan
| | - Malcolm C Pike
- 11Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center
| | - Martin Köbel
- 12Department of Pathology and Laboratory Medicine, University of Calgary, Canada
| | - Jennifer A Doherty
- 13Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah
| | - Ellen L Goode
- 14Department of Health Sciences Research, Mayo Clinic Rochester
| | - Brad H Nelson
- 3Deeley Research Centre, BC Cancer Res. Centre, Canada
| | - Anna DeFazio
- 15Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Australia
- 16Department of Gynaecological Oncology, Westmead Hospital, Australia
- 17The Daffodil Centre, a joint venture with Cancer Council NSW, The University of Sydney, Australia
| | - Susan J Ramus
- 2School of Women’s and Children’s Health, University of New South Wales, Australia
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31
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Tessier-Cloutier B, Kang EY, Alex D, Stewart CJR, McCluggage WG, Köbel M, Lee CH. Endometrial neuroendocrine carcinoma and undifferentiated carcinoma are distinct entities with overlap in neuroendocrine marker expression. Histopathology 2022; 81:44-54. [PMID: 35394077 DOI: 10.1111/his.14639] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/30/2022]
Abstract
AIMS Dedifferentiated/undifferentiated endometrial carcinomas (DDEC/UDEC) frequently harbor genomic activation of SWItch/Sucrose Non-Fermentable (SWI/SNF) complex proteins, and can show histologic overlap with neuroendocrine carcinoma (NEC). This study compares the expression of neuroendocrine markers, SWI/SNF proteins and mismatch repair (MMR) proteins in DDEC/UDEC and NEC. METHODS AND RESULTS The expressions of synaptophysin, chromogranin, CD56, ARID1A, ARID1B, SMARCA4, SMARCB1 and MMR proteins were evaluated by immunohistochemistry on 44 SWI/SNF-deficient DDEC/UDEC and 15 NEC. 33 of 44 (75%) DDEC/UDEC showed expression of at least one neuroendocrine marker with 18 of 44 (41%) expressing 2 or more neuroendocrine markers, whereas all 15 NEC showed expression of at least one neuroendocrine marker with 14 of 15 (93%) expressing 2 or more neuroendocrine markers. Neuroendocrine marker expression in DDEC/UDEC was typically focal when present, with an average extent of 17%, 4% and 8% for synaptophysin, chromogranin and CD56 in the positive cases respectively, in contrast to 73%, 40% and 62% in the positive NEC cases respectively. All 15 NEC showed intact expression of SWI/SNF proteins except for 1 that showed isolated loss of ARID1A. 38 of 44 DDEC/UDEC were MMR-abnormal (34 with loss of MLH1 and PMS2, 4 with loss of PMS2 alone) whereas all NEC retained MMR protein expression. CONCLUSIONS Our study demonstrates frequent but typically focal neuroendocrine marker expression in SWI/SNF-deficient DDEC/UDEC, while NECs typically express 2 or more neuroendocrine markers with diffuse expression in at least one marker. ARID1B, SMARCA4 and SMARCB1 immunohistochemistry can be used to aid differentiation between DDEC/UDEC and NEC.
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Affiliation(s)
- Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Deepu Alex
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, British Columbia, Canada
| | - Colin J R Stewart
- Department of Histopathology, King Edward Memorial Hospital and School for Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, British Columbia, Canada.,Department of Laboratory Medicine and Pathology, Royal Alexandra Hospital, Edmonton, Canada.,Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada
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32
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Heinze K, Nazeran TM, Lee S, Krämer P, Cairns ES, Chiu DS, Leung SC, Kang EY, Meagher NS, Kennedy CJ, Boros J, Kommoss F, Vollert HW, Heitze F, du Bois A, Harter P, Grube M, Kraemer B, Staebler A, Kommoss FK, Heublein S, Sinn HP, Singh N, Laslavic A, Elishaev E, Olawaiye A, Moysich K, Modugno F, Sharma R, Brand AH, Harnett PR, DeFazio A, Fortner RT, Lubinski J, Lener M, Tołoczko-Grabarek A, Cybulski C, Gronwald H, Gronwald J, Coulson P, El-Bahrawy MA, Jones ME, Schoemaker MJ, Swerdlow AJ, Gorringe KL, Campbell I, Cook L, Gayther SA, Carney ME, Shvetsov YB, Hernandez BY, Wilkens LR, Goodman MT, Mateoiu C, Linder A, Sundfeldt K, Kelemen LE, Gentry-Maharaj A, Widschwendter M, Menon U, Bolton KL, Alsop J, Shah M, Jimenez-Linan M, Pharoah PD, Brenton JD, Cushing-Haugen KL, Harris HR, Doherty JA, Gilks B, Ghatage P, Huntsman DG, Nelson GS, Tinker AV, Lee CH, Goode EL, Nelson BH, Ramus SJ, Kommoss S, Talhouk A, Köbel M, Anglesio MS. Validated biomarker assays confirm that ARID1A loss is confounded with MMR deficiency, CD8 + TIL infiltration, and provides no independent prognostic value in endometriosis-associated ovarian carcinomas. J Pathol 2022; 256:388-401. [PMID: 34897700 PMCID: PMC9544180 DOI: 10.1002/path.5849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/04/2021] [Revised: 11/12/2021] [Accepted: 12/10/2021] [Indexed: 11/11/2022]
Abstract
ARID1A (BAF250a) is a component of the SWI/SNF chromatin modifying complex, plays an important tumour suppressor role, and is considered prognostic in several malignancies. However, in ovarian carcinomas there are contradictory reports on its relationship to outcome, immune response, and correlation with clinicopathological features. We assembled a series of 1623 endometriosis-associated ovarian carcinomas, including 1078 endometrioid (ENOC) and 545 clear cell (CCOC) ovarian carcinomas, through combining resources of the Ovarian Tumor Tissue Analysis (OTTA) Consortium, the Canadian Ovarian Unified Experimental Resource (COEUR), local, and collaborative networks. Validated immunohistochemical surrogate assays for ARID1A mutations were applied to all samples. We investigated associations between ARID1A loss/mutation, clinical features, outcome, CD8+ tumour-infiltrating lymphocytes (CD8+ TILs), and DNA mismatch repair deficiency (MMRd). ARID1A loss was observed in 42% of CCOCs and 25% of ENOCs. We found no associations between ARID1A loss and outcomes, stage, age, or CD8+ TIL status in CCOC. Similarly, we found no association with outcome or stage in endometrioid cases. In ENOC, ARID1A loss was more prevalent in younger patients (p = 0.012) and was associated with MMRd (p < 0.001) and the presence of CD8+ TILs (p = 0.008). Consistent with MMRd being causative of ARID1A mutations, in a subset of ENOCs we also observed an association with ARID1A loss-of-function mutation as a result of small indels (p = 0.035, versus single nucleotide variants). In ENOC, the association with ARID1A loss, CD8+ TILs, and age appears confounded by MMRd status. Although this observation does not explicitly rule out a role for ARID1A influence on CD8+ TIL infiltration in ENOC, given current knowledge regarding MMRd, it seems more likely that effects are dominated by the hypermutation phenotype. This large dataset with consistently applied biomarker assessment now provides a benchmark for the prevalence of ARID1A loss-of-function mutations in endometriosis-associated ovarian cancers and brings clarity to the prognostic significance. © 2021 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Karolin Heinze
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Tayyebeh M. Nazeran
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Sandra Lee
- University of Calgary, Department of Pathology and Laboratory Medicine, Calgary, AB, Canada
| | - Pauline Krämer
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
- University Hospital Tübingen, Department of Women’s Health, Tübingen, Germany
| | - Evan S. Cairns
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
| | - Derek S. Chiu
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Samuel C.Y. Leung
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Eun Young Kang
- University of Calgary, Department of Pathology and Laboratory Medicine, Calgary, AB, Canada
| | - Nicola S. Meagher
- University of New South Wales, Adult Cancer Program, Lowy Cancer Research Centre, Sydney, New South Wales, Australia
- University of New South Wales, School of Women’s and Children’s Health, Sydney, New South Wales, Australia
| | - Catherine J. Kennedy
- The University of Sydney, Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Westmead Hospital, Department of Gynaecological Oncology, Sydney, New South Wales, Australia
| | - Jessica Boros
- The University of Sydney, Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Westmead Hospital, Department of Gynaecological Oncology, Sydney, New South Wales, Australia
| | - Friedrich Kommoss
- Medizin Campus Bodensee, Institute of Pathology, Friedrichshafen, Germany
| | - Hans-Walter Vollert
- Medizin Campus Bodensee, Department of Gynecology and Obstetrics, Friedrichshafen, Germany
| | - Florian Heitze
- Kliniken Essen Mitte, Department of Gynecology and Gynecologic Oncology, Essen, Germany
| | - Andreas du Bois
- Kliniken Essen Mitte, Department of Gynecology and Gynecologic Oncology, Essen, Germany
| | - Philipp Harter
- Kliniken Essen Mitte, Department of Gynecology and Gynecologic Oncology, Essen, Germany
| | - Marcel Grube
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
- University Hospital Tübingen, Department of Women’s Health, Tübingen, Germany
| | - Bernhard Kraemer
- University Hospital Tübingen, Department of Women’s Health, Tübingen, Germany
| | - Annette Staebler
- University Hospital Tübingen, Institute of Pathology and Neuropathology, Tübingen, Germany
| | - Felix K.F. Kommoss
- University Hospital Heidelberg, Institute of Pathology, Heidelberg, Germany
| | - Sabine Heublein
- University Hospital Heidelberg and National Center for Tumor Diseases, Department of Obstetrics and Gynecology, Heidelberg, Germany
| | - Hans-Peter Sinn
- University Hospital Heidelberg, Institute of Pathology, Heidelberg, Germany
| | - Naveena Singh
- Barts Health National Health Service Trust, Department of Pathology, London, UK
| | - Angela Laslavic
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, PA, USA
| | - Esther Elishaev
- University of Pittsburgh School of Medicine, Department of Pathology, PA, USA
| | - Alex Olawaiye
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, PA, USA
| | - Kirsten Moysich
- Roswell Park Cancer Institute, Department of Cancer Prevention and Control, Buffalo, NY, USA
| | - Francesmary Modugno
- University of Pittsburgh School of Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, PA, USA
| | - Raghwa Sharma
- Westmead Hospital, Tissue Pathology and Diagnostic Oncology, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
- Western Sydney University, Sydney, New South Wales, Australia
| | - Alison H. Brand
- Westmead Hospital, Department of Gynaecological Oncology, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Paul R. Harnett
- Westmead Hospital, Department of Gynaecological Oncology, Sydney, New South Wales, Australia
- Westmead Hospital, Crown Princess Mary Cancer Centre, Sydney, New South Wales, Australia
| | - Anna DeFazio
- The University of Sydney, Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- Westmead Hospital, Department of Gynaecological Oncology, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Renée T. Fortner
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Jan Lubinski
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Centre, Szczecin, Poland
| | - Marcin Lener
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Centre, Szczecin, Poland
| | - Aleksandra Tołoczko-Grabarek
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Centre, Szczecin, Poland
| | - Cezary Cybulski
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Centre, Szczecin, Poland
| | - Helena Gronwald
- Pomeranian Medical University, Department of Propaedeutics, Physical Diagnostics and Dental Physiotherapy, Szczecin, Poland
| | - Jacek Gronwald
- Pomeranian Medical University, Department of Genetics and Pathology, International Hereditary Cancer Centre, Szczecin, Poland
| | - Penny Coulson
- The Institute of Cancer Research, Division of Genetics and Epidemiology, London, UK
| | - Mona A El-Bahrawy
- Imperial College London, Department of Metabolism, Digestion and Reproduction, Hammersmith Hospital, London, UK
| | - Michael E. Jones
- The Institute of Cancer Research, Division of Genetics and Epidemiology, London, UK
| | - Minouk J. Schoemaker
- The Institute of Cancer Research, Division of Genetics and Epidemiology, London, UK
| | - Anthony J. Swerdlow
- The Institute of Cancer Research, Division of Genetics and Epidemiology, London, UK
- The Institute of Cancer Research, Division of Breast Cancer Research, London, UK
| | - Kylie L. Gorringe
- The University of Melbourne, Sir Peter MacCallum Department of Oncology, Melbourne, Australia
- Peter MacCallum Cancer Centre, Women’s Cancer Program, Melbourne, Australia
| | - Ian Campbell
- The University of Melbourne, Sir Peter MacCallum Department of Oncology, Melbourne, Australia
- Peter MacCallum Cancer Centre, Cancer Genetics Laboratory, Research Division, Melbourne, Australia
| | - Linda Cook
- The University of New Mexico, Division of Epidemiology and Biostatistics, Albuquerque, NM, USA
| | - Simon A. Gayther
- Cedars-Sinai Medical Center, Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Los Angeles, CA, USA
| | - Michael E. Carney
- John A. Burns School of Medicine, University of Hawaii, Honolulu, Department of Obstetrics and Gynecology, HI, USA
| | - Yurii B. Shvetsov
- University of Hawaii Cancer Center, Epidemiology Program, Honolulu, HI, USA
| | | | - Lynne R. Wilkens
- University of Hawaii Cancer Center, Epidemiology Program, Honolulu, HI, USA
| | - Marc T. Goodman
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Los Angeles, CA, USA
| | - Constantina Mateoiu
- Sahlgrenska Academy at Gothenburg University, Sahlgrenska Center for Cancer Research, Department of Obstetrics and Gynecology, Gothenburg, Sweden
| | - Anna Linder
- Sahlgrenska Academy at Gothenburg University, Sahlgrenska Center for Cancer Research, Department of Obstetrics and Gynecology, Gothenburg, Sweden
| | - Karin Sundfeldt
- Sahlgrenska Academy at Gothenburg University, Sahlgrenska Center for Cancer Research, Department of Obstetrics and Gynecology, Gothenburg, Sweden
| | - Linda E. Kelemen
- Medical University of South Carolina, Hollings Cancer Center and Department of Public Health Sciences, Charleston, SC, USA
| | - Aleksandra Gentry-Maharaj
- University College London, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
- University College London, Department of Women’s Cancer, Institute for Women’s Health, London, UK
| | | | - Usha Menon
- University College London, MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, London, UK
| | - Kelly L. Bolton
- Washington University School of Medicine, Department of Hematology and Oncology, Division of Oncology, St. Louis, MO, USA
| | - Jennifer Alsop
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
| | - Mitul Shah
- Addenbrookes Hospital, Department of Histopathology, Cambridge, UK
| | | | - Paul D.P. Pharoah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge, UK
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge, UK
| | - James D. Brenton
- University of Cambridge, Cancer Research UK Cambridge Institute, Cambridge, UK
| | - Kara L. Cushing-Haugen
- Fred Hutchinson Cancer Research Center, Program in Epidemiology, Division of Public Health Sciences, Seattle, WA, USA
| | - Holly R. Harris
- Fred Hutchinson Cancer Research Center, Program in Epidemiology, Division of Public Health Sciences, Seattle, WA, USA
| | - Jennifer A. Doherty
- University of Utah, Huntsman Cancer Institute, Department of Population Health Sciences, Salt Lake City, UT, USA
| | - Blake Gilks
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Prafull Ghatage
- University of Calgary, Department of Oncology, Division of Gynecologic Oncology, Calgary, AB, Canada
| | - David G. Huntsman
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Gregg S. Nelson
- University of Calgary, Department of Oncology, Division of Gynecologic Oncology, Calgary, AB, Canada
| | - Anna V. Tinker
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
- University of British Columbia, Department of Medicine, Vancouver, BC, Canada
| | - Cheng-Han Lee
- University of Alberta, Department of Laboratory Medicine and Pathology, Edmonton, AB, Canada
| | - Ellen L. Goode
- Mayo Clinic, Department of Health Science Research, Division of Epidemiology, Rochester, MN, USA
| | - Brad H. Nelson
- Trev & Joyce Deeley Research Centre, British Columbia Cancer Agency, Victoria, BC, Canada
| | - Susan J. Ramus
- University of New South Wales, Adult Cancer Program, Lowy Cancer Research Centre, Sydney, New South Wales, Australia
- University of New South Wales, School of Women’s and Children’s Health, Sydney, New South Wales, Australia
| | - Stefan Kommoss
- University Hospital Tübingen, Department of Women’s Health, Tübingen, Germany
| | - Aline Talhouk
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
| | - Martin Köbel
- University of Calgary, Department of Pathology and Laboratory Medicine, Calgary, AB, Canada
| | - Michael S. Anglesio
- University of British Columbia, Department of Obstetrics and Gynecology, Vancouver, BC, Canada
- University of British Columbia, Vancouver General Hospital, and BC Cancer. British Columbia’s Gynecological Cancer Research Team (OVCARE), Vancouver, BC, Canada
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33
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Kang EY, Millstein J, Popovic G, Meagher NS, Bolithon A, Talhouk A, Chiu DS, Anglesio MS, Leung B, Tang K, Lambie N, Pavanello M, Da-Anoy A, Lambrechts D, Loverix L, Olbrecht S, Bisinotto C, Garcia-Donas J, Ruiz-Llorente S, Yagüe-Fernandez M, Edwards RP, Elishaev E, Olawaiye A, Taylor S, Ataseven B, du Bois A, Harter P, Lester J, Høgdall CK, Armasu SM, Huang Y, Vierkant RA, Wang C, Winham SJ, Heublein S, Kommoss FKF, Cramer DW, Sasamoto N, van-Wagensveld L, Lycke M, Mateoiu C, Joseph J, Pike MC, Odunsi K, Tseng CC, Pearce CL, Bilic S, Conrads TP, Hartmann A, Hein A, Jones ME, Leung Y, Beckmann MW, Ruebner M, Schoemaker MJ, Terry KL, El-Bahrawy MA, Coulson P, Etter JL, LaVigne-Mager K, Andress J, Grube M, Fischer A, Neudeck N, Robertson G, Farrell R, Barlow E, Quinn C, Hettiaratchi A, Casablanca Y, Erber R, Stewart CJR, Tan A, Yu Y, Boros J, Brand AH, Harnett PR, Kennedy CJ, Nevins N, Morgan T, Fasching PA, Vergote I, Swerdlow AJ, Candido Dos Reis FJ, Maxwell GL, Neuhausen SL, Barquin-Garcia A, Modugno F, Moysich KB, Crowe PJ, Hirasawa A, Heitz F, Karlan BY, Goode EL, Sinn P, Horlings HM, Høgdall E, Sundfeldt K, Kommoss S, Staebler A, Wu AH, Cohen PA, DeFazio A, Lee CH, Steed H, Le ND, Gayther SA, Lawrenson K, Pharoah PDP, Konecny G, Cook LS, Ramus SJ, Kelemen LE, Köbel M. MCM3 is a novel proliferation marker associated with longer survival for patients with tubo-ovarian high-grade serous carcinoma. Virchows Arch 2022; 480:855-871. [PMID: 34782936 PMCID: PMC9035053 DOI: 10.1007/s00428-021-03232-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/19/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022]
Abstract
Tubo-ovarian high-grade serous carcinomas (HGSC) are highly proliferative neoplasms that generally respond well to platinum/taxane chemotherapy. We recently identified minichromosome maintenance complex component 3 (MCM3), which is involved in the initiation of DNA replication and proliferation, as a favorable prognostic marker in HGSC. Our objective was to further validate whether MCM3 mRNA expression and possibly MCM3 protein levels are associated with survival in patients with HGSC. MCM3 mRNA expression was measured using NanoString expression profiling on formalin-fixed and paraffin-embedded tissue (N = 2355 HGSC) and MCM3 protein expression was assessed by immunohistochemistry (N = 522 HGSC) and compared with Ki-67. Kaplan-Meier curves and the Cox proportional hazards model were used to estimate associations with survival. Among chemotherapy-naïve HGSC, higher MCM3 mRNA expression (one standard deviation increase in the score) was associated with longer overall survival (HR = 0.87, 95% CI 0.81-0.92, p < 0.0001, N = 1840) in multivariable analysis. MCM3 mRNA expression was highest in the HGSC C5.PRO molecular subtype, although no interaction was observed between MCM3, survival and molecular subtypes. MCM3 and Ki-67 protein levels were significantly lower after exposure to neoadjuvant chemotherapy compared to chemotherapy-naïve tumors: 37.0% versus 46.4% and 22.9% versus 34.2%, respectively. Among chemotherapy-naïve HGSC, high MCM3 protein levels were also associated with significantly longer disease-specific survival (HR = 0.52, 95% CI 0.36-0.74, p = 0.0003, N = 392) compared to cases with low MCM3 protein levels in multivariable analysis. MCM3 immunohistochemistry is a promising surrogate marker of proliferation in HGSC.
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Affiliation(s)
- Eun Young Kang
- Department of Pathology and Laboratory Medicine, Foothills Medical Center, University of Calgary, Calgary, AB, Canada
| | - Joshua Millstein
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Gordana Popovic
- Mark Wainwright Analytical Centre, Stats Central, University of New South Wales Sydney, Sydney, Australia
| | - Nicola S Meagher
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Adelyn Bolithon
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Aline Talhouk
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Derek S Chiu
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, BC, Canada
| | - Michael S Anglesio
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
- Histopathology/ISH Core Facility, Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Betty Leung
- Prince of Wales Clinical School, University of NSW Sydney, Sydney, NSW, Australia
| | - Katrina Tang
- Department of Anatomical Pathology, Prince of Wales Hospital, Sydney, Australia
| | - Neil Lambie
- NSW Health Pathology, Prince of Wales Hospital, Sydney, Australia
| | - Marina Pavanello
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
| | - Annalyn Da-Anoy
- Department of Pathology and Laboratory Medicine, Foothills Medical Center, University of Calgary, Calgary, AB, Canada
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Liselore Loverix
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Siel Olbrecht
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Christiani Bisinotto
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jesus Garcia-Donas
- HM Sanchinarro Centro Integral Oncológico Clara Campal, University Hospital, Madrid, Spain
| | - Sergio Ruiz-Llorente
- HM Sanchinarro Centro Integral Oncológico Clara Campal, University Hospital, Madrid, Spain
| | - Monica Yagüe-Fernandez
- HM Sanchinarro Centro Integral Oncológico Clara Campal, University Hospital, Madrid, Spain
| | - Robert P Edwards
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alexander Olawaiye
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Sarah Taylor
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Beyhan Ataseven
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen, Germany
- Department of Gynecology and Obstetrics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andreas du Bois
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen, Germany
- Department of Gynecology and Gynecological Oncology, Dr. Horst-Schmidt Klinik Wiesbaden, Wiesbaden, Germany
| | - Philipp Harter
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen, Germany
- Department of Gynecology and Gynecological Oncology, Dr. Horst-Schmidt Klinik Wiesbaden, Wiesbaden, Germany
| | - Jenny Lester
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Claus K Høgdall
- Department of Gynaecology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Sebastian M Armasu
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Yajue Huang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Robert A Vierkant
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Chen Wang
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Stacey J Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Sabine Heublein
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix K F Kommoss
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Daniel W Cramer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Naoko Sasamoto
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lilian van-Wagensveld
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Maria Lycke
- Department of Obstetrics and Gynecology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Constantina Mateoiu
- Department of Pathology and Cytology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Janine Joseph
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Malcolm C Pike
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Kunle Odunsi
- Department of Oncology, University of Chicago, Chicago, IL, USA
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
| | - Chiu-Chen Tseng
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Celeste L Pearce
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Sanela Bilic
- Department of Gynaecological Oncology, St John of God Subiaco Hospital, Subiaco, Australia
| | - Thomas P Conrads
- Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen-Nürnberg, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Yee Leung
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA, Australia
- Department of Gynaecological Oncology, King Edward Memorial Hospital, Subiaco, Australia
- Australia New Zealand Gynaecological Oncology Group, Camperdown, Australia
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Kathryn L Terry
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Mona A El-Bahrawy
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Penny Coulson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - John L Etter
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Juergen Andress
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Marcel Grube
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Anna Fischer
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Nina Neudeck
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Greg Robertson
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- St George Private Hospital, Kogarah, Australia
| | | | - Ellen Barlow
- Gynaecological Cancer Centre, Royal Hospital for Women, Sydney, Australia
| | - Carmel Quinn
- Mark Wainwright Analytical Centre, Stats Central, University of New South Wales Sydney, Sydney, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
- Prince of Wales Clinical School, University of NSW Sydney, Sydney, NSW, Australia
- Translational Cancer Research Network, University of New South Wales Sydney, Sydney, Australia
- UNSW Biorepository, Mark Wainwright Analytical Centre, University of New South Wales Sydney, Sydney, Australia
| | - Anusha Hettiaratchi
- UNSW Biorepository, Mark Wainwright Analytical Centre, University of New South Wales Sydney, Sydney, Australia
| | - Yovanni Casablanca
- Uniformed Services University of the Health Sciences, USAF, Bethesda, MD, USA
| | - Ramona Erber
- Institute of Pathology, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen-Nürnberg, Germany
| | - Colin J R Stewart
- School for Women's and Infants' Health, University of Western Australia, Perth, Australia
| | - Adeline Tan
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA, Australia
- Western Women's Pathology, Western Diagnostic Pathology, Wembley, Australia
| | - Yu Yu
- School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
| | - Jessica Boros
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Alison H Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Paul R Harnett
- The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, Australia
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Nikilyn Nevins
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, Australia
| | - Terry Morgan
- Department of Pathology, Oregon Health & Science University, Portland, OR, USA
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Ignace Vergote
- Division of Gynecologic Oncology, Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - G Larry Maxwell
- Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | | | - Francesmary Modugno
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Philip J Crowe
- Prince of Wales Clinical School, University of NSW Sydney, Sydney, NSW, Australia
| | - Akira Hirasawa
- Department of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte (KEM), Essen, Germany
- Department of Gynecology and Gynecological Oncology, Dr. Horst-Schmidt Klinik Wiesbaden, Wiesbaden, Germany
- Department for Gynecology with the Center for Oncologic Surgery, Charité Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Beth Y Karlan
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Peter Sinn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hugo M Horlings
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Estrid Høgdall
- Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Pathology, Molecular Unit, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Sahlgrenska Center for Cancer Research, Gothenburg University, Gothenburg, Sweden
| | - Stefan Kommoss
- Department of Women's Health, Tübingen University Hospital, Tübingen, Germany
| | - Annette Staebler
- Institute of Pathology, Tübingen University Hospital, Tübingen, Germany
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Paul A Cohen
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, WA, Australia
- Bendat Family Comprehensive Cancer Centre, St John of God Subiaco Hospital, Subiaco, WA, Australia
| | - Anna DeFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
- The Crown Princess Mary Cancer Centre Westmead, Sydney-West Cancer Network, Westmead Hospital, Sydney, NSW, Australia
- The University of Sydney, Sydney, Australia
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Nhu D Le
- Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Simon A Gayther
- Center for Bioinformatics and Functional Genomics and the Cedars Sinai Genomics Core, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Kate Lawrenson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women's Cancer Program at the Samuel Oschin Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Paul D P Pharoah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK
| | - Gottfried Konecny
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Linda S Cook
- School of Public Health, University of Colorado, Aurora, CO, USA
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Susan J Ramus
- School of Women's and Children's Health, Faculty of Medicine, University of NSW Sydney, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of NSW Sydney, Sydney, NSW, Australia
| | - Linda E Kelemen
- Bureau of Population Health Data Analytics & Informatics, South Carolina Department of Health and Environmental Control, Columbia, SC, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, Foothills Medical Center, University of Calgary, Calgary, AB, Canada.
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Wiedemeyer K, Wang L, Kang EY, Liu S, Ou Y, Kelemen LE, Feil L, Anglesio MS, Glaze S, Ghatage P, Nelson GS, Köbel M. Prognostic and Theranostic Biomarkers in Ovarian Clear Cell Carcinoma. Int J Gynecol Pathol 2022; 41:168-179. [PMID: 33770057 DOI: 10.1097/pgp.0000000000000780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In this study, we aimed to test whether prognostic biomarkers can achieve a clinically relevant stratification of patients with stage I ovarian clear cell carcinoma (OCCC) and to survey the expression of 10 selected actionable targets (theranostic biomarkers) in stage II to IV cases. From the population-based Alberta Ovarian Tumor Type study, 160 samples of OCCC were evaluated by immunohistochemistry and/or silver-enhanced in situ hybridization for the status of 5 prognostic (p53, p16, IGF2BP3, CCNE1, FOLR1) and 10 theranostic biomarkers (ALK, BRAF V600E, ERBB2, ER, MET, MMR, PR, ROS1, NTRK1-3, VEGFR2). Kaplan-Meier survival analyses were performed. Cases with abnormal p53 or combined p16/IFG2BP3 abnormal expression identified a small subset of patients (6/54 cases) with stage I OCCC with an aggressive course (5-yr ovarian cancer-specific survival of 33.3%, compared with 91.5% in the other stage I cases). Among theranostic targets, ERBB2 amplification was present in 11/158 (7%) of OCCC, while MET was ubiquitously expressed in OCCC similar to a variety of normal control tissues. ER/PR showed a low prevalence of expression. No abnormal expression was detected for any of the other targets. We propose a combination of 3 biomarkers (p53, p16, IGF2BP3) to predict prognosis and the potential need for adjuvant therapy for patients with stage I OCCC. This finding requires replication in larger cohorts. In addition, OCCC could be tested for ERBB2 amplification for inclusion in gynecological basket trials targeting this alteration.
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Kommoss FK, Tessier-Cloutier B, Witkowski L, Forgo E, Koelsche C, Köbel M, Foulkes WD, Lee CH, Kolin DL, von Deimling A, Howitt BE. Cellular context determines DNA methylation profiles in SWI/SNF-deficient cancers of the gynecologic tract. J Pathol 2022; 257:140-145. [PMID: 35218556 DOI: 10.1002/path.5889] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/23/2022] [Accepted: 02/24/2022] [Indexed: 11/06/2022]
Abstract
SWI/SNF (SWItch/Sucrose Non-Fermentable) complex deficiency has been reported in a wide variety of cancers and is often associated with an undifferentiated phenotype. In the gynecologic tract SWI/SNF deficient cancers are diagnostically challenging and little is known about their cellular origins. Here we show that undifferentiated endometrial carcinoma (UDEC), SMARCA4-deficient uterine sarcoma (SDUS) and ovarian small cell carcinoma, hypercalcemic type (SCCOHT) harbor distinct DNA methylation signatures despite shared morphology and SWI/SNF inactivation. Our results indicate that cellular context is an important determinant of the epigenetic landscape, even in the setting of core SWI/SNF deficiency, and therefore methylation profiling may represent a useful diagnostic tool in undifferentiated, SWI/SNF-deficient cancers. Furthermore, applying copy number analyses and group-wise differential methylation analyses including endometrioid endometrial carcinomas and extracranial malignant rhabdoid tumors, we uncover analogous molecular features in SDUS and SCCOHT in contrast to UDEC. These results suggest SDUS and SCCOHT to represent chromosomally stable SWI/SNF deficient cancers of the gynecologic tract, which are within the broader spectrum of malignant rhabdoid tumors. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Felix Kf Kommoss
- Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Leora Witkowski
- Department of Human Genetics, McGill University, Montreal, QC, Canada.,Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Erna Forgo
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
| | - Christian Koelsche
- Department of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Köbel
- Department of Laboratory Medicine and Pathology, University of Calgary, Calgary, AB, Canada
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada.,Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Cheng-Han Lee
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
| | - David L Kolin
- Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital and CCU Neuropathology DKFZ, Heidelberg, Germany
| | - Brooke E Howitt
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA
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Duggan MA, Duan Q, Pfeiffer RM, Brett MA, Lee S, Abubakar M, Köbel M, Rodriguez M, Sar A. Testing Algorithms for the Diagnosis of Malignant Glandular Tumors of the Uterine Cervix Histotyped per the International Endocervical Adenocarcinoma Criteria and Classification (IECC) System. Appl Immunohistochem Mol Morphol 2022; 30:91-98. [PMID: 34799503 PMCID: PMC8857037 DOI: 10.1097/pai.0000000000000988] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 09/28/2021] [Indexed: 02/03/2023]
Abstract
The International Endocervical adenocarcinoma Criteria and Classification (IECC) categorizes tumors into human papilloma virus (HPV) associated (HPVA), not associated (NHPV), and invasive adenocarcinoma not otherwise specified (IA NOS). HPVA and NHPV encompass 11 histotypes and an algorithm of mucin content, HPV ribonucleic acid (RNA), estrogen receptor and GATA3 is proposed for the diagnosis of most. In this study, the IECC algorithm's diagnoses were compared with hematoxylin and eosin (H&E) based IECC histotyping. Kappa statistics measured performance agreement. With additional markers, hierarchical clustering by random forest (RF) classification identified the most discriminating between tumor types, and investigated other algorithms. Three pathologists independently reviewed digitized H&E images of n=152 primary cervical adenocarcinomas for IECC histotype and mucin content, and tissue microarrays for expression of HPV RNA by in situ hybridization and 16 antibodies by immunohistochemistry. Results were finalized by consensus. There were n=113 HPVA, n=22 NHPV, and n=17 IA NOS. Mucin was obvious in n=36 and limited in n=116. Among n=124 with satisfactory test results, HPV RNA was positive in n=96, estrogen receptor in n=72, and GATA3 in n=15. The IECC algorithm diagnosed n=99 which agreed with H&E histotyping in n=64 for a fair κ of 0.36 (95% confidence interval, 0.21-0.50): n=12 were undiagnosed and n=13 were IA NOS. Small sample sizes restricted RF to HPVA versus NHPV which were discriminated by p16, HPV RNA, and MUC6 with an area under the curve of 0.74 (95% confidence interval, 0.58-0.90). The IECC algorithm for histotyping under-performed. The RF algorithmin for categorization was favorable, but validation in larger studies and investigation of additional algorithms to discriminate between all IECC histotypes are needed.
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Affiliation(s)
- Máire A. Duggan
- Departments of Pathology and Laboratory Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, Alberta
| | - Qiuli Duan
- Research Facilitation, Alberta Health Services, Calgary, Alberta, Canada
| | - Ruth M. Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | | | - Sandra Lee
- Departments of Pathology and Laboratory Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, Alberta
| | - Mustapha Abubakar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Martin Köbel
- Departments of Pathology and Laboratory Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, Alberta
| | - Monica Rodriguez
- Departments of Pathology and Laboratory Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, Alberta
| | - Aylin Sar
- Lions Gate Hospital, Vancouver, British Columbia
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Shah VI, Morgan SE, Köbel M, Lee CH, McCluggage WG. Dedifferentiation in Breast Metastasis of Endometrial Carcinoma: A Diagnostic Dilemma. Int J Gynecol Pathol 2022; 41:35-39. [PMID: 33741764 DOI: 10.1097/pgp.0000000000000770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Most breast tumors are primary to this site; breast metastasis of endometrial origin is extremely rare. Low-grade endometrioid endometrial carcinomas can undergo dedifferentiation to undifferentiated carcinoma but such transformation at a metastatic site has been reported previously in only 2 cases. We report a case of dedifferentiation occurring in an isolated solitary breast metastasis of a low-grade endometrioid endometrial carcinoma. A 64-yr-old woman presented with a breast mass 2 yr after initial diagnosis of a grade 1 FIGO stage IIIA endometrioid endometrial carcinoma. Ultrasound guided biopsy of the breast mass showed a grade 1 endometrioid carcinoma which was diffusely estrogen receptor and PAX8-positive, consistent with metastasis from the previous endometrial carcinoma. The tumor initially responded to Letrozole therapy but then abruptly increased in size. Mastectomy revealed a poorly differentiated malignant tumor with morphology and immunophenotype (including loss of ARID1A and ARID1B immunoreactivity) consistent with undifferentiated endometrial carcinoma with no residual low-grade component. Awareness of the phenomenon of dedifferentiation of endometrial carcinoma in a metastatic site is important to avoid misdiagnosis as a primary breast cancer or metastasis from another primary site.
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Cunningham JM, Winham SJ, Wang C, Weiglt B, Fu Z, Armasu SM, McCauley BM, Brand AH, Chiew YE, Elishaev E, Gourley C, Kennedy CJ, Laslavic A, Lester J, Piskorz A, Sekowska M, Brenton JD, Churchman M, DeFazio A, Drapkin R, Elias KM, Huntsman DG, Karlan BY, Köbel M, Konner J, Lawrenson K, Papaemmanuil E, Bolton KL, Modugno F, Goode EL. DNA Methylation Profiles of Ovarian Clear Cell Carcinoma. Cancer Epidemiol Biomarkers Prev 2022; 31:132-141. [PMID: 34697060 PMCID: PMC8755592 DOI: 10.1158/1055-9965.epi-21-0677] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/18/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Ovarian clear cell carcinoma (OCCC) is a rare ovarian cancer histotype that tends to be resistant to standard platinum-based chemotherapeutics. We sought to better understand the role of DNA methylation in clinical and biological subclassification of OCCC. METHODS We interrogated genome-wide methylation using DNA from fresh frozen tumors from 271 cases, applied nonsmooth nonnegative matrix factorization (nsNMF) clustering, and evaluated clinical associations and biological pathways. RESULTS Two approximately equally sized clusters that associated with several clinical features were identified. Compared with Cluster 2 (N = 137), Cluster 1 cases (N = 134) presented at a more advanced stage, were less likely to be of Asian ancestry, and tended to have poorer outcomes including macroscopic residual disease following primary debulking surgery (P < 0.10). Subset analyses of targeted tumor sequencing and IHC data revealed that Cluster 1 tumors showed TP53 mutation and abnormal p53 expression, and Cluster 2 tumors showed aneuploidy and ARID1A/PIK3CA mutation (P < 0.05). Cluster-defining CpGs included 1,388 CpGs residing within 200 bp of the transcription start sites of 977 genes; 38% of these genes (N = 369 genes) were differentially expressed across cluster in transcriptomic subset analysis (P < 10-4). Differentially expressed genes were enriched for six immune-related pathways, including IFNα and IFNγ responses (P < 10-6). CONCLUSIONS DNA methylation clusters in OCCC correlate with disease features and gene expression patterns among immune pathways. IMPACT This work serves as a foundation for integrative analyses that better understand the complex biology of OCCC in an effort to improve potential for development of targeted therapeutics.
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Affiliation(s)
- Julie M Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
| | - Stacey J Winham
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Chen Wang
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Britta Weiglt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Zhuxuan Fu
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Sebastian M Armasu
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Bryan M McCauley
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Alison H Brand
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Yoke-Eng Chiew
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Esther Elishaev
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Charlie Gourley
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Catherine J Kennedy
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Angela Laslavic
- Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania
| | - Jenny Lester
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Anna Piskorz
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Magdalena Sekowska
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Michael Churchman
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Anna DeFazio
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
| | - Ronny Drapkin
- Penn Ovarian Cancer Research Center, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | | | - David G Huntsman
- British Columbia's Ovarian Cancer Research (OVCARE) Program, BC Cancer, Vancouver General Hospital, and University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, British Columbia, Canada
| | - Beth Y Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, California
| | - Martin Köbel
- Department of Laboratory and Pathology Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jason Konner
- Weill Cornell Medical College of Cornell University, New York, New York
- Department of Medicine, Washington University, St. Louis, Missouri
| | - Kate Lawrenson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Women's Cancer Program at the Samuel Oschin Cancer Institute Cedars-Sinai Medical Center, Los Angeles, California
| | - Elli Papaemmanuil
- Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kelly L Bolton
- Department of Medicine, Washington University, St. Louis, Missouri
| | - Francesmary Modugno
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Womens Cancer Research Center, Magee-Womens Research Institute and Hillman Cancer Center, Pittsburgh, Pennsylvania
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Ellen L Goode
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
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Wang L, Piskorz A, Bosse T, Jimenez-Linan M, Rous B, Gilks CB, Brenton JD, Singh N, Köbel M. Immunohistochemistry and Next-generation Sequencing Are Complementary Tests in Identifying PTEN Abnormality in Endometrial Carcinoma Biopsies. Int J Gynecol Pathol 2022; 41:12-19. [PMID: 33720084 DOI: 10.1097/pgp.0000000000000763] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PTEN plays a central role in the pathogenesis of endometrial carcinoma. Previous studies reported a high interobserver reproducibility for the interpretation of PTEN immunohistochemistry (IHC). However, PTEN IHC and its interpretation remain challenging during laboratory practice. The purpose of this study was to reevaluate PTEN IHC pattern in direct comparison to next-generation sequencing in identifying PTEN abnormality. IHC and tagged-amplicon next-generation sequencing PTEN sequencing was performed on 182 endometrial carcinoma biopsy/curetting samples from five centers (Barts, Calgary, Cambridge, Leiden, and Vancouver). Sensitivity, specificity and accuracy of PTEN IHC to predict loss of function PTEN mutations were calculated. Abnormalities of PTEN in association with histotype and molecular subtype were assessed. A total of 5 PTEN IHC patterns were recorded: absent, subclonal loss, equivocal, reduced (relative to internal control) and retained. The absence of PTEN IHC has a sensitivity of 75.4% (95% confidence interval: 62.7-85.5%), a specificity of 84.6% (95% confidence interval: 76.2%-90.9%), and accuracy of 81.2% (95% confidence interval: 74.4%-86.9%) in predicting loss of function PTEN mutation. PTEN abnormality by complementary interpretation of both assays was present in 91.9% of endometrial endometrioid carcinoma, grade 1, and significantly higher in endometrial endometrioid carcinomas of all grades compared with endometrial serous carcinoma (80.0% vs. 19.4%, P<0.0001). PTEN abnormalities are common across all molecular subtypes of endometrioid carcinomas. Our data support the use of ancillary PTEN IHC for diagnostic purposes in endometrial neoplasms. However, for clinical trial design complementary testing of both IHC and sequencing of PTEN should be considered to assess the PTEN status in endometrial carcinomas.
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40
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Rodriguez M, Kang EY, Farrington K, Cook LS, Le ND, Karnezis AN, Lee CH, Nelson GS, Terzic T, Lee S, Köbel M. Accurate Distinction of Ovarian Clear Cell From Endometrioid Carcinoma Requires Integration of Phenotype, Immunohistochemical Predictions, and Genotype: Implications for Lynch Syndrome Screening. Am J Surg Pathol 2021; 45:1452-1463. [PMID: 34534137 DOI: 10.1097/pas.0000000000001798] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Ovarian clear cell carcinoma (OCCC) and ovarian endometrioid carcinoma (OEC) are both associated with endometriosis but differ in histologic phenotype, biomarker profile, and survival. Our objectives were to refine immunohistochemical (IHC) panels that help distinguish the histotypes and reassess the prevalence of mismatch repair deficiency (MMRd) in immunohistochemically confirmed OCCC. We selected 8 candidate IHC markers to develop first-line and second-line panels in a training set of 344 OCCC/OEC cases. Interobserver reproducibility of histotype diagnosis was assessed in an independent testing cohort of 100 OCC/OEC initially without and subsequently with IHC. The prevalence of MMRd was evaluated using the testing cohort and an expansion set of 844 ovarian carcinomas. The 2 prototypical combinations (OCCC: Napsin A+/HNF1B diffusely+/PR-; OEC: Napsin A-/HNF1B nondiffuse/PR+) occurred in 75% of cases and were 100% specific. A second-line panel (ELAPOR1, AMACR, CDX2) predicted the remaining cases with 83% accuracy. Integration of IHC improved interobserver reproducibility (κ=0.778 vs. 0.882, P<0.0001). The prevalence of MMRd was highest in OEC (11.5%, 44/383), lower in OCCC (1.7%, 5/297), and high-grade serous carcinomas (0.7%, 5/699), and absent in mucinous (0/126) and low-grade serous carcinomas (0/50). All 5 MMRd OCCC were probable Lynch syndrome cases with prototypical IHC profile but ambiguous morphologic features: 3/5 with microcystic architecture and 2/5 with intratumoral stromal inflammation. Integration of first-line and second-line IHC panels increases diagnostic precision and enhances prognostication and triaging for predisposing/predictive molecular biomarker testing. Our data support universal Lynch syndrome screening in all patients with OEC when the diagnosis of other histotypes has been vigorously excluded.
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Affiliation(s)
| | | | | | - Linda S Cook
- Division of Epidemiology, Biostatistics and Preventative Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM
| | - Nhu D Le
- Cancer Control Research, BC Cancer Agency
| | - Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of California Davis, Davis, CA
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, BC, Canada
| | - Gregg S Nelson
- Division of Gynecologic Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB
| | | | - Sandra Lee
- Department of Pathology, University of Calgary
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41
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Aubrey C, Mal H, Köbel M, Lee CH, Turashvili G, Yip S, Lum A, Nelson G. Protracted clinical course of an AFF1 fusion positive uterine smooth muscle tumor causing diagnostic confusion over a course of 15 years. Gynecol Oncol Rep 2021; 38:100890. [PMID: 34926770 PMCID: PMC8651790 DOI: 10.1016/j.gore.2021.100890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 12/04/2022] Open
Abstract
Histologic diagnostic criteria alone for uterine smooth muscle tumors lacks robust prognostication. Molecular/genetic techniques should be advocated to further investigate unusual case presentations. Novel identification of a PTP4A2-AFF1 genetic fusion was identified. The novel PTP4A2-AFF1 genetic fusion may have further diagnostic prognostic, and therapeutic implications.
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42
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Kang EY, Wiebe NJ, Aubrey C, Lee CH, Anglesio MS, Tilley D, Ghatage P, Nelson GS, Lee S, Köbel M. Selection of endometrial carcinomas for p53 immunohistochemistry based on nuclear features. J Pathol Clin Res 2021; 8:19-32. [PMID: 34596362 PMCID: PMC8682942 DOI: 10.1002/cjp2.243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/16/2021] [Accepted: 09/01/2021] [Indexed: 01/18/2023]
Abstract
The World Health Organization endorses molecular subclassification of endometrial endometrioid carcinomas (EECs). Our objectives were to test the sensitivity of tumor morphology in capturing p53 abnormal (p53abn) cases and to model the impact of p53abn on changes to ESGO/ESTRO/ESP (European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology) risk stratification. A total of 292 consecutive endometrial carcinoma resections received at Foothills Medical Centre, Calgary, Canada (2019–2021) were retrieved and assigned to ESGO risk groups with and without p53 status. Three pathologists reviewed the representative H&E‐stained slides, predicted the p53 status, and indicated whether p53 immunohistochemistry (IHC) would be ordered. Population‐based survival for endometrial carcinomas diagnosed during 2008–2016 in Alberta was obtained from the Alberta Cancer Registry. The cohort consisted mostly of grade 1/2 endometrioid carcinomas (EEC1/2; N = 218, 74.6%). One hundred and fifty‐two EEC1/2 (52.1% overall) were stage IA and 147 (50.3%) were low risk by ESGO. The overall prevalence of p53abn and subclonal p53 was 14.5 and 8.3%, respectively. The average sensitivity of predicting p53abn among observers was 83.6%. Observers requested p53 IHC for 39.4% with 98.5% sensitivity to detect p53abn (99.6% negative predictive value). Nuclear features including smudged chromatin, pleomorphism, atypical mitoses, and tumor giant cells accurately predicted p53abn. In 7/292 (2.4%), p53abn upgraded ESGO risk groups (2 to intermediate risk, 5 to high risk). EEC1/2/stage IA patients had an excellent disease‐specific 5‐year survival of 98.5%. Pathologists can select cases for p53 testing with high sensitivity and low risk of false negativity. Molecular characterization of endometrial carcinomas has great potential to refine ESGO risk classification for a small subset but offers little value for approximately half of endometrial carcinomas, namely, EEC1/2/stage IA cases.
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Affiliation(s)
- Eun Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Nicholas Jp Wiebe
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Christa Aubrey
- Department of Oncology, Division of Gynecologic Oncology, University of Calgary, Calgary, AB, Canada
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, AB, Canada
| | - Michael S Anglesio
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Derek Tilley
- Cancer Control, Alberta Health Services, Holy Cross Center, Calgary, AB, Canada
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, University of Calgary, Calgary, AB, Canada
| | - Gregg S Nelson
- Department of Oncology, Division of Gynecologic Oncology, University of Calgary, Calgary, AB, Canada
| | - Sandra Lee
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
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43
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Boschman J, Farahani H, Darbandsari A, Ahmadvand P, Van Spankeren A, Farnell D, Levine AB, Naso JR, Churg A, Jones SJ, Yip S, Köbel M, Huntsman DG, Gilks CB, Bashashati A. The utility of color normalization for AI-based diagnosis of hematoxylin and eosin-stained pathology images. J Pathol 2021; 256:15-24. [PMID: 34543435 DOI: 10.1002/path.5797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/11/2021] [Accepted: 09/16/2021] [Indexed: 12/17/2022]
Abstract
The color variation of hematoxylin and eosin (H&E)-stained tissues has presented a challenge for applications of artificial intelligence (AI) in digital pathology. Many color normalization algorithms have been developed in recent years in order to reduce the color variation between H&E images. However, previous efforts in benchmarking these algorithms have produced conflicting results and none have sufficiently assessed the efficacy of the various color normalization methods for improving diagnostic performance of AI systems. In this study, we systematically investigated eight color normalization algorithms for AI-based classification of H&E-stained histopathology slides, in the context of using images both from one center and from multiple centers. Our results show that color normalization does not consistently improve classification performance when both training and testing data are from a single center. However, using four multi-center datasets of two cancer types (ovarian and pleural) and objective functions, we show that color normalization can significantly improve the classification accuracy of images from external datasets (ovarian cancer: 0.25 AUC increase, p = 1.6 e-05; pleural cancer: 0.21 AUC increase, p = 1.4 e-10). Furthermore, we introduce a novel augmentation strategy by mixing color-normalized images using three easily accessible algorithms that consistently improves the diagnosis of test images from external centers, even when the individual normalization methods had varied results. We anticipate our study to be a starting point for reliable use of color normalization to improve AI-based, digital pathology-empowered diagnosis of cancers sourced from multiple centers. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Jeffrey Boschman
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Hossein Farahani
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amirali Darbandsari
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Pouya Ahmadvand
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Ashley Van Spankeren
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - David Farnell
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Vancouver General Hospital, Vancouver, BC, Canada
| | - Adrian B Levine
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Vancouver General Hospital, Vancouver, BC, Canada
| | - Julia R Naso
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Vancouver General Hospital, Vancouver, BC, Canada
| | - Andrew Churg
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Vancouver General Hospital, Vancouver, BC, Canada
| | - Steven Jm Jones
- British Columbia Cancer Research Center, Vancouver, BC, Canada
| | - Stephen Yip
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Vancouver General Hospital, Vancouver, BC, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, BC, Canada
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Cancer Research Center, Vancouver, BC, Canada
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Vancouver General Hospital, Vancouver, BC, Canada
| | - Ali Bashashati
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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44
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McAlpine JN, Chiu DS, Nout RA, Church DN, Schmidt P, Lam S, Leung S, Bellone S, Wong A, Brucker SY, Lee CH, Clarke BA, Huntsman DG, Bernardini MQ, Ngeow J, Santin AD, Goodfellow P, Levine DA, Köbel M, Kommoss S, Bosse T, Gilks CB, Talhouk A. Evaluation of treatment effects in patients with endometrial cancer and POLE mutations: An individual patient data meta-analysis. Cancer 2021; 127:2409-2422. [PMID: 33793971 DOI: 10.1002/cncr.33516] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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: 01/11/2021] [Revised: 01/29/2021] [Accepted: 02/05/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Endometrial cancers (ECs) with somatic mutations in DNA polymerase epsilon (POLE) are characterized by unfavorable pathological features, which prompt adjuvant treatment. Paradoxically, women with POLE-mutated EC have outstanding clinical outcomes, and this raises concerns of overtreatment. The authors investigated whether favorable outcomes were independent of treatment. METHODS A PubMed search for POLE and endometrial was restricted to articles published between March 1, 2012, and March 1, 2018, that provided individual patient data (IPD), adjuvant treatment, and survival. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines for IPD, the authors used univariate and multivariate one-stage meta-analyses with mixed effects Cox models (random effects for study cohorts) to infer the associations of treatment, traditional prognostic factors, and outcome, which was defined as the time from first diagnosis to any adverse event (progression/recurrence or death from EC). RESULTS Three hundred fifty-nine women with POLE-mutated EC were identified; 294 (82%) had pathogenic mutations. Worse outcomes were demonstrated in patients with nonpathogenic POLE mutations (hazard ratio, 3.42; 95% confidence interval, 1.47-7.58; log-rank P < .01). Except for stage (P < .01), traditional prognosticators were not associated with progression/recurrence or death from disease. Adverse events were rare (11 progressions/recurrences and 3 disease-specific deaths). Salvage rates in patients who experienced recurrence were high and sustained, with 8 of 11 alive without evidence of disease (range, 5.5-14.2 years). Adjuvant treatment was not associated with outcome. CONCLUSIONS Clinical outcomes for ECs with pathogenic POLE mutations are not associated with most traditional risk parameters, and patients do not appear to benefit from adjuvant therapy. The observed low rates of recurrence/progression and the high and sustained salvage rates raise the possibility of safely de-escalating treatment for these patients. LAY SUMMARY Ten percent of all endometrial cancers have mutations in the DNA repair gene DNA polymerase epsilon (POLE). Women who have endometrial cancers with true POLE mutations experience almost no recurrences or deaths from their cancer even when their tumors appear to have very unfavorable characteristics. Additional therapy (radiation and chemotherapy) does not appear to improve outcomes for women with POLE-mutated endometrial cancer, and this supports the move to less therapy and less associated toxicity. Diligent classification of endometrial cancers by molecular features provides valuable information to inform prognosis and to direct treatment/no treatment.
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Affiliation(s)
- Jessica N McAlpine
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
- BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Derek S Chiu
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Remi A Nout
- Department of Clinical Oncology, Leiden University Medical Centre, Leiden, the Netherlands
| | - David N Church
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Pascal Schmidt
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Statistics, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Stephanie Lam
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Samuel Leung
- Genetic Pathology Evaluation Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stefania Bellone
- Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut
| | - Adele Wong
- Department of Pathology and Laboratory Medicine, KK Women and Children's Hospital, Kallang, Singapore
| | - Sara Y Brucker
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - Cheng Han Lee
- BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Blaise A Clarke
- Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - David G Huntsman
- BC Cancer Agency, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marcus Q Bernardini
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Joanne Ngeow
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Alessandro D Santin
- Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut
| | - Paul Goodfellow
- Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Douglas A Levine
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York City, New York
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Stefan Kommoss
- Department of Women's Health, University of Tübingen, Tübingen, Germany
| | - Tjalling Bosse
- Department of Pathology, Leiden University Medical Centre, Leiden, the Netherlands
| | - C Blake Gilks
- BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Aline Talhouk
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada
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45
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Kar SP, Considine DP, Tyrer JP, Plummer JT, Chen S, Dezem FS, Barbeira AN, Rajagopal PS, Rosenow WT, Moreno F, Bodelon C, Chang-Claude J, Chenevix-Trench G, deFazio A, Dörk T, Ekici AB, Ewing A, Fountzilas G, Goode EL, Hartman M, Heitz F, Hillemanns P, Høgdall E, Høgdall CK, Huzarski T, Jensen A, Karlan BY, Khusnutdinova E, Kiemeney LA, Kjaer SK, Klapdor R, Köbel M, Li J, Liebrich C, May T, Olsson H, Permuth JB, Peterlongo P, Radice P, Ramus SJ, Riggan MJ, Risch HA, Saloustros E, Simard J, Szafron LM, Titus L, Thompson CL, Vierkant RA, Winham SJ, Zheng W, Doherty JA, Berchuck A, Lawrenson K, Im HK, Manichaikul AW, Pharoah PD, Gayther SA, Schildkraut JM. Pleiotropy-guided transcriptome imputation from normal and tumor tissues identifies candidate susceptibility genes for breast and ovarian cancer. HGG Adv 2021; 2:100042. [PMID: 34317694 PMCID: PMC8312632 DOI: 10.1016/j.xhgg.2021.100042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/04/2021] [Indexed: 12/12/2022] Open
Abstract
Familial, sequencing, and genome-wide association studies (GWASs) and genetic correlation analyses have progressively unraveled the shared or pleiotropic germline genetics of breast and ovarian cancer. In this study, we aimed to leverage this shared germline genetics to improve the power of transcriptome-wide association studies (TWASs) to identify candidate breast cancer and ovarian cancer susceptibility genes. We built gene expression prediction models using the PrediXcan method in 681 breast and 295 ovarian tumors from The Cancer Genome Atlas and 211 breast and 99 ovarian normal tissue samples from the Genotype-Tissue Expression project and integrated these with GWAS meta-analysis data from the Breast Cancer Association Consortium (122,977 cases/105,974 controls) and the Ovarian Cancer Association Consortium (22,406 cases/40,941 controls). The integration was achieved through application of a pleiotropy-guided conditional/conjunction false discovery rate (FDR) approach in the setting of a TWASs. This identified 14 candidate breast cancer susceptibility genes spanning 11 genomic regions and 8 candidate ovarian cancer susceptibility genes spanning 5 genomic regions at conjunction FDR < 0.05 that were >1 Mb away from known breast and/or ovarian cancer susceptibility loci. We also identified 38 candidate breast cancer susceptibility genes and 17 candidate ovarian cancer susceptibility genes at conjunction FDR < 0.05 at known breast and/or ovarian susceptibility loci. The 22 genes identified by our cross-cancer analysis represent promising candidates that further elucidate the role of the transcriptome in mediating germline breast and ovarian cancer risk.
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Affiliation(s)
- Siddhartha P. Kar
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Daniel P.C. Considine
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jonathan P. Tyrer
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Jasmine T. Plummer
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Science, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Biomedical Sciences, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Stephanie Chen
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Science, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Biomedical Sciences, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Felipe S. Dezem
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Science, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Department of Biomedical Sciences, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Alvaro N. Barbeira
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Padma S. Rajagopal
- Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Will T. Rosenow
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Fernando Moreno
- Department of Oncology, Hospital Clínico San Carlos, Madrid, Spain
| | - Clara Bodelon
- Divison of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Anna deFazio
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, NSW, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia
| | - Thilo Dörk
- Gynaecology Research Unit, Hannover Medical School, Hannover, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, University Hospital Erlangen, Erlangen, Germany
- Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen, Erlangen, Germany
| | - Ailith Ewing
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Ellen L. Goode
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Florian Heitz
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte/Evang., Essen, Germany
- Department of Gynecology, Center for Oncologic Surgery, Charité Campus Virchow-Klinikum, Berlin, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Estrid Høgdall
- Department of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus K. Høgdall
- The Juliane Marie Centre, Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Tomasz Huzarski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
- Department of Genetics and Pathology, University of Zielona Góra, Zielona Góra, Poland
| | - Allan Jensen
- Department of Lifestyle, Reproduction, and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Beth Y. Karlan
- David Geffen School of Medicine, Department of Obstetrics and Gynecology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Elza Khusnutdinova
- Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Lambertus A. Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne K. Kjaer
- Department of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Rüdiger Klapdor
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Jingmei Li
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Genome Institute of Singapore, Human Genetics, Singapore, Singapore
| | - Clemens Liebrich
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany
| | - Taymaa May
- Division of Gynecologic Oncology, University Health Network, Princess Margaret Hospital, Toronto, ON, Canada
| | - Håkan Olsson
- Division of Oncology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jennifer B. Permuth
- Departments of Cancer Epidemiology and Gastrointestinal Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM-The FIRC Institute of Molecular Oncology, Milan, Italy
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Susan J. Ramus
- School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Adult Cancer Program, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Marjorie J. Riggan
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Harvey A. Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | | | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval Research Center, Québec City, QC, Canada
| | - Lukasz M. Szafron
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Linda Titus
- Muskie School of Public Service, University of Southern Maine, Portland, ME, USA
| | - Cheryl L. Thompson
- Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA
| | - Robert A. Vierkant
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jennifer A. Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
| | - Kate Lawrenson
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Science, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Women’s Cancer Program at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Hae Kyung Im
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Ani W. Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Paul D.P. Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Simon A. Gayther
- Center for Bioinformatics and Functional Genomics, Department of Biomedical Science, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Joellen M. Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Xu X, Wang Y, Bryce N, Tang K, Meagher NS, Kang EY, Kelemen LE, Köbel M, Ramus SJ, Friedlander M, Ford CE, Hardeman EC, Gunning PW. Abstract 1045: Combined targeting of actin/tropomyosin and microtubules underlies a potential treatment strategy of epithelial ovarian cancer with cell-cycle dependent synergy. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-1045] [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
Anti-microtubule agents are widely used to treat ovarian cancers in the first line and recurrent setting either in combination with platinum or as single agents. However, the majority of patients will experience a recurrence, and most will die with drug resistant disease. We investigated co-targeting the actin cytoskeleton in combination with anti-microtubule agents to increase efficacy of treatment in epithelial ovarian cancers and potentially overcome resistance mechanisms. We examined the presence of actin/tropomyosin 3.1 (Tpm3.1) filaments in a large cohort of clinical specimens from patients with epithelial ovarian cancer of all histotypes using immunohistochemistry. Combinatorial effects of an anti-Tpm3.1 compound (ATM) with both vinorelbine and paclitaxel were evaluated in three ovarian cancer cell lines using cell viability and apoptosis assays. The mechanisms of synergy of both combinations were established using live-cell imaging, fluorescent microscopy, and pathway analysis. We found that Tpm3.1 is abundant and overexpressed in 97% of ovarian cancers examined (558 of 577) representing all histotypes of epithelial ovarian cancer. High levels of Tpm3.1 were also present in all sites sampled and similar at primary diagnosis and at recurrence. ATM displayed both single agent activity as well as synergy with both anti-microtubule drugs to reduce cell viability in all ovarian cancer cell lines tested, including one with platinum resistance. Only vinorelbine, however, synergised with ATM in the induction of apoptosis. Vinorelbine-induced mitotic arrest was significantly prolonged by ATM with elevated activity of the spindle assembly checkpoint, leading to almost one third of total cells dying in mitosis. In contrast, ATM showed minor impact on paclitaxel-induced mitotic defects. Both combinations resulted in a substantial increase in cells arrested in the subsequent G1 phase with a large decrease of both cyclin D1 and E1 as compared to single agents. Upregulation of p21Cip and p27Kip were associated with both combinations. In summary, targeting Tpm3.1-associated actin filaments in combination with anti-microtubule drugs is a promising treatment strategy that should be tested in clinical trials and is potentially applicable to all histotypes of ovarian cancer.
Citation Format: Xing Xu, Yao Wang, Nicole Bryce, Katrina Tang, Nicola S. Meagher, Eun Young Kang, Linda E. Kelemen, Martin Köbel, Susan J. Ramus, Michael Friedlander, Caroline E. Ford, Edna C. Hardeman, Peter W. Gunning. Combined targeting of actin/tropomyosin and microtubules underlies a potential treatment strategy of epithelial ovarian cancer with cell-cycle dependent synergy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1045.
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Affiliation(s)
- Xing Xu
- 1University of New South Wales, Sydney, Australia
| | - Yao Wang
- 1University of New South Wales, Sydney, Australia
| | - Nicole Bryce
- 1University of New South Wales, Sydney, Australia
| | | | | | | | | | - Martin Köbel
- 3University of Calgary, Calgary, Alberta, Canada
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Virani S, Baiocchi G, Bowtell D, Cabasag CJ, Cho KR, Fortner RT, Fujiwara K, Kim JW, Köbel M, Kurtz JE, Levine DA, Menon U, Norquist BM, Pharoah PDP, Sood AK, Tworoger ST, Wentzensen N, Chanock SJ, Brennan P, Trabert B. Joint IARC/NCI International Cancer Seminar Series Report: expert consensus on future directions for ovarian carcinoma research. Carcinogenesis 2021; 42:785-793. [PMID: 34037709 PMCID: PMC8427725 DOI: 10.1093/carcin/bgab043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/18/2021] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
Recently, ovarian cancer research has evolved considerably because of the emerging recognition that rather than a single disease, ovarian carcinomas comprise several different histotypes that vary by etiologic origin, risk factors, molecular profiles, therapeutic approaches and clinical outcome. Despite significant progress in our understanding of the etiologic heterogeneity of ovarian cancer, as well as important clinical advances, it remains the eighth most frequently diagnosed cancer in women worldwide and the most fatal gynecologic cancer. The International Agency for Research on Cancer and the United States National Cancer Institute jointly convened an expert panel on ovarian carcinoma to develop consensus research priorities based on evolving scientific discoveries. Expertise ranged from etiology, prevention, early detection, pathology, model systems, molecular characterization and treatment/clinical management. This report summarizes the current state of knowledge and highlights expert consensus on future directions to continue advancing etiologic, epidemiologic and prognostic research on ovarian carcinoma.
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Affiliation(s)
- Shama Virani
- International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
| | - Glauco Baiocchi
- Department of Gynecology Oncology, A.C. Camargo Cancer Center, São Paulo, SP, Brazil
| | - David Bowtell
- Women’s Cancer Program, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Citadel J Cabasag
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Kathleen R Cho
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Tokyo, Japan
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jean-Emmanuel Kurtz
- Department of Medical and Surgical Oncology and Hematology, Strasbourg Cancer Institute (ICANS-Europe), Strasbourg, France
| | - Douglas A Levine
- Gynecologic Oncology, Laura and Isaac Pearlmutter Cancer Center, New York University Langone Medical Center, New York, NY, USA
| | - Usha Menon
- MRC CTU at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Barbara M Norquist
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - Paul D P Pharoah
- Department of Oncology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Anil K Sood
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shelley T Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD, USA
| | - Paul Brennan
- International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France
| | - Britton Trabert
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, Bethesda, MD, USA
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Sue-A-Quan R, Patel PG, Shakfa N, Nyi MPN, Afriyie-Asante A, Kang EY, Köbel M, Koti M. Prognostic significance of T cells, PD-L1 immune checkpoint and tumour associated macrophages in clear cell carcinoma of the ovary. Gynecol Oncol 2021; 162:421-430. [PMID: 34088514 DOI: 10.1016/j.ygyno.2021.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To define the pre-treatment tumour immune landscape of clear cell carcinoma of the ovary (CCOC). METHODS We investigated the infiltration profiles of selected immune cell populations and immune checkpoint proteins that have been previously shown to have prognostic relevance in high grade serous carcinoma of the ovary to determine their association with clinical outcomes in CCOC patients. Using multiplex immunohistochemistry, we evaluated the density of CD3+, FoxP3+, CD8+ T cells, CD20+ B cells and expression of PD-1, PD-L1 and IDO1 immune checkpoints in a cohort of 162 CCOC tumour specimens on a tissue microarray. RESULTS Increased infiltration of CD3+ CD8- (helper T) cells, CD8+ (cytotoxic T) cells, and CD68+ macrophages significantly associated with shorter disease-free survival, recurrence-free survival and overall survival. Importantly, higher expression of PD-L1 and IDO-1 immune checkpoints was associated with better clinical outcomes. CONCLUSION Findings from our study are foundational towards the development of immune classifiers and biomarkers of response to immune checkpoint blockade therapy in CCOC.
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Affiliation(s)
- Rachel Sue-A-Quan
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Cancer Biology and Genetics, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Palak G Patel
- Cancer Biology and Genetics, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada; Department of Cell Biology, The Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON, Canada; Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Noor Shakfa
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Cancer Biology and Genetics, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - May-Phyo Nyi Nyi
- Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada
| | - Afrakoma Afriyie-Asante
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Cancer Biology and Genetics, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Eun Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Madhuri Koti
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada; Cancer Biology and Genetics, Queen's Cancer Research Institute, Queen's University, Kingston, Ontario, Canada; Department of Obstetrics and Gynecology, Kingston Health Sciences Center, Queen's University, Kingston, Canada.
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Kang EY, Tessier-Cloutier B, Duggan MA, Stewart CJR, Lee CH, Köbel M. Loss of ARID1B and SMARCB1 expression are specific for the diagnosis of dedifferentiated/undifferentiated carcinoma in tumours of the upper gynaecological tract and cervix. Histopathology 2021; 79:160-167. [PMID: 33432679 DOI: 10.1111/his.14333] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/27/2022]
Abstract
AIMS Genomic inactivation of ARID1B in ARID1A-inactivated tumour and genomic inactivation of SMARCB1 represent two recurrent mechanisms, core SWItch/sucrose non-fermentable (SWI/SNF) complex inactivation, that are associated with de-differentiation in endometrial carcinoma. Approximately one-third of dedifferentiated/undifferentiated endometrial carcinomas (DDEC/UEC) show loss of ARID1B expression with a minor subset showing loss of SMARCB1 expression, but little is known regarding the specificity of ARID1B or SMARCB1 loss in gynaecological tract tumours in general. The aim of this study was to examine the frequency of ARID1B and SMARCB1 loss by immunohistochemistry in a series of gynaecological tract epithelial/mesenchymal neoplasms. METHODS AND RESULTS We evaluated 1849 tumours that included 748 endometrial carcinomas, 101 uterine carcinosarcomas/adenosarcomas, 64 uterine sarcomas, 221 cervical carcinomas and 715 ovarian carcinomas/borderline tumours by tissue microarrays (TMA). We observed ARID1B loss in 35 of 86 (41%) and SMARCB1 loss in three of 86 (3%) DDEC/UEC, but not in any other uterine tumour types examined. ARID1B-deficient DDEC/UEC also showed concurrent loss of ARID1A expression. All SMARCB1-deficient tumours showed loss of MLH1 and PMS2, while 29 of 35 ARID1B-deficient tumours showed loss of MLH1 and PMS2 or loss of MSH6. All ovarian carcinomas/borderline tumours and cervical carcinomas showed intact expression of ARID1B and SMARCB1. CONCLUSION Our findings indicate that the loss of expression of ARID1B or SMARCB1 by immunohistochemistry is highly specific for undifferentiated carcinoma among tumours of the upper gynaecological tract and cervix, and therefore can be used to identify these highly aggressive malignant tumours.
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Affiliation(s)
- Eun-Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Máire A Duggan
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Colin J R Stewart
- Department of Histopathology, King Edward Memorial Hospital and School for Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia
| | - Cheng-Han Lee
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, BC Cancer, Vancouver, British Columbia, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
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50
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Dieters-Castator D, Dantonio PM, Piaseczny M, Zhang G, Liu J, Kuljanin M, Sherman S, Jewer M, Quesnel K, Kang EY, Köbel M, Siegers GM, Leask A, Hess D, Lajoie G, Postovit LM. Embryonic protein NODAL regulates the breast tumor microenvironment by reprogramming cancer-derived secretomes. Neoplasia 2021; 23:375-390. [PMID: 33784590 PMCID: PMC8041663 DOI: 10.1016/j.neo.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
The tumor microenvironment (TME) is an important mediator of breast cancer progression. Cancer-associated fibroblasts constitute a major component of the TME and may originate from tissue-associated fibroblasts or infiltrating mesenchymal stromal cells (MSCs). The mechanisms by which cancer cells activate fibroblasts and recruit MSCs to the TME are largely unknown, but likely include deposition of a pro-tumorigenic secretome. The secreted embryonic protein NODAL is clinically associated with breast cancer stage and promotes tumor growth, metastasis, and vascularization. Herein, we show that NODAL expression correlates with the presence of activated fibroblasts in human triple-negative breast cancers and that it directly induces Cancer-associated fibroblasts phenotypes. We further show that NODAL reprograms cancer cell secretomes by simultaneously altering levels of chemokines (e.g., CXCL1), cytokines (e.g., IL-6) and growth factors (e.g., PDGFRA), leading to alterations in MSC chemotaxis. We therefore demonstrate a hitherto unappreciated mechanism underlying the dynamic regulation of the TME.
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Affiliation(s)
| | - Paola M Dantonio
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Matt Piaseczny
- Department of Anatomy and Cell Biology, Western University, London, ON, Canada
| | - Guihua Zhang
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Jiahui Liu
- Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Miljan Kuljanin
- Robarts Research Institute, London, ON, Canada; Department of Biochemistry, Western University, London, ON, Canada
| | - Stephen Sherman
- Robarts Research Institute, London, ON, Canada; Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - Michael Jewer
- Department of Anatomy and Cell Biology, Western University, London, ON, Canada; Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Katherine Quesnel
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - Eun Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Andrew Leask
- Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - David Hess
- Robarts Research Institute, London, ON, Canada; Department of Physiology and Pharmacology, Western University, London, ON, Canada
| | - Gilles Lajoie
- Department of Biochemistry, Western University, London, ON, Canada
| | - Lynne-Marie Postovit
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada; Department of Oncology, University of Alberta, Edmonton, AB, Canada.
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