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Franceschini GM, Quaini O, Mizuno K, Orlando F, Ciani Y, Ku SY, Sigouros M, Rothmann E, Alonso A, Benelli M, Nardella C, Auh J, Freeman D, Hanratty B, Adil M, Elemento O, Tagawa ST, Feng FY, Caffo O, Buttigliero C, Basso U, Nelson PS, Corey E, Haffner MC, Attard G, Aparicio A, Demichelis F, Beltran H. Noninvasive Detection of Neuroendocrine Prostate Cancer through Targeted Cell-free DNA Methylation. Cancer Discov 2024; 14:424-445. [PMID: 38197680 PMCID: PMC10905672 DOI: 10.1158/2159-8290.cd-23-0754] [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: 07/11/2023] [Revised: 10/31/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Abstract
Castration-resistant prostate cancer (CRPC) is a heterogeneous disease associated with phenotypic subtypes that drive therapy response and outcome differences. Histologic transformation to castration-resistant neuroendocrine prostate cancer (CRPC-NE) is associated with distinct epigenetic alterations, including changes in DNA methylation. The current diagnosis of CRPC-NE is challenging and relies on metastatic biopsy. We developed a targeted DNA methylation assay to detect CRPC-NE using plasma cell-free DNA (cfDNA). The assay quantifies tumor content and provides a phenotype evidence score that captures diverse CRPC phenotypes, leveraging regions to inform transcriptional state. We tested the design in independent clinical cohorts (n = 222 plasma samples) and qualified it achieving an AUC > 0.93 for detecting pathology-confirmed CRPC-NE (n = 136). Methylation-defined cfDNA tumor content was associated with clinical outcomes in two prospective phase II clinical trials geared towards aggressive variant CRPC and CRPC-NE. These data support the application of targeted DNA methylation for CRPC-NE detection and patient stratification. SIGNIFICANCE Neuroendocrine prostate cancer is an aggressive subtype of treatment-resistant prostate cancer. Early detection is important, but the diagnosis currently relies on metastatic biopsy. We describe the development and validation of a plasma cell-free DNA targeted methylation panel that can quantify tumor fraction and identify patients with neuroendocrine prostate cancer noninvasively. This article is featured in Selected Articles from This Issue, p. 384.
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Affiliation(s)
- Gian Marco Franceschini
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Orsetta Quaini
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Kei Mizuno
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Francesco Orlando
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Yari Ciani
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Sheng-Yu Ku
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Michael Sigouros
- Institute for Computational Biomedicine and Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Emily Rothmann
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Alicia Alonso
- Institute for Computational Biomedicine and Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | | | - Caterina Nardella
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Joonghoon Auh
- Institute for Computational Biomedicine and Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Dory Freeman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Brian Hanratty
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Mohamed Adil
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Olivier Elemento
- Institute for Computational Biomedicine and Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, New York
| | - Scott T. Tagawa
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, New York
| | - Felix Y. Feng
- Department of Radiation Oncology, University of California San Francisco, San Francisco, California
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Trento, Italy
| | - Consuelo Buttigliero
- Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | - Umberto Basso
- Department of Oncology, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy
| | | | - Eva Corey
- University of Washington, Seattle, Washington
| | - Michael C. Haffner
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- University of Washington, Seattle, Washington
| | - Gerhardt Attard
- Cancer Institute and University College London Hospitals, University College London, London, United Kingdom
| | - Ana Aparicio
- Department of GU Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Francesca Demichelis
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Himisha Beltran
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Bacci M, Lorito N, Smiriglia A, Subbiani A, Bonechi F, Comito G, Morriset L, El Botty R, Benelli M, López-Velazco JI, Caffarel MM, Urruticoechea A, Sflomos G, Malorni L, Corsini M, Ippolito L, Giannoni E, Meattini I, Matafora V, Havas K, Bachi A, Chiarugi P, Marangoni E, Morandi A. Acetyl-CoA carboxylase 1 controls a lipid droplet-peroxisome axis and is a vulnerability of endocrine-resistant ER + breast cancer. Sci Transl Med 2024; 16:eadf9874. [PMID: 38416843 DOI: 10.1126/scitranslmed.adf9874] [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] [Received: 11/24/2022] [Accepted: 01/30/2024] [Indexed: 03/01/2024]
Abstract
Targeting aromatase deprives ER+ breast cancers of estrogens and is an effective therapeutic approach for these tumors. However, drug resistance is an unmet clinical need. Lipidomic analysis of long-term estrogen-deprived (LTED) ER+ breast cancer cells, a model of aromatase inhibitor resistance, revealed enhanced intracellular lipid storage. Functional metabolic analysis showed that lipid droplets together with peroxisomes, which we showed to be enriched and active in the LTED cells, controlled redox homeostasis and conferred metabolic adaptability to the resistant tumors. This reprogramming was controlled by acetyl-CoA-carboxylase-1 (ACC1), whose targeting selectively impaired LTED survival. However, the addition of branched- and very long-chain fatty acids reverted ACC1 inhibition, a process that was mediated by peroxisome function and redox homeostasis. The therapeutic relevance of these findings was validated in aromatase inhibitor-treated patient-derived samples. Last, targeting ACC1 reduced tumor growth of resistant patient-derived xenografts, thus identifying a targetable hub to combat the acquisition of estrogen independence in ER+ breast cancers.
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Affiliation(s)
- Marina Bacci
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Nicla Lorito
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Alfredo Smiriglia
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Angela Subbiani
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Francesca Bonechi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Giuseppina Comito
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Ludivine Morriset
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France
| | - Rania El Botty
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France
| | - Matteo Benelli
- Department of Medical Oncology, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, 59100 Prato, Italy
| | - Joanna I López-Velazco
- Biodonostia Health Research Institute, Paseo Dr Begiristain s/n, 20014 San Sebastian, Spain
| | - Maria M Caffarel
- Biodonostia Health Research Institute, Paseo Dr Begiristain s/n, 20014 San Sebastian, Spain
- Ikerbasque, Basque Foundation for Science, Plaza Euskadi 5, 48009 Bilbao, Spain
| | - Ander Urruticoechea
- Biodonostia Health Research Institute, Paseo Dr Begiristain s/n, 20014 San Sebastian, Spain
- Gipuzkoa Cancer Unit, OSI Donostialdea-Onkologikoa Foundation, Paseo Dr Begiristain 121, 20014 San Sebastian, Spain
| | - George Sflomos
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
| | - Luca Malorni
- Department of Medical Oncology, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, 59100 Prato, Italy
| | - Michela Corsini
- Department of Molecular and Translational Medicine, University of Brescia, Via Branze 39, 25123 Brescia, Italy
| | - Luigi Ippolito
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Elisa Giannoni
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Icro Meattini
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50134 Florence, Italy
| | - Vittoria Matafora
- IFOM ETS-AIRC Institute of Molecular Oncology, Via Adamello 16, 20139 Milan, Italy
| | - Kristina Havas
- IFOM ETS-AIRC Institute of Molecular Oncology, Via Adamello 16, 20139 Milan, Italy
| | - Angela Bachi
- IFOM ETS-AIRC Institute of Molecular Oncology, Via Adamello 16, 20139 Milan, Italy
| | - Paola Chiarugi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
| | - Elisabetta Marangoni
- Laboratory of Preclinical Investigation, Translational Research Department, Institut Curie, PSL University, 26 rue d'Ulm, 75005 Paris, France
| | - Andrea Morandi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, 50134 Florence, Italy
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Migliaccio I, Romagnoli D, Galardi F, De Luca F, Biagioni C, Curigliano G, Criscitiello C, Minisini AM, Moretti E, Risi E, Guarducci C, Nardone A, Biganzoli L, Benelli M, Malorni L. Mutational Analysis of Circulating Tumor DNA in Patients With Estrogen Receptor-Positive/Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer Receiving Palbociclib: Results From the TREnd Trial. JCO Precis Oncol 2024; 8:e2300285. [PMID: 38427931 PMCID: PMC10919481 DOI: 10.1200/po.23.00285] [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] [Received: 06/12/2023] [Revised: 10/20/2023] [Accepted: 12/06/2023] [Indexed: 03/03/2024] Open
Abstract
PURPOSE To identify prognostic circulating biomarkers to cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i), we performed a mutational analysis on circulating tumor DNA (ctDNA) samples from patients included in the TREnd trial, which randomly assigned patients to receive the CDK4/6i palbociclib alone or with the endocrine treatment (ET) to which they had progressed. METHODS Forty-six patients were enrolled in this substudy. Plasma was collected before treatment (T0), after the first cycle of therapy (T1), and at the time of progression (T2). ctDNA hybridization and capture were performed using the Illumina TruSight Tumor 170 Kit. Acquired mutations were confirmed by digital polymerase chain reaction. Progression-free survival analysis was estimated using the Kaplan-Meier method and compared with the log-rank test. RESULTS The most frequently mutated genes at T0 were ESR1 (23%), PIK3CA (17%), AR, FGFR2, and TP53 (10%). Mutations in ESR1 at T0 conferred higher risk of progression in the entire population (P = .02) and in patients treated with palbociclib + ET (P = .04). ESR1 mutation effect remained significant after correction for clinical variables (P = .03). PIK3CA mutations at T0 were not prognostic, but higher risk of progression was observed when a broader analysis of PI3K pathway was performed (P = .04). At T2, we observed the emergence of nine new mutations in seven genes. CONCLUSION Mutations in ESR1 and in PI3K pathway genes at T0 were associated with worse prognosis in palbociclib-treated patients. We describe the emergence of newly acquired mutations in palbociclib-treated patients, which might potentially affect subsequent treatment.
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Affiliation(s)
- Ilenia Migliaccio
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Dario Romagnoli
- Bioinformatics Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Francesca Galardi
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Francesca De Luca
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Chiara Biagioni
- Bioinformatics Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Giuseppe Curigliano
- Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | - Carmen Criscitiello
- Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
| | | | - Erica Moretti
- Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Emanuela Risi
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
- Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Cristina Guarducci
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Agostina Nardone
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Laura Biganzoli
- Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Luca Malorni
- Translational Research Unit, Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
- Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
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4
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Petrelli A, Rizzolio S, Pietrantonio F, Bellomo SE, Benelli M, De Cecco L, Romagnoli D, Berrino E, Orrù C, Ribisi S, Moya-Rull D, Migliore C, Conticelli D, Maina IM, Puliga E, Serra V, Pellegrino B, Llop-Guevara A, Musolino A, Siena S, Sartore-Bianchi A, Prisciandaro M, Morano F, Antista M, Fumagalli U, De Manzoni G, Degiuli M, Baiocchi GL, Amisano MF, Ferrero A, Marchiò C, Corso S, Giordano S. BRCA2 Germline Mutations Identify Gastric Cancers Responsive to PARP Inhibitors. Cancer Res 2023; 83:1699-1710. [PMID: 37129948 PMCID: PMC10183806 DOI: 10.1158/0008-5472.can-22-2620] [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] [Received: 09/26/2022] [Revised: 02/02/2023] [Accepted: 03/02/2023] [Indexed: 05/03/2023]
Abstract
Despite negative results of clinical trials conducted on the overall population of patients with gastric cancer, PARP inhibitor (PARPi) therapeutic strategy still might represent a window of opportunity for a subpopulation of patients with gastric cancer. An estimated 7% to 12% of gastric cancers exhibit a mutational signature associated with homologous recombination (HR) failure, suggesting that these patients could potentially benefit from PARPis. To analyze responsiveness of gastric cancer to PARPi, we exploited a gastroesophageal adenocarcinoma (GEA) platform of patient-derived xenografts (PDX) and PDX-derived primary cells and selected 10 PDXs with loss-of-function mutations in HR pathway genes. Cell viability assays and preclinical trials showed that olaparib treatment was effective in PDXs harboring BRCA2 germline mutations and somatic inactivation of the second allele. Olaparib responsive tumors were sensitive to oxaliplatin as well. Evaluation of HR deficiency (HRD) and mutational signatures efficiently stratified responder and nonresponder PDXs. A retrospective analysis on 57 patients with GEA showed that BRCA2 inactivating variants were associated with longer progression-free survival upon platinum-based regimens. Five of 7 patients with BRCA2 germline mutations carried the p.K3326* variant, classified as "benign." However, familial history of cancer, the absence of RAD51 foci in tumor cells, and a high HRD score suggest a deleterious effect of this mutation in gastric cancer. In conclusion, PARPis could represent an effective therapeutic option for BRCA2-mutated and/or high HRD score patients with GEA, including patients with familial intestinal gastric cancer. SIGNIFICANCE PARP inhibition is a potential strategy for treating patients with gastric cancer with mutated BRCA2 or homologous repair deficiency, including patients with familial intestinal gastric cancer, for whom BRCA2 germline testing should be recommended.
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Affiliation(s)
| | | | - Filippo Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara E Bellomo
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Oncology Department, Nuovo Ospedale-Santo Stefano, Prato, Italy
| | - Loris De Cecco
- Molecular Mechanisms Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Dario Romagnoli
- Bioinformatics Unit, Oncology Department, Nuovo Ospedale-Santo Stefano, Prato, Italy
| | - Enrico Berrino
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Claudia Orrù
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
| | - Salvatore Ribisi
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
| | | | - Cristina Migliore
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
| | - Daniela Conticelli
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
| | - Irene M Maina
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
| | | | - Violeta Serra
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Benedetta Pellegrino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Oncology and Breast Unit, University Hospital of Parma, Parma, Italy
- Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC), Parma, Italy
| | - Alba Llop-Guevara
- Experimental Therapeutics Group, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Antonino Musolino
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Oncology and Breast Unit, University Hospital of Parma, Parma, Italy
- Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC), Parma, Italy
| | - Salvatore Siena
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Sartore-Bianchi
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Michele Prisciandaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Federica Morano
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maria Antista
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Uberto Fumagalli
- Digestive Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giovanni De Manzoni
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Section of Surgery, University of Verona, Verona, Italy
| | | | - Gian Luca Baiocchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marco F Amisano
- Department of Surgery, Santo Spirito Hospital, ASL-AL, Rome, Italy
| | | | - Caterina Marchiò
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Medical Sciences, University of Torino, Torino, Italy
| | - Simona Corso
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
| | - Silvia Giordano
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy
- Department of Oncology, University of Torino, Candiolo, Italy
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Pasquali S, Percio S, Callegaro D, Martini S, Beretta A, Bertolotti A, Brich S, Collini P, Barisella M, De Cecco L, Vallacchi V, Stacchiotti S, Benelli M, Gronchi A, Zaffaroni N. Abstract 2245: The transcriptomic profile of retroperitoneal primary well differentiated liposarcoma (WDLPS) and well differentiated (WD)/dedifferentiated (DD) components of DD liposarcoma (DDLPS) reveals the progression from WDLPS to DDLPS. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2245] [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: 04/07/2023]
Abstract
Abstract
This study aimed at unravelling whether WDLPS undergo a progressive evolution to DDLPS through analyzing the transcriptomic profile of retroperitoneal liposarcoma. In a contemporary retrospective series of primary retroperitoneal DDLPS and WDLPS (N=107), we sampled paired DD/WD/normal fat (NF) components of DDLPS and paired WD/NF components of WDLPS. RNA-Seq data was normalized using the trimmed mean of M-value (TMM) algorithm, heteroscedasticity was removed, and differential expression analysis (DEA) performed. Gene sets enrichment analysis (GSEA) evaluated enrichment in biological hallmarks and was performed to overcome FDR correction of DEA and evaluate the ensemble. FDR threshold 0.05 was considered for significance. Marked transcriptional changes exist among paired components of DDLPS (DD, WD, NF) or WDLPS (WD, NF). Although DEA did not show significant changes between WD and NF components of DDLPS and WDLPS, GSEA analysis highlighted deregulation in hallmarks. An upregulation of G2M checkpoint and mitotic spindle gene sets was observed when WD components of DDLPS was compared to WDLPS and progressively increase in the DD component. Some targetable genes from the leading edge of these pathways (PLK1, AURKA, and EZH2) as well as the primary oncogenic drivers (MDM2, CDK4, and HMGA2) of liposarcoma were functionally validated with targeted agents in cell lines of DDLPS and WDLPS, supporting findings of transcriptomic analysis. We also observed that adipogenesis, fatty acid metabolism, cholesterol homeostasis, oxidative phosphorylation, and peroxisome gene sets were down-regulated in the DD component, while glycolysis was upregulated compared to WD components. When NF were compared with their paired tumor components, G2M checkpoint and mitotic spindle gene sets did not differ between DDLPS and WDLPS, suggesting these two hallmarks as tumor-specific. NF of patients with DDLPS demonstrated higher expression of adipogenesis, and other pathways related to metabolism suggesting its metabolic activation compared to NF of patients with WDLPS. In conclusion, changes distinguishing WDLPS/DDLPS early at the WD stage and progressively increasing in the DD component of DDLPS supported the hypothesis of an orderly progression from WDLPS to DDLPS and represent a source of additional therapeutic targets.
Citation Format: Sandro Pasquali, Stefano Percio, Dario Callegaro, Silvia Martini, Alessia Beretta, Alessia Bertolotti, Silvia Brich, Paola Collini, Marta Barisella, Loris De Cecco, Viviana Vallacchi, Silvia Stacchiotti, Matteo Benelli, Alessandro Gronchi, Nadia Zaffaroni. The transcriptomic profile of retroperitoneal primary well differentiated liposarcoma (WDLPS) and well differentiated (WD)/dedifferentiated (DD) components of DD liposarcoma (DDLPS) reveals the progression from WDLPS to DDLPS [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2245.
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Affiliation(s)
- Sandro Pasquali
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Percio
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Dario Callegaro
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Silvia Martini
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessia Beretta
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Silvia Brich
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Collini
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Barisella
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Loris De Cecco
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Matteo Benelli
- 2Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | | | - Nadia Zaffaroni
- 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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6
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Romagnoli D, Nardone A, Galardi F, Paoli M, De Luca F, Biagioni C, Franceschini GM, Pestrin M, Sanna G, Moretti E, Demichelis F, Migliaccio I, Biganzoli L, Malorni L, Benelli M. MIMESIS: minimal DNA-methylation signatures to quantify and classify tumor signals in tissue and cell-free DNA samples. Brief Bioinform 2023; 24:6991124. [PMID: 36653909 DOI: 10.1093/bib/bbad015] [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: 11/16/2022] [Revised: 12/17/2022] [Accepted: 01/03/2023] [Indexed: 01/20/2023] Open
Abstract
DNA-methylation alterations are common in cancer and display unique characteristics that make them ideal markers for tumor quantification and classification. Here we present MIMESIS, a computational framework exploiting minimal DNA-methylation signatures composed by a few dozen informative DNA-methylation sites to quantify and classify tumor signals in tissue and cell-free DNA samples. Extensive analyses of multiple independent and heterogenous datasets including >7200 samples demonstrate the capability of MIMESIS to provide precise estimations of tumor content and to enable accurate classification of tumor type and molecular subtype. To assess our framework for clinical applications, we designed a MIMESIS-informed assay incorporating the minimal signatures for breast cancer. Using both artificial samples and clinical serial cell-free DNA samples from patients with metastatic breast cancer, we show that our approach provides accurate estimations of tumor content, sensitive detection of tumor signal and the ability to capture clinically relevant molecular subtype in patients' circulation. This study provides evidence that our extremely parsimonious approach can be used to develop cost-effective and highly scalable DNA-methylation assays that could support and facilitate the implementation of precision oncology in clinical practice.
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Affiliation(s)
| | - Agostina Nardone
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, 59100 Prato, Italy
| | - Francesca Galardi
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, 59100 Prato, Italy
| | - Marta Paoli
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Francesca De Luca
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, 59100 Prato, Italy
| | - Chiara Biagioni
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy
| | - Gian Marco Franceschini
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Marta Pestrin
- Medical Oncology Unit, Azienda Sanitaria Universitaria Giuliano Isontina, 34170 Gorizia, Italy
| | - Giuseppina Sanna
- Medical Oncology, Ospedale Civile SS Annunziata, 07100 Sassari, Italy
| | - Erica Moretti
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy
| | - Francesca Demichelis
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
- Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, USA
| | - Ilenia Migliaccio
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, 59100 Prato, Italy
| | - Laura Biganzoli
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy
| | - Luca Malorni
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, 59100 Prato, Italy
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy
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McCartney A, Biagioni C, Chen B, Shepherd L, Gelmon K, Joy AA, Parulekar W, Bergqvist M, Migliaccio I, Leo A, Benelli M, Risi E, Moretti E, Livraghi L, Biganzoli L, Malorni L. Abstract P5-02-27: Serum thymidine kinase activity as a prognostic marker in women with metastatic breast cancer treated with two different schedules of palbociclib plus second-line endocrine therapy within the CCTG MA38 trial. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-02-27] [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: 03/06/2023]
Abstract
Abstract
Background: Thymidine kinase-1 is a cell proliferation marker downstream of the CDK4/6 pathway, whose activity can be measured in serum to reflect tumor proliferation. The CDK4/6 inhibitor palbociclib (P) is approved for the treatment of patients (pts) with hormone receptor positive metastatic breast cancer (MBC) in first or second line endocrine-based treatment settings. Approximately 10-15% of pts exhibit de novo resistance to P, with circulating levels of thymidine kinase activity (TKa) previously shown as a potential marker of early treatment resistance. Therapeutic strategies to address primary resistance to P are currently lacking. Little is known of the clinical efficacy of alternative dosing schedules of P, and its effect on TKa. Here we report serum TKa measured at different timepoints from samples collected within the MA38 (NCT02630693) study. Methods: MA38 is an open label randomised Phase 2 trial comparing two different schedules of P plus second-line ET in pts with ER-positive, HER2-negative MBC. Pts were assigned to receive physician’s choice ET plus either standard P dosing (125mg daily for 21 days on a 28-day cycle), or 100mg daily continuously. Serum samples were collected at baseline (BL; n=135), at 12 weeks (W12; n=122) and 24 weeks (W24; n=95). TKa was measured with DiviTum®, a refined ELISA-based assay (lower limit of detection [LLOD] = 100 DuA). Kaplan-Meier method estimated BL, W12 and W24 (95% CI) median PFS (mPFS; from randomization until progression by RECIST criteria or death) and overall survival (OS; from randomization until death from any cause) in groups of patients defined by dichotomizing TKa as “high” or “low” at the median. Results: MA38 enrolled 180 pts from December 2015 and February 2017 across Canada. Median follow up was 19 months. Overall, the median age was 60, and 90% of pts were post-menopausal. All pts had estrogen receptor-positive disease, and 64% had visceral metastases. On study, 56% received fulvestrant with P, 34% aromatase inhibitor and 10% tamoxifen. TKa was successfully measured in 100% of samples. Median TKa (mTKa) at BL was 234 DuA (IQR 138.5 - 438). BL TKa was not associated with clinical or pathological characteristics. TKa was prognostic at BL with mPFS of 5.5 months (mo) in pts with high TKa vs 16.3 mo with low TKa (HR=2.43; 95% CI, 1.6-3.7; p< 0.001). Similar results were obtained employing other previously reported cut off values. At multivariate analysis, BL TKa was independent from other prognostic factors including age, ECOG status and presence of visceral metastases (adjusted HR= 2.34; 95%CI 1.5- 3.6; p < 0.001). In terms of OS, BL TKa was an independent prognostic factor (adjusted HR=2.0; 95% CI, 1.1-3.7; p=0.02). At 12 mo, OS rate was 68% in pts with high BL TKa vs 92% in low TKa. Both for PFS and OS, no interaction between BL TKa and study arm was observed. At W12 mTKa was 129.5 DuA (IQR 100 - 219.8) and below LLOD (IQR 100 - 180) at W24. At these timepoints, landmark analyses showed no significant difference in PFS according to TKa. However, at W12 high TKa was significantly associated with worse OS (HR 2.0; 95%CI 1.0- 4.0; p=0.03), with a similar trend at W24 (HR 2.5; 95%CI 0.9-6.4; p=0.06). Conclusions: Baseline TKa is a reliable prognostic marker of both PFS and OS in pts treated with P and ET, further substantiating previous data. Monitoring TKa during treatment may provide important clinical information. A significant relationship between TKa and assigned treatment arm was not observed, suggesting TKa is not influenced by P treatment dose or intensity. These data confirm the role of baseline TKa as a new marker for patient stratification, and supports further investigation for the assessment of the clinical utility of TKa as a monitoring biomarker in the advanced setting.
Citation Format: Amelia McCartney, Chiara Biagioni, Bingshu Chen, Lois Shepherd, Karen Gelmon, Anil A. Joy, Wendy Parulekar, Mattias Bergqvist, Ilenia Migliaccio, Angela Leo, Matteo Benelli, Emanuela Risi, Erica Moretti, Luca Livraghi, Laura Biganzoli, Luca Malorni. Serum thymidine kinase activity as a prognostic marker in women with metastatic breast cancer treated with two different schedules of palbociclib plus second-line endocrine therapy within the CCTG MA38 trial [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-27.
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Affiliation(s)
- Amelia McCartney
- 1School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Chiara Biagioni
- 2Bioinformatics Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | | | - Lois Shepherd
- 4Canadian Cancer Trials Group, Queen’s University, Kingston, Ontario, Canada
| | - Karen Gelmon
- 5BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Anil A. Joy
- 6University of Alberta, Department of Oncology, Cross Cancer Institute, Division of Medical Oncology, Edmonton, Alberta, Canada
| | | | | | - Ilenia Migliaccio
- 9Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Angela Leo
- 10Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Matteo Benelli
- 11Bioinformatics Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Emanuela Risi
- 12Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Erica Moretti
- 13Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Luca Livraghi
- 14Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Laura Biganzoli
- 15Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Luca Malorni
- 16Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
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Malorni L, Benelli M, Liu Y, Deng S, Zhang Z, Guarducci C, Leo A, Nardone A, Galardi F, Risi E, Moretti E, Romagnoli D, Biagioni C, Paoli M, Biganzoli L, Migliaccio I. Abstract P5-02-17: Prognostic and predictive role of RBsig and CCNE1/RB1 gene-expression signatures in patients with advanced breast cancer treated with palbociclib in combination with endocrine therapy in the PALOMA-2 and 3 trials. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p5-02-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: We have previously identified two potentially predictive signatures of palbociclib resistance: the RBsig, composed of E2F1/E2F2 dependent genes, which is correlated with genetic loss of RB1, and the ratio between the gene expression levels of CCNE1 to RB1 (CCNE1/RB1). Both signatures have been previously tested in vitro and in neoadjuvant studies with palbociclib. The present analysis aims to explore the prognostic and predictive role of RBsig and CCNE1/RB1 in the pivotal phase III randomized trials PALOMA-2 and PALOMA-3. Materials and methods: Gene expression data from the PALOMA-2 and PALOMA-3 datasets were generated using the HTG EdgeSeq Oncology BM Panel, as previously described. Of the 87 genes composing RBsig, 46 were available within the EdgeSeq dataset and were used for the analyses; CCNE1 and RB1 were both available. RBsig was calculated as the mean of the Z-score scaled gene expression (log) of the 46 genes; CCNE1/RB1 was computed as the log ratio between the mRNA expression of CCNE1 and RB1. High and low values of RBsig and CCNE1/RB1 were defined based on the third quartile (Q3) as cutoff or as continuous variables. The prognostic/predictive effect of the signatures in terms of PFS was tested using Cox proportional hazard models and the Wald test. Results: The 46-genes RBsig versus the original signature showed excellent correlation in the METABRIC dataset (R=0.99), confirming its reliability as a surrogate of the original RBsig using EdgeSeq data. In both PALOMA-2 and PALOMA-3, RBsig high was significantly associated with a worse outcome compared to RBsig low in the palbociclib arm but not in the control arm [PALOMA-2: HR 1.4 (95% CI 1.0, 2.0) p=0.029 for palbociclib arm; HR 1.1 (95% CI 0.7, 1.6) p=0.71 for control arm. PALOMA-3: HR 1.7 (95% CI 1.1, 2.6) p=0.01 for palbociclib arm; HR 1.2 (95% CI 0.7, 1.9) p= 0.49 for control arm]. However, in both studies RBsig was not predictive of palbociclib resistance both when considered as a continuous variable and when dichotomized at Q3. Similarly to RBsig, in PALOMA- 3 patients with CCNE1/RB1 high tumors treated in the palbociclib arm showed a significantly worse outcome compared to those with CCNE1/RB1 low but this effect was not observed in those treated in the control arm [HR 1.6 (95% CI 1.1- 2.5) p= 0.03 for palbociclib arm; HR 1.2 (95% CI 0.7, 1.9) p=0.5 for control arm]. In addition, CCNE1/RB1 as a continuous variable was predictive of palbociclib benefit in PALOMA-3 (interaction p= 0.047). These effects were not observed in PALOMA-2. Conclusions: RBsig is a prognostic biomarker in patients treated with palbociclib, suggesting it may help in patients’ risk stratification. CCNE1/RB1 is predictive of palbociclib benefit in PALOMA-3, but not in PALOMA-2 probably due to the different patient populations and characteristics. Further studies of these biomarkers in patients treated with CDK4/6 inhibitors in the metastatic as well in the adjuvant setting are warranted.
Citation Format: Luca Malorni, Matteo Benelli, Yuan Liu, Shibing Deng, Zhe Zhang, Cristina Guarducci, Angela Leo, Agostina Nardone, Francesca Galardi, Emanuela Risi, Erica Moretti, Dario Romagnoli, Chiara Biagioni, Marta Paoli, Laura Biganzoli, Ilenia Migliaccio. Prognostic and predictive role of RBsig and CCNE1/RB1 gene-expression signatures in patients with advanced breast cancer treated with palbociclib in combination with endocrine therapy in the PALOMA-2 and 3 trials [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-17.
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Affiliation(s)
- Luca Malorni
- 1Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Matteo Benelli
- 2Bioinformatics Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Yuan Liu
- 3Pfizer Inc, San Diego, California
| | | | | | - Cristina Guarducci
- 6Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Angela Leo
- 7Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Agostina Nardone
- 8Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Francesca Galardi
- 9Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Emanuela Risi
- 10Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Erica Moretti
- 11Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Dario Romagnoli
- 12Bioinformatics Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Chiara Biagioni
- 13Bioinformatics Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Marta Paoli
- 14Bioinformatics Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Laura Biganzoli
- 15Medical Oncology Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
| | - Ilenia Migliaccio
- 16Translational Research Unit, Hospital of Prato, AUSL Toscana Centro, Prato, Italy
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9
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Malorni L, Bianchini G, Caputo R, Zambelli A, Puglisi F, Bianchi GV, Del Mastro L, Paris I, Montemurro F, Allegrini G, Colleoni M, Tamberi S, Zamagni C, Cazzaniga ME, Orditura M, Guarneri V, Castelletti D, Benelli M, Di Marino M, Arpino G, De Laurentiis M. Serum thymidine kinase activity in patients with HR-positive/HER2-negative advanced breast cancer treated with ribociclib plus letrozole: results from the prospective BioItaLEE trial. Eur J Cancer 2023; 186:1-11. [PMID: 37003098 DOI: 10.1016/j.ejca.2023.03.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Thymidine kinase 1 (TK1) is an enzyme downstream of the CDK4/6 pathway, with a critical role in DNA synthesis; serum TK1 activity (sTKa) is a novel liquid biopsy biomarker of tumour cell proliferation. METHODS The phase IIIb, BioItaLEE trial (NCT03439046) collected sera from postmenopausal patients with hormone receptor-positive (HR+), HER2-negative (HER2-) advanced breast cancer (ABC) treated with first-line ribociclib plus letrozole at baseline, day 15 of cycle 1 (C1D15), day 1 of cycle 2 (C2D1), and at first imaging. Associations between sTKa assessed at different time points or sTKa dynamic patterns, and progression-free survival (PFS) were evaluated using multivariate Cox models. RESULTS Overall, 287 patients were enroled. Median follow-up was 26.9 months. High sTKa (>median) at baseline was associated with higher risk of progression (hazard ratio [HR], 2.21; 95% confidence interval [95% CI], 1.45, 3.37; P = 0.0002); similar results were observed for patients with high sTKa levels at C1D15 and C2D1. Early sTKa dynamic patterns were strongly predictive of PFS. The pattern with high sTKa levels at C2D1 following initial decrease at C1D15 was associated with higher risk of progression versus the pattern with low sTKa levels at both time points (HR, 2.89; 95% CI, 1.57, 5.31; P = 0.0006), while the pattern with high sTKa levels at C1D15 was associated with the shortest PFS (HR, 5.65; CI: 2.84, 11.2; P < 0.0001). Baseline and dynamic sTKa changes provided independent information. CONCLUSIONS sTKa appears to be a new promising prognostic and pharmacodynamic biomarker in patients with HR+/HER2- ABC treated with ribociclib plus letrozole as first-line therapy.
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Affiliation(s)
- Luca Malorni
- Department of Oncology and Translational Research Unit "Sandro Pitigliani", Ospedale di Prato, Azienda USL Toscana Centro, Italy.
| | | | - Roberta Caputo
- Department of Breast and Thoracic Oncology, IRCCS Istituto Nazionale dei Tumori Fondazione G Pascale, Napoli, Italy
| | - Alberto Zambelli
- Medical Oncology Unit, IRCCS Humanitas Research Hospital and Department of Biomedical Sciences - Humanitas University, Milano, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, IRCCS, Centro di Riferimento Oncologico,Aviano, Italy; Department of Medicine, University of Udine, Italy
| | - Giulia V Bianchi
- SC Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Del Mastro
- U.O.S.D. Breast Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ida Paris
- Department of Woman and Child Sciences, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | | | | | - Marco Colleoni
- Division of Medical Senology, Istituto Europeo di Oncologia (IEO), IRCCS, Milano, Italy
| | - Stefano Tamberi
- U.O. Oncologia, P.O. Ospedale degli Infermi - AUSL, Ravenna, Italy
| | - Claudio Zamagni
- IRCCS Azienda ospedaliero-universitaria di Bologna, Bologna, Italy
| | - Marina E Cazzaniga
- Phase 1 Research Unit & Oncology Unit, Azienda Socio Sanitaria Territoriale Monza & Milano Bicocca School of Medicine and Surgery, Monza, Italy
| | - Michele Orditura
- U.O.C. Oncologia Medica e Ematologia, A.O.U. Università degli Studi L. Vanvitelli, Napoli, Italy
| | - Valentina Guarneri
- Deparment of Surgery, Oncology and Gastroenterology, University of Padova, Italy; Oncologia 2, Istituto Oncologico Veneto (IOV) IRCCS, Padova, Italy
| | | | - Matteo Benelli
- Department of Oncology and Bioinformatics Unit, Ospedale di Prato, Azienda USL Toscana Centro, Italy
| | | | - Grazia Arpino
- Department of Medical Clinics and Surgery, Università Federico II, Napoli, Italy
| | - Michelino De Laurentiis
- Department of Breast and Thoracic Oncology, IRCCS Istituto Nazionale dei Tumori Fondazione G Pascale, Napoli, Italy
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Corso S, Petrelli A, Rizzolio S, Pietrantonio F, Bellomo S, Benelli M, De Cecco L, Romagnoli D, Serra V, Pellegrino B, Giordano S. Identification of a subpopulation of patients with gastric cancer responsive to PARP inhibitors. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.432] [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: 01/25/2023] Open
Abstract
432 Background: Treatment with PARP inhibitors (PARPi) has been approved in some tumors bearing a deficient Homologous Recombination (HR) system. Despite negative results of clinical trials conducted on the overall population of gastric cancer (GC) patients, we wondered whether a PARPi therapeutic strategy might represent a window of opportunity for a subpopulation of these patients. 7-12% of gastric cancers exhibit a mutational signature associated with HR failure, suggesting that these patients might benefit from PARPi. Methods: To analyze responsiveness to PARPi we exploited a proprietary human Gastro-Esophageal Adenocarcinoma (GEA) annotated platform of Patient-Derived Xenografts (PDXs) and PDX-derived primary cells on which we performed in vivo and in vitro experiments. Results: We selected 10 PDXs with loss-of-function mutations in HR pathway genes. Cell viability assays and preclinical trials showed that treatment with PARPi was effective in PDXs harbouring BRCA2 germline mutations and somatic inactivation of the second allele in a microsatellite stable background. PARPi responsive tumors were sensitive to oxaliplatin as well. Evaluation of HR deficiency and mutational signatures efficiently stratified responder vs non-responder PDXs. A retrospective analysis on 57 GEA patients showed that those carrying BRCA2 inactivating variants had longer PFS upon platinum-based regimens (used as proxy). In 5 out of 7 BRCA2 germline mutated patients we identified the p.K3326* variant, currently classified as “benign”. However, familial history of cancer, the absence of RAD51 foci in the tumor cells and a high HR deficiency score suggest a deleterious effect for this mutation in gastric cancer. Conclusions: PARP inhibition could represent a new therapeutic perspective for BRCA2 mutated and/or high HRD score GEA patients, including familial intestinal gastric cancer patients.
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Affiliation(s)
- Simona Corso
- University of Torino, Dept of Oncology; Candiolo Cancer Institute - FPO, IRCCS, Candiolo (Torino), Italy
| | - Annalisa Petrelli
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy, Candiolo (Torino), Italy
| | - Sabrina Rizzolio
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy, Candiolo (Torino), Italy
| | - Filippo Pietrantonio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sara Bellomo
- Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Italy, Candiolo (Torino), Italy
| | - Matteo Benelli
- Department of Oncology and Bioinformatics Unit, Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Loris De Cecco
- Molecular Mechanisms Unit, Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Dario Romagnoli
- Bioinformatic Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy
| | - Violeta Serra
- Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Kerschbamer E, Arnoldi M, Tripathi T, Pellegrini M, Maturi S, Erdin S, Salviato E, Di Leva F, Sebestyén E, Dassi E, Zarantonello G, Benelli M, Campos E, Basson M, Gusella J, Gustincich S, Piazza S, Demichelis F, Talkowski M, Ferrari F, Biagioli M. CHD8 suppression impacts on histone H3 lysine 36 trimethylation and alters RNA alternative splicing. Nucleic Acids Res 2022; 50:12809-12828. [PMID: 36537238 PMCID: PMC9825192 DOI: 10.1093/nar/gkac1134] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/03/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022] Open
Abstract
Disruptive mutations in the chromodomain helicase DNA-binding protein 8 gene (CHD8) have been recurrently associated with autism spectrum disorders (ASDs). Here we investigated how chromatin reacts to CHD8 suppression by analyzing a panel of histone modifications in induced pluripotent stem cell-derived neural progenitors. CHD8 suppression led to significant reduction (47.82%) in histone H3K36me3 peaks at gene bodies, particularly impacting on transcriptional elongation chromatin states. H3K36me3 reduction specifically affects highly expressed, CHD8-bound genes and correlates with altered alternative splicing patterns of 462 genes implicated in 'regulation of RNA splicing' and 'mRNA catabolic process'. Mass spectrometry analysis uncovered a novel interaction between CHD8 and the splicing regulator heterogeneous nuclear ribonucleoprotein L (hnRNPL), providing the first mechanistic insights to explain the CHD8 suppression-derived splicing phenotype, partly implicating SETD2, a H3K36me3 methyltransferase. In summary, our results point toward broad molecular consequences of CHD8 suppression, entailing altered histone deposition/maintenance and RNA processing regulation as important regulatory processes in ASD.
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Affiliation(s)
- Emanuela Kerschbamer
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Michele Arnoldi
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Takshashila Tripathi
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Miguel Pellegrini
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Samuele Maturi
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Serkan Erdin
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Elisa Salviato
- IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Francesca Di Leva
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Endre Sebestyén
- IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Erik Dassi
- Laboratory of RNA Regulatory Networks, Department of Cellular, Computational and Integrative Biology, (CIBIO), University of Trento, Trento, Italy
| | - Giulia Zarantonello
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, Istituto Toscano Tumori, Prato, Italy
| | - Eric Campos
- Genetics & Genome Biology Program, The Hospital for Sick Children, Toronto, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Canada
| | - M Albert Basson
- Centre for Craniofacial and Regenerative Biology and MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - James F Gusella
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Stefano Gustincich
- Central RNA Laboratory, Istituto Italiano di Tecnologia (IIT), Genova, Italy
| | - Silvano Piazza
- Bioinformatic facility, Department of Cellular, Computational and Integrative Biology (CIBIO) University of Trento, Italy
| | - Francesca Demichelis
- Laboratory of Computational and Functional Oncology, Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Michael E Talkowski
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Francesco Ferrari
- IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
- CNR Institute of Molecular Genetics ‘Luigi Luca Cavalli-Sforza’, Pavia, Italy
| | - Marta Biagioli
- NeuroEpigenetics laboratory, Department of Cellular, Computational and Integrative Biology, (CIBIO) University of Trento, Trento, Italy
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12
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Risi E, Lisanti C, Vignoli A, Biagioni C, Paderi A, Cappadona S, Monte FD, Moretti E, Sanna G, Livraghi L, Malorni L, Benelli M, Puglisi F, Luchinat C, Tenori L, Biganzoli L. Risk assessment of disease recurrence in early breast cancer: A serum metabolomic study focused on elderly patients. Transl Oncol 2022; 27:101585. [PMID: 36403505 PMCID: PMC9676351 DOI: 10.1016/j.tranon.2022.101585] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/28/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We previously showed that metabolomics predicts relapse in early breast cancer (eBC) patients, unselected by age. This study aims to identify a "metabolic signature" that differentiates eBC from advanced breast cancer (aBC) patients, and to investigate its potential prognostic role in an elderly population. METHODS Serum samples from elderly breast cancer (BC) patients enrolled in 3 onco-geriatric trials, were retrospectively analyzed via proton nuclear magnetic resonance (1H NMR) spectroscopy. Three nuclear magnetic resonance (NMR) spectra were acquired for each serum sample: NOESY1D, CPMG, Diffusion-edited. Random Forest (RF) models to predict BC relapse were built on NMR spectra, and resulting RF risk scores were evaluated by Kaplan-Meier curves. RESULTS Serum samples from 140 eBC patients and 27 aBC were retrieved. In the eBC cohort, median age was 76 years; 77% of patients had luminal, 10% HER2-positive and 13% triple negative (TN) BC. Forty-two percent of patients had tumors >2 cm, 43% had positive axillary nodes. Using NOESY1D spectra, the RF classifier discriminated free-from-recurrence eBC from aBC with sensitivity, specificity and accuracy of 81%, 67% and 70% respectively. We tested the NOESY1D spectra of each eBC patient on the RF models already calculated. We found that patients classified as "high risk" had higher risk of disease recurrence (hazard ratio (HR) 3.42, 95% confidence interval (CI) 1.58-7.37) than patients at low-risk. CONCLUSIONS This analysis suggests that a "metabolic signature", identified employing NMR fingerprinting, is able to predict the risk of disease recurrence in elderly patients with eBC independently from standard clinicopathological features.
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Affiliation(s)
- Emanuela Risi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Camilla Lisanti
- Cro Aviano - National Cancer Institute - IRCCS, Medical Oncology and Cancer Prevention, Aviano, Italy
| | - Alessia Vignoli
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
| | | | - Agnese Paderi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Silvia Cappadona
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Francesca Del Monte
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Erica Moretti
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Giuseppina Sanna
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Luca Livraghi
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Luca Malorni
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy
| | | | - Fabio Puglisi
- Cro Aviano - National Cancer Institute - IRCCS, Medical Oncology and Cancer Prevention, Aviano, Italy
| | - Claudio Luchinat
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
| | - Leonardo Tenori
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
| | - Laura Biganzoli
- Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Prato, Italy,Corresponding author.
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13
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Risi E, Vignoli A, Lisanti C, Biagioni C, Paderi A, Cappadona Sciammetta S, Del Monte F, Moretti E, Sanna G, Livraghi L, Malorni L, Benelli M, Puglisi F, Luchinat C, Tenori L, Biganzoli L. 148P Serum metabolomics based risk assessment of disease recurrence in elderly patients with early breast cancer (eBC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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14
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Pasquali S, Percio S, Callegaro D, Bertolotti A, Brich S, Barisella M, Collini P, De Cecco L, Sanfilippo R, Frezza AM, Stacchiotti S, Benelli M, Zaffaroni N, Gronchi A. A transcriptomic analysis of retroperitoneal well differentiated liposarcoma (WDLPS) and well differentiated (WD) and dedifferentiated (DD) components of dedifferentiated liposarcoma (DDLPS). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e23520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e23520 Background: Retroperitoneal DDLPS is an aggressive tumor characterized by a WD component, morphologically similar to a WDLPS, and a DD component that drives patient prognosis. We aimed at unraveling whether WDLPS and DDLPS are distinct entities or entail a progressive evolution from WDLPS to DDLPS through a transcriptomic analysis. Methods: A transcriptomic analysis was performed in a retrospective series of 107 patients with primary retroperitoneal WDLPS (N = 68, 63.5%) or DDLPS (N = 39, 36.5%) who underwent surgery (2011-15). Paired DD, WD, and normal fat (NF) components were sampled in DDLPS, while paired WD and NF components were sampled in WDLPS. RNA-Seq data were normalized according to the trimmed mean of M-value (TMM) algorithm and differential expression was evaluated with the voom method implemented into the edgeR package. Enrichment in hallmark gene sets from Molecular Signatures Database (MSigDB) was evaluated with gene sets enrichment analysis (GSEA), by using t-statistic as measure of ranking. A false discovery rate (FDR) adjusted p-value < 0.05 was considered for statistical significance. Results: Differential expression analysis revealed marked transcriptional changes within paired components of DDLPS (DD, WD, NF) and WDLPS (WD, NF). Changes of WD and NF components between WDLPS and DDLPS were not statistically significant. Gene sets were analyzed to evaluate the ensemble and overcome the FDR correction applied to single genes. Hallmarks deregulated in WD component of DDLPS compared to WDLPS were detected also in their paired DD component. Among them, G2M checkpoint and mitotic spindle were up-regulated, while adipogenesis, fatty acid metabolism, cholesterol homeostasis, oxidative phosphorylation, and peroxisome were down-regulated. These differences persisted also when NF components were compared with their paired WD component of DDLPS and WDLPS. G2M checkpoint and mitotic spindle gene sets did not differ between NF of DDLPS and NF of WDLPS, suggesting these two hallmarks as tumor-specific. Conversely, expression of adipogenesis, fatty acid metabolism, and oxidative phosphorylation was up-regulated together with other gene sets related to metabolism in NF of DDLPS. Tumor inflammation and interferon response were up-regulated in WD components compared to their paired NF components. Also, interferon response was down-regulated in WD component of DDLPS compared to WDLPS, and inflammation was down-regulated in DD component compared to both WD components. Conclusions: Transcriptomic changes that distinguished WDLPS and WD component of DDLPS increased progressively also in the paired DD component of DDLPS, supporting the hypothesis of a progression from WDLPS to DDLPS in some liposarcomas. Changes observed in NF may suggest a paracrine effect sustaining tumor dedifferentiation.
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Affiliation(s)
- Sandro Pasquali
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Percio
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Dario Callegaro
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessia Bertolotti
- Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale Tumori di Milano, Milan, Italy
| | - Silvia Brich
- Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Barisella
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Collini
- Soft Tissue and Bone Pathology, Histopathology and Pediatric Pathology Unit, Department of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Loris De Cecco
- Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Anna Maria Frezza
- Adult Mesenchymal and Rare Tumor Unit, Department of Cancer Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Matteo Benelli
- Department of Oncology and Bioinformatics Unit, Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Nadia Zaffaroni
- Molecular Pharmacology Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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15
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Arpino G, Bianchini G, Malorni L, Zambelli A, Puglisi F, Del Mastro L, Colleoni M, Montemurro F, Bianchi GV, Paris I, Allegrini G, Tamberi S, Cazzaniga ME, Orditura M, Zamagni C, Grasso D, Benelli M, Callari M, Benfante A, De Laurentiis M. Circulating tumor DNA (ctDNA) and serum thymidine kinase 1 activity (TKa) matched dynamics in patients (pts) with hormone receptor–positive (HR+), human epidermal growth factor 2–negative (HER2-) advanced breast cancer (ABC) treated in first-line (1L) with ribociclib (RIB) and letrozole (LET) in the BioItaLEE trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.1012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1012 Background: Independent early dynamic assessment (baseline [D0] and day 15 of first cycle [D15]) of both TKa and ctDNA was prognostic and predictive in pts with HR+, HER2− ABC treated with RIB+LET enrolled in the BioItaLEE trial (NCT03439046). Here we performed a combined analysis of these two biomarkers. Methods: 287 pts were enrolled in the study. Overall, early dynamics were assessable for both biomarkers in 241/287 pts (84.0%). Methods applied for ctDNA and TKa evaluation were previously reported. For ctDNA, samples were defined as wild type (WT) if no mutations were observed at D0 and D15, ctDNA positive (+) if with or negative (-) if without a primary target mutation at D15. Samples were TKa+ or TKa- if TKa levels were above or below the limit of detection at D15. According to ctDNA and TKa pts were classified as: WT/TKa-, WT/TKa+, ctDNA-/TKa-, ctDNA-/TKa+, ctDNA+/TKa- and ctDNA+/TKa+ and then divided into 3 main study groups (GRs) WT/TKa- (GR1, n = 126), WT/TKa+, ctDNA-/TKa-, ctDNA-/TKa+, ctDNA+/TKa- (GR2, n = 96) and ctDNA+/TKa+ (GR3, n = 19). The association between biomarkers and PFS (progression-free survival) was estimated using Kaplan-Meier analysis and multivariate Cox models with 95% confidence intervals (CIs) adjusted for clinical variables. Results: Median follow-up was 26.9 months. In multivariate Cox models both TKa dynamics and mutational tumor burden at D15 were independently predictive of PFS. Hazard ratios (HRs) were 0.37 (95% CI: 0.23-0.60; p < 0.0001) for WT vs ctDNA+ and 0.56 (95% CI: 0.32-1.00; p = 0.0506) for ctDNA- vs ctDNA+. For TKa, HR was 0.49 (95% CI: 0.30-0.80; p = 0.0040) in TKa- vs TKa+. Interestingly combining the two variables further improve prediction of outcome. HRs for TKa- vs TKa+ were 0.17 (95% CI: 0.09-0.32; p < 0.0001), 0.28 (95% CI: 0.13-0.59; p = 0.0009) and 0.44 (95% CI: 0.23-0.86; p = 0.0169) in WT, ctDNA- and ctDNA+ pts, respectively. Considering the 3 study GRs, median PFSs (95% CI) were not reached (27.89, NE), 19.58 (13.83, 23.39) and 6.65 (2.83, 12.16) months in GR1, GR2 and GR3, respectively, p < 0.001. At multivariate Cox models, HRs of GR1 and GR2 compared with GR3 were 0.17 (95% CI: 0.09-0.32; p < 0.0001) and 0.37 (95% CI: 0.20-0.67; p = 0.001) respectively. Conclusions: These findings suggest that combining the early dynamic assessment of both ctDNA and TKa may improve outcome prediction in pts treated with RIB+LET. Pts with ctDNA+/TKa+ are strongly enriched for non-responders. TKa and ctDNA capture different features of tumor biological activity and their combination warrants further evaluation in relation to other treatments, settings, and diseases. Clinical trial information: NCT03439046.
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Affiliation(s)
- Grazia Arpino
- Department of Medical Clinics and Surgery, Università Federico II, Napoli, Italy
| | | | - Luca Malorni
- Department of Oncology and Translational Research Unit "Sandro Pitigliani", Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Alberto Zambelli
- U.S.C. Oncologia, Presidio Ospedaliero Papa Giovanni XXIII, Bergamo, Italy
| | - Fabio Puglisi
- S.O.C. Oncologia Medica e Prevenzione Oncologica, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Lucia Del Mastro
- U.O.S.D. Breast Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marco Colleoni
- Senologia Medica, IEO, Istituto Europeo di Oncologia, IRCCS, Milano, Italy
| | | | | | - Ida Paris
- Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Giacomo Allegrini
- U.O.C. Oncologia Medica, Presidio Ospedaliero Livorno, Livorno, Italy
| | - Stefano Tamberi
- U.O. Oncologia, P.O. Ospedale degli Infermi – AUSL, Ravenna, Italy
| | - Marina Elena Cazzaniga
- Phase 1 Research Unit & Oncology Unit, Azienda Socio Sanitaria Territoriale Monza & Milano Bicocca School of Medicine and Surgery, Monza, Italy
| | - Michele Orditura
- U.O.C. Oncologia Medica e Ematologia, A.O.U. Università Degli Studi L. Vanvitelli, Napoli, Italy
| | - Claudio Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Matteo Benelli
- Department of Oncology and Bioinformatics Unit, Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Maurizio Callari
- CRUK Cambridge Institute, University of Cambridge Li Ka Shing Centre, Cambridge, United Kingdom
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16
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Malorni L, Tyekucheva S, Hilbers FS, Ignatiadis M, Neven P, Colleoni M, Henry S, Ballestrero A, Bonetti A, Jerusalem G, Papadimitriou K, Bernardo A, Seles E, Duhoux FP, MacPherson IR, Thomson A, Davies DM, Bergqvist M, Migliaccio I, Gebhart G, Zoppoli G, Bliss JM, Benelli M, McCartney A, Kammler R, De Swert H, Ruepp B, Fumagalli D, Maibach R, Cameron D, Loi S, Piccart M, Regan MM. Serum thymidine kinase activity in patients with hormone receptor-positive and HER2-negative metastatic breast cancer treated with palbociclib and fulvestrant. Eur J Cancer 2022; 164:39-51. [DOI: 10.1016/j.ejca.2021.12.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 12/26/2022]
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17
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Migliaccio I, Paoli M, Risi E, Biagioni C, Biganzoli L, Benelli M, Malorni L. PIK3CA co-occurring mutations and copy-number gain in hormone receptor positive and HER2 negative breast cancer. NPJ Breast Cancer 2022; 8:24. [PMID: 35181669 PMCID: PMC8857304 DOI: 10.1038/s41523-022-00382-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/11/2022] [Indexed: 12/31/2022] Open
Abstract
We aim to elucidate the prognostic value of PIK3CA mutations and copy number (CN) gain (PIK3CA-mut/gain) in hormone receptor-positive and HER2-negative (HR + /HER2−) breast cancer (BC). We analyzed primary HR + /HER2− BC from three publicly available datasets comprising over 2000 samples and assessed the associations with tumoral and clinical characteristics and outcome. Clinical benefit (CB) in alpelisib-treated patients from two studies including 46 patients was analyzed. About 8–10% of HR + /HER2− primary BC had PIK3CA-mut/gain. In two of the datasets analyzed, among patients with PIK3CA mutant tumors, those with mut/gain had significantly worse outcome compared to those with CN neutral (PIK3CA-mut/neut) and PIK3CA-mut/gain remained an independent prognostic factor. CB of alpelisib-treated patients with PIK3CA-mut/gain and PIK3CA-mut/neut tumors was comparable. PIK3CA CN might help clarifying the prognostic and predictive role of PIK3CA mutations. Further studies are warranted.
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Affiliation(s)
- Ilenia Migliaccio
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy.
| | - Marta Paoli
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy
| | - Emanuela Risi
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy
| | - Chiara Biagioni
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy.,"Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy
| | - Laura Biganzoli
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy
| | - Luca Malorni
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy.,"Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100, Prato, Italy
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18
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Bianchini G, Malorni L, Arpino G, Zambelli A, Puglisi F, Mastro LD, Colleoni M, Montemurro F, Bianchi G, Paris I, Allegrini G, Cazzaniga ME, Orditura M, Zamagni C, Tamberi S, Castelletti D, Benelli M, Callari M, Santoro A, De Laurentiis M. Abstract GS3-07: Circulating tumor DNA (ctDNA) dynamics in patients with hormone receptor positive (HR+)/HER2 negative (HER2-) advanced breast cancer (aBC) treated in first line with ribociclib (R) and letrozole (L) in the BioItaLEE trial. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-gs3-07] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: ctDNA analysis is emerging as an attractive non-invasive approach to characterize tumor biology, describe its evolution over time, and predict treatment benefit. Here, we assessed the prognostic and predictive role of baseline and dynamic ctDNA analysis in HR+/HER2- aBC patients (pts) treated with R+L. Methods: 287 postmenopausal pts were enrolled in the BioItaLEE trial (NCT03439046). Liquid biopsies were collected at baseline (D0; n=263), day 15 of cycle 1 (D15; n=238), day 1 of cycle 2 (C2D1; n=241) and at first imaging (FI, at approximately 12 weeks; n=206). ctDNA analysis was carried out using a 533-amplicon Custom AmpliSeq HD Panel, with amplicons covering the coding exons of 39 BC-related genes (limit of detection: 0.1%). Target mutations were defined as single-nucleotide variant (SNV) or Insertion/Deletion detected at D0. When multiple target mutations were detected, the one with the highest variant allele frequency (VAF) was considered. The association between pre-treatment and on-treatment ctDNA dynamics with progression-free survival (PFS) was assessed using Multivariate Cox models. VAF clearance was defined as 100% decrease in a target mutation. Results: Median follow-up was 26.9 months and median PFS was 23.39 (20.8-NE) months. At baseline, target mutations were detected in 113 pts (43.0%), whereas 150 pts were wild-type (wt). Mean (SD) pre-treatment VAF at D0 was 11.3% (14.4). The absence of a target mutation at D0 was associated with good prognosis (HR: 0.41, 95% CI: 0.27–0.61; p<0.0001). Considering early ctDNA dynamics, a significant VAF reduction was observed at D15 and C2D1 with a mean (SD) change of -64.3% (55.9) and -68.6% (52.2), respectively. In pts with a target mutation detected at baseline, early VAF clearance was observed in 47.1% of pts at D15 and in 52.4% of pts at C2D1. Clearance at D15 or C2D1 was associated with improved PFS (D15, HR: 0.51, 95% CI: 0.28-0.91, p=0.0228; C2D1, HR: 0.44, 95% CI: 0.25-0.78, p=0.0052). Pts achieving clearance at D15, which was maintained at C2D1 (39.4%) had the lowest risk of progression compared to those who had no clearance at any or both timepoints (HR: 0.40, 95% CI: 0.20-0.79; p=0.084). Monitoring of the 150 pts without a detectable target mutation at baseline revealed a new, detectable mutation at later timepoints (D15, C2D1 and FI) in 34 pts (22.7%). The absence of new mutations was associated with a lower risk of progression (HR: 0.45, 95% CI: 0.24-0.85; p=0.0143). Considering all time points individually, D15 was the most informative of patient outcome. Indeed, pts without mutation at D15 (42.9%) had an extremely favorable outcome, either because they achieved early treatment-related clearance or maintained baseline absence of a target mutation (HR: 0.32, 95% CI: 0.20-0.51; p<0.0001). Notably, in pts with detectable target mutation at D15, a VAF below the median showed a trend for better prognosis versus high VAF (HR: 0.56, 95% CI: 0.30-1.04; p=0.065). Conclusions: The presence of a detectable mutation in baseline liquid biopsies appears to be a negative prognostic factor. Within this high-risk group, early VAF clearance during the first R+L cycle was informative of treatment benefit and associated with a lower risk of progression. Monitoring of ctDNA in patients without baseline mutations demonstrated that the detection of new mutations by FI assessment was associated with worse outcome. Overall, pre-treatment and early dynamics of ctDNA (assessed by NGS) represent promising prognostic and predictive biomarkers in patients with HR+/HER2- aBC treated with ribociclib/letrozole in the first-line. Further studies are warranted to validate the clinical utility of these biomarkers.
Citation Format: Giampaolo Bianchini, Luca Malorni, Grazia Arpino, Alberto Zambelli, Fabio Puglisi, Lucia Del Mastro, Marco Colleoni, Filippo Montemurro, Giulia Bianchi, Ida Paris, Giacomo Allegrini, Marina Elena Cazzaniga, Michele Orditura, Claudio Zamagni, Stefano Tamberi, Daniela Castelletti, Matteo Benelli, Maurizio Callari, Angela Santoro, Michelino De Laurentiis. Circulating tumor DNA (ctDNA) dynamics in patients with hormone receptor positive (HR+)/HER2 negative (HER2-) advanced breast cancer (aBC) treated in first line with ribociclib (R) and letrozole (L) in the BioItaLEE trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr GS3-07.
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Affiliation(s)
| | - Luca Malorni
- Department of Oncology and Translational Research Unit "Sandro Pitigliani", Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Grazia Arpino
- Department of Medical Clinics and Surgery, Università Federico II, Napoli, Italy
| | - Alberto Zambelli
- U.S.C. Oncologia, Presidio Ospedaliero Papa Giovanni XXIII, Bergamo, Italy
| | - Fabio Puglisi
- S.O.C. Oncologia Medica e Prevenzione Oncologica, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Lucia Del Mastro
- U.O.S.D. Breast Unit, I.R.C.C.S. Ospedale Policlinico San Martino, Genoa, Italy
| | - Marco Colleoni
- Senologia Medica, IEO, Istituto Europeo di Oncologia, IRCCS,, Milano, Italy
| | | | - Giulia Bianchi
- SC Oncologia Medica 1, Fondazione IRCCS Istituto Nazionale Tumori Milano, Milan, Italy
| | - Ida Paris
- Department of Woman and Child Sciences, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Giacomo Allegrini
- U.O.C. Oncologia Medica, Presidio Ospedaliero Livorno, Livorno, Italy
| | - Marina Elena Cazzaniga
- Phase 1 Research Unit & Oncology Unit, Azienda Socio Sanitaria Territoriale Monza & Milano Bicocca School of Medicine and Surgery, Monza, Italy
| | - Michele Orditura
- U.O.C. Oncologia Medica e Ematologia, A.O.U. Università Degli Studi L. Vanvitelli, Napoli, Italy
| | - Claudio Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Tamberi
- U.O. Oncologia, P.O. Ospedale degli Infermi – AUSL, Ravenna, Italy
| | | | - Matteo Benelli
- Department of Oncology and Bioinformatics Unit, Ospedale di Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Maurizio Callari
- CRUK Cambridge Institute, University of Cambridge Li Ka Shing Centre, Cambridge, United Kingdom
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Migliaccio I, Paoli M, Risi E, Biagioni C, Biganzoli L, Benelli M, Malorni L. Abstract P5-13-13: PIK3CA mutations co-occurring with copy number gain identify patients with adverse outcome and potentially different treatment sensitivity among hormone receptor positive and HER2 negative metastatic breast cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p5-13-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
INTRODUCTION: Somatic mutations of the PIK3CA gene, encoding for the class IA PI3K p110α subunit, are the most common activating mutations in breast cancer (BC), occurring in 30-50% of early and in 28% of metastatic ER+/HER2- disease. We have previously demonstrated that PIK3CA mutations co-occurring with copy number (CN) gain (PIK3CA-mut/gain) are associated with worse outcome in patients with early hormone receptor positive and HER2 negative (HR+/HER2-) BC, including those receiving endocrine therapy (ET). Here we aim to evaluate the prognostic role of PIK3CA-mut/gain in patients with metastatic HR+/HER2- BC treated with chemotherapy, ET alone or in combination with targeted therapies (CDK4/6 inhibitors or everolimus) included in a publicly available dataset of BC. PATIENTS AND METHODS: We accessed genomic, clinical, treatment and outcome data from 1365 patients with HR+/HER2- BC included in the MSK-2018 dataset. Patients treated for distant metastases were selected. PIK3CA status, considering both protein-affecting mutations and CN alterations, was derived from pre-treatment biopsies data. Tumors were classified as: PIK3CA wt and CN neutral (-wt/neut), PIK3CA wt with CN gain (-wt/gain), PIK3CA mutant and CN neutral (-mut/neut), and PIK3CA mutant with CN gain (-mut/gain). Tumors with PIK3CA loss were excluded from the analyses. For each patient and treatment type, only progression free survival (PFS) from the first available line of treatment was analyzed, thus excluding data concerning possible retreatments with the same drug in subsequent lines. Multivariate Cox proportional hazard models were used to assess the association between PIK3CA status and PFS including treatment line and the four categories of PIK3CA as co-variates. RESULTS: The proportion of PIK3CA-mut/gain was 15.4% in the chemotherapy group (n=454), 17.3% in the ET alone group (n= 352), 13.4% in the ET plus CDK4/6 inhibitors group (n= 268) and 10.5% in the ET plus everolimus group (n= 143). As expected, in all groups treatment line was significantly and independently associated with PFS. In the ET alone group, patients whose tumors had gain in PIK3CA CN, with or without co-occurring mutations, were at significantly higher risk of progression compared with PIK3CA-wt/neut (HR 2.2 [1.53-3.2] p<0.001 for PIK3CA -mut/gain; HR 1.5 [1.03-2.2] p= 0.034 for PIK3CA-wt/gain), while PIK3CA-mut/neut status was not significantly associated with progression (HR 1.2 [0.87 − 1.6] p= 0.289). Similar observations, without reaching statistical significance, were also made in the CDK4/6 inhibitors group (HR 1.6 [0.92-2.6] p= 0.099 for PIK3CA-mut/gain; HR 1.6 [0.97-2.5] p= 0.068 for PIK3CA-wt/gain) and in the chemotherapy group (HR 1.4 [0.98-2] p= 0.063 for PIK3CA-mut/gain; 1.2 [0.89-1.6] p= 0.223 for PIK3CA-wt/gain). On the other hand, in patients treated with ET plus everolimus, while there was a borderline significant increased risk of progression for patients with PIK3CA-wt/gain tumors (HR 1.8 [1.00 − 3.3] p= 0.051) and for those with PIK3CA-mut/neut (HR 1.6 [0.98-2.5) p= 0.06), this was not observed in patients with PIK3CA-mut/gain tumors (HR 1.1 [0.5-2.2] p=0.89), potentially suggesting a treatment benefit. CONCLUSIONS: Our data suggest that patients with metastatic HR+/HER2- BC with tumors with PIK3CA-mut/gain have poor outcome. These data are in line with our previous report in patients with early BC. Further studies are warranted to understand if patients with PIK3CA-mut/gain tumors might benefit from the combination of ET and everolimus.
Citation Format: Ilenia Migliaccio, Marta Paoli, Emanuela Risi, Chiara Biagioni, Laura Biganzoli, Matteo Benelli, Luca Malorni. PIK3CA mutations co-occurring with copy number gain identify patients with adverse outcome and potentially different treatment sensitivity among hormone receptor positive and HER2 negative metastatic breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-13-13.
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Affiliation(s)
| | - Marta Paoli
- Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Emanuela Risi
- Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | | | | | - Matteo Benelli
- Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Luca Malorni
- Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
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Romagnoli D, Galardi F, De Luca F, Biagioni C, Moretti E, Biganzoli L, Migliaccio I, Malorni L, Benelli M. Abstract P3-05-02: A minimal DNA-methylation signature to estimate tumor content and molecular subtype in breast cancer tissue samples with potential application to liquid biopsy. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-05-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Breast cancer (BC) is a heterogeneous disease characterized by different molecular "intrinsic" subtypes (PAM50) with distinct prognostic and therapeutic implications. DNA methylation (DNAm) is one of the most studied epigenetic mechanisms involved in BC tumorigenesis and progression. Recently, many studies have demonstrated the capability of DNAm-based assays in detecting and monitoring the disease in liquid biopsy samples from patients with BC, thus confirming promising role of DNAm-based biomarkers in the context of precision oncology. Here we present a novel computational method that exploits a minimal set of informative, clonal DNAm sites to estimate tumor content and molecular subtype in BC tissue samples with potential application for liquid biopsy analyses. Methods: DNAm data of TCGA-BRCA comprising 737 tumor samples, including 135 Basal-like (Basal), 46 HER2-enriched (HER2e) and 556 Luminal A/B (LumA/B) samples, and 96 normal tissue samples were downloaded from GDC Data Portal. To estimate tumor purity, we selected DNAm sites based on the following characteristics: (1) AUC>0.8 or AUC<0.2 (hyper- and hypo-methylated sites, respectively) in tumor versus normal samples; (2) range of beta-values in tumor samples greater than 0.5; (3) max and min beta-values above 0.9 or below 0.1, for hyper- and hypo-methylated sites, respectively; (4) the 3rd and 1st quartiles of normal samples beta-values below 0.3 or above 0.7, for hyper- and hypo-methylated sites, respectively. Tumor purity was then estimated taking the median of beta-values for hyper and 1-beta for hypo of selected sites for each sample. This selection was carried out considering all TCGA-BRCA samples and by PAM50 subtype (Basal, HER2e and LumA/B). After correction for purity, the set of subtype-specific sites (n=89) was also used as input to a generalized multinomial regression model (GLMNET) to classify BC samples into molecular subtypes. The model was trained in the TCGA-BRCA dataset using a 5-fold cross-validation. The performance was then tested in two independent datasets retrieved through the recountmethylation R package: GSE72251 (n=117) and GSE84207 (n=254). Results: Our estimates of sample purities, exploiting only 20 DNAm sites, show high correlation with those from InfiniumPurify (R=0.90, p < 10-16), another DNAm-based tool that requires hundreds of sites for purity estimation. The correlation was further improved using subtype-specific sites (LumA/B: R=0.95, p < 10-16; HER2e: R=0.96, p < 10-16; Basal: R=0.93, p < 10-16). For classification of tumor samples into molecular subtypes, our model obtained high accuracy for all subtypes (99%, 84% and 99%, for Basal, HER2e and LumA/B, respectively) in the training dataset. In the test datasets the F1-scores for Basal, HER2e and LumA/B subtypes were 89%, 60% and 87% for GSE72251, 91%, 42% and 93% for GSE84207. Conclusions: Our computational framework exploiting a minimal signature of DNAm sites demonstrates high accuracy in quantifying tumor purity and predicting molecular subtypes in the training dataset. In the two independent test sets including >350 samples, high accuracy was obtained for LumA/B and Basal samples while HER2e samples showed lower F1-score due to a drop of recall, though obtaining precision >80% in both datasets. Based on these results, a DNAm-based targeted-seq assay has been designed and will be applied to a series of plasma samples from patients with metastatic BC collected within our center. First results of the assay will be presented during the meeting.
Citation Format: Dario Romagnoli, Francesca Galardi, Francesca De Luca, Chiara Biagioni, Erica Moretti, Laura Biganzoli, Ilenia Migliaccio, Luca Malorni, Matteo Benelli. A minimal DNA-methylation signature to estimate tumor content and molecular subtype in breast cancer tissue samples with potential application to liquid biopsy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-05-02.
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Fedeli L, Betti M, Bicchi S, Benelli M, Quattrocchi M, Gilio M, Rossi F, Busoni S, Taddeucci A, Comeglio M, Maioli M, Lisi C, Meucci F, Vaiano A, Fedele D, Mazzoni L, Bernardi L. Correlation between operator eye lens doses and transcatheter cardiovascular procedure characteristic: multi-parametric linear regression model. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00098-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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Betti M, Benelli M, Bicchi S, Fedeli L, Laghai I, Marciello L, Meucci F, Vaiano A, Fedele D, Mazzoni L, Marzano S, Sestini S, Bernardi L. 18F-FDG-PET radiomic assessment for RT treatment strategy in patients with head and neck cancer: a feasibility study. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00191-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Pallotta S, Benelli M, Taddeucci A, Doria S, Calusi S, Marrazzo L, Talamonti C, Belli G, Cusumano D, Lenkowicz J, de Spirito M, Zoppetti N, Barucci A. RadiomiK phantom to test the robustness of CT radiomic features. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00066-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Fedeli L, Belli G, Ciccarone A, Coniglio A, Esposito M, Giannelli M, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Benelli M, Bernardi L, Betti M, Caivano R, Carni M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliado G, Morzenti S, Niespolo A, Nocetti L, Noferini L, Oberhofer N, Orsingher L, Quattrocchi M, Ricci A, Savini A, Taddeucci A, Testa C, Tortoli P, Luchinat C, Tenori L, Gobbi G, Gori C, Busoni S, Mazzoni L. Multicenter comparison of MR scanners for quantitative diffusion weighted imaging: apparent diffusion coefficient dependence on acquisition plan and spatial position – preliminary results. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00475-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Aftimos P, Oliveira M, Irrthum A, Fumagalli D, Sotiriou C, Gal-Yam EN, Robson ME, Ndozeng J, Di Leo A, Ciruelos EM, de Azambuja E, Viale G, Scheepers ED, Curigliano G, Bliss JM, Reis-Filho JS, Colleoni M, Balic M, Cardoso F, Albanell J, Duhem C, Marreaud S, Romagnoli D, Rojas B, Gombos A, Wildiers H, Guerrero-Zotano A, Hall P, Bonetti A, Larsson KF, Degiorgis M, Khodaverdi S, Greil R, Sverrisdóttir Á, Paoli M, Seyll E, Loibl S, Linderholm B, Zoppoli G, Davidson NE, Johannsson OT, Bedard PL, Loi S, Knox S, Cameron DA, Harbeck N, Montoya ML, Brandão M, Vingiani A, Caballero C, Hilbers FS, Yates LR, Benelli M, Venet D, Piccart MJ. Genomic and Transcriptomic Analyses of Breast Cancer Primaries and Matched Metastases in AURORA, the Breast International Group (BIG) Molecular Screening Initiative. Cancer Discov 2021; 11:2796-2811. [PMID: 34183353 PMCID: PMC9414283 DOI: 10.1158/2159-8290.cd-20-1647] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [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: 11/11/2020] [Revised: 04/05/2021] [Accepted: 06/11/2021] [Indexed: 02/01/2023]
Abstract
AURORA aims to study the processes of relapse in metastatic breast cancer (MBC) by performing multi-omics profiling on paired primary tumors and early-course metastases. Among 381 patients (primary tumor and metastasis pairs: 252 targeted gene sequencing, 152 RNA sequencing, 67 single nucleotide polymorphism arrays), we found a driver role for GATA1 and MEN1 somatic mutations. Metastases were enriched in ESR1, PTEN, CDH1, PIK3CA, and RB1 mutations; MDM4 and MYC amplifications; and ARID1A deletions. An increase in clonality was observed in driver genes such as ERBB2 and RB1. Intrinsic subtype switching occurred in 36% of cases. Luminal A/B to HER2-enriched switching was associated with TP53 and/or PIK3CA mutations. Metastases had lower immune score and increased immune-permissive cells. High tumor mutational burden correlated to shorter time to relapse in HR+/HER2- cancers. ESCAT tier I/II alterations were detected in 51% of patients and matched therapy was used in 7%. Integration of multi-omics analyses in clinical practice could affect treatment strategies in MBC. SIGNIFICANCE: The AURORA program, through the genomic and transcriptomic analyses of matched primary and metastatic samples from 381 patients with breast cancer, coupled with prospectively collected clinical data, identified genomic alterations enriched in metastases and prognostic biomarkers. ESCAT tier I/II alterations were detected in more than half of the patients.This article is highlighted in the In This Issue feature, p. 2659.
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Affiliation(s)
- Philippe Aftimos
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | - Mafalda Oliveira
- Medical Oncology Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | | | - Christos Sotiriou
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | | | - Mark E Robson
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Justin Ndozeng
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | | - Giuseppe Viale
- IEO, Istituto Europeo di Oncologia, IRCCS, and University of Milan, Milan, Italy
| | | | - Giuseppe Curigliano
- IEO, Istituto Europeo di Oncologia, IRCCS, and University of Milan, Milan, Italy
| | - Judith M Bliss
- The Institute of Cancer Research, London, United Kingdom
| | | | - Marco Colleoni
- IEO, Istituto Europeo di Oncologia, IRCCS, and University of Milan, Milan, Italy
| | | | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Joan Albanell
- Hospital del Mar - CIBERONC; IMIM, Barcelona; Pompeu Fabra University, Barcelona, Spain
| | - Caroline Duhem
- Centre Hospitalier Luxembourg, Luxembourg City, Luxembourg
| | | | | | - Beatriz Rojas
- CIOCC (Centro Integral Oncologico "Clara Campal"), Madrid, Spain
| | - Andrea Gombos
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Peter Hall
- University of Edinburgh Cancer Research Centre, Edinburgh, United Kingdom
| | - Andrea Bonetti
- Department of Oncology AZIENDA ULSS 9 Verona, Verona, Italy
| | | | | | - Silvia Khodaverdi
- Sana Klinikum Offenbach, Klinik für Gynaekologie und Geburtshilfe, Offenbach, Germany
| | - Richard Greil
- Paracelsus Medical University Salzburg, Salzburg Cancer Research Institute-CCCIT and Cancer Cluster Salzburg, Salzburg, Austria
| | | | | | - Ethel Seyll
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Gabriele Zoppoli
- Università degli Studi di Genova and IRCCS Ospedale Policlinico San Martino, San Martino, Italy
| | - Nancy E Davidson
- Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Washington
| | | | | | - Sherene Loi
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Susan Knox
- Europa Donna- The European Breast Cancer Coalition, Milan, Italy
| | - David A Cameron
- University of Edinburgh Cancer Research Centre, Edinburgh, United Kingdom
| | - Nadia Harbeck
- Breast Center, LMU University Hospital, Munich, Germany, and West German Study Group, Moenchengladbach, Germany
| | | | - Mariana Brandão
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | - Andrea Vingiani
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | - Lucy R Yates
- Wellcome Trust Sanger Institute, London, United Kingdom
| | | | - David Venet
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium
| | - Martine J Piccart
- Institut Jules Bordet - Université Libre de Bruxelles, Brussels, Belgium.
- Breast International Group, Brussels, Belgium
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Ciani Y, Fedrizzi T, Prandi D, Lorenzin F, Locallo A, Gasperini P, Franceschini GM, Benelli M, Elemento O, Fava LL, Inga A, Demichelis F. Allele-specific genomic data elucidate the role of somatic gain and copy-number neutral loss of heterozygosity in cancer. Cell Syst 2021; 13:183-193.e7. [PMID: 34731645 PMCID: PMC8856743 DOI: 10.1016/j.cels.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/28/2021] [Revised: 07/23/2021] [Accepted: 10/08/2021] [Indexed: 12/12/2022]
Abstract
Pan-cancer studies sketched the genomic landscape of the tumor types spectrum. We delineated the purity- and ploidy-adjusted allele-specific profiles of 4,950 patients across 27 tumor types from the Cancer Genome Atlas (TCGA). Leveraging allele-specific data, we reclassified as loss of heterozygosity (LOH) 9% and 7% of apparent copy-number wild-type and gain calls, respectively, and overall observed more than 18 million allelic imbalance somatic events at the gene level. Reclassification of copy-number events revealed associations between driver mutations and LOH, pointing out the timings between the occurrence of point mutations and copy-number events. Integrating allele-specific genomics and matched transcriptomics, we observed that allele-specific gene status is relevant in the regulation of TP53 and its targets. Further, we disclosed the role of copy-neutral LOH in the impairment of tumor suppressor genes and in disease progression. Our results highlight the role of LOH in cancer and contribute to the understanding of tumor progression.
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Affiliation(s)
- Yari Ciani
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Tarcisio Fedrizzi
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Davide Prandi
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Francesca Lorenzin
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Alessio Locallo
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Paola Gasperini
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Gian Marco Franceschini
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Matteo Benelli
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy; Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy
| | - Olivier Elemento
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Al-Saud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, NY 10021, USA; The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Luca L Fava
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Alberto Inga
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy
| | - Francesca Demichelis
- Department of Cellular, Computational and Integrative Biology, University of Trento, 38123 Trento, Italy; Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10021, USA; The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Al-Saud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, NY 10021, USA; The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY 10021, USA.
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De Angelis C, Fu X, Cataldo ML, Nardone A, Pereira R, Veeraraghavan J, Nanda S, Qin L, Sethunath V, Wang T, Hilsenbeck SG, Benelli M, Migliaccio I, Guarducci C, Malorni L, Litchfield LM, Liu J, Donaldson J, Selenica P, Brown DN, Weigelt B, Reis-Filho JS, Park BH, Hurvitz SA, Slamon DJ, Rimawi MF, Jansen VM, Jeselsohn R, Osborne CK, Schiff R. Correction: Activation of the IFN Signaling Pathway is Associated with Resistance to CDK4/6 Inhibitors and Immune Checkpoint Activation in ER-Positive Breast Cancer. Clin Cancer Res 2021; 27:4939. [PMID: 34470810 DOI: 10.1158/1078-0432.ccr-21-2431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Malorni L, De Laurentiis M, Bianchini G, Zambelli A, Puglisi F, Bianchi G, Del Mastro L, Paris I, Montemurro F, Allegrini G, Colleoni M, Tamberi S, Zamagni C, Cazzaniga M, Orditura M, Guarneri V, Castelletti D, Benelli M, Di Marino M, Arpino G. 292P Serum thymidine kinase 1 activity in patients with hormone receptor positive (HR+)/HER2 negative (HER2-) advanced breast cancer (aBC) treated in first-line with ribociclib (R) and letrozole (L) in the BioItaLEE trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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De Angelis C, Fu X, Cataldo ML, Nardone A, Pereira R, Veeraraghavan J, Nanda S, Qin L, Sethunath V, Wang T, Hilsenbeck SG, Benelli M, Migliaccio I, Guarducci C, Malorni L, Litchfield LM, Liu J, Donaldson J, Selenica P, Brown DN, Weigelt B, Reis-Filho JS, Park BH, Hurvitz SA, Slamon DJ, Rimawi MF, Jansen VM, Jeselsohn R, Osborne CK, Schiff R. Activation of the IFN Signaling Pathway is Associated with Resistance to CDK4/6 Inhibitors and Immune Checkpoint Activation in ER-Positive Breast Cancer. Clin Cancer Res 2021; 27:4870-4882. [PMID: 33536276 PMCID: PMC8628647 DOI: 10.1158/1078-0432.ccr-19-4191] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 12/05/2020] [Accepted: 02/01/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors (CDK4/6i) are highly effective against estrogen receptor-positive (ER+)/HER2- breast cancer; however, intrinsic and acquired resistance is common. Elucidating the molecular features of sensitivity and resistance to CDK4/6i may lead to identification of predictive biomarkers and novel therapeutic targets, paving the way toward improving patient outcomes. EXPERIMENTAL DESIGN Parental breast cancer cells and their endocrine-resistant derivatives (EndoR) were used. Derivatives with acquired resistance to palbociclib (PalboR) were generated from parental and estrogen deprivation-resistant MCF7 and T47D cells. Transcriptomic and proteomic analyses were performed in palbociclib-sensitive and PalboR lines. Gene expression data from CDK4/6i neoadjuvant trials and publicly available datasets were interrogated for correlations of gene signatures and patient outcomes. RESULTS Parental and EndoR breast cancer lines showed varying degrees of sensitivity to palbociclib. Transcriptomic analysis of these cell lines identified an association between high IFN signaling and reduced CDK4/6i sensitivity; thus an "IFN-related palbociclib-resistance Signature" (IRPS) was derived. In two neoadjuvant trials of CDK4/6i plus endocrine therapy, IRPS and other IFN-related signatures were highly enriched in patients with tumors exhibiting intrinsic resistance to CDK4/6i. PalboR derivatives displayed dramatic activation of IFN/STAT1 signaling compared with their short-term treated or untreated counterparts. In primary ER+/HER2- tumors, the IRPS score was significantly higher in lumB than lumA subtype and correlated with increased gene expression of immune checkpoints, endocrine resistance, and poor prognosis. CONCLUSIONS Aberrant IFN signaling is associated with intrinsic resistance to CDK4/6i. Experimentally, acquired resistance to palbociclib is associated with activation of the IFN pathway, warranting additional studies to clarify its involvement in resistance to CDK4/6i.
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Affiliation(s)
- Carmine De Angelis
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA,Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Xiaoyong Fu
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA,University of California, Los Angeles, Los Angeles, CA, USA
| | - Maria Letizia Cataldo
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA,Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Agostina Nardone
- Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Resel Pereira
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Jamunarani Veeraraghavan
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Sarmistha Nanda
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Lanfang Qin
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Vidyalakshmi Sethunath
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Tao Wang
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Susan G. Hilsenbeck
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Matteo Benelli
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Ilenia Migliaccio
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Prato, Italy,,“Sandro Pitigliani” Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Cristina Guarducci
- Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA,“Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Luca Malorni
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Prato, Italy,,“Sandro Pitigliani” Medical Oncology Department, Hospital of Prato, Prato, Italy
| | | | | | - Joshua Donaldson
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pier Selenica
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David N. Brown
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jorge S. Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ben H. Park
- Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Mothaffar F. Rimawi
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | | | - Rinath Jeselsohn
- Center for Functional Cancer Epigenetics, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - C. Kent Osborne
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA,Department of Medicine, Baylor College of Medicine, Houston, TX, USA,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Rachel Schiff
- Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, Texas. .,Department of Medicine, Baylor College of Medicine, Houston, Texas.,Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas.,Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas
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Migliaccio I, Leo A, Galardi F, Guarducci C, Fusco GM, Benelli M, Di Leo A, Biganzoli L, Malorni L. Circulating Biomarkers of CDK4/6 Inhibitors Response in Hormone Receptor Positive and HER2 Negative Breast Cancer. Cancers (Basel) 2021; 13:2640. [PMID: 34072070 PMCID: PMC8199335 DOI: 10.3390/cancers13112640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/26/2021] [Revised: 05/17/2021] [Accepted: 05/25/2021] [Indexed: 12/25/2022] Open
Abstract
CDK4/6 inhibitors (CDK4/6i) and endocrine therapy are the standard treatment for patients with hormone receptor-positive and HER2 negative (HR+/HER2-) metastatic breast cancer. Patients might show intrinsic and acquired resistance, which leads to treatment failure and progression. Circulating biomarkers have the potential advantages of recognizing patients who might not respond to treatment, monitoring treatment effects and identifying markers of acquired resistance during tumor progression with a simple withdrawal of peripheral blood. Genomic alterations on circulating tumor DNA and serum thymidine kinase activity, but also circulating tumor cells, epigenetic or exosome markers are currently being tested as markers of CDK4/6i treatment response, even though none of these have been integrated into clinical practice. In this review, we discuss the recent advancements in the development of circulating biomarkers of CDK4/6i response in patients with HR+/HER2-breast cancer.
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Affiliation(s)
- Ilenia Migliaccio
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.L.); (F.G.); (G.M.F.); (L.M.)
| | - Angela Leo
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.L.); (F.G.); (G.M.F.); (L.M.)
| | - Francesca Galardi
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.L.); (F.G.); (G.M.F.); (L.M.)
| | - Cristina Guarducci
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA;
| | - Giulio Maria Fusco
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.L.); (F.G.); (G.M.F.); (L.M.)
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy;
| | - Angelo Di Leo
- “Sandro Pitigliani” Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.D.L.); (L.B.)
| | - Laura Biganzoli
- “Sandro Pitigliani” Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.D.L.); (L.B.)
| | - Luca Malorni
- “Sandro Pitigliani” Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.L.); (F.G.); (G.M.F.); (L.M.)
- “Sandro Pitigliani” Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, 59100 Prato, Italy; (A.D.L.); (L.B.)
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31
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Fedeli L, Benelli M, Busoni S, Belli G, Ciccarone A, Coniglio A, Esposito M, Nocetti L, Sghedoni R, Tarducci R, Altabella L, Belligotti E, Bettarini S, Betti M, Caivano R, Carnì M, Chiappiniello A, Cimolai S, Cretti F, Fulcheri C, Gasperi C, Giacometti M, Levrero F, Lizio D, Maieron M, Marzi S, Mascaro L, Mazzocchi S, Meliadò G, Morzenti S, Niespolo A, Noferini L, Oberhofer N, Orsingher L, Quattrocchi M, Ricci A, Savini A, Taddeucci A, Testa C, Tortoli P, Gobbi G, Gori C, Bernardi L, Giannelli M, Mazzoni LN. On the dependence of quantitative diffusion-weighted imaging on scanner system characteristics and acquisition parameters: A large multicenter and multiparametric phantom study with unsupervised clustering analysis. Phys Med 2021; 85:98-106. [PMID: 33991807 DOI: 10.1016/j.ejmp.2021.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/31/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The purpose of this multicenter phantom study was to exploit an innovative approach, based on an extensive acquisition protocol and unsupervised clustering analysis, in order to assess any potential bias in apparent diffusion coefficient (ADC) estimation due to different scanner characteristics. Moreover, we aimed at assessing, for the first time, any effect of acquisition plan/phase encoding direction on ADC estimation. METHODS Water phantom acquisitions were carried out on 39 scanners. DWI acquisitions (b-value = 0-200-400-600-800-1000 s/mm2) with different acquisition plans (axial, coronal, sagittal) and phase encoding directions (anterior/posterior and right/left, for the axial acquisition plan), for 3 orthogonal diffusion weighting gradient directions, were performed. For each acquisition setup, ADC values were measured in-center and off-center (6 different positions), resulting in an entire dataset of 84 × 39 = 3276 ADC values. Spatial uniformity of ADC maps was assessed by means of the percentage difference between off-center and in-center ADC values (Δ). RESULTS No significant dependence of in-center ADC values on acquisition plan/phase encoding direction was found. Ward unsupervised clustering analysis showed 3 distinct clusters of scanners and an association between Δ-values and manufacturer/model, whereas no association between Δ-values and maximum gradient strength, slew rate or static magnetic field strength was revealed. Several acquisition setups showed significant differences among groups, indicating the introduction of different biases in ADC estimation. CONCLUSIONS Unsupervised clustering analysis of DWI data, obtained from several scanners using an extensive acquisition protocol, allows to reveal an association between measured ADC values and manufacturer/model of scanner, as well as to identify suboptimal DWI acquisition setups for accurate ADC estimation.
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Affiliation(s)
- Luca Fedeli
- S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, A.U.S.L. Toscana Centro, Italy
| | - Simone Busoni
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy
| | - Giacomo Belli
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy
| | | | - Angela Coniglio
- Department of Medical Physics, P.O. S. Filippo Neri, Roma, Italy
| | - Marco Esposito
- S.C. Fisica Sanitaria Firenze-Empoli, A.U.S.L. Toscana Centro, Firenze, Italy
| | - Luca Nocetti
- Servizio di Fisica Medica, A.O.U. Policlinico di Modena, Modena, Italy
| | - Roberto Sghedoni
- Fisica Medica, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Luisa Altabella
- Medical Physics Department, Hospital of Trento, APSS, Trento, Italy
| | - Eleonora Belligotti
- Fisica Medica ed Alte Tecnologie, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Silvia Bettarini
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy; Università degli Studi di Firenze, Firenze, Italy
| | - Margherita Betti
- S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy
| | - Rocchina Caivano
- U.O. Radioterapia Oncologica e Fisica Sanitaria, I.R.C.C.S. CROB, Rionero in Vulture (PZ), Italy
| | - Marco Carnì
- U.O.D. Fisica Sanitaria, A.O.U. Policlinico Umberto I, Roma, Italy
| | | | - Sara Cimolai
- U.O. Fisica Sanitaria, U.L.S.S. 2 Marca Trevigiana, Treviso, Italy
| | - Fabiola Cretti
- U.S.C. Fisica Sanitaria, A.O. Papa Giovanni XXIII, Bergamo, Italy
| | | | - Chiara Gasperi
- U.O.S.D. Fisica Sanitaria Arezzo, A.U.S.L. Toscana Sud Est, Arezzo, Italy
| | - Mara Giacometti
- S.O.D. Fisica Sanitaria, A.O.U. Ospedali Riuniti di Ancona, Ancona, Italy
| | - Fabrizio Levrero
- U.O. Fisica Sanitaria, Ospedale Policlinico San Martino, Genova, Italy
| | - Domenico Lizio
- Fisica Sanitaria, A.S.S.T. Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Marta Maieron
- S.O.C. Fisica Sanitaria, A.S.U.I. Udine S. Maria della Misericordia, Udine, Italy
| | - Simona Marzi
- S.C. Laboratorio di Fisica Medica e Sistemi Esperti, Istituto Nazionale Tumori Regina Elena, Roma, Italy
| | - Lorella Mascaro
- U.O.C. Fisica Sanitaria, A.S.S.T. Spedali Civili, Brescia, Italy
| | - Silvia Mazzocchi
- S.C. Fisica Sanitaria Firenze-Empoli, A.U.S.L. Toscana Centro, Firenze, Italy
| | - Gabriele Meliadò
- U.O.C. Fisica Sanitaria, A.O.U. Integrata di Verona, Verona, Italy
| | | | - Alessandra Niespolo
- U.O.C. Fisica Sanitaria Area Nord, A.U.S.L. Toscana Nord Ovest, Lucca, Italy
| | | | - Nadia Oberhofer
- Servizio Aziendale di Fisica Sanitaria, A.S. dell'Alto Adige, Bolzano, Italy
| | - Laura Orsingher
- U.O. Fisica Sanitaria, U.L.S.S. 2 Marca Trevigiana, Treviso, Italy
| | | | | | - Alessandro Savini
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Claudia Testa
- Dipartimento di Fisica e Astronomia, Università di Bologna, Bologna, Italy
| | - Paolo Tortoli
- U.O.C. Fisica Sanitaria, A.O.U. Careggi, Firenze, Italy; Università degli Studi di Firenze, Firenze, Italy
| | - Gianni Gobbi
- Università degli Studi di Perugia, Perugia, Italy
| | - Cesare Gori
- Università degli Studi di Firenze, Firenze, Italy
| | - Luca Bernardi
- S.O.C. Fisica Sanitaria Pistoia-Prato, A.U.S.L. Toscana Centro, Italy
| | - Marco Giannelli
- Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy.
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Galardi F, De Luca F, Biagioni C, Migliaccio I, Curigliano G, Minisini AM, Bonechi M, Moretti E, Risi E, McCartney A, Benelli M, Romagnoli D, Cappadona S, Gabellini S, Guarducci C, Conti V, Biganzoli L, Di Leo A, Malorni L. Circulating tumor cells and palbociclib treatment in patients with ER-positive, HER2-negative advanced breast cancer: results from a translational sub-study of the TREnd trial. Breast Cancer Res 2021; 23:38. [PMID: 33761970 PMCID: PMC7992319 DOI: 10.1186/s13058-021-01415-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Circulating tumor cells (CTCs) are prognostic in patients with advanced breast cancer (ABC). However, no data exist about their use in patients treated with palbociclib. We analyzed the prognostic role of CTC counts in patients enrolled in the cTREnd study, a pre-planned translational sub-study of TREnd (NCT02549430), that randomized patients with ABC to palbociclib alone or palbociclib plus the endocrine therapy received in the prior line of treatment. Moreover, we evaluated RB1 gene expression on CTCs and explored its prognostic role within the cTREnd subpopulation. Methods Forty-six patients with ER-positive, HER2-negative ABC were analyzed. Blood samples were collected before starting palbociclib treatment (timepoint T0), after the first cycle of treatment (timepoint T1), and at disease progression (timepoint T2). CTCs were isolated and counted by CellSearch® System using the CellSearch™Epithelial Cell kit. Progression-free survival (PFS), clinical benefit (CB) during study treatment, and time to treatment failure (TTF) after study treatment were correlated with CTC counts. Samples with ≥ 5 CTCs were sorted by DEPArray system® (DA). RB1 and GAPDH gene expression levels were measured by ddPCR. Results All 46 patients were suitable for CTCs analysis. CTC count at T0 did not show significant prognostic value in terms of PFS and CB. Patients with at least one detectable CTC at T1 (n = 26) had a worse PFS than those with 0 CTCs (n = 16) (p = 0.02). At T1, patients with an increase of at least three CTCs showed reduced PFS compared to those with no increase (mPFS = 3 versus 9 months, (p = 0.004). Finally, patients with ≥ 5 CTCs at T2 (n = 6/23) who received chemotherapy as post-study treatment had a shorter TTF (p = 0.02). Gene expression data for RB1 were obtained from 19 patients. CTCs showed heterogeneous RB1 expression. Patients with detectable expression of RB1 at any timepoint showed better, but not statistically significant, outcomes than those with undetectable levels. Conclusions CTC count seems to be a promising modality in monitoring palbociclib response. Moreover, CTC count at the time of progression could predict clinical outcome post-palbociclib. RB1 expression analysis on CTCs is feasible and may provide additional prognostic information. Results should be interpreted with caution given the small studied sample size. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01415-w.
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Affiliation(s)
- Francesca Galardi
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Francesca De Luca
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Prato, Italy
| | | | - Ilenia Migliaccio
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Giuseppe Curigliano
- Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy.,Department of Haematology and Haemato-Oncology, University of Milan, Milan, Italy
| | - Alessandro M Minisini
- Department of Oncology, Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Martina Bonechi
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Prato, Italy
| | - Erica Moretti
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Emanuela Risi
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Amelia McCartney
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy.,School of Clinical Sciences, Monash University, Melbourne, Australia
| | | | | | - Silvia Cappadona
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Stefano Gabellini
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Cristina Guarducci
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Prato, Italy.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - Valerio Conti
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Laura Biganzoli
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Angelo Di Leo
- "Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy
| | - Luca Malorni
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Prato, Italy. .,"Sandro Pitigliani" Medical Oncology Department, Hospital of Prato, Prato, Italy.
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Malorni L, Tyekucheva S, Hilbers FS, Ignatiadis M, Neven P, Colleoni M, Henry S, Ballestrero A, Bonetti A, Jerusalem G, Papadimitriou K, Bernardo A, Duhoux F, MacPherson I, Thomson A, Davies DM, Bergqvist M, Benelli M, McCartney A, De Swert H, Ruepp B, Rabaglio M, Maibach R, Piccart M, Regan MM. Abstract PS5-05: Serum thymidine kinase activity in patients with luminal metastatic breast cancer treated with palbociclib and fulvestrant within the PYTHIA trial. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ps5-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The CDK4/6 inhibitor palbociclib (P) plus fulvestrant (F) is approved for the treatment of patients (pts) with luminal metastatic breast cancer (MBC) progressed on prior endocrine therapy (ET). Despite clinical activity, a significant proportion of pts in this setting show primary resistance to P+F, with treatment failure within 3-6 months of initiation. To date there is no validated biomarker to identify such pts. Thymidine kinase 1 is a cancer proliferation marker downstream of the CDK4/6 pathway, whose activity can be measured in serum as a readout of tumour proliferation. Circulating thymidine kinase activity (TKa) is a potential prognostic and monitoring marker in pts treated with ET alone or in combination with P for MBC. However, the prognostic value of early changes in TKa during P+F treatment and its role in identifying pts with primary resistance are not yet defined. Here we prospectively investigated the role of serum TKa measured at different timepoints in pts treated with P+F within the PYTHIA trial (IBCSG 53-14/BIG 14-04; NCT02536742), a downstream trial of the AURORA platform (BIG 14-01; NCT02102165).
Methods: PYTHIA is a biomarker discovery phase II trial including pts (Aug ‘16 to Jun ’19) with ET-resistant luminal MBC who received P+F at standard schedule and dose with 3-monthly imaging. Serum samples were collected at baseline (D0; n=122), on-treatment at day 11-16 of cycle 1 (D15; n=108), and during the one week off P before initiating cycle 2 (D28: Day 24-37 of Cycle 1; n=108). TKa was measured with DiviTum®, a refined ELISA-based assay. Complete TKa response (CTR) was defined as TKa below the limit of detection (LOD; 20 Du/L) at D15. Cox models evaluated association of log-transformed TKa measurements with progression-free survival (PFS; from initiation of therapy until progression by RECIST criteria or death). Kaplan-Meier method estimated median, 3 and 6 months (95% CI) PFS in groups of patients defined by dichotomizing TKa as “high” or “low” at the median or by CTR. A sample size of 120 provided 80% power to detect a hazard ratio of 2.0 for biomarker with 30-50% prevalence (two-sided α=0.05) after ≥80 events.
Results: A total of 122 pts were enrolled. About half had received one prior line of ET for MBC, and 18% had received one prior line of chemotherapy. 48% had visceral metastases and 31% had bone-only disease. TKa at D0 was not associated with clinical characteristics. Median TKa (mTKa) at D0 was 87 Du/L. Overall, 82 pts experienced progression, with a median PFS (mPFS) of 11 months (95% CI: 8.6 - 16). P+F dramatically suppressed mTKa levels at D15, with 90/108 (83%) pts achieving CTR. At D28, TKa showed some rebound in most pts. At each timepoint, higher TKa was significantly and consistently associated with shorter PFS (each p<0.001). The effect of TKa on PFS remained statistically significant after adjusting for clinical variables. At 6 months, the largest difference between PFS probabilities was observed between patients with CTR versus no CTR at D15.
Conclusions: TKa is an independent prognostic biomarker in pts treated with P+F. High baseline TKa and incomplete suppression of TKa during treatment may identify pts with poor prognosis and primary resistance to P+F. TKa may represent a novel biomarker to select pts for alternative treatment modalities. These results warrant further investigation in prospective comparative trials.
TimepointBaseline (D0)D151D28TK median value (Du/L) (range)87 (<20 - 14,510)<20 (<20 - 7,060)52 (<20 - 3,533)Sample sizeHigh TKa611854Low TKa619054mPFS (months) (95% CI)High TKa7.4 m (5.5 - 8.7)4.9 m (2.8 - 5.9)8.3 m (5.6 - 11)Low TKa17.0 m (14 - NR2)16.0 m (11 - 30)19.0 m (17 - NR2)PFS at 3 months(95% CI)High Tka79% (43% - 68%)61% (42% - 88%)78% (67% - 90%)Low TKa93% (87% - 100%)92% (87% - 98%)96% (91% - 100%)PFS at 6 months(95% CI)High TKa54% (43% - 68%)17% (6% - 47%)56% (44% - 71%)Low TKa88% (81% - 97%)85% (78% - 93%)92% (86% - 100%)1For D15 High/Low TKa correspond to no CTR/CTR; 2 NR = not reached
Citation Format: Luca Malorni, Svitlana Tyekucheva, Florentine S Hilbers, Michail Ignatiadis, Patrick Neven, Marco Colleoni, Stéphanie Henry, Alberto Ballestrero, Andrea Bonetti, Guy Jerusalem, Konstantinos Papadimitriou, Antonio Bernardo, Francois Duhoux, Iain MacPherson, Alastair Thomson, David Mark Davies, Mattias Bergqvist, Matteo Benelli, Amelia McCartney, Heidi De Swert, Barbara Ruepp, Manuela Rabaglio, Rudolf Maibach, Martine Piccart, Meredith M Regan. Serum thymidine kinase activity in patients with luminal metastatic breast cancer treated with palbociclib and fulvestrant within the PYTHIA trial [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS5-05.
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Affiliation(s)
- Luca Malorni
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Svitlana Tyekucheva
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Florentine S Hilbers
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Michail Ignatiadis
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Patrick Neven
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Marco Colleoni
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Stéphanie Henry
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Alberto Ballestrero
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Andrea Bonetti
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Guy Jerusalem
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Konstantinos Papadimitriou
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Antonio Bernardo
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Francois Duhoux
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Iain MacPherson
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Alastair Thomson
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - David Mark Davies
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Mattias Bergqvist
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Matteo Benelli
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Amelia McCartney
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Heidi De Swert
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Barbara Ruepp
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Manuela Rabaglio
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Rudolf Maibach
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Martine Piccart
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
| | - Meredith M Regan
- PYTHIA collaborators, International Breast Cancer Study Group and Breast International Group, Bern, Switzerland
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Beltran H, Romanel A, Conteduca V, Casiraghi N, Sigouros M, Franceschini GM, Orlando F, Fedrizzi T, Ku SY, Dann E, Alonso A, Mosquera JM, Sboner A, Xiang J, Elemento O, Nanus DM, Tagawa ST, Benelli M, Demichelis F. Circulating tumor DNA profile recognizes transformation to castration-resistant neuroendocrine prostate cancer. J Clin Invest 2020; 130:1653-1668. [PMID: 32091413 DOI: 10.1172/jci131041] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [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: 08/15/2019] [Accepted: 12/18/2019] [Indexed: 12/15/2022] Open
Abstract
Loss of androgen receptor (AR) signaling dependence occurs in approximately 15%-20% of advanced treatment-resistant prostate cancers, and this may manifest clinically as transformation from a prostate adenocarcinoma histology to a castration-resistant neuroendocrine prostate cancer (CRPC-NE). The diagnosis of CRPC-NE currently relies on a metastatic tumor biopsy, which is invasive for patients and sometimes challenging to diagnose due to morphologic heterogeneity. By studying whole-exome sequencing and whole-genome bisulfite sequencing of cell free DNA (cfDNA) and of matched metastatic tumor biopsies from patients with metastatic prostate adenocarcinoma and CRPC-NE, we identified CRPC-NE features detectable in the circulation. Overall, there was markedly higher concordance between cfDNA and biopsy tissue genomic alterations in patients with CRPC-NE compared with castration-resistant adenocarcinoma, supporting greater intraindividual genomic consistency across metastases. Allele-specific copy number and serial sampling analyses allowed for the detection and tracking of clonal and subclonal tumor cell populations. cfDNA methylation was indicative of circulating tumor content fraction, reflective of methylation patterns observed in biopsy tissues, and was capable of detecting CRPC-NE-associated epigenetic changes (e.g., hypermethylation of ASXL3 and SPDEF; hypomethylation of INSM1 and CDH2). A targeted set combining genomic (TP53, RB1, CYLD, AR) and epigenomic (hypo- and hypermethylation of 20 differential sites) alterations applied to ctDNA was capable of identifying patients with CRPC-NE.
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Affiliation(s)
- Himisha Beltran
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Alessandro Romanel
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Vincenza Conteduca
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA.,Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Nicola Casiraghi
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Michael Sigouros
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Gian Marco Franceschini
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Francesco Orlando
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Tarcisio Fedrizzi
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Sheng-Yu Ku
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Emma Dann
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Alicia Alonso
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Juan Miguel Mosquera
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA.,Department of Pathology and Laboratory Medicine, and
| | - Andrea Sboner
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA.,Institute for Computational Biomedicine, Weill Cornell Medicine, New York, New York, USA
| | - Jenny Xiang
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Olivier Elemento
- Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA.,Institute for Computational Biomedicine, Weill Cornell Medicine, New York, New York, USA
| | - David M Nanus
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, New York, USA.,Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Scott T Tagawa
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, New York, USA.,Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA
| | - Matteo Benelli
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy.,Bioinformatics Unit, Hospital of Prato, Prato, Italy
| | - Francesca Demichelis
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy.,Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA.,Institute for Computational Biomedicine, Weill Cornell Medicine, New York, New York, USA
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35
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Galardi F, De Luca F, Romagnoli D, Biagioni C, Moretti E, Biganzoli L, Di Leo A, Migliaccio I, Malorni L, Benelli M. Cell-Free DNA-Methylation-Based Methods and Applications in Oncology. Biomolecules 2020; 10:E1677. [PMID: 33334040 PMCID: PMC7765488 DOI: 10.3390/biom10121677] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 10/27/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022] Open
Abstract
Liquid biopsy based on cell-free DNA (cfDNA) enables non-invasive dynamic assessment of disease status in patients with cancer, both in the early and advanced settings. The analysis of DNA-methylation (DNAm) from cfDNA samples holds great promise due to the intrinsic characteristics of DNAm being more prevalent, pervasive, and cell- and tumor-type specific than genomics, for which established cfDNA assays already exist. Herein, we report on recent advances on experimental strategies for the analysis of DNAm in cfDNA samples. We describe the main steps of DNAm-based analysis workflows, including pre-analytics of cfDNA samples, DNA treatment, assays for DNAm evaluation, and methods for data analysis. We report on protocols, biomolecular techniques, and computational strategies enabling DNAm evaluation in the context of cfDNA analysis, along with practical considerations on input sample requirements and costs. We provide an overview on existing studies exploiting cell-free DNAm biomarkers for the detection and monitoring of cancer in early and advanced settings, for the evaluation of drug resistance, and for the identification of the cell-of-origin of tumors. Finally, we report on DNAm-based tests approved for clinical use and summarize their performance in the context of liquid biopsy.
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Affiliation(s)
- Francesca Galardi
- «Sandro Pitigliani» Translational Research Unit, Hospital of Prato, 59100 Prato, Italy; (F.G.); (F.D.L.); (I.M.); (L.M.)
| | - Francesca De Luca
- «Sandro Pitigliani» Translational Research Unit, Hospital of Prato, 59100 Prato, Italy; (F.G.); (F.D.L.); (I.M.); (L.M.)
| | - Dario Romagnoli
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy; (D.R.); (C.B.)
| | - Chiara Biagioni
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy; (D.R.); (C.B.)
- «Sandro Pitigliani» Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy; (E.M.); (L.B.); (A.D.L.)
| | - Erica Moretti
- «Sandro Pitigliani» Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy; (E.M.); (L.B.); (A.D.L.)
| | - Laura Biganzoli
- «Sandro Pitigliani» Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy; (E.M.); (L.B.); (A.D.L.)
| | - Angelo Di Leo
- «Sandro Pitigliani» Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy; (E.M.); (L.B.); (A.D.L.)
| | - Ilenia Migliaccio
- «Sandro Pitigliani» Translational Research Unit, Hospital of Prato, 59100 Prato, Italy; (F.G.); (F.D.L.); (I.M.); (L.M.)
| | - Luca Malorni
- «Sandro Pitigliani» Translational Research Unit, Hospital of Prato, 59100 Prato, Italy; (F.G.); (F.D.L.); (I.M.); (L.M.)
- «Sandro Pitigliani» Medical Oncology Department, Hospital of Prato, 59100 Prato, Italy; (E.M.); (L.B.); (A.D.L.)
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy; (D.R.); (C.B.)
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Migliaccio I, Bonechi M, McCartney A, Guarducci C, Benelli M, Biganzoli L, Di Leo A, Malorni L. CDK4/6 inhibitors: A focus on biomarkers of response and post-treatment therapeutic strategies in hormone receptor-positive HER2-negative breast cancer. Cancer Treat Rev 2020; 93:102136. [PMID: 33360919 DOI: 10.1016/j.ctrv.2020.102136] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022]
Abstract
CDK4/6 inhibitors (CDK4/6i) in combination with endocrine therapy are the mainstay of treatment for patients with hormone receptor-positive, HER2 negative (HR+/HER2neg) metastatic breast cancer. However, resistance - either de novo or acquired - invariably occurs, leading to treatment failure and cancer progression. Genomic alterations, gene expression data and circulating biomarkers have been correlated to response to treatment, but to date no biomarker has been approved to stratify patients. Treatment strategies after progression on CDK4/6i are yet to be standardized. Current approaches include endocrine therapy alone or in combination with target therapy, or chemotherapy. New agents are in clinical development based on potential mechanisms of acquired resistance. Here we will review recent advancements in biomarkers of response to CDK4/6i, and in post- treatment therapeutic strategies.
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Affiliation(s)
- Ilenia Migliaccio
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy.
| | - Martina Bonechi
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Amelia McCartney
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Cristina Guarducci
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Laura Biganzoli
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Angelo Di Leo
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Luca Malorni
- "Sandro Pitigliani" Translational Research Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy; "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
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37
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Ghini V, Laera L, Fantechi B, del Monte F, Benelli M, McCartney A, Tenori L, Luchinat C, Pozzessere D. Metabolomics to Assess Response to Immune Checkpoint Inhibitors in Patients with Non-Small-Cell Lung Cancer. Cancers (Basel) 2020; 12:cancers12123574. [PMID: 33265926 PMCID: PMC7760033 DOI: 10.3390/cancers12123574] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Recently, immunotherapy has presented new opportunities for clinical development in the treatment of non-small cell lung cancer (NSCLC). Although effective in sustaining overall survival in several clinical trials, not all the NSCLC patients respond to these treatments. Thus, a better patient selection, as well as the identification of predictive biomarkers of treatment efficacy, are of paramount importance. In this work, metabolomics was used with the aim of identifying responder with respect to non-responder subjects. We show that the metabolomic fingerprint of serum samples, collected before therapy, acts as a predictive biomarker to treatment response. Prospective identification of subjects that will benefit from immunotherapy could improve patient stratification, thus optimizing the treatment and avoiding unsuccessful strategies. Abstract In the treatment of advanced non-small cell lung cancer (NSCLC), immune checkpoint inhibitors have shown remarkable results. However, not all patients with NSCLC respond to this drug treatment or receive durable benefits. Thus, patient stratification and selection, as well as the identification of predictive biomarkers, represent pivotal aspects to address. In this framework, metabolomics can be used to support the discrimination between responders and non-responders. Here, metabolomics was used to analyze the sera samples from 50 patients with NSCL treated with immune checkpoint inhibitors. All the samples were collected before the beginning of the treatment and were analyzed by NMR spectroscopy and multivariate statistical analyses. Significantly, we show that the metabolomic fingerprint of serum acts as a predictive “collective” biomarker to immune checkpoint inhibitors response, being able to predict individual therapy outcome with > 80% accuracy. Metabolomics represents a potential strategy for the real-time selection and monitoring of patients treated with immunotherapy. The prospective identification of responders and non-responders could improve NSCLC treatment and patient stratification, thus avoiding ineffective therapeutic strategies.
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Affiliation(s)
- Veronica Ghini
- Cirmmp, Via Luigi Sacconi 6, 50019 Sesto Fiorentino, Florence, Italy;
- Magnetic Resonance Center, CERM, University of Florence, Via Luigi Sacconi 6, 50019 Sesto Fiorentino, Florence, Italy;
| | - Letizia Laera
- Sandro Pitigliani, Department of Medical Oncology, Hospital of Prato, via Suor Niccolina Infermiera, 20/22, 59100 Prato, Italy; (L.L.); (B.F.); (F.d.M.); (A.M.)
- Department of Oncology, Miulli hospital, Acquaviva delle Fonti, 70021 Bari, Italy
| | - Beatrice Fantechi
- Sandro Pitigliani, Department of Medical Oncology, Hospital of Prato, via Suor Niccolina Infermiera, 20/22, 59100 Prato, Italy; (L.L.); (B.F.); (F.d.M.); (A.M.)
| | - Francesca del Monte
- Sandro Pitigliani, Department of Medical Oncology, Hospital of Prato, via Suor Niccolina Infermiera, 20/22, 59100 Prato, Italy; (L.L.); (B.F.); (F.d.M.); (A.M.)
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, via Suor Niccolina Infermiera, 20/22, 59100 Prato, Italy;
| | - Amelia McCartney
- Sandro Pitigliani, Department of Medical Oncology, Hospital of Prato, via Suor Niccolina Infermiera, 20/22, 59100 Prato, Italy; (L.L.); (B.F.); (F.d.M.); (A.M.)
| | - Leonardo Tenori
- Magnetic Resonance Center, CERM, University of Florence, Via Luigi Sacconi 6, 50019 Sesto Fiorentino, Florence, Italy;
- Department of Chemistry, University of Florence, via della Lastruccia 3, 50019 Sesto Fiorentino, Florence, Italy
| | - Claudio Luchinat
- Magnetic Resonance Center, CERM, University of Florence, Via Luigi Sacconi 6, 50019 Sesto Fiorentino, Florence, Italy;
- Department of Chemistry, University of Florence, via della Lastruccia 3, 50019 Sesto Fiorentino, Florence, Italy
- Correspondence: (C.L.); (D.P.); Tel.: +39-0554-574-296 (C.L.); +39-0574-802-520 (D.P.)
| | - Daniele Pozzessere
- Sandro Pitigliani, Department of Medical Oncology, Hospital of Prato, via Suor Niccolina Infermiera, 20/22, 59100 Prato, Italy; (L.L.); (B.F.); (F.d.M.); (A.M.)
- Correspondence: (C.L.); (D.P.); Tel.: +39-0554-574-296 (C.L.); +39-0574-802-520 (D.P.)
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38
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Cyrta J, Augspach A, De Filippo MR, Prandi D, Thienger P, Benelli M, Cooley V, Bareja R, Wilkes D, Chae SS, Cavaliere P, Dephoure N, Uldry AC, Lagache SB, Roma L, Cohen S, Jaquet M, Brandt LP, Alshalalfa M, Puca L, Sboner A, Feng F, Wang S, Beltran H, Lotan T, Spahn M, Kruithof-de Julio M, Chen Y, Ballman KV, Demichelis F, Piscuoglio S, Rubin MA. Role of specialized composition of SWI/SNF complexes in prostate cancer lineage plasticity. Nat Commun 2020; 11:5549. [PMID: 33144576 PMCID: PMC7642293 DOI: 10.1038/s41467-020-19328-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 10/07/2020] [Indexed: 01/06/2023] Open
Abstract
Advanced prostate cancer initially responds to hormonal treatment, but ultimately becomes resistant and requires more potent therapies. One mechanism of resistance observed in around 10–20% of these patients is lineage plasticity, which manifests in a partial or complete small cell or neuroendocrine prostate cancer (NEPC) phenotype. Here, we investigate the role of the mammalian SWI/SNF (mSWI/SNF) chromatin remodeling complex in NEPC. Using large patient datasets, patient-derived organoids and cancer cell lines, we identify mSWI/SNF subunits that are deregulated in NEPC and demonstrate that SMARCA4 (BRG1) overexpression is associated with aggressive disease. We also show that SWI/SNF complexes interact with different lineage-specific factors in NEPC compared to prostate adenocarcinoma. These data point to a role for mSWI/SNF complexes in therapy-related lineage plasticity, which may also be relevant for other solid tumors. The differentiation of prostate adenocarcinoma to neuroendocrine prostate cancer (CRPC-NE) is a mechanism of resistance to androgen deprivation therapy. Here the authors show that SWI/SNF chromatin-remodeling complex is deregulated in CRPC-NE and that the complex interacts with different lineage specific factors throughout prostate cancer transdifferentiation.
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Affiliation(s)
- Joanna Cyrta
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland.,The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Anke Augspach
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland
| | - Maria Rosaria De Filippo
- Department for BioMedical Research, Urology Research Laboratory, University of Bern, 3008, Bern, Switzerland.,Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, 4051, Basel, Switzerland
| | - Davide Prandi
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, 38122, Trento, Italy
| | - Phillip Thienger
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland
| | - Matteo Benelli
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, 38122, Trento, Italy.,Bioinformatics Unit, Hospital of Prato, 59100, Prato, Italy
| | - Victoria Cooley
- Department of Healthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Rohan Bareja
- The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA.,Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - David Wilkes
- The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Sung-Suk Chae
- Department of Laboratory Medicine and Pathology, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Paola Cavaliere
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Noah Dephoure
- Meyer Cancer Center, Weill Cornell Medicine, New York, NY, 10021, USA.,Department of Biochemistry, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Anne-Christine Uldry
- Proteomics Mass Spectrometry Core Facility, University of Bern, 3010, Bern, Switzerland
| | - Sophie Braga Lagache
- Proteomics Mass Spectrometry Core Facility, University of Bern, 3010, Bern, Switzerland
| | - Luca Roma
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, 4051, Basel, Switzerland
| | - Sandra Cohen
- Department of Laboratory Medicine and Pathology, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Muriel Jaquet
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland
| | - Laura P Brandt
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland
| | - Mohammed Alshalalfa
- Department of Radiation Oncology, Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, CA, USA
| | - Loredana Puca
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Andrea Sboner
- The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA.,Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA.,HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, 10021, USA.,Meyer Cancer Center, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Felix Feng
- Proteomics Mass Spectrometry Core Facility, University of Bern, 3010, Bern, Switzerland
| | - Shangqian Wang
- Human Oncology and Pathogenesis Program and Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065, USA
| | - Himisha Beltran
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, NY, 10021, USA.,Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Tamara Lotan
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.,Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Martin Spahn
- Lindenhofspital Bern, Prostate Center Bern, 3012, Bern, Switzerland.,Department of Urology, Essen University Hospital, University of Duisburg-Essen, 47057, Essen, Germany
| | - Marianna Kruithof-de Julio
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland.,Department for BioMedical Research, Urology Research Laboratory, University of Bern, 3008, Bern, Switzerland.,Department of Urology, Inselspital, 3010, Bern, Switzerland
| | - Yu Chen
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Karla V Ballman
- Department of Healthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, 10021, USA
| | - Francesca Demichelis
- The Caryl and Israel Englander Institute for Precision Medicine, Weill Cornell Medicine, New York, NY, 10021, USA.,Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, 38122, Trento, Italy
| | - Salvatore Piscuoglio
- Institute of Pathology and Medical Genetics, University Hospital Basel, University of Basel, 4051, Basel, Switzerland.,Visceral Surgery Research Laboratory, Clarunis, Department of Biomedicine, University of Basel, 4051, Basel, Switzerland.,Clarunis Universitäres Bauchzentrum Basel, 4002, Basel, Switzerland
| | - Mark A Rubin
- Department for BioMedical Research, University of Bern, 3008, Bern, Switzerland. .,Inselspital, 3010, Bern, Switzerland. .,Bern Center for Precision Medicine, 3008, Bern, Switzerland.
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39
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Guarnieri G, Sarchielli E, Comeglio P, Herrera-Puerta E, Piaceri I, Nacmias B, Benelli M, Kelsey G, Maggi M, Gallina P, Vannelli GB, Morelli A. Tumor Necrosis Factor α Influences Phenotypic Plasticity and Promotes Epigenetic Changes in Human Basal Forebrain Cholinergic Neuroblasts. Int J Mol Sci 2020; 21:E6128. [PMID: 32854421 PMCID: PMC7504606 DOI: 10.3390/ijms21176128] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 01/08/2023] Open
Abstract
TNFα is the main proinflammatory cytokine implicated in the pathogenesis of neurodegenerative disorders, but it also modulates physiological functions in both the developing and adult brain. In this study, we investigated a potential direct role of TNFα in determining phenotypic changes of a recently established cellular model of human basal forebrain cholinergic neuroblasts isolated from the nucleus basalis of Meynert (hfNBMs). Exposing hfNBMs to TNFα reduced the expression of immature markers, such as nestin and β-tubulin III, and inhibited primary cilium formation. On the contrary, TNFα increased the expression of TNFα receptor TNFR2 and the mature neuron marker MAP2, also promoting neurite elongation. Moreover, TNFα affected nerve growth factor receptor expression. We also found that TNFα induced the expression of DNA-methylation enzymes and, accordingly, downregulated genes involved in neuronal development through epigenetic mechanisms, as demonstrated by methylome analysis. In summary, TNFα showed a dual role on hfNBMs phenotypic plasticity, exerting a negative influence on neurogenesis despite a positive effect on differentiation, through mechanisms that remain to be elucidated. Our results help to clarify the complexity of TNFα effects in human neurons and suggest that manipulation of TNFα signaling could provide a potential therapeutic approach against neurodegenerative disorders.
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Affiliation(s)
- Giulia Guarnieri
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (E.S.); (G.B.V.)
| | - Erica Sarchielli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (E.S.); (G.B.V.)
| | - Paolo Comeglio
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | | | - Irene Piaceri
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy; (I.P.); (B.N.)
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy; (I.P.); (B.N.)
| | - Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, 50122 Prato, Italy;
| | - Gavin Kelsey
- Epigenetics Programme, The Babraham Institute, Cambridge CB22 3AT, UK;
- Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 1TN, UK
| | - Mario Maggi
- Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, 50134 Florence, Italy;
| | - Pasquale Gallina
- Neurosurgical Unit, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, 50134 Florence, Italy;
| | - Gabriella Barbara Vannelli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (E.S.); (G.B.V.)
| | - Annamaria Morelli
- Section of Human Anatomy and Histology, Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy; (E.S.); (G.B.V.)
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Benelli M, Biagioni C, Fimereli D, Hilbers FS, De Angelis C, Vivancos A, Venet D, Vingiani A, Irrthum A, Van Dooren V, Vuylsteke PW, Servitja S, Reis-Filho J, Curigliano G, Oliveira M, Piccart M, Aftimos P. Abstract 2488: Characterization of gene fusions in paired primary and metastatic samples of breast cancer in the AURORA molecular screening program. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Gene fusions (GFs) are genomic alterations with oncogenic potential. This class of alterations is highly actionable with targeted therapies showing high rates of durable responses in agnostic settings such as tumors with NTRK fusions. Recurrent GFs are rare in metastatic breast cancer (mBC) and ESR1 fusions drive endocrine resistance. AURORA is a molecular screening program for patients with mBC early in the course of their disease, collecting primary tumors, metastatic samples, liquid samples and longitudinal clinical follow-up data.
Experimental procedures
Patients are enrolled at the diagnosis of metastatic disease or after 1 line of therapy. Targeted gene sequencing of 411 BC genes is performed on the primary tumor, a metastatic sample, whole blood for germline variants and, for a subset of these genes, on tumor DNA from a baseline plasma sample. RNA-seq is performed on primary and metastatic tumor tissue samples. GFs were identified by rnafusion, a pipeline implementing 5 widely-used tools. Only GFs detected by at least 3 tools or 2 tools and 1 GF database match were considered for downstream analysis. Selected GFs were validated in-silico by FusionInspector. GFs detected in independent human normal tissue datasets were filtered out. Findings were correlated to available genomics, transcriptomics and clinical data.
Results
GFs data were generated from 316 paired primary/metastatic samples from 158 patients with curated clinical and genomic data: 97 ER+/HER2- (61.4%), 37 triple-negative (23.4%) and 24 HER2+ (15.2%). A total of 538 fusions were called in the primary samples (mean = 3.4 per sample) and 707 in the metastatic samples (mean = 4.5) with a validation rate of 72%. The gene fusion burden in metastatic samples was higher than in the primary (p<1e-4), especially for ER+ patients. In metastatic samples, gene fusion burden by PAM50 subtype was higher for basal, HER2-E and LumB when compared to LumA (max p=2e-3). A total of 400 acquired GFs were identified (mean=2.5 per sample), involving relevant BC genes, such as ESR1, ERBB2, NF1 and FGFR1.The presence of fusions involving actionable genes was associated with a shorter progression-free survival (PFS) on therapies in the metastatic setting (median PFS=8 vs 17 months, p=0.001).
Conclusions
We report on the characterization of GFs in a large cohort of patients with mBC. Through the analysis of matched primary and metastatic tumor samples from 158 patients, we delineated the landscape of acquired gene fusions in BC. We observed a significant increase of gene fusion burden in metastatic compared to corresponding primary samples, involving key BC genes. Fusions involving actionable genes were associated with shorter PFS. Additional integrative analyses combining detected GFs and available genomics, gene expression and/or patients' treatments and outcomes are ongoing and will be presented during the meeting.
Citation Format: Matteo Benelli, Chiara Biagioni, Danai Fimereli, Florentine S. Hilbers, Claudia De Angelis, Ana Vivancos, David Venet, Andrea Vingiani, Alexandre Irrthum, Veerle Van Dooren, Peter Willem Vuylsteke, Sonia Servitja, Jorge Reis-Filho, Giuseppe Curigliano, Mafalda Oliveira, Martine Piccart, Philippe Aftimos. Characterization of gene fusions in paired primary and metastatic samples of breast cancer in the AURORA molecular screening program [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2488.
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Affiliation(s)
- Matteo Benelli
- 1Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy
| | - Chiara Biagioni
- 1Azienda USL Toscana Centro, Hospital of Prato, Prato, Italy
| | - Danai Fimereli
- 2Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | | | - Claudia De Angelis
- 2Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | - Ana Vivancos
- 4Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - David Venet
- 2Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | - Andrea Vingiani
- 5Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, Milan, Italy
| | | | - Veerle Van Dooren
- 2Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | | - Giuseppe Curigliano
- 9Istituto Europeo di Oncologia, IRCCS and University of Milano, Milan, Italy
| | - Mafalda Oliveira
- 10Vall d'Hebron University Hospital / Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - Martine Piccart
- 2Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Aftimos
- 2Institut Jules Bordet – Université Libre de Bruxelles, Brussels, Belgium
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Riera-Escamilla A, Enguita-Marruedo A, Moreno-Mendoza D, Chianese C, Sleddens-Linkels E, Contini E, Benelli M, Natali A, Colpi GM, Ruiz-Castañé E, Maggi M, Baarends WM, Krausz C. Corrigendum. Sequencing of a 'mouse azoospermia' gene panel in azoospermic men: identification of RNF212 and STAG3 mutations as novel genetic causes of meiotic arrest. Hum Reprod 2020; 35:1945-1946. [PMID: 32715309 DOI: 10.1093/humrep/deaa179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/20/2019] [Accepted: 12/05/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Riera-Escamilla
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Instituto de Investigaciones Biomedicas Sant Pau (IIB-Sant Pau), 08025 Barcelona, Catalonia, Spain
| | - A Enguita-Marruedo
- Department of Developmental Biology, Erasmus MC University Medical Centre, 3015GD Rotterdam, The Netherlands
| | - D Moreno-Mendoza
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Instituto de Investigaciones Biomedicas Sant Pau (IIB-Sant Pau), 08025 Barcelona, Catalonia, Spain
| | - C Chianese
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', Centre of Excellence DeNothe, University of Florence, 50139 Florence, Italy
| | - E Sleddens-Linkels
- Department of Developmental Biology, Erasmus MC University Medical Centre, 3015GD Rotterdam, The Netherlands
| | - E Contini
- Department of Experimental and Clinical Medicine, Center of Research and Innovation of Myeloproliferative neoplasms (CRIMM), AOU Careggi, University of Florence, 50139 Florence, Italy
| | - M Benelli
- Bioinformatics Unit, Hospital of Prato, 59100 Prato, Italy
| | - A Natali
- Department of Urology, Careggi Hospital, University of Florence, 50139 Florence, Italy
| | - G M Colpi
- Department of Andrology and IVF, San Carlo Clinic, Paderno-Dugnano/Milano, 20037 Italy
| | - E Ruiz-Castañé
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Instituto de Investigaciones Biomedicas Sant Pau (IIB-Sant Pau), 08025 Barcelona, Catalonia, Spain
| | - M Maggi
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', Centre of Excellence DeNothe, University of Florence, 50139 Florence, Italy
| | - W M Baarends
- Department of Developmental Biology, Erasmus MC University Medical Centre, 3015GD Rotterdam, The Netherlands
| | - C Krausz
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Instituto de Investigaciones Biomedicas Sant Pau (IIB-Sant Pau), 08025 Barcelona, Catalonia, Spain.,Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', Centre of Excellence DeNothe, University of Florence, 50139 Florence, Italy
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42
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Benelli M, Barucci A, Zoppetti N, Calusi S, Redapi L, Della Gala G, Piffer S, Bernardi L, Fusi F, Pallotta S. Comprehensive Analysis of Radiomic Datasets by RadAR. Cancer Res 2020; 80:3170-3174. [PMID: 32540962 DOI: 10.1158/0008-5472.can-20-0332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/14/2020] [Accepted: 06/10/2020] [Indexed: 11/16/2022]
Abstract
Quantitative analysis of biomedical images, referred to as radiomics, is emerging as a promising approach to facilitate clinical decisions and improve patient stratification. The typical radiomic workflow includes image acquisition, segmentation, feature extraction, and analysis of high-dimensional datasets. While procedures for primary radiomic analyses have been established in recent years, processing the resulting radiomic datasets remains a challenge due to the lack of specific tools for doing so. Here we present RadAR (Radiomics Analysis with R), a new software to perform comprehensive analysis of radiomic features. RadAR allows users to process radiomic datasets in their entirety, from data import to feature processing and visualization, and implements multiple statistical methods for analysis of these data. We used RadAR to analyze the radiomic profiles of more than 850 patients with cancer from publicly available datasets and showed that it was able to recapitulate expected results. These results demonstrate RadAR as a reliable and valuable tool for the radiomics community. SIGNIFICANCE: A new computational tool performs comprehensive analysis of high-dimensional radiomic datasets, recapitulating expected results in the analysis of radiomic profiles of >850 patients with cancer from independent datasets.
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Affiliation(s)
- Matteo Benelli
- Bioinformatics Unit, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy.
| | - Andrea Barucci
- "Nello Carrara" Institute of Applied Physics, National Research Council, Florence, Italy
| | - Nicola Zoppetti
- "Nello Carrara" Institute of Applied Physics, National Research Council, Florence, Italy
| | - Silvia Calusi
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio", University of Florence, Florence, Italy
| | - Laura Redapi
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio", University of Florence, Florence, Italy
| | - Giuseppe Della Gala
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio", University of Florence, Florence, Italy
| | - Stefano Piffer
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio", University of Florence, Florence, Italy
| | - Luca Bernardi
- Medical Physics Unit Pistoia Prato, Azienda USL Toscana Centro, Pistoia, Italy
| | - Franco Fusi
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio", University of Florence, Florence, Italy
| | - Stefania Pallotta
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio", University of Florence, Florence, Italy.,Medical Physics Unit, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
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McCartney A, Benelli M, Di Leo A. Estimating the magnitude of clinical benefit from (neo)adjuvant chemotherapy in patients with ER-positive/HER2-negative breast cancer. Breast 2020; 48 Suppl 1:S81-S84. [PMID: 31839168 DOI: 10.1016/s0960-9776(19)31130-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Gene-expression assays were originally validated retrospectively as tools of prognostication, with evidence emerging from more recent prospectively-conducted studies such as MINDACT and TAILORx supporting their clinical validity and utility as biomarkers in identifying patients with luminal breast cancer who might be spared chemotherapy. However, these assays still do not have the ability to identify all patients who may safely avoid chemotherapy, and may over-estimate the risk of relapse in some cases. Future studies should aim to prospectively integrate contemporary approaches that assume a theoretical risk of relapse (based on pathological and/or genomic evaluation of the primary tumour), with new tools that can detect signals of active micro-metastatic disease. Until current methods of estimating prognosis and predicting benefit from adjuvant chemotherapy are significantly refined, estimating and improving the true magnitude of benefit derived from chemotherapy remains a challenge for clinicians.
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Affiliation(s)
- Amelia McCartney
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Prato, Italy
| | | | - Angelo Di Leo
- "Sandro Pitigliani" Department of Medical Oncology, Hospital of Prato, Prato, Italy.
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Galardi F, Biagioni C, De Luca F, Curigliano G, Minisini A, Bonechi M, Moretti E, Risi E, Migliaccio I, McCartney A, Benelli M, Romagnoli D, Conti V, Biganzoli L, Di Leo A, Malorni L. 6P Circulating tumour cells (CTCs) as biomarkers of resistance to the CDK4/6 inhibitor (CDK4/6i) palbociclib (P) in patients (pts) with ER+/HER2-negative advanced breast cancer (ABC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Bianchini G, De Laurentiis M, Arpino G, Zambelli A, Puglisi F, Del Mastro L, Colleoni M, Montemurro F, Bianchi G, Paris I, Allegrini G, Amaducci L, Cazzaniga M, Orditura M, Zamagni C, Bianchetti S, Castelletti D, Benelli M, Callari M, Malorni L. 11P BioItaLEE: Comparative biomarker analysis of liquid biopsies and paired tissue samples of patients treated with ribociclib and letrozole as first-line therapy for advanced breast cancer (aBC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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46
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Wu A, Cremaschi P, Wetterskog D, Conteduca V, Franceschini GM, Kleftogiannis D, Jayaram A, Sandhu S, Wong SQ, Benelli M, Salvi S, Gurioli G, Feber A, Pereira MB, Wingate AM, Gonzalez-Billalebeitia E, De Giorgi U, Demichelis F, Lise S, Attard G. Genome-wide plasma DNA methylation features of metastatic prostate cancer. J Clin Invest 2020; 130:1991-2000. [PMID: 32149736 PMCID: PMC7108919 DOI: 10.1172/jci130887] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [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: 06/06/2019] [Accepted: 01/08/2020] [Indexed: 12/25/2022] Open
Abstract
Tumor DNA circulates in the plasma of cancer patients admixed with DNA from noncancerous cells. The genomic landscape of plasma DNA has been characterized in metastatic castration-resistant prostate cancer (mCRPC) but the plasma methylome has not been extensively explored. Here, we performed next-generation sequencing (NGS) on plasma DNA with and without bisulfite treatment from mCRPC patients receiving either abiraterone or enzalutamide in the pre- or post-chemotherapy setting. Principal component analysis on the mCRPC plasma methylome indicated that the main contributor to methylation variance (principal component one, or PC1) was strongly correlated with genomically determined tumor fraction (r = -0.96; P < 10-8) and characterized by hypermethylation of targets of the polycomb repressor complex 2 components. Further deconvolution of the PC1 top-correlated segments revealed that these segments are comprised of methylation patterns specific to either prostate cancer or prostate normal epithelium. To extract information specific to an individual's cancer, we then focused on an orthogonal methylation signature, which revealed enrichment for androgen receptor binding sequences and hypomethylation of these segments associated with AR copy number gain. Individuals harboring this methylation pattern had a more aggressive clinical course. Plasma methylome analysis can accurately quantitate tumor fraction and identify distinct biologically relevant mCRPC phenotypes.
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Affiliation(s)
- Anjui Wu
- University College London Cancer Institute, London, United Kingdom
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom
| | - Paolo Cremaschi
- University College London Cancer Institute, London, United Kingdom
| | | | - Vincenza Conteduca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | | | - Anuradha Jayaram
- University College London Cancer Institute, London, United Kingdom
| | - Shahneen Sandhu
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen Q. Wong
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Victoria, Australia
| | - Matteo Benelli
- Centre for Integrative Biology, University of Trento, Trento, Italy
| | - Samanta Salvi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giorgia Gurioli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Andrew Feber
- University College London Cancer Institute, London, United Kingdom
| | | | | | - Enrique Gonzalez-Billalebeitia
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, IMIB-Universidad de Murcia, Murcia, Spain
| | - Ugo De Giorgi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Francesca Demichelis
- Centre for Integrative Biology, University of Trento, Trento, Italy
- Institute of Computational Biomedicine, Weill Cornell Medicine, New York, New York, USA
| | - Stefano Lise
- Centre for Evolution and Cancer, The Institute of Cancer Research, London, United Kingdom
| | - Gerhardt Attard
- University College London Cancer Institute, London, United Kingdom
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Lorito N, Bacci M, Smiriglia A, Mannelli M, Parri M, Comito G, Ippolito L, Giannoni E, Bonechi M, Benelli M, Migliaccio I, Malorni L, Chiarugi P, Morandi A. Glucose Metabolic Reprogramming of ER Breast Cancer in Acquired Resistance to the CDK4/6 Inhibitor Palbociclib .. Cells 2020; 9:cells9030668. [PMID: 32164162 PMCID: PMC7140692 DOI: 10.3390/cells9030668] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 12/21/2022] Open
Abstract
The majority of breast cancers express the estrogen receptor (ER) and are dependent on estrogen for their growth and survival. Endocrine therapy (ET) is the standard of care for these tumors. However, a superior outcome is achieved in a subset of ER positive (ER+)/human epidermal growth factor receptor 2 negative (HER2−) metastatic breast cancer patients when ET is administrated in combination with a cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor, such as palbociclib. Moreover, CDK4/6 inhibitors are currently being tested in ER+/HER2+ breast cancer and reported encouraging results. Despite the clinical advances of a combinatorial therapy using ET plus CDK4/6 inhibitors, potential limitations (i.e., resistance) could emerge and the metabolic adaptations underlying such resistance warrant further elucidation. Here we investigate the glucose-dependent catabolism in a series of isogenic ER+ breast cancer cell lines sensitive to palbociclib and in their derivatives with acquired resistance to the drug. Importantly, ER+/HER2− and ER+/HER2+ cell lines show a different degree of glucose dependency. While ER+/HER2− breast cancer cells are characterized by enhanced aerobic glycolysis at the time of palbociclib sensitivity, ER+/HER2+ cells enhance their glycolytic catabolism at resistance. This metabolic phenotype was shown to have prognostic value and was targeted with multiple approaches offering a series of potential scenarios that could be of clinical relevance.
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Affiliation(s)
- Nicla Lorito
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Marina Bacci
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Alfredo Smiriglia
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Michele Mannelli
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Matteo Parri
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Giuseppina Comito
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Luigi Ippolito
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Elisa Giannoni
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Martina Bonechi
- Translational Research Unit, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, I-59100 Prato, Italy; (M.B.); (I.M.); (L.M.)
| | - Matteo Benelli
- Bioinformatics Unit, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, I-59100 Prato, Italy;
| | - Ilenia Migliaccio
- Translational Research Unit, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, I-59100 Prato, Italy; (M.B.); (I.M.); (L.M.)
| | - Luca Malorni
- Translational Research Unit, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, I-59100 Prato, Italy; (M.B.); (I.M.); (L.M.)
- “Sandro Pitigliani” Oncology Department, Azienda USL Toscana Centro, Hospital of Prato, Via Suor Niccolina Infermiera 20, I-59100 Prato, Italy
| | - Paola Chiarugi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
| | - Andrea Morandi
- Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Morgagni 50, I-50134 Florence, Italy; (N.L.); (M.B.); (A.S.); (M.M.); (M.P.); (G.C.); (L.I.); (E.G.); (P.C.)
- Correspondence:
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Beltran H, Romanel A, Conteduca V, Casiraghi N, Sigouros M, Franceschini GM, Fedrizzi T, Ku SY, Alonso A, Mosquera JM, Dann E, Sboner A, Xiang J, Elemento O, Nanus DM, Tagawa ST, Benelli M, Demichelis F. Circulating tumor DNA (ctDNA) to detect neuroendocrine prostate cancer genomic and DNA methylation changes. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8 Background: Loss of androgen receptor signaling dependence occurs in approximately 20% of treatment resistant prostate cancers, and this may manifest as transformation to castration resistant neuroendocrine prostate cancer (CRPC-NE). The diagnosis of CRPC-NE relies on a metastatic tumor biopsy, which is invasive for patients. Here we study ctDNA as an approach to identify CRPC-NE-associated genomic and epigenomic changes. We also use this as a tool to understand tumor heterogeneity and clonal dynamics that occurs during CRPC-NE progression. Methods: 64 patients with metastatic prostate cancer (10 hormone naive, 35 castration resistant adenocarcinoma (CRPC-Adeno), 17 CRPC-NE) were prospectively enrolled for matched metastatic biopsy and blood collection. Twenty-four had multiple time-points, for total of 69 plasma and 98 metastatic tissues. Whole exome sequencing (WES) and whole genome bisulfite sequencing(of subset) of ctDNA,germline DNA, and metastatic biopsies were performed. Results: Overall there was high concordance of alterations between ctDNA and patient-matched metastasis, though this was highest in CRPC-NE. There was also less heterogeneity across patients with CRPC-NE. Alteration frequencies were consistent with published tissue-based studies with AR alterations enriched in CRPC-Adeno and TP53and RB1loss enriched in CRPC-NE ctDNA. The prognostic significance of these alterations differed based on histologic subtype. Allele-specific copy number analysis and serial sampling allowed for the detection and tracking of clonal and subclonal tumor cell populations. cfDNA methylation was reflective of methylation patterns in biopsies and detected CRPC-NE-associated epigenetic changes.A targeted set combining genomic ( TP53, RB1, CYLD, AR) and epigenomic(20 differential DNA methylation sites) was capable of identifying patients with CRPC-NE. Conclusions: WES and whole genome methylation of ctDNA is feasible, concordant with biopsy tissues, and identifies the spectrum and frequency of CRPC-NE genomic and epigenomic changes. A targeted panel extended and validated in larger cohorts could potentially improve the detection of CRPC-NE using non-invasive ctDNA profiling.
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Affiliation(s)
| | | | | | | | - Michael Sigouros
- Department of Medicine, Division of Medical Oncology, Weill Cornell Medicine, New York City, NY
| | | | | | | | | | - Juan Miguel Mosquera
- Department of Pathology & Laboratory Medicine, Englander Institute for Precision Medicine, Weill Cornell Medical College & New York-Presbyterian Hospital, New York, NY
| | | | | | | | - Olivier Elemento
- Department of Physiology and Biophysics, Institute for Computational Biomedicine, Englander Institute for Precision Medicine, Weill Cornell Medical College, New York, NY
| | | | | | | | - Francesca Demichelis
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
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Benelli M, Bonechi M, Romagnoli D, Biagioni C, Migliaccio I, De Luca F, Galardi F, Leo AD, Malorni L. Abstract P4-04-07: A DNA-methylation signature to predict resistance to the CDK4/6 inhibitor palbociclib. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p4-04-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: CDK4/6 inhibitors, such as palbociclib, target the cyclin-dependent kinases 4 and 6, essential for cell cycle regulation. Preclinical studies have suggested potential determinants of palbociclib sensitivity and clinical data have recently indicated loss-of function mutations in RB1 and increased expression of CCNE1 as potential biomarkers of resistance in a fraction of breast cancer (BC) patients. In line with these studies, using a panel of resistant luminal BC cell lines made resistant to palbociclib we recently demonstrated a common transcriptional signature of resistance to this agent, including the over-expression of CCNE1 and under-expression of RB1. Based on these data, we developed a minimal signature of de-novo resistance to palbociclib (ratio between CCNE1 and RB1, CCNE1/RB1) and demonstrated its prognostic role in both preclinical and clinical datasets. Gene expression signatures, such as CCNE1/RB1, are limited to the analysis of tissue samples because they are not easily detectable in liquid biopsies. Based on the key role DNA-methylation (DNAm) plays in regulating gene expression in human cells, we hypothesized that DNAm could be used as surrogate of our gene expression signature, with the further advantage of being easily adapted to non-invasive screenings. Exploiting this concept, here we report on a DNAm-based signature mirroring CCNE1/RB1 and its potential role in predicting resistance to palbociclib in BC patients.
Materials and methods: Seven estrogen receptor positive breast cancer cell lines with acquired in vitro resistance to palbociclib were used. DNAm profiles of untreated parental cells and of their palbociclib-resistant counterparts were generated through Illumina Infinium MethylationEPIC BeadChip. For each cell line, candidate DNAm sites associated with resistance to palbociclib were selected by differential DNAm analysis in resistant versus sensitive counterparts. To identify DNAm sites/regions distinguishing CCNE1/RB1 high vs low patients, RNA-seq data from ER+/HER2- patients in the TCGA-BRCA dataset were considered and patients were classified as CCNE1/RB1 high (≥90% quantile) or low (≤10% quantile). Matched DNAm data were exploited to perform differential DNAm analysis between CCNE1/RB1 high and low samples by Rocker-meth, a tool recently developed by our group to perform differential DNAm analysis. The pharmacogenomic cancerrxgene dataset was used to test the association between the CCNE1/RB1 DNAm signature and the measure of effectiveness of palbociclib across multiple BC cell lines.
Results: From the differential methylation analysis of CCNE1/RB1 high versus low ER+/HER2- BC patients from the TCGA-BRCA dataset we identified the set of sites and regions that compose our DNAm-based signature. In-silico functional analysis of differentially methylated sites and regions showed significant enrichment of regulatory-related terms. Both hyper- and hypo- DNAm sites in resistant versus untreated sensitive cell lines were significantly enriched in the set of differentially methylated sites in CCNE1/RB1 high versus low TCGA samples. In the cancerrxgene dataset, the CCNE1/RB1 DNAm signature correlated with higher IC50 in breast cancer cell lines.
Conclusions: This study shows that DNAm is a potential predictor of resistance to palbociclib in ER+/HER2- patients. The DNAm-based signature mirroring CCNE1/RB1 developed using TCGA-BRCA dataset was validated in our preclinical BC cell lines and associated with effectiveness of palbociclib in an independent BC cell line dataset. Ongoing studies on the analysis of DNAm in liquid biopsies of metastatic luminal BC patients will evaluate the reliability of this DNAm signature in predicting resistance to palbociclib.
Citation Format: Matteo Benelli, Martina Bonechi, Dario Romagnoli, Chiara Biagioni, Ilenia Migliaccio, Francesca De Luca, Francesca Galardi, Angelo Di Leo, Luca Malorni. A DNA-methylation signature to predict resistance to the CDK4/6 inhibitor palbociclib [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-04-07.
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Affiliation(s)
- Matteo Benelli
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Martina Bonechi
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Dario Romagnoli
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Chiara Biagioni
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Ilenia Migliaccio
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Francesca De Luca
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Francesca Galardi
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Angelo Di Leo
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Luca Malorni
- "Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
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Malorni L, Migliaccio I, Biagioni C, Rossi L, De Santo I, Love RL, McCartney A, Bergqvist M, Bonechi M, De Luca F, Galardi F, Benelli M, Romagnoli D, Risi E, Biganzoli L, Laudico A, Van Dinh N, Leo AD. Abstract P5-06-11: Serum thymidine kinase-1 activity (TKa) as a prognostic marker in premenopausal women with hormone receptor positive (HR+) operable breast cancer (BC). Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p5-06-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Thymidine kinase is an established marker of cancer cell proliferation and its activity can be measured in blood. We and others have recently shown that baseline and dynamic evaluation of circulating thymidine kinase activity (TKa) during treatment gives prognostic and predictive information in patients with HR+, HER2-negative metastatic BC treated with endocrine therapy alone, as well as in the setting of CDK4/6 inhibition. However, there is limited data regarding the role of TKa as a prognostic biomarker in operable BC. Here we present a retrospective analysis of TKa in serum samples collected in a cohort of premenopausal women with operable BC enrolled in a phase III adjuvant multicenter clinical trial (NCT00201851).
Materials and methods: Serum samples were available for 644 (87%) of participants prospectively enrolled in a randomized trial between 2003 and 2009 in South East Asia. All women were premenopausal, had stage II-IIIB HR+ operable BC and uniformly received bilateral surgical oophorectomy concurrent with mastectomy followed by tamoxifen alone for five years. Patients did not receive chemotherapy or targeted therapy pre- or post-operatively. Participants were randomized in the study according to the timing of surgery with respect to the phase of the menstrual cycle. Serum samples were collected preoperatively on the day of surgery. Serum TKa was measured using the ELISA-based DiviTum™ assay (Biovica, Sweden). TKa analysis was performed at a central laboratory, blind to clinical data. Baseline TKa values were correlated with clinico-pathological characteristics and clinical outcome. Clinical outcome was estimated using the Kaplan-Meier method.
Results: The majority of patients had both estrogen and progesterone receptor positive tumors (94% and 92% respectively), 65% were HER2 negative (18% positive; 17% unknown). Most had pT2 or pT3 disease (60% and 27% respectively), and more than half were node-positive (pN0 42%, pN1 27%, pN2 19%, pN3 11%, pNx 1%). The overall median TKa value was 65.4 Du/L. At five years, patients with a baseline TKa value below the median had a disease-free survival (DFS) rate of 75% versus 61% in those with a baseline over the median (HR 1.82, 95% CI 1.37-2.4, p<0.001). Similar results were observed when women with HER2+ disease were excluded from analysis (HR 1.71, 95% CI 1.21-2.42, p=0.0025). Further prognostic precision was achieved when TKa values were divided by quartiles, with a 5 year DFS rate of 81%, 69%, 63% and 58% observed in the 1st, 2nd, 3rd and 4th quartiles respectively. After adjusting for major prognostic factors and randomization arm, TKa remained an independent marker.
Conclusions: This study shows pre-operative TKa measured in serum is a strong prognostic marker in a large cohort of women with HR+ operable BC uniformly treated within a clinical trial. The notable rate of recurrence seen within this cohort of patients derived from non-high income countries may be mainly attributed to the relative degree of disease burden at diagnosis. TKa may be seen as a potential circulating marker of proliferation akin to tumor Ki67, which may provide useful prognostic information to guide adjuvant therapies.
Citation Format: Luca Malorni, Ilenia Migliaccio, Chiara Biagioni, Lorenzo Rossi, Irene De Santo, Richard L Love, Amelia McCartney, Mattias Bergqvist, Martina Bonechi, Francesca De Luca, Francesca Galardi, Matteo Benelli, Dario Romagnoli, Emanuela Risi, Laura Biganzoli, Adriano Laudico, Nguyen Van Dinh, Angelo Di Leo. Serum thymidine kinase-1 activity (TKa) as a prognostic marker in premenopausal women with hormone receptor positive (HR+) operable breast cancer (BC) [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P5-06-11.
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Affiliation(s)
- Luca Malorni
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Ilenia Migliaccio
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Chiara Biagioni
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Lorenzo Rossi
- 2Institute of Oncology of Southern Switzerland, Bellinzona, Switzerland
| | | | - Richard L Love
- 4Department of Computer Science, Marquette University, Milwakee, WI
| | - Amelia McCartney
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | | | - Martina Bonechi
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Francesca De Luca
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Francesca Galardi
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Matteo Benelli
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Dario Romagnoli
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Emanuela Risi
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | - Laura Biganzoli
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
| | | | | | - Angelo Di Leo
- 1"Sandro Pitigliani" Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy
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