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Ricciuti B, Lamberti G, Puchala SR, Mahadevan NR, Lin JR, Alessi JV, Chowdhury A, Li YY, Wang X, Spurr L, Pecci F, Di Federico A, Venkatraman D, Barrichello AP, Gandhi M, Vaz VR, Pangilinan AJ, Haradon D, Lee E, Gupta H, Pfaff KL, Welsh EL, Nishino M, Cherniack AD, Johnson BE, Weirather JL, Dryg ID, Rodig SJ, Sholl LM, Sorger P, Santagata S, Umeton R, Awad MM. Genomic and Immunophenotypic Landscape of Acquired Resistance to PD-(L)1 Blockade in Non-Small-Cell Lung Cancer. J Clin Oncol 2024; 42:1311-1321. [PMID: 38207230 DOI: 10.1200/jco.23.00580] [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: 03/15/2023] [Revised: 08/27/2023] [Accepted: 10/24/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE Although immune checkpoint inhibitors (ICI) have extended survival in patients with non-small-cell lung cancer (NSCLC), acquired resistance (AR) to ICI frequently develops after an initial benefit. However, the mechanisms of AR to ICI in NSCLC are largely unknown. METHODS Comprehensive tumor genomic profiling, machine learning-based assessment of tumor-infiltrating lymphocytes, multiplexed immunofluorescence, and/or HLA-I immunohistochemistry (IHC) were performed on matched pre- and post-ICI tumor biopsies from patients with NSCLC treated with ICI at the Dana-Farber Cancer Institute who developed AR to ICI. Two additional cohorts of patients with intervening chemotherapy or targeted therapies between biopsies were included as controls. RESULTS We performed comprehensive genomic profiling and immunophenotypic characterization on samples from 82 patients with NSCLC and matched pre- and post-ICI biopsies and compared findings with a control cohort of patients with non-ICI intervening therapies between biopsies (chemotherapy, N = 32; targeted therapies, N = 89; both, N = 17). Putative resistance mutations were identified in 27.8% of immunotherapy-treated cases and included acquired loss-of-function mutations in STK11, B2M, APC, MTOR, KEAP1, and JAK1/2; these acquired alterations were not observed in the control groups. Immunophenotyping of matched pre- and post-ICI samples demonstrated significant decreases in intratumoral lymphocytes, CD3e+ and CD8a+ T cells, and PD-L1-PD1 engagement, as well as increased distance between tumor cells and CD8+PD-1+ T cells. There was a significant decrease in HLA class I expression in the immunotherapy cohort at the time of AR compared with the chemotherapy (P = .005) and the targeted therapy (P = .01) cohorts. CONCLUSION These findings highlight the genomic and immunophenotypic heterogeneity of ICI resistance in NSCLC, which will need to be considered when developing novel therapeutic strategies aimed at overcoming resistance.
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Affiliation(s)
- Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Sreekar R Puchala
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
| | | | - Jia-Ren Lin
- Laboratory of Systems Pharmacology, Department of Systems Biology, Harvard Medical School, Boston, MA
- Ludwig Center at Harvard, Harvard Medical School, Boston, MA
| | - Joao V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Alexander Chowdhury
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
| | - Yvonne Y Li
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Xinan Wang
- Harvard School of Public Health, Boston, MA
| | - Liam Spurr
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Federica Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Deepti Venkatraman
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Malini Gandhi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Victor R Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Andy J Pangilinan
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Danielle Haradon
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Elinton Lee
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Hersh Gupta
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
| | - Kathleen L Pfaff
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Emma L Welsh
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, MA
| | - Andrew D Cherniack
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
- Ludwig Center at Harvard, Harvard Medical School, Boston, MA
| | - Bruce E Johnson
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jason L Weirather
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Ian D Dryg
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Scott J Rodig
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Peter Sorger
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
- Laboratory of Systems Pharmacology, Department of Systems Biology, Harvard Medical School, Boston, MA
- Ludwig Center at Harvard, Harvard Medical School, Boston, MA
| | - Sandro Santagata
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
- Laboratory of Systems Pharmacology, Department of Systems Biology, Harvard Medical School, Boston, MA
- Ludwig Center at Harvard, Harvard Medical School, Boston, MA
| | - Renato Umeton
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
| | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
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Doyle TJ, Juge PA, Peljto AL, Lee S, Walts AD, Esposito AJ, Poli S, Gill R, Hatabu H, Nishino M, Dellaripa PF, Weinblatt ME, Shadick NA, Demoruelle MK, Sparks JA, Rosas IO, Granger B, Deane KD, Crestani B, Wolters PJ, Dieudé P, Lee JS. Short peripheral blood leukocyte telomere length in rheumatoid arthritis-interstitial lung disease. Thorax 2024; 79:182-185. [PMID: 38071573 PMCID: PMC10911453 DOI: 10.1136/thorax-2023-220022] [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] [Indexed: 12/22/2023]
Abstract
Shortened telomere lengths (TLs) can be caused by single nucleotide polymorphisms and loss-of-function mutations in telomere-related genes (TRG), as well as ageing and lifestyle factors such as smoking. Our objective was to determine if shortened TL is associated with interstitial lung disease (ILD) in individuals with rheumatoid arthritis (RA). This is the largest study to demonstrate and replicate that shortened peripheral blood leukocytes-TL is associated with ILD in patients with RA compared with RA without ILD in a multinational cohort, and short PBL-TL was associated with baseline disease severity in RA-ILD as measured by forced vital capacity percent predicted.
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Affiliation(s)
- Tracy J Doyle
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Pierre-Antoine Juge
- Université Paris Cité, INSERM UMR 1152, F-75018, Paris, France
- Service de Rhumatologie, Hôpital Bichat-Claude Bernard, AP-HP, F-75018, Paris, France
| | - Anna L Peljto
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, California, USA
| | - Seoyeon Lee
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, California, USA
| | - Avram D Walts
- Department of Medicine, National Jewish Health, Denver, Colorado, USA
| | - Anthony Joseph Esposito
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sergio Poli
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ritu Gill
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Paul F Dellaripa
- Department of Medicine, Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Michael E Weinblatt
- Department of Medicine, Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nancy A Shadick
- Department of Medicine, Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - M Kristen Demoruelle
- Department of Medicine, Division of Rheumatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jeffrey A Sparks
- Department of Medicine, Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ivan O Rosas
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Benjamin Granger
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Hôpital Pitié Salpétrière, Public Health Department, F75013, Paris, France
| | - Kevin D Deane
- Department of Medicine, Division of Rheumatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Bruno Crestani
- Université Paris Cité, INSERM UMR 1152, F-75018, Paris, France
- Department of Pulmonology, Centre de Référence des Maladies Pulmonaires Rares, Hopital Bichat-Claude Bernard, APHP, Paris, France
| | - Paul J Wolters
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
| | - Philippe Dieudé
- Université Paris Cité, INSERM UMR 1152, F-75018, Paris, France
- Service de Rhumatologie, Hôpital Bichat-Claude Bernard, AP-HP, F-75018, Paris, France
| | - Joyce S Lee
- Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Denver, Colorado, USA
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Nishino M. Jellyfish Sign for Visceral Pleural Invasion in Lung Cancer: Reviving the Lost Art of Radiology. Radiology 2024; 310:e233171. [PMID: 38193843 DOI: 10.1148/radiol.233171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Affiliation(s)
- Mizuki Nishino
- From the Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215
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4
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Luo J, Sanchez M, Lee E, Hertzler H, Luong N, Mazzola E, Finstein B, Tamen R, Brisbane G, Nguyen T, Paik PK, Chaft JE, Cheng ML, Khalil H, Piha-Paul SA, Sholl LM, Nishino M, Jänne PA, DuBois SG, Hanna GJ, Shapiro GI, French CA. Initial Chemotherapy for Locally Advanced and Metastatic NUT Carcinoma. J Thorac Oncol 2023:S1556-0864(23)02431-0. [PMID: 38154515 DOI: 10.1016/j.jtho.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION NUT carcinoma (NC) is an underdiagnosed and aggressive poorly differentiated or squamous cell cancer. A subset of NC is sensitive to chemotherapy, but the optimal regimen is unknown. Experts have recommended platinum- and ifosfamide-based therapy based on case reports. METHODS Patients with pathologically confirmed NC with known survival outcomes after chemotherapy and consented to participate in a worldwide registry were studied. Results were summarized using descriptive methods. RESULTS The study included 118 patients with NC. Median age was 34 (range: 1-82) years, 39% were women, and 61% harbored a BRD4::NUTM1 fusion. Patients received platinum (74%) or ifosfamide (26%, including regimens with both, 13%). Of 62 patients with nonmetastatic disease, 40% had a thoracic primary. Compared with platinum-based chemotherapy, patients who received ifosfamide-based chemotherapy had nominally higher progression-free survival (12 mo: 59% [95% CI: 32-87] versus 37% [95% CI: 22-52], hazard ratio = 0.68 [0.32, 1.42], p = 0.3) but not overall survival (OS). Among the 56 patients with metastatic disease, 80% had a thoracic primary. Ifosfamide had an objective response rate (ORR) of 75% (six of eight) and platinum had an ORR of 31% (11 of 36). Nevertheless, there was no difference in progression-free survival or OS. The 3-year OS of the entire cohort was 19% (95% CI: 10%-28%). Of the 11 patients alive greater than 3 years, all presented with nonmetastatic and operable or resectable disease. CONCLUSION There is a numerically higher ORR for ifosfamide-based therapy compared with platinum-based therapy, with limited durability. OS at 3 years is only 19%, and development of effective therapies is an urgent unmet need for this patient population.
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Affiliation(s)
- Jia Luo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michelle Sanchez
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elinton Lee
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hans Hertzler
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Nhi Luong
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Emanuele Mazzola
- Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Bryanna Finstein
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Rubii Tamen
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gifty Brisbane
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Tom Nguyen
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Paul K Paik
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jamie E Chaft
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael L Cheng
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Hassan Khalil
- Department of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Sarina A Piha-Paul
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Pasi A Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Steven G DuBois
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Glenn J Hanna
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Geoffrey I Shapiro
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Center for Cancer Therapeutic Innovation, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christopher A French
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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5
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Odintsov I, Makarem M, Nishino M, Bachert SE, Zhang T, LoPiccolo J, Paweletz CP, Gokhale PC, Ivanova E, Saldanha A, Rudin CM, Lockwood WW, Ladanyi M, Somwar R, Jänne PA, Sholl LM. Prevalence and Therapeutic Targeting of High-Level ERBB2 Amplification in NSCLC. J Thorac Oncol 2023:S1556-0864(23)02428-0. [PMID: 38154514 DOI: 10.1016/j.jtho.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION ERBB2 amplification in lung cancer remains poorly characterized. HER2 (encoded by ERBB2) is a transmembrane tyrosine kinase capable of ligand-independent dimerization and signaling when overexpressed, and a common cause of HER2 overexpression is ERBB2 amplification. Here, we evaluated the clinicopathologic and genomic characteristics of ERBB2-amplified NSCLC and explored a HER2 antibody-drug conjugate (ADC) therapeutic strategy. METHODS Our institutional next-generation DNA sequencing data (OncoPanel) from 5769 NSCLC samples (5075 patients) were queried for cases having high-level ERBB2 amplification (≥6 copies). Clinical and demographic characteristics were extracted from the electronic medical records. Efficacy of the pan-ERBB inhibitor afatinib or HER2 ADCs (trastuzumab deruxtecan and trastuzumab emtansine) was evaluated in NSCLC preclinical models and patients with ERBB2 amplification. RESULTS High-level ERBB2 amplification was identified in 0.9% of lung adenocarcinomas and reliably predicted overexpression of HER2. ERBB2 amplification events are detected in two distinct clinicopathologic and genomic subsets of NSCLC: as the sole mitogenic driver in tumors arising in patients with a smoking history or as a concomitant alteration with other mitogenic drivers in patients with a light or never smoking history. We further reveal that trastuzumab deruxtecan is effective therapy in in vitro and in vivo preclinical models of NSCLC harboring ERBB2 amplification and report two cases of clinical activity of an anti-HER2 ADC in patients who acquired ERBB2 amplification after previous targeted therapy. CONCLUSIONS High-level ERBB2 amplification reliably predicts HER2 overexpression in patients with NSCLC, and HER2 ADC is effective therapy in this population.
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Affiliation(s)
- Igor Odintsov
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Maisam Makarem
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sara Emily Bachert
- Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, Kentucky
| | - Tom Zhang
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; School of Medicine, New York Medical College, Valhalla, New York
| | - Jaclyn LoPiccolo
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Cloud P Paweletz
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Prafulla C Gokhale
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elena Ivanova
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Aisha Saldanha
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Charles M Rudin
- Department of Medicine, Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William W Lockwood
- Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Marc Ladanyi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Romel Somwar
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pasi A Jänne
- Lowe Center for Thoracic Oncology and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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6
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Wada N, Li Y, Gagne S, Hino T, Valtchinov VI, Gay E, Nishino M, Hammer MM, Madore B, Guttmann CRG, Ishigami K, Hunninghake GM, Levy BD, Kaye KM, Christiani DC, Hatabu H. Incidence and severity of pulmonary embolism in COVID-19 infection: Ancestral, Alpha, Delta, and Omicron variants. Medicine (Baltimore) 2023; 102:e36417. [PMID: 38050198 PMCID: PMC10695578 DOI: 10.1097/md.0000000000036417] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
Little information is available regarding incidence and severity of pulmonary embolism (PE) across the periods of ancestral strain, Alpha, Delta, and Omicron variants. The aim of this study is to investigate the incidence and severity of PE over the dominant periods of ancestral strain and Alpha, Delta, and Omicron variants. We hypothesized that the incidence and the severity by proximity of PE in patients with the newer variants and vaccination would be decreased compared with those in ancestral and earlier variants. Patients with COVID-19 diagnosis between March 2020 and February 2022 and computed tomography pulmonary angiogram performed within a 6-week window around the diagnosis (-2 to +4 weeks) were studied retrospectively. The primary endpoints were the associations of the incidence and location of PE with the ancestral strain and each variant. Of the 720 coronavirus disease 2019 patients with computed tomography pulmonary angiogram (58.6 ± 17.2 years; 374 females), PE was diagnosed among 42/358 (12%) during the ancestral strain period, 5/60 (8%) during the Alpha variant period, 16/152 (11%) during the Delta variant period, and 13/150 (9%) during the Omicron variant period. The most proximal PE (ancestral strain vs variants) was located in the main/lobar arteries (31% vs 6%-40%), in the segmental arteries (52% vs 60%-75%), and in the subsegmental arteries (17% vs 0%-19%). There was no significant difference in both the incidence and location of PE across the periods, confirmed by multivariable logistic regression models. In summary, the incidence and severity of PE did not significantly differ across the periods of ancestral strain and Alpha, Delta, and Omicron variants.
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Affiliation(s)
- Noriaki Wada
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Yi Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Staci Gagne
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Takuya Hino
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan
| | - Vladimir I. Valtchinov
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Elizabeth Gay
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Mizuki Nishino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Mark M. Hammer
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Bruno Madore
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Charles R. G. Guttmann
- Center for Neurological Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka City, Fukuoka, Japan
| | - Gary M. Hunninghake
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Bruce D. Levy
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kenneth M. Kaye
- Division of Infectious Diseases, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - David C. Christiani
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
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7
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Alessi JV, Wang X, Elkrief A, Ricciuti B, Li YY, Gupta H, Spurr LF, Rizvi H, Luo J, Pecci F, Lamberti G, Recondo G, Venkatraman D, Di Federico A, Gandhi MM, Vaz VR, Nishino M, Sholl LM, Cherniack AD, Ladanyi M, Price A, Richards AL, Donoghue M, Lindsay J, Sharma B, Turner MM, Pfaff KL, Felt KD, Rodig SJ, Lin X, Meyerson ML, Johnson BE, Christiani DC, Schoenfeld AJ, Awad MM. Impact of Aneuploidy and Chromosome 9p Loss on Tumor Immune Microenvironment and Immune Checkpoint Inhibitor Efficacy in NSCLC. J Thorac Oncol 2023; 18:1524-1537. [PMID: 37247843 PMCID: PMC10913104 DOI: 10.1016/j.jtho.2023.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 12/08/2022] [Revised: 04/28/2023] [Accepted: 05/13/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Although gene-level copy number alterations have been studied as a potential biomarker of immunotherapy efficacy in NSCLC, the impact of aneuploidy burden and chromosomal arm-level events on immune checkpoint inhibitor (ICI) efficacy in NSCLC is uncertain. METHODS Patients who received programmed cell death protein 1 or programmed death-ligand 1 (PD-L1) inhibitor at two academic centers were included. Across all 22 chromosomes analyzed, an arm was considered altered if at least 70% of its territory was either gained or deleted. Among nonsquamous NSCLCs which underwent targeted next-generation sequencing, we retrospectively quantified aneuploidy using the adjusted fraction of chromosomal arm alterations (FAA), defined as the number of altered chromosome arms divided by the number of chromosome arms assessed, adjusted for tumor purity. RESULTS Among 2293 nonsquamous NSCLCs identified, the median FAA increased with more advanced cancer stage and decreased with higher PD-L1 tumor proportion score (TPS) levels (median FAA in TPS < 1%: 0.09, TPS 1%-49%: 0.08, TPS ≥ 50%: 0.05, p < 0.0001). There was a very weak correlation between FAA and tumor mutational burden when taken as continuous variables (R: 0.07, p = 0.0005). A total of 765 advanced nonsquamous NSCLCs with available FAA values were treated with ICIs. With decreasing FAA tertiles, there was a progressive improvement in objective response rate (ORR 15.1% in upper tertile versus 23.2% in middle tertile versus 28.4% in lowest tertile, p = 0.001), median progression-free survival (mPFS 2.5 versus 3.3 versus 4.1 mo, p < 0.0001), and median overall survival (mOS 12.5 versus 13.9 versus 16.4 mo, p = 0.006), respectively. In the arm-level enrichment analysis, chromosome 9p loss (OR = 0.22, Q = 0.0002) and chromosome 1q gain (OR = 0.43, Q = 0.002) were significantly enriched in ICI nonresponders after false discovery rate adjustment. Compared with NSCLCs without chromosome 9p loss (n = 452), those with 9p loss (n = 154) had a lower ORR (28.1% versus 7.8%, p < 0.0001), a shorter mPFS (4.1 versus 2.3 mo, p < 0.0001), and a shorter mOS (18.0 versus 9.6 mo, p < 0.0001) to immunotherapy. In addition, among NSCLCs with high PD-L1 expression (TPS ≥ 50%), chromosome 9p loss was associated with lower ORR (43% versus 6%, p < 0.0001), shorter mPFS (6.4 versus 2.6 mo, p = 0.0006), and shorter mOS (30.2 versus 14.3 mo, p = 0.0008) to immunotherapy compared with NSCLCs without 9p loss. In multivariable analysis, adjusting for key variables including FAA, chromosome 9p loss, but not 1q gain, retained a significant impact on ORR (hazard ratio [HR] = 0.25, p < 0.001), mPFS (HR = 1.49, p = 0.001), and mOS (HR = 1.47, p = 0.003). Multiplexed immunofluorescence and computational deconvolution of RNA sequencing data revealed that tumors with either high FAA levels or chromosome 9p loss had significantly fewer tumor-associated cytotoxic immune cells. CONCLUSIONS Nonsquamous NSCLCs with high aneuploidy and chromosome 9p loss have a distinct tumor immune microenvironment and less favorable outcomes to ICIs.
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Affiliation(s)
- Joao V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Xinan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Arielle Elkrief
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Yvonne Y Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Hersh Gupta
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Liam F Spurr
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Hira Rizvi
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jia Luo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Federica Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gonzalo Recondo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Deepti Venkatraman
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Malini M Gandhi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Victor R Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Andrew D Cherniack
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Adam Price
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Allison L Richards
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark Donoghue
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - James Lindsay
- Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Bijaya Sharma
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Madison M Turner
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kathleen L Pfaff
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kristen D Felt
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Scott J Rodig
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts; Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Matthew L Meyerson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Bruce E Johnson
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Adam J Schoenfeld
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
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McDermott GC, Hayashi K, Yoshida K, Moll M, Cho MH, Doyle TJ, Kinney GL, Dellaripa PF, Putman RK, San Jose Estepar R, Hata A, Hino T, Hida T, Yanagawa M, Nishino M, Washko G, Regan EA, Hatabu H, Hunninghake GM, Silverman EK, Sparks JA. Prevalence and mortality associations of interstitial lung abnormalities in rheumatoid arthritis within a multicentre prospective cohort of smokers. Rheumatology (Oxford) 2023; 62:SI286-SI295. [PMID: 37871923 PMCID: PMC10593512 DOI: 10.1093/rheumatology/kead277] [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: 01/27/2023] [Accepted: 05/16/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE To investigate the prevalence and mortality impact of interstitial lung abnormalities (ILAs) in RA and non-RA comparators. METHODS We analysed associations between ILAs, RA, and mortality in COPDGene, a multicentre prospective cohort study of current and past smokers, excluding known interstitial lung disease (ILD) or bronchiectasis. All participants had research chest high-resolution CT (HRCT) reviewed by a sequential reading method to classify ILA as present, indeterminate or absent. RA cases were identified by self-report RA and DMARD use; non-RA comparators had neither an RA diagnosis nor used DMARDs. We examined the association and mortality risk of RA and ILA using multivariable logistic regression and Cox regression. RESULTS We identified 83 RA cases and 8725 non-RA comparators with HRCT performed for research purposes. ILA prevalence was 16.9% in RA cases and 5.0% in non-RA comparators. After adjusting for potential confounders, including genetics, current/past smoking and other lifestyle factors, ILAs were more common among those with RA compared with non-RA [odds ratio 4.76 (95% CI 2.54, 8.92)]. RA with ILAs or indeterminate for ILAs was associated with higher all-cause mortality compared with non-RA without ILAs [hazard ratio (HR) 3.16 (95% CI 2.11, 4.74)] and RA cases without ILA [HR 3.02 (95% CI 1.36, 6.75)]. CONCLUSIONS In this cohort of smokers, RA was associated with ILAs and this persisted after adjustment for current/past smoking and genetic/lifestyle risk factors. RA with ILAs in smokers had a 3-fold increased all-cause mortality, emphasizing the importance of further screening and treatment strategies for preclinical ILD in RA.
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Affiliation(s)
- Gregory C McDermott
- Division of Rheumatology, Department of Medicine, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Keigo Hayashi
- Division of Rheumatology, Department of Medicine, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, USA
| | - Kazuki Yoshida
- Division of Rheumatology, Department of Medicine, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew Moll
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Pulmonary, Allergy, Sleep and Critical Care Medicine Section, Department of Medicine, VA Boston Healthcare System, West Roxbury, MA, USA
| | - Michael H Cho
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Tracy J Doyle
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Gregory L Kinney
- Colorado School of Public Health, Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Paul F Dellaripa
- Division of Rheumatology, Department of Medicine, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Rachel K Putman
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Raul San Jose Estepar
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Akinori Hata
- Department of Radiology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Takuya Hino
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoyuki Hida
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - George Washko
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Hiroto Hatabu
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Gary M Hunninghake
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Edwin K Silverman
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Jeffrey A Sparks
- Division of Rheumatology, Department of Medicine, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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9
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Nishino M, Wang X, Ricciuti B, Tseng SC, Park H, Alessi JV, Vaz VR, Hatabu H, Lin X, Christiani DC, Awad MM. Advanced non-small-cell lung cancer treated with first-line pembrolizumab plus chemotherapy: tumor response dynamics as a marker for survival. Eur Radiol 2023; 33:7284-7293. [PMID: 37099174 PMCID: PMC10896107 DOI: 10.1007/s00330-023-09658-1] [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: 12/28/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVES The study investigated tumor burden dynamics on computed tomography (CT) scans in patients with advanced non-small-cell lung cancer (NSCLC) during first-line pembrolizumab plus chemotherapy, to provide imaging markers for overall survival (OS). METHODS The study included 133 patients treated with first-line pembrolizumab plus platinum-doublet chemotherapy. Serial CT scans during therapy were assessed for tumor burden dynamics during therapy, which were studied for the association with OS. RESULTS There were 67 responders, with overall response rate of 50%. The tumor burden change at the best overall response ranged from - 100.0% to + 132.1% (median of - 30%). Higher response rates were associated with younger age (p < 0.001) and higher programmed cell death-1 (PD-L1) expression levels (p = 0.01). Eighty-three patients (62%) showed tumor burden below the baseline burden throughout therapy. Using an 8-week landmark analysis, OS was longer in patients with tumor burden below the baseline burden in the first 8 weeks than in those who experienced ≥ 0% increase (median OS: 26.8 vs. 7.6 months, hazard ratio (HR): 0.36, p < 0.001). Tumor burden remained below their baseline throughout therapy was associated with significantly reduced hazards of death (HR: 0.72, p = 0.03) in the extended Cox models, after adjusting for other clinical variables. Pseudoprogression was noted in only one patient (0.8%). CONCLUSIONS Tumor burden staying below the baseline burden throughout the therapy was predictive of prolonged overall survival in patients with advanced NSCLC treated with first-line pembrolizumab plus chemotherapy, and may be used as a practical marker for therapeutic decisions in this widely used combination regimen. CLINICAL RELEVANCE STATEMENT The analysis of tumor burden dynamics on serial CT scans in reference to the baseline burden can provide an additional objective guide for treatment decision making in patients treated with first-line pembrolizumab plus chemotherapy for their advanced NSCLC. KEY POINTS • Tumor burden remaining below baseline burden during therapy predicted longer survival during first-line pembrolizumab plus chemotherapy. • Pseudoprogression was noted in 0.8%, demonstrating the rarity of the phenomenon. • Tumor burden dynamics may serve as an objective marker for treatment benefit to guide treatment decisions during first-line pembrolizumab plus chemotherapy.
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Affiliation(s)
- Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave., MA, 02215, Boston, USA.
| | - Xinan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - Biagio Ricciuti
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Shu-Chi Tseng
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave., MA, 02215, Boston, USA
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Hyesun Park
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave., MA, 02215, Boston, USA
| | - Joao V Alessi
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Victor R Vaz
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450 Brookline Ave., Boston, MA, 02215, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave., MA, 02215, Boston, USA
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA
- Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02115, USA
| | - Mark M Awad
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450 Brookline Ave., Boston, MA, 02215, USA
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10
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Moll M, Peljto AL, Kim JS, Xu H, Debban CL, Chen X, Menon A, Putman RK, Ghosh AJ, Saferali A, Nishino M, Hatabu H, Hobbs BD, Hecker J, McDermott G, Sparks JA, Wain LV, Allen RJ, Tobin MD, Raby BA, Chun S, Silverman EK, Zamora AC, Ortega VE, Garcia CK, Barr RG, Bleecker ER, Meyers DA, Kaner RJ, Rich SS, Manichaikul A, Rotter JI, Dupuis J, O’Connor GT, Fingerlin TE, Hunninghake GM, Schwartz DA, Cho MH. A Polygenic Risk Score for Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormalities. Am J Respir Crit Care Med 2023; 208:791-801. [PMID: 37523715 PMCID: PMC10563194 DOI: 10.1164/rccm.202212-2257oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/14/2022] [Accepted: 07/31/2023] [Indexed: 08/02/2023] Open
Abstract
Rationale: In addition to rare genetic variants and the MUC5B locus, common genetic variants contribute to idiopathic pulmonary fibrosis (IPF) risk. The predictive power of common variants outside the MUC5B locus for IPF and interstitial lung abnormalities (ILAs) is unknown. Objectives: We tested the predictive value of IPF polygenic risk scores (PRSs) with and without the MUC5B region on IPF, ILA, and ILA progression. Methods: We developed PRSs that included (PRS-M5B) and excluded (PRS-NO-M5B) the MUC5B region (500-kb window around rs35705950-T) using an IPF genome-wide association study. We assessed PRS associations with area under the receiver operating characteristic curve (AUC) metrics for IPF, ILA, and ILA progression. Measurements and Main Results: We included 14,650 participants (1,970 IPF; 1,068 ILA) from six multi-ancestry population-based and case-control cohorts. In cases excluded from genome-wide association study, the PRS-M5B (odds ratio [OR] per SD of the score, 3.1; P = 7.1 × 10-95) and PRS-NO-M5B (OR per SD, 2.8; P = 2.5 × 10-87) were associated with IPF. Participants in the top PRS-NO-M5B quintile had ∼sevenfold odds for IPF compared with those in the first quintile. A clinical model predicted IPF (AUC, 0.61); rs35705950-T and PRS-NO-M5B demonstrated higher AUCs (0.73 and 0.7, respectively), and adding both genetic predictors to a clinical model yielded the highest performance (AUC, 0.81). The PRS-NO-M5B was associated with ILA (OR, 1.25) and ILA progression (OR, 1.16) in European ancestry participants. Conclusions: A common genetic variant risk score complements the MUC5B variant to identify individuals at high risk of interstitial lung abnormalities and pulmonary fibrosis.
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Affiliation(s)
- Matthew Moll
- Division of Pulmonary and Critical Care Medicine, and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anna L. Peljto
- Department of Medicine and
- Department of Immunology, Division of Pulmonary Medicine, University of Colorado, Aurora, Colorado
| | - John S. Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Hanfei Xu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
| | - Catherine L. Debban
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Xianfeng Chen
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Phoenix, Arizona
| | - Aravind Menon
- Division of Pulmonary and Critical Care Medicine, and
| | | | - Auyon J. Ghosh
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, State University of New York Upstate Medical Center, Syracuse, New York
| | - Aabida Saferali
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mizuki Nishino
- Center for Pulmonary Functional Imaging, Department of Radiology
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology
| | - Brian D. Hobbs
- Division of Pulmonary and Critical Care Medicine, and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Julian Hecker
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gregory McDermott
- Division of Rheumatology, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jeffrey A. Sparks
- Division of Rheumatology, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Louise V. Wain
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Richard J. Allen
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Martin D. Tobin
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
- National Institute for Health Research, Leicester Respiratory Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom
| | - Benjamin A. Raby
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Pediatrics
- Division of Pulmonary Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sung Chun
- Division of Pulmonary Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Edwin K. Silverman
- Division of Pulmonary and Critical Care Medicine, and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ana C. Zamora
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Phoenix, Arizona
| | - Victor E. Ortega
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Phoenix, Arizona
| | - Christine K. Garcia
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - R. Graham Barr
- Department of Medicine and
- Division of General Medicine, Department of Epidemiology, Columbia University Medical Center, New York, New York
| | - Eugene R. Bleecker
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Deborah A. Meyers
- Division of Genetics, Genomics, and Precision Medicine, Department of Medicine, University of Arizona, Tucson, Arizona
| | - Robert J. Kaner
- Division of Pulmonary Medicine, Weill Cornell School of Medicine, New York, New York
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Ani Manichaikul
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-University of California, Los Angeles Medical Center, Torrance, California
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada
| | - George T. O’Connor
- Department of Medicine, Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts; and
| | - Tasha E. Fingerlin
- The National Jewish Health Cohen Family Asthma Institute, Division of Allergy and Immunology, National Jewish Health, Denver, Colorado
| | | | - David A. Schwartz
- Department of Medicine and
- Department of Immunology, Division of Pulmonary Medicine, University of Colorado, Aurora, Colorado
| | - Michael H. Cho
- Division of Pulmonary and Critical Care Medicine, and
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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11
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Gandhi MM, Ricciuti B, Harada G, Repetto M, Gildenberg MS, Singh A, Li YY, Gagné A, Wang X, Aizer A, Fitzgerald K, Nishino M, Alessi J, Pecci F, Di Federico A, Fisch A, Drilon A, Nardi V, Sholl L, Awad MM, Rotow J. Amplification of Wild-Type RET Represents a Novel Molecular Subtype of Several Cancer Types With Clinical Response to Selpercatinib. JCO Precis Oncol 2023; 7:e2300295. [PMID: 37972337 PMCID: PMC10681403 DOI: 10.1200/po.23.00295] [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: 06/09/2023] [Revised: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE RET rearrangements and RET activating point mutations represent targetable genomic alterations in advanced solid tumors. However, the frequency and clinicopathologic characteristics of wild-type RET amplification in cancer and its potential role as a targetable oncogenic driver are not well-characterized. METHODS In two institutional cohorts of patients with solid cancers from the Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSKCC) whose tumors underwent next-generation sequencing (NGS), the frequency and clinicopathologic features of wild-type RET amplification in the absence of RET rearrangements or activating mutations was assessed. The findings were validated using merged data from The Cancer Genome Atlas (TCGA), Genomics Evidence Neoplasia Information Exchange (GENIE), and China Pan-Cancer data sets. RESULTS The frequency of wild-type RET amplification across all solid cancers was 0.08% (26 of 32,505) in the DFCI cohort, 0.05% (26 of 53,152) in the MSKCC cohort, and 0.25% (71 of 28,623) in the cohort from TCGA, GENIE, and China Pan-Cancer. Cancer types with RET amplification included non-small-cell lung cancer (NSCLC), hepatobiliary cancer, prostate cancer, breast cancer, and others. The median RET copy number in RET-amplified cases was 7.5 (range, 6-36) in the DFCI cohort and 5.7 (range, 4-27.7) in the MSKCC cohort. Among 11 RET-amplified NSCLCs, eight had no other concurrent driver mutations. Finally, we report on a 69-year-old man with recurrent NSCLC harboring high-level wild-type RET amplification (22-28 copies) as the only identified putative genomic driver who experienced both a systemic and intracranial confirmed response to the RET inhibitor selpercatinib. CONCLUSION Amplification of wild-type RET represents a novel, targetable molecular subset of cancer.
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Affiliation(s)
- Malini M. Gandhi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Guilherme Harada
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | - Matteo Repetto
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | | | - Ankit Singh
- Center for Integrated Diagnostics, Massachusetts General Hospital, Boston, MA
| | - Yvonne Y. Li
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Andréanne Gagné
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Xinan Wang
- Harvard School of Public Health, Boston, MA
| | - Ayal Aizer
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Kelly Fitzgerald
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Joao Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Federica Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Adam Fisch
- Department of Pathology, Massachusetts General Hospital, Boston, MA
| | - Alexander Drilon
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | - Valentina Nardi
- Department of Pathology, Massachusetts General Hospital, Boston, MA
| | - Lynette Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Julia Rotow
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
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12
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Nishino M, Kusumoto M, Bankier AA, Kurihara Y, Zhang L, Rasheed Z, Meinhardt G, Arunachalam M, Taitt C, Wang Q, Powell CA. Trastuzumab Deruxtecan‒Related Interstitial Lung Disease/Pneumonitis: Computed Tomography Imaging Patterns to Guide Diagnosis and Management. JCO Precis Oncol 2023; 7:e2300391. [PMID: 38061008 DOI: 10.1200/po.23.00391] [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: 07/21/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate approved for the treatment of several advanced cancers; however, severe or fatal interstitial lung disease/pneumonitis can occur. We characterized the computed tomography (CT) patterns of T-DXd‒related pneumonitis as a marker for its clinical severity. MATERIALS AND METHODS Ninety patients with advanced cancers who developed T-DXd‒related pneumonitis in two completed single-arm clinical trials were included. Three radiologists independently characterized the CT patterns of pneumonitis at diagnosis, for analyses of those patterns' relationships with clinical severity and pneumonitis outcome. RESULTS T-DXd‒related pneumonitis most commonly presented with cryptogenic organizing pneumonia (COP) pattern, observed in 65 patients (72%), followed by a newly identified COP/hypersensitivity pneumonitis (HP) pattern (13%), acute interstitial pneumonia (AIP)/acute respiratory distress syndrome (ARDS) pattern (11%), and HP pattern (3%). A subset of cases with COP pattern demonstrated an atypical distribution with upper and peripheral lung involvement (6/65; 9%). CT patterns were associated with Common Terminology Criteria for Adverse Events severity grades of pneumonitis, with the AIP/ARDS pattern having higher grades compared with others (P < .0001). Fatal pneumonitis was more common in the AIP/ARDS pattern than in others (P = .005). The onset of pneumonitis was earlier in the AIP/ARDS pattern compared with others (median time to onset: at 17.9 v 32.7 weeks of therapy; P = .019). Pneumonitis was treated by withholding T-DXd with or without corticosteroids in most patients (78/90; 87%). CONCLUSION T-DXd‒related pneumonitis most commonly demonstrated a COP pattern, with a subset having an atypical distribution. The AIP/ARDS pattern was indicative of severe, potentially fatal pneumonitis, and requires immediate clinical attention to mitigate serious adverse events.
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Affiliation(s)
- Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Masahiko Kusumoto
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Alexander A Bankier
- Department of Radiology, UMass Memorial Medical Center, University of Massachusetts Chan Medical School, Worcester, MA
| | - Yasuyuki Kurihara
- Department of Radiology, St Luke's International Hospital, Tokyo, Japan
| | - Lin Zhang
- Daiichi Sankyo, Inc, Basking Ridge, NJ
| | | | | | | | | | | | - Charles A Powell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY
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13
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Horst C, Nishino M. If Only We Had a Time Machine: Prior CT in Deep Learning for Lung Nodule Prognostication. Radiology 2023; 308:e231560. [PMID: 37526543 DOI: 10.1148/radiol.231560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Affiliation(s)
- Carolyn Horst
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, London SE1 7EU, England (C.H.); Guy's and St Thomas' Hospital NHS Foundation Trust, London, England (C.H.); and Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Mass (M.N.)
| | - Mizuki Nishino
- From the School of Biomedical Engineering and Imaging Sciences, King's College London, Becket House, 1 Lambeth Palace Road, London SE1 7EU, England (C.H.); Guy's and St Thomas' Hospital NHS Foundation Trust, London, England (C.H.); and Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Mass (M.N.)
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14
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Negrao MV, Araujo HA, Lamberti G, Cooper AJ, Akhave NS, Zhou T, Delasos L, Hicks JK, Aldea M, Minuti G, Hines J, Aredo JV, Dennis MJ, Chakrabarti T, Scott SC, Bironzo P, Scheffler M, Christopoulos P, Stenzinger A, Riess JW, Kim SY, Goldberg SB, Li M, Wang Q, Qing Y, Ni Y, Do MT, Lee R, Ricciuti B, Alessi JV, Wang J, Resuli B, Landi L, Tseng SC, Nishino M, Digumarthy SR, Rinsurongkawong W, kawong VR, Vaporciyan AA, Blumenschein GR, Zhang J, Owen DH, Blakely CM, Mountzios G, Shu CA, Bestvina CM, Garassino MC, Marrone KA, Gray JE, Patel SP, Cummings AL, Wakelee HA, Wolf J, Scagliotti GV, Cappuzzo F, Barlesi F, Patil PD, Drusbosky L, Gibbons DL, Meric-Bernstam F, Lee JJ, Heymach JV, Hong DS, Heist RS, Awad MM, Skoulidis F. Comutations and KRASG12C Inhibitor Efficacy in Advanced NSCLC. Cancer Discov 2023; 13:1556-1571. [PMID: 37068173 PMCID: PMC11024958 DOI: 10.1158/2159-8290.cd-22-1420] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [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: 12/20/2022] [Revised: 03/08/2023] [Accepted: 03/29/2023] [Indexed: 04/19/2023]
Abstract
Molecular modifiers of KRASG12C inhibitor (KRASG12Ci) efficacy in advanced KRASG12C-mutant NSCLC are poorly defined. In a large unbiased clinicogenomic analysis of 424 patients with non-small cell lung cancer (NSCLC), we identified and validated coalterations in KEAP1, SMARCA4, and CDKN2A as major independent determinants of inferior clinical outcomes with KRASG12Ci monotherapy. Collectively, comutations in these three tumor suppressor genes segregated patients into distinct prognostic subgroups and captured ∼50% of those with early disease progression (progression-free survival ≤3 months) with KRASG12Ci. Pathway-level integration of less prevalent coalterations in functionally related genes nominated PI3K/AKT/MTOR pathway and additional baseline RAS gene alterations, including amplifications, as candidate drivers of inferior outcomes with KRASG12Ci, and revealed a possible association between defective DNA damage response/repair and improved KRASG12Ci efficacy. Our findings propose a framework for patient stratification and clinical outcome prediction in KRASG12C-mutant NSCLC that can inform rational selection and appropriate tailoring of emerging combination therapies. SIGNIFICANCE In this work, we identify co-occurring genomic alterations in KEAP1, SMARCA4, and CDKN2A as independent determinants of poor clinical outcomes with KRASG12Ci monotherapy in advanced NSCLC, and we propose a framework for patient stratification and treatment personalization based on the comutational status of individual tumors. See related commentary by Heng et al., p. 1513. This article is highlighted in the In This Issue feature, p. 1501.
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Affiliation(s)
- Marcelo V. Negrao
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Haniel A. Araujo
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Neal S. Akhave
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Teng Zhou
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Lukas Delasos
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J. Kevin Hicks
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Mihaela Aldea
- Institut Gustave Roussy, Villejuif, France
- Paris-Saclay University, Paris, France
| | | | - Jacobi Hines
- University of Chicago Medical Center, Chicago, Illinois, USA
| | | | - Michael J. Dennis
- Moores Cancer Center, University of California San Diego, San Diego, California, USA
| | - Turja Chakrabarti
- Department of Medicine, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California, USA
| | - Susan C. Scott
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Paolo Bironzo
- Department of Oncology, University of Turin, Turin, Italy
| | - Matthias Scheffler
- Department for Internal Medicine, Center for Integrated Oncology Köln-Bonn, University Hospital Cologne, Germany
| | - Petros Christopoulos
- Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital
| | | | - Jonathan W. Riess
- University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - So Yeon Kim
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Mingjia Li
- Division of Medical Oncology, The Ohio State University - James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Qi Wang
- Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yun Qing
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ying Ni
- Center for Immunotherapy & Precision Immuno-Oncology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Minh Truong Do
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Richard Lee
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Joao Victor Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jing Wang
- Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Blerina Resuli
- Istituto Nazionale Tumori IRCCS “Regina Elena”, Rome, Italy
| | - Lorenza Landi
- Istituto Nazionale Tumori IRCCS “Regina Elena”, Rome, Italy
| | - Shu-Chi Tseng
- Department of Radiology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Mizuki Nishino
- Department of Radiology, Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Subba R. Digumarthy
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Waree Rinsurongkawong
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Vadeerat Rinsurong kawong
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Ara A. Vaporciyan
- Department Thoracic & Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - George R. Blumenschein
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jianjun Zhang
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Dwight H. Owen
- Division of Medical Oncology, The Ohio State University - James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Collin M. Blakely
- Department of Medicine, Division of Hematology and Oncology, University of California San Francisco, San Francisco, California, USA
| | - Giannis Mountzios
- Fourth Department of Medical Oncology and Clinical Trials Unit, Henry Dunant Hospital Center, Greece
| | - Catherine A. Shu
- Department of Medicine, Columbia University, New York, New York, USA
| | | | | | - Kristen A. Marrone
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jhanelle E. Gray
- Department of Thoracic Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, USA
| | - Sandip Pravin Patel
- Moores Cancer Center, University of California San Diego, San Diego, California, USA
| | - Amy L. Cummings
- University of California Los Angeles, Los Angeles, California, USA
| | | | - Juergen Wolf
- Department for Internal Medicine, Center for Integrated Oncology Köln-Bonn, University Hospital Cologne, Germany
| | | | | | - Fabrice Barlesi
- Institut Gustave Roussy, Villejuif, France
- Paris-Saclay University, Paris, France
| | | | | | - Don L. Gibbons
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Funda Meric-Bernstam
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J. Jack Lee
- Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - John V. Heymach
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - David S. Hong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ferdinandos Skoulidis
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
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15
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Ricciuti B, Elkrief A, Alessi J, Wang X, Li Y, Gupta H, Muldoon DM, Bertram AA, Pecci F, Lamberti G, Federico AD, Barrichello A, Vaz VR, Gandhi M, Lee E, Shapiro GI, Park H, Nishino M, Lindsay J, Felt KD, Sharma B, Cherniack AD, Rodig S, Gomez DR, Shaverdian N, Rakaee M, Bandlamudi C, Ladanyi M, Janne PA, Schoenfeld AJ, Sholl LM, Awad MM, Cheng ML. Clinicopathologic, Genomic, and Immunophenotypic Landscape of ATM Mutations in Non-Small Cell Lung Cancer. Clin Cancer Res 2023; 29:2540-2550. [PMID: 37097610 PMCID: PMC11031845 DOI: 10.1158/1078-0432.ccr-22-3413] [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: 11/04/2022] [Revised: 03/09/2023] [Accepted: 04/20/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE ATM is the most commonly mutated DNA damage and repair gene in non-small cell lung cancer (NSCLC); however, limited characterization has been pursued. EXPERIMENTAL DESIGN Clinicopathologic, genomic, and treatment data were collected for 5,172 patients with NSCLC tumors which underwent genomic profiling. ATM IHC was performed on 182 NSCLCs with ATM mutations. Multiplexed immunofluorescence was performed on a subset of 535 samples to examine tumor-infiltrating immune cell subsets. RESULTS A total of 562 deleterious ATM mutations were identified in 9.7% of NSCLC samples. ATM-mutant (ATMMUT) NSCLC was significantly associated with female sex (P = 0.02), ever smoking status (P < 0.001), non-squamous histology (P = 0.004), and higher tumor mutational burden (DFCI, P < 0.0001; MSK, P < 0.0001) compared with ATM-wild-type (ATMWT) cases. Among 3,687 NSCLCs with comprehensive genomic profiling, co-occurring KRAS, STK11, and ARID2 oncogenic mutations were significantly enriched among ATMMUT NSCLCs (Q < 0.05), while TP53 and EGFR mutations were enriched in ATMWT NSCLCs. Among 182 ATMMUT samples with ATM IHC, tumors with nonsense, insertions/deletions, or splice site mutations were significantly more likely to display ATM loss by IHC (71.4% vs. 28.6%; P < 0.0001) compared with tumors with only predicted pathogenic missense mutations. Clinical outcomes to PD-(L)1 monotherapy (N = 1,522) and chemo-immunotherapy (N = 951) were similar between ATMMUT and ATMWT NSCLCs. Patients with concurrent ATM/TP53 mutations had significantly improved response rate and progression-free survival with PD-(L)1 monotherapy. CONCLUSIONS Deleterious ATM mutations defined a subset of NSCLC with unique clinicopathologic, genomic, and immunophenotypic features. Our data may serve as resource to guide interpretation of specific ATM mutations in NSCLC.
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Affiliation(s)
- Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Arielle Elkrief
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joao Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Xinan Wang
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Yvonne Li
- Department of Analytics and Informatics, Dana-Farber Cancer Institute, Boston, Massachusetts; Cancer Program, Broad Institute of Harvard and Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
| | - Hersh Gupta
- Department of Analytics and Informatics, Dana-Farber Cancer Institute, Boston, Massachusetts; Cancer Program, Broad Institute of Harvard and Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
| | - Daniel M. Muldoon
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Arrien A. Bertram
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Federica Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Alessandro Di Federico
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Adriana Barrichello
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Victor R. Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Malini Gandhi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Elinton Lee
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Geoffrey I. Shapiro
- Center for DNA Damage and Repair (CDDR), Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hyesun Park
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - James Lindsay
- ImmunoProfile, Brigham & Women’s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kristen D. Felt
- ImmunoProfile, Brigham & Women’s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Bijaya Sharma
- ImmunoProfile, Brigham & Women’s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Andrew D. Cherniack
- Department of Analytics and Informatics, Dana-Farber Cancer Institute, Boston, Massachusetts; Cancer Program, Broad Institute of Harvard and Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts
| | - Scott Rodig
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Daniel R. Gomez
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Narek Shaverdian
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mehrdad Rakaee
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chaitanya Bandlamudi
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc Ladanyi
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pasi A. Janne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Adam J. Schoenfeld
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lynette M. Sholl
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Michael L. Cheng
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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16
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Boiarsky D, Lydon CA, Chambers ES, Sholl LM, Nishino M, Skoulidis F, Heymach JV, Luo J, Awad MA, Janne PA, Van Allen EM, Barbie DA, Vokes NI. Molecular markers of metastatic disease in KRAS-mutant lung adenocarcinoma. Ann Oncol 2023; 34:589-604. [PMID: 37121400 PMCID: PMC10425882 DOI: 10.1016/j.annonc.2023.04.514] [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: 02/03/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Prior studies characterized the association of molecular alterations with treatment-specific outcomes in KRAS-mutant (KRASMUT) lung adenocarcinoma (LUAD). Less is known about the prognostic role of molecular alterations and their associations with metastatic disease. PATIENTS AND METHODS We analyzed clinicogenomic data from 1817 patients with KRASMUT LUAD sequenced at the Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSKCC). Patients with metastatic (M1) and nonmetastatic (M0) disease were compared. Transcriptomic data from The Cancer Genome Atlas (TCGA) were investigated to characterize the biology of differential associations with clinical outcomes. Organ-specific metastasis was associated with overall survival (OS). RESULTS KEAP1 (DFCI: OR = 2.3, q = 0.04; MSKCC: OR = 2.2, q = 0.00027) and SMARCA4 mutations (DFCI: OR = 2.5, q = 0.06; MSKCC: OR = 2.6, q = 0.0021) were enriched in M1 versus M0 tumors. On integrative modeling, NRF2 activation was the genomic feature most associated with OS. KEAP1 mutations were enriched in M1 versus M0 tumors independent of STK11 status (KEAP1MUT/STK11WT: DFCI OR = 3.0, P = 0.0064; MSKCC OR = 2.0, P = 0.041; KEAP1MUT/STK11MUT: DFCI OR = 2.3, P = 0.0063; MSKCC OR = 2.5, P = 3.6 × 10-05); STK11 mutations without KEAP1 loss were not associated with stage (KEAP1WT/STK11MUT: DFCI OR = 0.97, P = 1.0; MSKCC OR = 1.2, P = 0.33) or outcome. KEAP1/KRAS-mutated tumors with and without STK11 mutations exhibited high functional STK11 loss. The negative effects of KEAP1 were compounded in the presence of bone (HR = 2.3, P = 4.4 × 10-14) and negated in the presence of lymph node metastasis (HR = 1.0, P = 0.91). CONCLUSIONS Mutations in KEAP1 and SMARCA4, but not STK11, were associated with metastatic disease and poor OS. Functional STK11 loss, however, may contribute to poor outcomes in KEAP1MUT tumors. Integrating molecular data with clinical and metastatic-site annotations can more accurately risk stratify patients.
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Affiliation(s)
- D Boiarsky
- Department of Medicine, Tufts Medical Center, Boston
| | - C A Lydon
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston
| | - E S Chambers
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston
| | - L M Sholl
- Center for Advanced Molecular Diagnostics, Brigham & Women's Hospital & Harvard Medical School, Boston
| | - M Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston
| | - F Skoulidis
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston
| | - J Luo
- Department of Medicine, Dana-Farber Cancer Institute, Boston
| | - M A Awad
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston
| | - P A Janne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston
| | - E M Van Allen
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston; Broad Institute of Harvard & MIT, Cambridge; Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston
| | - D A Barbie
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston
| | - N I Vokes
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston; Department of Genomic Medicine, University of Texas M.D. Anderson Cancer Center, Houston, USA.
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Tseng SC, Gagne S, Hatabu H, Lin G, Sholl L, Nishino M. Lung Cancer in Lung Transplant Recipients: Clinical, Radiologic, and Pathologic Characteristics and Treatment Outcome. J Comput Assist Tomogr 2023; 47:590-597. [PMID: 36944140 PMCID: PMC10363202 DOI: 10.1097/rct.0000000000001466] [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] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This study aimed to investigate clinical and radiologic characteristics of lung cancer in lung transplant recipients and evaluate the treatment course and prognosis. METHODS The study included 448 patients who underwent lung transplant between 2005 and 2021. All patients had pretransplant chest computed tomography (CT), 429 patients had posttransplant CT, whereas 19 had no posttransplant CT (median number of posttransplant CT, 6; range, 0-24). Medical records of these patients were reviewed to identify patients who developed lung cancer after lung transplant. Computed tomography and positron emission tomography/CT at the time of lung cancer diagnoses were reviewed to obtain imaging features. Demographics, tumor histology, stages, and survival were compared using Fisher exact test and Wilcoxon rank sum test. RESULTS Among 448 lung transplant recipients with a median follow-up of 71.3 months after lung transplant, 15 patients (3.3%) developed posttransplant lung cancer (13 unilateral, 2 bilateral; 10 men, 5 women; median age, 63.1 years; median time from transplantation to cancer diagnosis, 3.1 years). Twelve cancers were in native lung, and 3 were in transplanted lung. The incidence of lung cancer was higher in single lung transplant recipients than in bilateral lung transplant recipients (10.3% vs 0.6%, respectively; P < 0.0001). Imaging manifestations varied according to tumor stages. Among 12 patients treated for lung cancer, 2 patients developed posttreatment acute respiratory distress syndrome. The median survival from cancer diagnosis of cancer was 6.2 months. CONCLUSIONS Posttransplant lung cancer was noted in 3% of lung transplant recipients and was more common in unilateral transplant recipients. The prognosis upon diagnosis was poor with rapid clinical deterioration and serious posttreatment complications.
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Affiliation(s)
- Shu-Chi Tseng
- Department of Imaging, Dana-Farber Cancer Institute 450 Brookline Ave. Boston MA, 02215, USA
- Department of Radiology, Brigham and Women’s Hospital 75 Francis St. Boston MA, 02215, USA
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Staci Gagne
- Department of Imaging, Dana-Farber Cancer Institute 450 Brookline Ave. Boston MA, 02215, USA
- Department of Radiology, Brigham and Women’s Hospital 75 Francis St. Boston MA, 02215, USA
| | - Hiroto Hatabu
- Department of Imaging, Dana-Farber Cancer Institute 450 Brookline Ave. Boston MA, 02215, USA
- Department of Radiology, Brigham and Women’s Hospital 75 Francis St. Boston MA, 02215, USA
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Lynnette Sholl
- Department of Pathology, Brigham and Women’s Hospital 75 Francis St. Boston MA, 02215, USA
| | - Mizuki Nishino
- Department of Imaging, Dana-Farber Cancer Institute 450 Brookline Ave. Boston MA, 02215, USA
- Department of Radiology, Brigham and Women’s Hospital 75 Francis St. Boston MA, 02215, USA
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18
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Alessi JV, Elkrief A, Ricciuti B, Wang X, Cortellini A, Vaz VR, Lamberti G, Frias RL, Venkatraman D, Fulgenzi CAM, Pecci F, Recondo G, Di Federico A, Barrichello A, Park H, Nishino M, Hambelton GM, Egger JV, Ladanyi M, Digumarthy S, Johnson BE, Christiani DC, Lin X, Gainor JF, Lin JJ, Pinato DJ, Schoenfeld AJ, Awad MM. Clinicopathologic and Genomic Factors Impacting Efficacy of First-Line Chemoimmunotherapy in Advanced NSCLC. J Thorac Oncol 2023; 18:731-743. [PMID: 36775193 PMCID: PMC10500613 DOI: 10.1016/j.jtho.2023.01.091] [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: 11/09/2022] [Revised: 01/17/2023] [Accepted: 01/29/2023] [Indexed: 02/12/2023]
Abstract
INTRODUCTION Although programmed cell death protein 1 and programmed death-ligand 1 (PD-L1) blockade in combination with platinum-doublet chemotherapy has become a mainstay of first-line treatment for advanced NSCLC, factors associated with efficacy of chemoimmunotherapy (CIT) are not well characterized. METHODS In this multicenter retrospective analysis, clinicopathologic and genomic data were collected from patients with advanced NSCLC (lacking sensitizing genomic alterations in EGFR and ALK) and evaluated with clinical outcomes to first-line CIT. RESULTS Among 1285 patients treated with CIT, a worsening performance status and increasing derived neutrophil-to-lymphocyte ratio in the blood were associated with a significantly reduced objective response rate (ORR), median progression-free survival (mPFS), and median overall survival (mOS). With increasing PD-L1 tumor proportion scores of less than 1%, 1% to 49%, 50% to 89%, and greater than or equal to 90%, there was a progressive improvement in ORR (32.7% versus 37.5% versus 51.6% versus 61.7%, p < 0.001), mPFS (5.0 versus 6.1 versus 6.8 versus 13.0 mo, p < 0.001), and generally mOS (12.9 versus 14.6 versus 34.7 versus 23.1 mo, p = 0.009), respectively. Of 789 NSCLCs with comprehensive genomic data, NSCLCs with a tumor mutational burden (TMB) greater than or equal to the 90th percentile had an improved ORR (53.5% versus 36.4%, p = 0.004), mPFS (10.8 versus 5.5 mo, p < 0.001), and mOS (29.2 versus 13.1 mo, p < 0.001), compared with those with a TMB less than the 90th percentile. In all-comers with nonsquamous NSCLC, the presence of an STK11, KEAP1, or SMARCA4 mutation was associated with significantly worse ORR, mPFS, and mOS to CIT (all p < 0.05); this was also observed in the KRAS-mutant subgroup of NSCLCs with co-occurring mutations in STK11, KEAP1, or SMARCA4 (all p < 0.05). In KRAS wild-type NSCLC, KEAP1 and SMARCA4 mutations were associated with a significantly shorter mPFS and mOS to CIT (all p < 0.05), but STK11 mutation status had no significant impact on mPFS (p = 0.16) or mOS (p = 0.38). CONCLUSIONS In advanced NSCLC, better patient performance status, low derived neutrophil-to-lymphocyte ratio, increasing PD-L1 expression, a very high TMB, and STK11/KEAP1/SMARCA4 wild-type status are associated with improved clinical outcomes to first-line CIT.
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Affiliation(s)
- Joao V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Arielle Elkrief
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Xinan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Alessio Cortellini
- Division of Cancer, Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom; Department of Medical Oncology, University Campus Bio-Medico of Rome, Italy
| | - Victor R Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Rosa L Frias
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Deepti Venkatraman
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Claudia A M Fulgenzi
- Division of Cancer, Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom; Department of Medical Oncology, University Campus Bio-Medico of Rome, Italy
| | - Federica Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gonzalo Recondo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Adriana Barrichello
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Hyesun Park
- Department of Radiology, Lahey Hospital and Medical Center, Burlington, Massachusetts; Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Grace M Hambelton
- Center for Thoracic Cancers, Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Jacklynn V Egger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marc Ladanyi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Subba Digumarthy
- Department of Radiology, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Bruce E Johnson
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Justin F Gainor
- Center for Thoracic Cancers, Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - Jessica J Lin
- Center for Thoracic Cancers, Department of Medicine, Massachusetts General Hospital Cancer Center, Boston, Massachusetts
| | - David J Pinato
- Division of Cancer, Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom
| | - Adam J Schoenfeld
- Thoracic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
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Cheng ML, Huang Y, Luong N, LoPiccolo J, Nishino M, Sholl LM, Chirieac LR, Santucci AD, Rabin MS, Jänne PA, Coker S, Diamond JR, Hilton J, Shapiro GI, French CA. Exceptional Response to Bromodomain and Extraterminal Domain Inhibitor Therapy With BMS-986158 in BRD4-NUTM1 NUT Carcinoma Harboring a BRD4 Splice Site Mutation. JCO Precis Oncol 2023; 7:e2200633. [PMID: 37384867 PMCID: PMC10581614 DOI: 10.1200/po.22.00633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/24/2023] [Accepted: 05/25/2023] [Indexed: 07/01/2023] Open
Affiliation(s)
- Michael L. Cheng
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Yeying Huang
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nhi Luong
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jaclyn LoPiccolo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Lynette M. Sholl
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Lucian R. Chirieac
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alison D. Santucci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
- Boston Medical Center, Boston, MA
| | - Michael S. Rabin
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Pasi A. Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | | | | | - John Hilton
- Division of Medical Oncology, Ottawa Hospital, Ottawa, ON
| | - Geoffrey I. Shapiro
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Christopher A. French
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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20
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Egashira R, Nishino M. Quantitative Texture Analysis of Interstitial Lung Abnormalities Opens a New Chapter for Chest CT Interpretation. Radiology 2023; 307:e230469. [PMID: 37097139 DOI: 10.1148/radiol.230469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- Ryoko Egashira
- From the Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan (R.E.); and Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Mass (M.N.)
| | - Mizuki Nishino
- From the Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan (R.E.); and Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Mass (M.N.)
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21
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Negrao MV, Araujo HA, Lamberti G, Cooper AJ, Zhou T, Akhave N, Delasos L, Hicks JK, Aldea M, Minuti G, Hines J, Aredo JV, Dennis MJ, Chakrabarti T, Scott S, Bironzo P, Scheffler M, Christopoulos P, Kim SY, Goldberg S, Ni Y, Resuli B, Landi L, Tseng SC, Nishino M, Owen D, Blakely C, Mountzios G, Shu CA, Bestvina C, Garassino M, Marrone K, Gray J, Patel SP, Cummings AL, Wakelee HA, Wolf J, Scagliotti GV, Cappuzzo F, Barlesi F, Patil P, Gibbons DL, Meric-Bernstam F, Lee JJ, Heymach JV, Hong DS, Heist RS, Awad MM, Skoulidis F. Abstract 3431: Molecular determinants of KRAS p.G12C inhibitor efficacy in advanced NSCLC. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3431] [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
Background: Irreversible allosteric KRAS p.G12C inhibitors (KG12Ci) such as sotorasib and adagrasib have revolutionized the therapeutic landscape of advanced KG12C-mutant NSCLC, however individual responses are heterogeneous and curtailed by innate and adaptive/acquired resistance. Molecular determinants of KG12Ci efficacy in NSCLC are poorly defined. We dissected the impact of major KG12C co-mutations and explored the effects of less prevalent co-alterations on the clinical activity of KG12Ci in the largest treated cohort to date of patients (pts) with advanced NSCLC. Key findings were validated in preclinical KG12C NSCLC models.
Methods: Baseline clinico-genomic features and clinical outcome data from pts with stage IV KG12C NSCLC (ECOG PS 0-2) treated with single-agent KG12Ci were collected retrospectively from 20 centers in the US and Europe. The Kaplan-Meier method was used to estimate PFS and OS and differences were assessed with the log-rank test. Hazard ratios (HR) and their 95% CI were estimated using a Cox proportional hazards model stratified for clinical co-variates. The impact of selected co-alterations on sotorasib efficacy was assessed in syngeneic (C57BL/6) KG12C NSCLC models.
Results: 411 eligible pts were included in the study. Median age was 68 years, 77% of pts had received both platinum-based chemotherapy and PD-(L)1 inhibitors and 35% had brain metastases. 83% of pts received sotorasib. ORR with KG12Ci was 32.4% (95% CI, 27.9-37.1), PFS was 5.1m (95% CI, 4.5-5.6) and OS was 10.2m (95% CI, 8.4-12.1). Co-alterations in KEAP1, SMARCA4 and CDKN2A/B were each associated with significantly shorter PFS (KEAP1: 2.8m vs 5.5m, HR 2.50, P<0.001; SMARCA4: 1.7m vs 5.5m, HR 2.64, P=0.001; CDKN2A/B: 2.3m vs 5.3m, HR 2.57, P<0.001) and OS with KG12Ci even after adjustment for clinical covariates. STK11 co-mutations without concurrent KEAP1 alterations did not impact clinical outcomes with KG12Ci. In an exploratory analysis, co-mutations in DNA damage repair (DDR) genes and genes encoding components of the ATRX/DAXX/EZH2 pathway were associated with improved KG12Ci efficacy, whereas PI3K/AKT/MTOR/PTEN alterations and missense ROS1/ALK/BRAF/NTRK1-3 mutations resulted in inferior outcomes. The impact of SMARCA4 and DDR gene inactivation was validated in isogenic syngeneic KG12CNSCLC models; additional co-alterations are under evaluation. Integration of KEAP1/SMARCA4/CDKN2A/B co-mutations identified a subgroup (KSCMUT, 37.6% of all pts) with significantly shorter PFS (2.7m vs 6.2m, P<0.001) and OS (6.3m vs 14.6m, P<0.001) that accounted for 57.3% of pts with primary refractory (PFS≤3m) disease.
Conclusions: Co-mutations in KEAP1, SMARCA4 and CDKN2A/2B define subgroups of KG12C NSCLC pts with markedly distinct outcomes with KG12Ci monotherapy. Tailoring of KG12C inhibitor-anchored therapeutic strategies and patient stratification should take into account the co-mutation status of individual tumors.
Citation Format: Marcelo V. Negrao, Haniel A. Araujo, Giuseppe Lamberti, Alissa J. Cooper, Teng Zhou, Neal Akhave, Lukas Delasos, J Kevin Hicks, Mihaela Aldea, Gabriele Minuti, Jacobi Hines, Jacqueline V. Aredo, Michael J. Dennis, Turja Chakrabarti, Susan Scott, Paolo Bironzo, Matthias Scheffler, Petros Christopoulos, So Yeon Kim, Sarah Goldberg, Ying Ni, Blerina Resuli, Lorenza Landi, Shu-Chi Tseng, Mizuki Nishino, Dwight Owen, Collin Blakely, Giannis Mountzios, Catherine A. Shu, Christine Bestvina, Marina Garassino, Kristen Marrone, Jhanelle Gray, Sandip Pravin Patel, Amy L. Cummings, Heather A. Wakelee, Jurgen Wolf, Giorgio V. Scagliotti, Federico Cappuzzo, Fabrice Barlesi, Pradnya Patil, Don L. Gibbons, Funda Meric-Bernstam, J Jack Lee, John V. Heymach, David S. Hong, Rebecca S. Heist, Mark M. Awad, Ferdinandos Skoulidis. Molecular determinants of KRAS p.G12C inhibitor efficacy in advanced NSCLC [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 3431.
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Affiliation(s)
| | | | - Giuseppe Lamberti
- 2Lowe Center for Thoracic Oncology del Dana-Farber Cancer Institute - Harvard Medical School Cancer Center of Boston, Boston, MA
| | - Alissa J. Cooper
- 3Harvard Medical School - Massachusetts General Hospital, Boston, MA
| | - Teng Zhou
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | | | | | | | | | | | - Susan Scott
- 12Johns Hopkins University School of Medicine, Baltimore, MD
| | - Paolo Bironzo
- 13University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy
| | | | | | | | | | - Ying Ni
- 4Cleveland Clinic Cancer Center, Cleveland, OH
| | | | - Lorenza Landi
- 7IRCCS Instituti Fisioterapici Ospitalieri, Rome, Italy
| | | | | | - Dwight Owen
- 19Ohio State University - Wexher Medical Center, Columbus, OH
| | - Collin Blakely
- 11University of California San Francisco, San Francisco, CA
| | | | | | | | | | - Kristen Marrone
- 22Johns Hopkins University School of Medicine - Bayview, Baltimore, MD
| | | | | | | | | | - Jurgen Wolf
- 14University Hospital of Cologne, Cologne, Germany
| | | | | | | | | | | | | | - J Jack Lee
- 1UT MD Anderson Cancer Center, Houston, TX
| | | | | | - Rebecca S. Heist
- 3Harvard Medical School - Massachusetts General Hospital, Boston, MA
| | - Mark M. Awad
- 2Lowe Center for Thoracic Oncology del Dana-Farber Cancer Institute - Harvard Medical School Cancer Center of Boston, Boston, MA
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22
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Hino T, Nishino M, Valtchinov VI, Gagne S, Gay E, Wada N, Tseng SC, Madore B, Guttmann CR, Ishigami K, Li Y, Christiani DC, Hunninghake GM, Levy BD, Kaye KM, Hatabu H. Severe COVID-19 pneumonia leads to post-COVID-19 lung abnormalities on follow-up CT scans. Eur J Radiol Open 2023; 10:100483. [PMID: 36883046 PMCID: PMC9981527 DOI: 10.1016/j.ejro.2023.100483] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Purpose To investigate the association of the maximal severity of pneumonia on CT scans obtained within 6-week of diagnosis with the subsequent development of post-COVID-19 lung abnormalities (Co-LA). Methods COVID-19 patients diagnosed at our hospital between March 2020 and September 2021 were studied retrospectively. The patients were included if they had (1) at least one chest CT scan available within 6-week of diagnosis; and (2) at least one follow-up chest CT scan available ≥ 6 months after diagnosis, which were evaluated by two independent radiologists. Pneumonia Severity Categories were assigned on CT at diagnosis according to the CT patterns of pneumonia and extent as: 1) no pneumonia (Estimated Extent, 0%); 2) non-extensive pneumonia (GGO and OP, <40%); and 3) extensive pneumonia (extensive OP and DAD, >40%). Co-LA on follow-up CT scans, categorized using a 3-point Co-LA Score (0, No Co-LA; 1, Indeterminate Co-LA; and 2, Co-LA). Results Out of 132 patients, 42 patients (32%) developed Co-LA on their follow-up CT scans 6-24 months post diagnosis. The severity of COVID-19 pneumonia was associated with Co-LA: In 47 patients with extensive pneumonia, 33 patients (70%) developed Co-LA, of whom 18 (55%) developed fibrotic Co-LA. In 52 with non-extensive pneumonia, 9 (17%) developed Co-LA: In 33 with no pneumonia, none (0%) developed Co-LA. Conclusions Higher severity of pneumonia at diagnosis was associated with the increased risk of development of Co-LA after 6-24 months of SARS-CoV-2 infection.
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Key Words
- 2019-nCoV, 2019 novel coronavirus
- ARDS, acute respiratory distress syndrome
- Abnormalities
- COVID-19
- COVID-19 pneumonia
- COVID-19 related lung abnormalities
- COVID-19, coronavirus disease 2019
- Chest CT
- Co-LA, post-COVID-19 lung abnormalities
- DAD, diffuse alveolar damage
- GGO, ground-glass opacity
- ILA, interstitial lung abnormalities
- ILD, interstitial lung disease
- Lung
- OP, organizing pneumonia
- PE, pulmonary embolism
- SARS-CoV2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
- Takuya Hino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3–1-1 Maidashi, Higashi-ku, Fukuoka 8128582, Japan
| | - Mizuki Nishino
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Vladimir I. Valtchinov
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Staci Gagne
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Elizabeth Gay
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Noriaki Wada
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Shu Chi Tseng
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Bruno Madore
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Charles R.G. Guttmann
- Center for Neurological Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3–1-1 Maidashi, Higashi-ku, Fukuoka 8128582, Japan
| | - Yi Li
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - David C. Christiani
- Department of Environmental Health, Harvard TH Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA
- Division of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA 02114, USA
| | - Gary M. Hunninghake
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Bruce D. Levy
- Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Kenneth M. Kaye
- Division of Infectious Diseases, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
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Nishino M, Lu J, Hino T, Vokes NI, Jänne PA, Hatabu H, Johnson BE. Prediction Model for Tumor Volume Nadir in EGFR -mutant NSCLC Patients Treated With EGFR Tyrosine Kinase Inhibitors. J Thorac Imaging 2023; 38:82-87. [PMID: 34524205 PMCID: PMC8920948 DOI: 10.1097/rti.0000000000000615] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE In patients with advanced non-small cell lung cancer (NSCLC) and oncogenic driver mutations treated with effective targeted therapy, a characteristic pattern of tumor volume dynamics with an initial regression, nadir, and subsequent regrowth is observed on serial computed tomography (CT) scans. We developed and validated a linear model to predict the tumor volume nadir in EGFR -mutant advanced NSCLC patients treated with EGFR tyrosine kinase inhibitors (TKI). MATERIALS AND METHODS Patients with EGFR -mutant advanced NSCLC treated with EGFR-TKI as their first EGFR-directed therapy were studied for CT tumor volume kinetics during therapy, using a previously validated CT tumor measurement technique. A linear regression model was built to predict tumor volume nadir in a training cohort of 34 patients, and then was validated in an independent cohort of 84 patients. RESULTS The linear model for tumor nadir prediction was obtained in the training cohort of 34 patients, which utilizes the baseline tumor volume before initiating therapy (V 0 ) to predict the volume decrease (mm 3 ) when the nadir volume (V p ) was reached: V 0 -V p =0.717×V 0 -1347 ( P =2×10 -16 ; R2 =0.916). The model was tested in the validation cohort, resulting in the R2 value of 0.953, indicating that the prediction model generalizes well to another cohort of EGFR -mutant patients treated with EGFR-TKI. Clinical variables were not significant predictors of tumor volume nadir. CONCLUSION The linear model was built to predict the tumor volume nadir in EGFR -mutant advanced NSCLC patients treated with EGFR-TKIs, which provide an important metrics in treatment monitoring and therapeutic decisions at nadir such as additional local abrasive therapy.
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Affiliation(s)
- Mizuki Nishino
- Department of Imaging, Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215
- Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115
| | - Junwei Lu
- Department of Biostatistics, Harvard Chan School of Public Health
| | | | - Natalie I. Vokes
- Department of Medical Oncology, Dana Farber Cancer Institute and Department of Medicine, Brigham and Women’s Hospital, 450 Brookline Ave, Boston, MA, 02215
| | - Pasi A. Jänne
- Department of Medical Oncology, Dana Farber Cancer Institute and Department of Medicine, Brigham and Women’s Hospital, 450 Brookline Ave, Boston, MA, 02215
| | - Hiroto Hatabu
- Department of Imaging, Dana Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215
- Department of Radiology, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115
| | - Bruce E. Johnson
- Department of Medical Oncology, Dana Farber Cancer Institute and Department of Medicine, Brigham and Women’s Hospital, 450 Brookline Ave, Boston, MA, 02215
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Fox AH, Nishino M, Osarogiagbon RU, Rivera MP, Rosenthal LS, Smith RA, Farjah F, Sholl LM, Silvestri GA, Johnson BE. Acquiring tissue for advanced lung cancer diagnosis and comprehensive biomarker testing: A National Lung Cancer Roundtable best-practice guide. CA Cancer J Clin 2023. [PMID: 36859638 DOI: 10.3322/caac.21774] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 03/03/2023] Open
Abstract
Advances in biomarker-driven therapies for patients with nonsmall cell lung cancer (NSCLC) both provide opportunities to improve the treatment (and thus outcomes) for patients and pose new challenges for equitable care delivery. Over the last decade, the continuing development of new biomarker-driven therapies and evolving indications for their use have intensified the importance of interdisciplinary communication and coordination for patients with or suspected to have lung cancer. Multidisciplinary teams are challenged with completing comprehensive and timely biomarker testing and navigating the constantly evolving evidence base for a complex and time-sensitive disease. This guide provides context for the current state of comprehensive biomarker testing for NSCLC, reviews how biomarker testing integrates within the diagnostic continuum for patients, and illustrates best practices and common pitfalls that influence the success and timeliness of biomarker testing using a series of case scenarios.
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Affiliation(s)
- Adam H Fox
- Division of Pulmonary Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Mizuki Nishino
- Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Raymond U Osarogiagbon
- Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, Tennessee, USA
| | - M Patricia Rivera
- Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Lauren S Rosenthal
- Prevention and Early Detection Department, American Cancer Society, Atlanta, Georgia, USA
| | - Robert A Smith
- Prevention and Early Detection Department, American Cancer Society, Atlanta, Georgia, USA
| | - Farhood Farjah
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Gerard A Silvestri
- Division of Pulmonary Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Bruce E Johnson
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
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Nishino M, Wei Z, Mazzola E, Hino T, Tseng SC, Sanchez ME, Hatabu H, Johnson BE, Awad MM. Tumor Volume Nadir in Patients With ALK-Rearranged Non-Small-Cell Lung Cancer Treated With Alectinib. JCO Precis Oncol 2023; 7:e2200603. [PMID: 36893377 DOI: 10.1200/po.22.00603] [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: 03/11/2023] Open
Abstract
PURPOSE Patients with oncogene-driven advanced non-small-cell lung cancer (NSCLC) treated with effective targeted therapy demonstrate characteristic tumor volume dynamics with initial response, nadir, and subsequent regrowth. This study investigated tumor volume nadir and time to nadir in patients with ALK-rearranged advanced NSCLC treated with alectinib. MATERIALS AND METHODS In patients with advanced ALK-rearranged NSCLC treated with alectinib monotherapy, tumor volume dynamics were evaluated on serial computed tomography (CT) scans using a previously validated CT tumor measurement technique. A linear regression model was built to predict tumor volume nadir. Time-to-event analyses were performed to evaluate time to nadir. RESULTS Among 45 patients who experienced initial volume decrease, 37 patients (25 with tumor regrowth and 12 without regrowth but >6 months follow-up) were studied for nadir volume (Vp). The linear model to predict tumor volume nadir was built using the baseline tumor volume (V0): V0-Vp = .696 × V0 + 5,326 (P < 2 × 10-16; adjusted R2 = 0.86). The percent volume changes at nadir (median, -90.9%, mean, -85.3%) showed larger decrease in patients who were treated with alectinib as first-line therapy than in the ≥2nd-line group and were independent of V0 and clinical variables. Time to nadir had a median of 11.5 months and was longer in the first-line group (P = .04). CONCLUSION The tumor nadir volume in patients with ALK-rearranged advanced NSCLC treated with alectinib can be predicted by the liner regression model and consists of approximately 30% of the baseline volume minus 5 cm3, providing additional insights into precision therapy monitoring and potential guides for local ablative therapy to prolong disease control.
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Affiliation(s)
- Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Zihan Wei
- Department of Data Science, Dana-Farber Cancer Institute, Boston MA
| | - Emanuele Mazzola
- Department of Data Science, Dana-Farber Cancer Institute, Boston MA
| | - Takuya Hino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Shu-Chi Tseng
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Michelle E Sanchez
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Bruce E Johnson
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
| | - Mark M Awad
- Department of Medical Oncology and Department of Medicine, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA
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Lamberti G, Aizer A, Ricciuti B, Alessi JV, Pecci F, Tseng SC, Sholl LM, Nishino M, Awad MM. Incidence of Brain Metastases and Preliminary Evidence of Intracranial Activity With Sotorasib in Patients With KRASG12C-Mutant Non-Small-Cell Lung Cancer. JCO Precis Oncol 2023; 7:e2200621. [PMID: 36809054 DOI: 10.1200/po.22.00621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Ayal Aizer
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA
| | - Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Joao V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Federica Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Shu-Chi Tseng
- Department of Radiology, Brigham and Women's Hospital, Boston, MA.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, MA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, MA
| | - Mark M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
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Nishino M, Schiebler ML. Advances in Thoracic Imaging: Key Developments in the Past Decade and Future Directions. Radiology 2023; 306:e222536. [PMID: 36625742 PMCID: PMC9885337 DOI: 10.1148/radiol.222536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Mizuki Nishino
- From the Department of Radiology, Brigham and Women’s Hospital
and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston MA (M.N.); and
Department of Radiology, University of Wisconsin–Madison School of
Medicine and Public Health, Madison, Wis (M.L.S.)
| | - Mark L. Schiebler
- From the Department of Radiology, Brigham and Women’s Hospital
and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston MA (M.N.); and
Department of Radiology, University of Wisconsin–Madison School of
Medicine and Public Health, Madison, Wis (M.L.S.)
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28
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Kronzer VL, Hayashi K, Yoshida K, Davis JM, McDermott GC, Huang W, Dellaripa PF, Cui J, Feathers V, Gill RR, Hatabu H, Nishino M, Blaustein R, Crowson CS, Robinson WH, Sokolove J, Liao KP, Weinblatt ME, Shadick NA, Doyle TJ, Sparks JA. Autoantibodies against citrullinated and native proteins and prediction of rheumatoid arthritis-associated interstitial lung disease: A nested case-control study. Lancet Rheumatol 2023; 5:e77-e87. [PMID: 36874209 PMCID: PMC9979957 DOI: 10.1016/s2665-9913(22)00380-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background To identify fine specificity anti-citrullinated protein antibodies (ACPA) associated with incident rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods This nested case-control study within the Brigham RA Sequential Study matched incident RA-ILD cases to RA-noILD controls on time of blood collection, age, sex, RA duration, and rheumatoid factor status. A multiplex assay measured ACPA and anti-native protein antibodies from stored serum prior to RA-ILD onset. Logistic regression models calculated odds ratios (OR) with 95% confidence intervals (CI) for RA-ILD, adjusting for prospectively-collected covariates. We estimated optimism-corrected area under the curves (AUC) using internal validation. Model coefficients generated a risk score for RA-ILD. Findings We analyzed 84 incident RA-ILD cases (mean age 67 years, 77% female, 90% White) and 233 RA-noILD controls (mean age 66 years, 80% female, 94% White). We identified six fine specificity antibodies that were associated with RA-ILD. The antibody isotypes and targeted proteins were: IgA2 to citrullinated histone 4 (OR 0.08 per log-transformed unit, 95% CI 0.03-0.22), IgA2 to citrullinated histone 2A (OR 4.03, 95% CI 2.03-8.00), IgG to cyclic citrullinated filaggrin (OR 3.47, 95% CI 1.71-7.01), IgA2 to native cyclic histone 2A (OR 5.52, 95% CI 2.38-12.78), IgA2 to native histone 2A (OR 4.60, 95% CI 2.18-9.74), and IgG to native cyclic filaggrin (OR 2.53, 95% CI 1.47-4.34). These six antibodies predicted RA-ILD risk better than all clinical factors combined (optimism-corrected AUC=0·84 versus 0·73). We developed a risk score for RA-ILD combining these antibodies with the clinical factors (smoking, disease activity, glucocorticoid use, obesity). At 50% predicted RA-ILD probability, the risk scores both without (score=2·6) and with (score=5·9) biomarkers achieved specificity ≥93% for RA-ILD. Interpretation Specific ACPA and anti-native protein antibodies improve RA-ILD prediction. These findings implicate synovial protein antibodies in the pathogenesis of RA-ILD and suggest clinical utility in predicting RA-ILD once validated in external studies. Funding National Institutes of Health.
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Affiliation(s)
| | - Keigo Hayashi
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Kazuki Yoshida
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - John M. Davis
- Division of Rheumatology, Mayo Clinic; Rochester, Minnesota, USA
| | - Gregory C. McDermott
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Weixing Huang
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Paul F. Dellaripa
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Jing Cui
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Vivi Feathers
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Ritu R. Gill
- Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School; Boston, Massachusetts, USA
| | - Hiroto Hatabu
- Department of Radiology Brigham and Women’s Hospital and Harvard Medical School; Boston, Massachusetts, USA
| | - Mizuki Nishino
- Department of Radiology Brigham and Women’s Hospital and Harvard Medical School; Boston, Massachusetts, USA
- Department of Imaging, Dana-Farber Cancer Institute and Harvard Medical School; Boston, Massachusetts, USA
| | - Rachel Blaustein
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Cynthia S. Crowson
- Division of Rheumatology, Mayo Clinic; Rochester, Minnesota, USA
- Department of Quantitative Health Sciences, Mayo Clinic; Rochester, Minnesota, USA
| | - William H. Robinson
- Stanford University School of Medicine; Palo Alto, California, USA
- VA Palo Alto Health Care System; Palo Alto, California, USA
| | - Jeremy Sokolove
- Stanford University School of Medicine; Palo Alto, California, USA
- VA Palo Alto Health Care System; Palo Alto, California, USA
- GlaxoSmithKline
| | - Katherine P. Liao
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Michael E. Weinblatt
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Nancy A. Shadick
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
| | - Tracy J. Doyle
- Division of Pulmonary and Critical Care, Brigham and Women’s Hospital and Harvard Medical School; Boston, Massachusetts, USA
| | - Jeffrey A. Sparks
- Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital and Harvard Medical School; Boston, USA
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Park H, Hata A, Hatabu H, Ricciuti B, Awad M, Nishino M. Immune-Related Thyroiditis in Patients with Advanced Lung Cancer Treated with Immune Checkpoint Inhibitors: Imaging Features and Clinical Implications. Cancers (Basel) 2023; 15:cancers15030649. [PMID: 36765606 PMCID: PMC9913779 DOI: 10.3390/cancers15030649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
Immune checkpoint inhibitors (ICI) are widely used in advanced nonsmall cell lung cancer (NSCLC) treatment, and the immune-related adverse events involving many organs have been recognized. This article investigated the incidence and imaging characteristics of immune-related thyroiditis in NSCLC patients and correlated the findings with clinical features. A total of 534 NSCLC patients treated with ICI were included. Imaging findings indicative of thyroiditis included changes in morphology and attenuation on restaging chest CT scans and FDG uptake on PET/CT during ICI therapy. Fifty patients (9.4%) had imaging findings indicative of thyroiditis. The median time to onset was 9.5 weeks (range: 0.9-87.4 weeks). The most common finding was diffuse hypoattenuation of the gland (72%), with enlargement in 15 and atrophy in 12 patients. Heterogeneous attenuation of the gland was noted in 12 patients (24%), with enlargement in 7 and atrophy in 1 patient. Two patients (4%) showed increased FDG uptake in the gland on PET/CT without changes in the CT scan. Twenty-two patients who had both clinical and radiologic diagnoses of thyroiditis were more frequently managed with hormone replacement than those with thyroiditis without an imaging abnormality (p < 0.0001). Therefore, awareness of the imaging findings of immune-related thyroiditis may alert clinicians to the presence of clinically relevant thyroiditis.
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Affiliation(s)
- Hyesun Park
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Correspondence: ; Tel.: +1-617-632-2595
| | - Akinori Hata
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Biagio Ricciuti
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Mark Awad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA 02115, USA
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Rose JA, Menon AA, Hino T, Hata A, Nishino M, Lynch DA, Rosas IO, El-Chemaly S, Raby BA, Ash SY, Choi B, Washko GR, Silverman EK, Cho MH, Hatabu H, Putman RK, Hunninghake GM. Suspected Interstitial Lung Disease in COPDGene Study. Am J Respir Crit Care Med 2023; 207:60-68. [PMID: 35930450 PMCID: PMC9952869 DOI: 10.1164/rccm.202203-0550oc] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/04/2022] [Indexed: 02/03/2023] Open
Abstract
Rationale: Although interstitial lung abnormalities (ILA), specific patterns of incidentally-detected abnormal density on computed tomography, have been associated with abnormal lung function and increased mortality, it is unclear if a subset with incidental interstitial lung disease (ILD) accounts for these adverse consequences. Objectives: To define the prevalence and risk factors of suspected ILD and assess outcomes. Methods: Suspected ILD was evaluated in the COPDGene (Chronic Obstructive Pulmonary Disease Genetic Epidemiology) study, defined as ILA and at least one additional criterion: definite fibrosis on computed tomography, FVC less than 80% predicted, or DLCO less than 70% predicted. Multivariable linear, longitudinal, and Cox proportional hazards regression models were used to assess associations with St. George's Respiratory Questionnaire, 6-minute-walk test, supplemental oxygen use, respiratory exacerbations, and mortality. Measurements and Main Results: Of 4,361 participants with available data, 239 (5%) had evidence for suspected ILD, whereas 204 (5%) had ILA without suspected ILD. In multivariable analyses, suspected ILD was associated with increased St. George's Respiratory Questionnaire score (mean difference [MD], 3.9 points; 95% confidence interval [CI], 0.6-7.1; P = 0.02), reduced 6-minute-walk test (MD, -35 m; 95% CI, -56 m to -13 m; P = 0.002), greater supplemental oxygen use (odds ratio [OR], 2.3; 95% CI, 1.1-5.1; P = 0.03) and severe respiratory exacerbations (OR, 2.9; 95% CI, 1.1-7.5; P = 0.03), and higher mortality (hazard ratio, 2.4; 95% CI, 1.2-4.6; P = 0.01) compared with ILA without suspected ILD. Risk factors associated with suspected ILD included self-identified Black race (OR, 2.0; 95% CI, 1.1-3.3; P = 0.01) and pack-years smoking history (OR, 1.2; 95% CI, 1.1-1.3; P = 0.0005). Conclusions: Suspected ILD is present in half of those with ILA in COPDGene and is associated with exercise decrements and increased symptoms, supplemental oxygen use, severe respiratory exacerbations, and mortality.
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Affiliation(s)
| | | | | | - Akinori Hata
- Department of Radiology, Osaka University, Osaka, Japan
| | | | | | - Ivan O. Rosas
- Pulmonary Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, Texas; and
| | | | - Benjamin A. Raby
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | | | - Bina Choi
- Pulmonary and Critical Care Division
| | | | - Edwin K. Silverman
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Michael H. Cho
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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31
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Tseng SC, Lee HY, Nishino M. Imaging of Drug-Related Pneumonitis in Oncology. Semin Respir Crit Care Med 2022; 43:887-898. [PMID: 36307109 DOI: 10.1055/s-0042-1755569] [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: 12/15/2022]
Abstract
Clinical applications of novel anticancer agents in the past few decades brought marked advances in cancer treatment, enabling remarkable efficacy and effectiveness; however, these novel agents are also associated with toxicities. Among various toxicities, drug-related pneumonitis is one of the major clinical challenges in the management of cancer patients. Imaging plays a key role in detection, diagnosis, and monitoring of drug-related pneumonitis during cancer treatment. In the current era of precision oncology, pneumonitis from molecular targeted therapy and immune-checkpoint inhibitors (ICI) has been recognized as an event of clinical significance. Additionally, further advances of therapeutic approaches in cancer have brought several emerging issues in diagnosis and monitoring of pneumonitis. This article will describe the computed tomography (CT) pattern-based approach for drug-related pneumonitis that has been utilized to describe the imaging manifestations of pneumonitis from novel cancer therapies. Then, we will discuss pneumonitis from representative agents of precision cancer therapy, including mammalian target of rapamycin inhibitors, epidermal growth factor receptor inhibitors, and ICI, focusing on the incidence, risk factors, and the spectrum of CT patterns. Finally, the article will address emerging challenges in the diagnosis and monitoring of pneumonitis, including pneumonitis from combination ICI and radiation therapy and from antibody conjugate therapy, as well as the overlapping imaging features of drug-related pneumonitis and coronavirus disease 2019 pneumonia. The review is designed to provide a practical overview of drug-related pneumonitis from cutting-edge cancer therapy with emphasis on the role of imaging.
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Affiliation(s)
- Shu-Chi Tseng
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ho Yun Lee
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, Korea
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
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Nishino M, Bluemke DA. Diagnosis Please Certificates of Recognition Awarded to Two Individuals and to International and North American Radiology Resident Groups. Radiology 2022; 305:E74. [DOI: 10.1148/radiol.229032] [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: 11/22/2022]
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33
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Park H, Tseng SC, Sholl LM, Hatabu H, Awad MM, Nishino M. Molecular Characterization and Therapeutic Approaches to Small Cell Lung Cancer: Imaging Implications. Radiology 2022; 305:512-525. [PMID: 36283111 PMCID: PMC9713457 DOI: 10.1148/radiol.220585] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 01/16/2023]
Abstract
Small cell lung cancer (SCLC) is a highly aggressive malignancy with exceptionally poor prognosis, comprising approximately 15% of lung cancers. Emerging knowledge of the molecular and genomic landscape of SCLC and recent successful clinical applications of new systemic agents have allowed for precision oncology treatment approaches. Imaging is essential for the diagnosis, staging, and treatment monitoring of patients with SCLC. The role of imaging is increasing with the approval of new treatment agents, including immune checkpoint inhibitors, which lead to novel imaging manifestations of response and toxicities. The purpose of this state-of-the-art review is to provide the reader with the latest information about SCLC, focusing on the subtyping of this malignancy (molecular characterization) and the emerging systemic therapeutic approaches and their implications for imaging. The review will also discuss the future directions of SCLC imaging, radiomics and machine learning.
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Affiliation(s)
- Hyesun Park
- From the Departments of Radiology (H.P., S.C.T., H.H., M.N.),
Pathology (L.M.S.), Medical Oncology (M.M.A.), and Medicine (M.M.A.),
Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450
Brookline Ave, Boston, MA 02215
| | | | - Lynette M. Sholl
- From the Departments of Radiology (H.P., S.C.T., H.H., M.N.),
Pathology (L.M.S.), Medical Oncology (M.M.A.), and Medicine (M.M.A.),
Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450
Brookline Ave, Boston, MA 02215
| | - Hiroto Hatabu
- From the Departments of Radiology (H.P., S.C.T., H.H., M.N.),
Pathology (L.M.S.), Medical Oncology (M.M.A.), and Medicine (M.M.A.),
Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450
Brookline Ave, Boston, MA 02215
| | - Mark M. Awad
- From the Departments of Radiology (H.P., S.C.T., H.H., M.N.),
Pathology (L.M.S.), Medical Oncology (M.M.A.), and Medicine (M.M.A.),
Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450
Brookline Ave, Boston, MA 02215
| | - Mizuki Nishino
- From the Departments of Radiology (H.P., S.C.T., H.H., M.N.),
Pathology (L.M.S.), Medical Oncology (M.M.A.), and Medicine (M.M.A.),
Dana-Farber Cancer Institute and Brigham and Women's Hospital, 450
Brookline Ave, Boston, MA 02215
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Tseng SC, Hino T, Hatabu H, Park H, Sanford NN, Lin G, Nishino M, Mamon H. Interstitial Lung Abnormalities in Patients With Locally Advanced Esophageal Cancer: Prevalence, Risk Factors, and Clinical Implications. J Comput Assist Tomogr 2022; 46:871-877. [PMID: 35995596 PMCID: PMC9675694 DOI: 10.1097/rct.0000000000001366] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE Interstitial lung abnormalities (ILAs) represent nondependent abnormalities on chest computed tomography (CT) indicating lung parenchymal damages due to inflammation and fibrosis. Interstitial lung abnormalities have been studied as a predictor of clinical outcome in lung cancer, but not in other thoracic malignancies. The present study investigated the prevalence of ILA in patients with esophageal cancer and identified risk factors and clinical implications of ILA in these patients. METHODS The study included 208 patients with locally advanced esophageal cancer (median age, 65.6 years; 166 males, 42 females). Interstitial lung abnormality was scored on baseline CT scans before treatment using a 3-point scale (0 = no evidence of ILA, 1 = equivocal for ILA, 2 = ILA). Clinical characteristics and overall survival were compared in patients with ILA (score 2) and others. RESULTS An ILA was present in 14 of 208 patients (7%) with esophageal cancer on pretreatment chest CT. Patients with ILA were significantly older (median age, 69 vs 65, respectively; P = 0.011), had a higher number of pack-years of smoking ( P = 0.02), and more commonly had T4 stage disease ( P = 0.026) than patients with ILA score of 1 or 0. Interstitial lung abnormality on baseline scan was associated with a lack of surgical resection after chemoradiotherapy (7/14, 50% vs 39/194, 20% respectively; P = 0.016). Interstitial lung abnormality was not associated with overall survival (log-rank P = 0.75, Cox P = 0.613). CONCLUSIONS An ILA was present in 7% of esophageal cancer patients, which is similar to the prevalence in general population and in smokers. Interstitial lung abnormality was strongly associated with a lack of surgical resection after chemoradiotherapy, indicating an implication of ILA in treatment selection in these patients, which can be further studied in larger cohorts.
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Affiliation(s)
- Shu-Chi Tseng
- Department of Radiology, Brigham and Women’s Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave. Boston MA, 02215, USA
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Takuya Hino
- Department of Radiology, Brigham and Women’s Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave. Boston MA, 02215, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women’s Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave. Boston MA, 02215, USA
| | - Hyesun Park
- Department of Radiology, Brigham and Women’s Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave. Boston MA, 02215, USA
| | - Nina N. Sanford
- Department of Radiation Oncology, University of Texas Southwestern
| | - Gigin Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan, Taiwan
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women’s Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave. Boston MA, 02215, USA
| | - Harvey Mamon
- Department of Radiation Oncology, Brigham and Women’s Hospital and Department of Imaging, Dana-Farber Cancer Institute, 450 Brookline Ave. Boston MA, 02215, USA
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Hata A, Hino T, Yanagawa M, Nishino M, Hida T, Hunninghake GM, Tomiyama N, Christiani DC, Hatabu H. Interstitial Lung Abnormalities at CT: Subtypes, Clinical Significance, and Associations with Lung Cancer. Radiographics 2022; 42:1925-1939. [PMID: 36083805 PMCID: PMC9630713 DOI: 10.1148/rg.220073] [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: 04/03/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/11/2022]
Abstract
Interstitial lung abnormality (ILA) is defined as an interstitial change detected incidentally on CT images. It is seen in 4%-9% of smokers and 2%-7% of nonsmokers. ILA has a tendency to progress with time and is associated with respiratory symptoms, decreased exercise capability, reduced pulmonary function, and increased mortality. ILAs can be classified into three subcategories: nonsubpleural, subpleural nonfibrotic, and subpleural fibrotic. In cases of ILA, clinically significant interstitial lung disease should be identified and requires clinically driven management by a pulmonologist. Risk factors for the progression of ILA include clinical elements (ie, inhalation exposures, medication use, radiation therapy, thoracic surgery, physiologic findings, and gas exchange findings) and radiologic elements (ie, basal and peripheral predominance and fibrotic findings). It is recommended that individuals with one or more clinical or radiologic risk factors for progression of ILA be actively monitored with pulmonary function testing and CT. To avoid overcalling ILA at CT, radiologists must recognize the imaging pitfalls, including centrilobular nodularity, dependent abnormality, suboptimal inspiration, osteophyte-related lesions, apical cap and pleuroparenchymal fibroelastosis-like lesions, aspiration, and infection. There is a close association between ILA and lung cancer, and many studies have reported an increased incidence of lung cancer, worse prognoses, and/or increased pulmonary complications in relation to cancer treatment in patients with ILA. ILA is considered to be an important comorbidity in patients with lung cancer. Accordingly, all radiologists involved with body CT must have sound knowledge of ILAs owing to the high prevalence and potential clinical significance of these anomalies. An overview of ILAs, including a literature review of the associations between ILAs and lung cancer, is presented. ©RSNA, 2022.
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Affiliation(s)
- Akinori Hata
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Takuya Hino
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Masahiro Yanagawa
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Mizuki Nishino
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Tomoyuki Hida
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Gary M. Hunninghake
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Noriyuki Tomiyama
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - David C. Christiani
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
| | - Hiroto Hatabu
- From the Department of Diagnostic and Interventional Radiology,
Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka
5650871, Japan (A.H., M.Y., N.T.); Center for Pulmonary Functional Imaging,
Department of Radiology (A.H., T.H., M.N., G.M.H., H.H.) and Pulmonary and
Critical Care Division (G.M.H.), Brigham and Women’s Hospital and Harvard
Medical School, Boston, MA; Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hino, T. Hida);
Department of Imaging, Dana Farber Cancer Institute, Boston, MA (M.N.); and
Department of Environmental Health, Harvard TH Chan School of Public Health,
Boston, Mass (D.C.C.)
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36
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Cheng ML, Lee JK, Kumar R, Klein H, Raskina K, Schrock AB, Michael KS, Mazor T, Cerami E, Oxnard GR, Liu D, Beltran H, Sholl LM, Nishino M, Jänne PA. Response to MEK Inhibitor Therapy in MAP2K1 ( MEK1) K57N Non-Small-Cell Lung Cancer and Genomic Landscape of MAP2K1 Mutations in Non-Small-Cell Lung Cancer. JCO Precis Oncol 2022; 6:e2200382. [PMID: 36455195 DOI: 10.1200/po.22.00382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Affiliation(s)
- Michael L Cheng
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA.,Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.,Present address: Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA
| | | | - Rachit Kumar
- Harold Alfond Center for Cancer Care, MaineHealth, Augusta, MA
| | - Harry Klein
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Kesi S Michael
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA.,Present address: Foundation Medicine, Cambridge, MA
| | - Tali Mazor
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | - Ethan Cerami
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA
| | | | - David Liu
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Himisha Beltran
- Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Pasi A Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA.,Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.,Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
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37
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Nishino M. Invited Commentary: Pearls and Pitfalls in Imaging Evaluation of Lung Cancer Immunotherapy. Radiographics 2022; 42:E205-E207. [PMID: 36240078 DOI: 10.1148/rg.220170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mizuki Nishino
- From the Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215
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38
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Nishino M, Bluemke DA. Diagnosis Please Certificates of Recognition Awarded to Two Individuals and to International and North American Radiology Resident Groups. Radiology 2022; 305:502-504. [PMID: 36219113 DOI: 10.1148/radiol.221476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ricciuti B, Alessi JV, Elkrief A, Wang X, Cortellini A, Li YY, Vaz VR, Gupta H, Pecci F, Barrichello A, Lamberti G, Nguyen T, Lindsay J, Sharma B, Felt K, Rodig SJ, Nishino M, Sholl LM, Barbie DA, Negrao MV, Zhang J, Cherniack AD, Heymach JV, Meyerson M, Ambrogio C, Jänne PA, Arbour KC, Pinato DJ, Skoulidis F, Schoenfeld AJ, Awad MM, Luo J. Dissecting the clinicopathologic, genomic, and immunophenotypic correlates of KRAS G12D-mutated non-small-cell lung cancer. Ann Oncol 2022; 33:1029-1040. [PMID: 35872166 PMCID: PMC11006449 DOI: 10.1016/j.annonc.2022.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Allele-specific KRAS inhibitors are an emerging class of cancer therapies. KRAS-mutant (KRASMUT) non-small-cell lung cancers (NSCLCs) exhibit heterogeneous outcomes, driven by differences in underlying biology shaped by co-mutations. In contrast to KRASG12C NSCLC, KRASG12D NSCLC is associated with low/never-smoking status and is largely uncharacterized. PATIENTS AND METHODS Clinicopathologic and genomic information were collected from patients with NSCLCs harboring a KRAS mutation at the Dana-Farber Cancer Institute (DFCI), Memorial Sloan Kettering Cancer Center, MD Anderson Cancer Center, and Imperial College of London. Multiplexed immunofluorescence for CK7, programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), Foxp3, and CD8 was carried out on a subset of samples with available tissue at the DFCI. Clinical outcomes to PD-(L)1 inhibition ± chemotherapy were analyzed according to KRAS mutation subtype. RESULTS Of 2327 patients with KRAS-mutated (KRASMUT) NSCLC, 15% (n = 354) harbored KRASG12D. Compared to KRASnon-G12D NSCLC, KRASG12D NSCLC had a lower pack-year (py) smoking history (median 22.5 py versus 30.0 py, P < 0.0001) and was enriched in never smokers (22% versus 5%, P < 0.0001). KRASG12D had lower PD-L1 tumor proportion score (TPS) (median 1% versus 5%, P < 0.01) and lower tumor mutation burden (TMB) compared to KRASnon-G12D (median 8.4 versus 9.9 mt/Mb, P < 0.0001). Of the samples which underwent multiplexed immunofluorescence, KRASG12D had lower intratumoral and total CD8+PD1+ T cells (P < 0.05). Among 850 patients with advanced KRASMUT NSCLC who received PD-(L)1-based therapies, KRASG12D was associated with a worse objective response rate (ORR) (15.8% versus 28.4%, P = 0.03), progression-free survival (PFS) [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.45-2.00, P = 0.003], and overall survival (OS; HR 1.45, 1.05-1.99, P = 0.02) to PD-(L)1 inhibition alone but not to chemo-immunotherapy combinations [ORR 30.6% versus 35.7%, P = 0.51; PFS HR 1.28 (95%CI 0.92-1.77), P = 0.13; OS HR 1.36 (95%CI 0.95-1.96), P = 0.09] compared to KRASnon-G12D. CONCLUSIONS KRASG12D lung cancers harbor distinct clinical, genomic, and immunologic features compared to other KRAS-mutated lung cancers and worse outcomes to PD-(L)1 blockade. Drug development for KRASG12D lung cancers will have to take these differences into account.
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Affiliation(s)
- B Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J V Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - A Elkrief
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - X Wang
- Harvard School of Public Health, Boston, USA
| | - A Cortellini
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - Y Y Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Cancer Program, Broad Institute of Harvard and Massachusetts Institute of Technology (MIT), Cambridge, USA
| | - V R Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - H Gupta
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - F Pecci
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - A Barrichello
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - G Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - T Nguyen
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J Lindsay
- Knowledge Systems Group, Dana-Farber Cancer Institute, Boston, USA
| | - B Sharma
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA
| | - K Felt
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA
| | - S J Rodig
- ImmunoProfile, Brigham & Women's Hospital and Dana-Farber Cancer Institute, Boston, USA; Department of Pathology, Brigham and Women's Hospital, Boston, USA
| | - M Nishino
- Department of Radiology, Brigham and Women's Hospital and Department of Imaging, Dana-Farber Cancer Institute, Boston, USA
| | - L M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, USA
| | - D A Barbie
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - M V Negrao
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Zhang
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - A D Cherniack
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - M Meyerson
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - C Ambrogio
- Molecular Biotechnology and Health Science, University of Turin, Turin, Italy
| | - P A Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - K C Arbour
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - D J Pinato
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK
| | - F Skoulidis
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - A J Schoenfeld
- Thoracic Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M M Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA
| | - J Luo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA.
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Hata A, Hino T, Putman RK, Yanagawa M, Hida T, Menon AA, Honda O, Yamada Y, Nishino M, Araki T, Valtchinov VI, Jinzaki M, Honda H, Ishigami K, Johkoh T, Tomiyama N, Christiani DC, Lynch DA, San José Estépar R, Washko GR, Cho MH, Silverman EK, Hunninghake GM, Hatabu H. Traction Bronchiectasis/Bronchiolectasis on CT Scans in Relationship to Clinical Outcomes and Mortality: The COPDGene Study. Radiology 2022; 304:694-701. [PMID: 35638925 PMCID: PMC9434811 DOI: 10.1148/radiol.212584] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/14/2022] [Accepted: 03/23/2022] [Indexed: 01/16/2023]
Abstract
Background The clinical impact of interstitial lung abnormalities (ILAs) on poor prognosis has been reported in many studies, but risk stratification in ILA will contribute to clinical practice. Purpose To investigate the association of traction bronchiectasis/bronchiolectasis index (TBI) with mortality and clinical outcomes in individuals with ILA by using the COPDGene cohort. Materials and Methods This study was a secondary analysis of prospectively collected data. Chest CT scans of participants with ILA for traction bronchiectasis/bronchiolectasis were evaluated and outcomes were compared with participants without ILA from the COPDGene study (January 2008 to June 2011). TBI was classified as follows: TBI-0, ILA without traction bronchiectasis/bronchiolectasis; TBI-1, ILA with bronchiolectasis but without bronchiectasis or architectural distortion; TBI-2, ILA with mild to moderate traction bronchiectasis; and TBI-3, ILA with severe traction bronchiectasis and/or honeycombing. Clinical outcomes and overall survival were compared among the TBI groups and the non-ILA group by using multivariable linear regression model and Cox proportional hazards model, respectively. Results Overall, 5295 participants (median age, 59 years; IQR, 52-66 years; 2779 men) were included, and 582 participants with ILA and 4713 participants without ILA were identified. TBI groups were associated with poorer clinical outcomes such as quality of life scores in the multivariable linear regression model (TBI-0: coefficient, 3.2 [95% CI: 0.6, 5.7; P = .01]; TBI-1: coefficient, 3.3 [95% CI: 1.1, 5.6; P = .003]; TBI-2: coefficient, 7.6 [95% CI: 4.0, 11; P < .001]; TBI-3: coefficient, 32 [95% CI: 17, 48; P < .001]). The multivariable Cox model demonstrated that ILA without traction bronchiectasis (TBI-0-1) and with traction bronchiectasis (TBI-2-3) were associated with shorter overall survival (TBI-0-1: hazard ratio [HR], 1.4 [95% CI: 1.0, 1.9; P = .049]; TBI-2-3: HR, 3.8 [95% CI: 2.6, 5.6; P < .001]). Conclusion Traction bronchiectasis/bronchiolectasis was associated with poorer clinical outcomes compared with the group without interstitial lung abnormalities; TBI-2 and 3 were associated with shorter survival. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Lee and Im in this issue.
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Affiliation(s)
- Akinori Hata
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Takuya Hino
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Rachel K. Putman
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Masahiro Yanagawa
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Tomoyuki Hida
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Aravind A. Menon
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Osamu Honda
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Yoshitake Yamada
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Mizuki Nishino
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Tetsuro Araki
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Vladimir I. Valtchinov
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Masahiro Jinzaki
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Hiroshi Honda
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Kousei Ishigami
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Takeshi Johkoh
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Noriyuki Tomiyama
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - David C. Christiani
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - David A. Lynch
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Raúl San José Estépar
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - George R. Washko
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Michael H. Cho
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Edwin K. Silverman
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Gary M. Hunninghake
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - Hiroto Hatabu
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
| | - for the COPDGene Investigators
- From the Ctr for Pulmonary Functional Imaging, Dept of Radiology
(A.H., T. Hino, T. Hida, M.N., V.I.V., G.M.H., H. Hatabu), Pulmonary and
Critical Care Division (R.K.P., A.A.M., G.R.W., G.M.H.), Dept of Radiology
(R.S.J.E.), and Channing Division of Network Medicine (M.H.C., E.K.S.), Brigham
and Women’s Hospital and Harvard Medical School, Boston, Mass; Dept of
Radiology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita,
Osaka 5650871, Japan (A.H., M.Y., N.T.); Dept of Clinical Radiology, Graduate
School of Medical Sciences, Kyushu University, Fukuoka, Japan (T. Hida, H.
Honda, K.I.); Dept of Radiology, Kansai Medical University, Hirakata, Japan
(O.H.); Dept of Radiology, Keio University School of Medicine, Tokyo, Japan
(Y.Y., M.J.); Dept of Radiology, Hospital of the University of Pennsylvania,
Philadelphia, Pa (T.A.); Dept of Radiology, Kansai Rosai Hospital, Amagasaki,
Japan (T.J.); Dept of Environmental Health, Harvard TH Chan School of Public
Health, Boston, Mass (D.C.C.); and Dept of Radiology, National Jewish Health,
Denver, Colo (D.A.L.)
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Putman RK, Axelsson GT, Ash SY, Sanders JL, Menon AA, Araki T, Nishino M, Yanagawa M, Gudmundsson EF, Qiao D, San José Estépar R, Dupuis J, O'Connor GT, Rosas IO, Washko GR, El-Chemaly S, Raby BA, Gudnason V, DeMeo DL, Silverman EK, Hatabu H, De Vivo I, Cho MH, Gudmundsson G, Hunninghake GM. Interstitial lung abnormalities are associated with decreased mean telomere length. Eur Respir J 2022; 60:2101814. [PMID: 35115336 PMCID: PMC10052789 DOI: 10.1183/13993003.01814-2021] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 12/29/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Interstitial lung abnormalities (ILA) share many features with idiopathic pulmonary fibrosis; however, it is not known if ILA are associated with decreased mean telomere length (MTL). METHODS Telomere length was measured with quantitative PCR in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) and Age Gene/Environment Susceptibility Reykjavik (AGES-Reykjavik) cohorts and Southern blot analysis was used in the Framingham Heart Study (FHS). Logistic and linear regression were used to assess the association between ILA and MTL; Cox proportional hazards models were used to assess the association between MTL and mortality. RESULTS In all three cohorts, ILA were associated with decreased MTL. In the COPDGene and AGES-Reykjavik cohorts, after adjustment there was greater than twofold increase in the odds of ILA when comparing the shortest quartile of telomere length to the longest quartile (OR 2.2, 95% CI 1.5-3.4, p=0.0001, and OR 2.6, 95% CI 1.4-4.9, p=0.003, respectively). In the FHS, those with ILA had shorter telomeres than those without ILA (-767 bp, 95% CI 76-1584 bp, p=0.03). Although decreased MTL was associated with chronic obstructive pulmonary disease (OR 1.3, 95% CI 1.1-1.6, p=0.01) in COPDGene, the effect estimate was less than that noted with ILA. There was no consistent association between MTL and risk of death when comparing the shortest quartile of telomere length in COPDGene and AGES-Reykjavik (HR 0.82, 95% CI 0.4-1.7, p=0.6, and HR 1.2, 95% CI 0.6-2.2, p=0.5, respectively). CONCLUSION ILA are associated with decreased MTL.
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Affiliation(s)
- Rachel K Putman
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Gisli Thor Axelsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Icelandic Heart Association, Kopavogur, Iceland
| | - Samuel Y Ash
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jason L Sanders
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Aravind A Menon
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Tetsuro Araki
- Dept of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mizuki Nishino
- Dept of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Masahiro Yanagawa
- Dept of Radiology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | | | - Dandi Qiao
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Raúl San José Estépar
- Dept of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Josée Dupuis
- Dept of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - George T O'Connor
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA
| | - Ivan O Rosas
- Pulmonary and Critical Care Division, Baylor University Medical Center, Houston, TX, USA
| | - George R Washko
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Souheil El-Chemaly
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin A Raby
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary and Respiratory Diseases, Boston Children's Hospital, Boston, MA, USA
| | | | - Dawn L DeMeo
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Edwin K Silverman
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Hiroto Hatabu
- Dept of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Immaculata De Vivo
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michael H Cho
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Gunnar Gudmundsson
- Icelandic Heart Association, Kopavogur, Iceland
- Dept of Respiratory Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Gary M Hunninghake
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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42
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Cheng ML, Thomas V, Vaz N, Hammer MM, Nishino M, Vargas SO, Khalil HA. Lipid pneumonia associated with mineral oil use presenting as fluorine-18-fluorodeoxy-D-glucose–avid lung mass. JTCVS Tech 2022; 15:192-194. [PMID: 36276695 PMCID: PMC9579874 DOI: 10.1016/j.xjtc.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 12/02/2022] Open
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43
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Ricciuti B, Wang X, Alessi JV, Rizvi H, Mahadevan NR, Li YY, Polio A, Lindsay J, Umeton R, Sinha R, Vokes NI, Recondo G, Lamberti G, Lawrence M, Vaz VR, Leonardi GC, Plodkowski AJ, Gupta H, Cherniack AD, Tolstorukov MY, Sharma B, Felt KD, Gainor JF, Ravi A, Getz G, Schalper KA, Henick B, Forde P, Anagnostou V, Jänne PA, Van Allen EM, Nishino M, Sholl LM, Christiani DC, Lin X, Rodig SJ, Hellmann MD, Awad MM. Association of High Tumor Mutation Burden in Non-Small Cell Lung Cancers With Increased Immune Infiltration and Improved Clinical Outcomes of PD-L1 Blockade Across PD-L1 Expression Levels. JAMA Oncol 2022; 8:1160-1168. [PMID: 35708671 PMCID: PMC9204620 DOI: 10.1001/jamaoncol.2022.1981] [Citation(s) in RCA: 103] [Impact Index Per Article: 51.5] [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: 10/02/2021] [Accepted: 04/03/2022] [Indexed: 01/16/2023]
Abstract
Importance Although tumor mutation burden (TMB) has been explored as a potential biomarker of immunotherapy efficacy in solid tumors, there still is a lack of consensus about the optimal TMB threshold that best discriminates improved outcomes of immune checkpoint inhibitor therapy among patients with non-small cell lung cancer (NSCLC). Objectives To determine the association between increasing TMB levels and immunotherapy efficacy across clinically relevant programmed death ligand-1 (PD-L1) levels in patients with NSCLC. Design, Setting, and Participants This multicenter cohort study included patients with advanced NSCLC treated with immunotherapy who received programmed cell death-1 (PD-1) or PD-L1 inhibition in the Dana-Farber Cancer Institute (DFCI), Memorial Sloan Kettering Cancer Center (MSKCC), and in the Stand Up To Cancer (SU2C)/Mark Foundation data sets. Clinicopathological and genomic data were collected from patients between September 2013 and September 2020. Data analysis was performed from November 2021 to February 2022. Exposures Treatment with PD-1/PD-L1 inhibition without chemotherapy. Main Outcomes and Measures Association of TMB levels with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Results In the entire cohort of 1552 patients with advanced NSCLC who received PD-1/PD-L1 blockade, the median (range) age was 66 (22-92) years, 830 (53.5%) were women, and 1347 (86.8%) had cancer with nonsquamous histologic profile. A regression tree modeling ORR as a function of TMB identified 2 TMB groupings in the discovery cohort (MSKCC), defined as low TMB (≤19.0 mutations per megabase) and high TMB (>19.0 mutations per megabase), which were associated with increasing improvements in ORR, PFS, and OS in the discovery cohort and in 2 independent cohorts (DFCI and SU2C/Mark Foundation). These TMB levels also were associated with significant improvements in outcomes of immunotherapy in each PD-L1 tumor proportion score subgroup of less than 1%, 1% to 49%, and 50% or higher. The ORR to PD-1/PD-L1 inhibition was as high as 57% in patients with high TMB and PD-L1 expression 50% or higher and as low as 8.7% in patients with low TMB and PD-L1 expression less than 1%. Multiplexed immunofluorescence and transcriptomic profiling revealed that high TMB levels were associated with increased CD8-positive, PD-L1-positive T-cell infiltration, increased PD-L1 expression on tumor and immune cells, and upregulation of innate and adaptive immune response signatures. Conclusions and Relevance These findings suggest that increasing TMB levels are associated with immune cell infiltration and an inflammatory T-cell-mediated response, resulting in increased sensitivity to PD-1/PD-L1 blockade in NSCLC across PD-L1 expression subgroups.
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Affiliation(s)
- Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Xinan Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Joao V. Alessi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Hira Rizvi
- Department of Medicine, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Navin R. Mahadevan
- Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Yvonne Y. Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Andrew Polio
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - James Lindsay
- Knowledge Systems Group, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Renato Umeton
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Rileen Sinha
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Natalie I. Vokes
- Department of Thoracic/Head and Neck Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Gonzalo Recondo
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Marissa Lawrence
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Victor R. Vaz
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Giulia C. Leonardi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Andrew J. Plodkowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hersh Gupta
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Andrew D. Cherniack
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Michael Y. Tolstorukov
- Department of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Bijaya Sharma
- ImmunoProfile, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Kristen D. Felt
- ImmunoProfile, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Justin F. Gainor
- Department of Medicine, Massachusetts General Hospital Cancer Center, Boston
| | - Arvind Ravi
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Gad Getz
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Kurt A. Schalper
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Brian Henick
- Department of Medicine, Columbia University Medical Center, New York, New York
| | - Patrick Forde
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Valsamo Anagnostou
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pasi A. Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Eliezer M. Van Allen
- Center for Cancer Precision Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lynette M. Sholl
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - David C. Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Xihong Lin
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Scott J. Rodig
- Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Matthew D. Hellmann
- Department of Medicine, Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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44
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Wu X, Jeong Y, de Frias SP, Easthausen I, Hoffman K, Oromendia C, Taheri S, Esposito AJ, Arias LQ, Ayaub EA, Maurer R, Gill RR, Hatabu H, Nishino M, Frits ML, Iannaccone CK, Weinblatt ME, Shadick NA, Dellaripa PF, Choi AM, Kim EY, Rosas IO, Martinez FJ, Doyle TJ. Serum proteomic profiling of rheumatoid arthritis-interstitial lung disease with a comparison to idiopathic pulmonary fibrosis. Thorax 2022; 77:1041-1044. [PMID: 35907639 PMCID: PMC9976796 DOI: 10.1136/thorax-2021-217822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 06/13/2022] [Indexed: 11/03/2022]
Abstract
Although interstitial lung disease (ILD) causes significant morbidity and mortality in rheumatoid arthritis (RA), it is difficult to predict the development or progression of ILD, emphasising the need for improved discovery through minimally invasive diagnostic tests. Aptamer-based proteomic profiling was used to assess 1321 proteins from 159 patients with rheumatoid arthritis with interstitial lung disease (RA-ILD), RA without ILD, idiopathic pulmonary fibrosis and healthy controls. Differential expression and gene set enrichment analyses revealed molecular signatures that are strongly associated with the presence and severity of RA-ILD and provided insight into unexplored pathways of disease. These warrant further study as non-invasive diagnostic tools and future therapeutic targets.
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Affiliation(s)
- Xiaoping Wu
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Yunju Jeong
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Harvard Medical School, Boston, MA, United States
| | - Sergio Poli de Frias
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Imaani Easthausen
- Department of Population Health Science, Division of Biostatistics, Weill Cornell Medicine, New York, NY United States
| | - Katherine Hoffman
- Department of Population Health Science, Division of Biostatistics, Weill Cornell Medicine, New York, NY United States
| | - Clara Oromendia
- Department of Population Health Science, Division of Biostatistics, Weill Cornell Medicine, New York, NY United States
| | - Shahrad Taheri
- Department of Medicine, Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
| | - Anthony J. Esposito
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Luisa Quesada Arias
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, FL, United States
| | - Ehab A. Ayaub
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, United States
| | - Rie Maurer
- Center for Clinical Investigation, Brigham and Women’s Hospital, Boston, MA, United States
| | - Ritu R. Gill
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Hiroto Hatabu
- Harvard Medical School, Boston, MA, United States,Department of Radiology, Brigham and Women’s Hospital, Boston, MA, United States
| | - Mizuki Nishino
- Harvard Medical School, Boston, MA, United States,Department of Radiology, Brigham and Women’s Hospital, Boston, MA, United States
| | - Michelle L. Frits
- Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, United States
| | - Christine K. Iannaccone
- Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, United States
| | - Michael E. Weinblatt
- Harvard Medical School, Boston, MA, United States,Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, United States
| | - Nancy A. Shadick
- Harvard Medical School, Boston, MA, United States,Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, United States
| | - Paul F. Dellaripa
- Harvard Medical School, Boston, MA, United States,Department of Medicine, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, Boston, MA, United States
| | - Augustine M.K. Choi
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Edy Y. Kim
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Harvard Medical School, Boston, MA, United States
| | - Ivan O. Rosas
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Fernando J. Martinez
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Tracy J. Doyle
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, MA, United States,Harvard Medical School, Boston, MA, United States
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45
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Sanders JL, Axelsson G, Putman R, Menon A, Dupuis J, Xu H, Wang S, Murabito J, Vasan R, Araki T, Nishino M, Washko GR, Hatabu H, O'Connor G, Gudmundsson G, Gudnason V, Hunninghake GM. The relationship between interstitial lung abnormalities, mortality, and multimorbidity: a cohort study. Thorax 2022; 78:559-565. [PMID: 35777957 DOI: 10.1136/thoraxjnl-2021-218315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 06/06/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Interstitial lung abnormalities (ILAs) are associated with increased mortality. It is unclear whether multimorbidity accounts for the mortality association or how strongly ILA is associated with mortality relative to other common age-associated diseases. We determined the association of ILA with all-cause mortality adjusted for multimorbidity, compared mortality associated with ILA and prevalent cardiovascular disease (CVD), diabetes mellitus, chronic kidney disease, chronic obstructive pulmonary disease and cancer and also determined the association between ILA and these diseases. METHODS We measured ILA (none, indeterminant, definite) using blinded reads of CT images, prevalent chronic diseases and potential confounders in two observational cohorts, the Framingham Heart Study (FHS) (n=2449) and Age, Gene/Environment Susceptibility - Reykjavik Study (AGES-Reykjavik) (n=5180). We determined associations with mortality using Cox proportional hazards models and between ILA and diseases with multinomial logistic regression. RESULTS Over a median (IQR) follow-up of 8.8 (1.4) years in FHS and 12.0 (7.7) years in AGES-Reykjavik, in adjusted models, ILAs were significantly associated with increased mortality (HR, 95% CI 1.95, 1.23 to 3.08, p=0.0042, in FHS; HR 1.60, 1.41 to 1.82, p<0.0001, in AGES-Reykjavik) adjusted for multimorbidity. In both cohorts, the association of ILA with mortality was of similar magnitude to the association of most other diseases. In adjusted models, ILAs were associated only with prevalent kidney disease (OR, 95% CI 1.90, 1.01 to 3.57, p=0.0452) in FHS and with prevalent CVD (OR 1.42, 1.12 to 1.81, p=0.0040) in AGES-Reykjavik. CONCLUSIONS ILAs were associated with mortality adjusted for multimorbidity and were similarly associated with increased mortality compared with several common chronic diseases. ILAs were not consistently associated with the prevalence of these diseases themselves.
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Affiliation(s)
| | - Gisli Axelsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Icelandic Heart Association, Kopavogur, Iceland
| | - Rachel Putman
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Aravind Menon
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Josée Dupuis
- Biostatistics Department, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Hanfei Xu
- Biostatistics Department, Boston University School of Public Health, Boston, Massachusetts, USA
| | | | - Joanne Murabito
- Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts, USA.,Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ramachandran Vasan
- Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Massachusetts, USA.,Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Tetsuro Araki
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - George R Washko
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - George O'Connor
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.,Boston University Medical Center, Boston, Massachusetts, USA
| | - Gunnar Gudmundsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Icelandic Heart Association, Kopavogur, Iceland
| | - Gary M Hunninghake
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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46
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Moll M, Hobbs BD, Menon A, Ghosh AJ, Putman RK, Hino T, Hata A, Silverman EK, Quackenbush J, Castaldi PJ, Hersh CP, McGeachie MJ, Sin DD, Tal-Singer R, Nishino M, Hatabu H, Hunninghake GM, Cho MH. Blood gene expression risk profiles and interstitial lung abnormalities: COPDGene and ECLIPSE cohort studies. Respir Res 2022; 23:157. [PMID: 35715807 PMCID: PMC9204872 DOI: 10.1186/s12931-022-02077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/03/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Interstitial lung abnormalities (ILA) are radiologic findings that may progress to idiopathic pulmonary fibrosis (IPF). Blood gene expression profiles can predict IPF mortality, but whether these same genes associate with ILA and ILA outcomes is unknown. This study evaluated if a previously described blood gene expression profile associated with IPF mortality is associated with ILA and all-cause mortality. METHODS In COPDGene and ECLIPSE study participants with visual scoring of ILA and gene expression data, we evaluated the association of a previously described IPF mortality score with ILA and mortality. We also trained a new ILA score, derived using genes from the IPF score, in a subset of COPDGene. We tested the association with ILA and mortality on the remainder of COPDGene and ECLIPSE. RESULTS In 1469 COPDGene (training n = 734; testing n = 735) and 571 ECLIPSE participants, the IPF score was not associated with ILA or mortality. However, an ILA score derived from IPF score genes was associated with ILA (meta-analysis of test datasets OR 1.4 [95% CI: 1.2-1.6]) and mortality (HR 1.25 [95% CI: 1.12-1.41]). Six of the 11 genes in the ILA score had discordant directions of effects compared to the IPF score. The ILA score partially mediated the effects of age on mortality (11.8% proportion mediated). CONCLUSIONS An ILA gene expression score, derived from IPF mortality-associated genes, identified genes with concordant and discordant effects on IPF mortality and ILA. These results suggest shared, and unique biologic processes, amongst those with ILA, IPF, aging, and death.
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Affiliation(s)
- Matthew Moll
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Brian D Hobbs
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Aravind Menon
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Auyon J Ghosh
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Rachel K Putman
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Takuya Hino
- Harvard Medical School, Boston, MA, 02115, USA
- Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Akinori Hata
- Harvard Medical School, Boston, MA, 02115, USA
- Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Edwin K Silverman
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - John Quackenbush
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Peter J Castaldi
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, 02115, Canada
| | - Craig P Hersh
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Michael J McGeachie
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, and Department of Medicine (Respiratory Division), University of British Columbia, Vancouver, BC, Canada
| | | | - Mizuki Nishino
- Harvard Medical School, Boston, MA, 02115, USA
- Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Hiroto Hatabu
- Harvard Medical School, Boston, MA, 02115, USA
- Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Gary M Hunninghake
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Michael H Cho
- Channing Division for Network Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Harvard Medical School, Boston, MA, 02115, USA.
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47
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Ricciuti B, Alessi JV, Wang X, Bertram AA, Vaz VR, Nishino M, Lindsay J, Felt KD, Sharma B, Sholl LM, Scott R, Awad MM, Cheng ML. Abstract 2143: Clinicopathologic, genomic and immunophenotypic landscape of ATM mutations in non-small cell lung cancer. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-2143] [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: Defective DNA damage repair machinery is a hallmark of cancer, resulting in increased mutation rates and genomic instability. In non-small cell lung cancer (NSCLC), ATM is mutated in ~10% of cases, representing the most commonly mutated DNA damage and repair gene. However, the clinicopathologic, genomic, and immunophenotypic correlates of ATM mutations in NSCLC are unknown. The impact of ATM mutation on clinical outcomes to PD-(L)1 blockade is also unclear.
Methods: Clinicopathologic and genomic data were collected from 3592 patients (pts) with NSCLC who had consented to correlative studies at the Dana-Farber Cancer Institute (DFCI), and whose tumors underwent genomic profiling (OncoPanel). Multiplexed immunofluorescence (mIF) for CD8, PD1, PD-L1, FOXP3, and CK AE1/AE3 was performed on a subset of 416 NSCLC samples to examine tumor-infiltrating immune cells. ATM immunohistochemistry (IHC) was also performed on 184 ATM mutated NSCLCs with available tissue. ATM mutated (ATMMUT) tumors were defined as harboring loss-of-function mutations (nonsense, frameshift, splice site, known deleterious missense mutations). Missense mutation of unknown significance were excluded, unless deemed to affect protein function in silico. Tumors lacking ATM mutations or harboring benign ATM alterations were defined as ATM wild type (ATMWT).
Results: A total of 399 deleterious ATM mutations were identified in 10.2% (365/3592) of samples; 138 (34.6%) mutations were truncating (nonsense, frameshift, and splice site mutations); the remaining 261 (65.4%) were missense mutations. Truncating mutations were significantly more likely to result in ATM loss by IHC compared to missense mutations (71.4% vs 28.9%, P<0.01) When we examined the genomic profiles of tumors with versus without deleterious ATM mutations, we found that ATMMUT NSCLCs were significantly enriched with KRAS, STK11, RBM10, and KDM5C co-mutations (P<0.01), while co-mutations in EGFR, CDKN2A and TP53 were nearly mutually exclusive (P<0.01). Among ATMMUT NSCLCs, those with ATM loss by IHC were significantly enriched with KRAS and STK11 co-mutations, while those with retained ATM expression were enriched with TP53 co-mutations (P<0.01). Pts with ATMMUT NSCLCs had similar outcomes to PD-(L)1 inhibition +/- chemotherapy, compared to ATMWT cases, and similar immune cell subsets infiltration (P>0.05). Pts with deleterious mutations in ATM and TP53 (ATMMUT/TP53MUT) had increased response rates to chemo-immunotherapy compared to those with ATMMUT/TP53WT, ATMWT/TP53MUT, or ATMWT/TP53WT genotypes (70% vs 56.2% vs 35.7% vs 27.4%, respectively, P=0.01), as well as increased tumor-stroma interface CD8+ T cells (P<0.01) and higher PD-L1 expression by mIF on tumor (P<0.01) and immune cells (P<0.01).
Conclusion: Deleterious ATM mutations defined a subset of NSCLC with unique clinicopathologic, genomic, and immunophenotypic features.
Citation Format: Biagio Ricciuti, Joao Victor Alessi, Xinan Wang, Arrien A. Bertram, Victor R. Vaz, Mizuki Nishino, James Lindsay, Kristen D. Felt, Bijaya Sharma, Lynette M. Sholl, Rodig Scott, Mark M. Awad, Michael L. Cheng. Clinicopathologic, genomic and immunophenotypic landscape of ATM mutations in non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2143.
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Affiliation(s)
| | | | - Xinan Wang
- 2Harvard T.H. Chan School of Public Health, Boston, MA
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Nishino M. Radiomics-based Cluster Groups to Predict Clinical-Pathologic and Genomic Characteristics of Stage I Lung Adenocarcinoma. Radiology 2022; 303:673-674. [PMID: 35230188 PMCID: PMC9131164 DOI: 10.1148/radiol.213015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Mizuki Nishino
- From the Department of Radiology, Brigham and Women’s
Hospital, Boston, Mass; and Department of Imaging, Dana-Farber Cancer Institute,
450 Brookline Ave, Boston, MA 02215
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49
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Vokes NI, Chambers E, Nguyen T, Coolidge A, Lydon CA, Le X, Sholl L, Heymach JV, Nishino M, Van Allen EM, Jänne PA. Concurrent TP53 Mutations Facilitate Resistance Evolution in EGFR-Mutant Lung Adenocarcinoma. J Thorac Oncol 2022; 17:779-792. [PMID: 35331964 PMCID: PMC10478031 DOI: 10.1016/j.jtho.2022.02.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [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: 11/03/2021] [Revised: 02/08/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Patients with EGFR-mutant NSCLC experience variable duration of benefit on EGFR tyrosine kinase inhibitors. The effect of concurrent genomic alterations on outcome has been incompletely described. METHODS In this retrospective study, targeted next-generation sequencing data were collected from patients with EGFR-mutant lung cancer treated at the Dana-Farber Cancer Institute. Clinical data were collected and correlated with somatic mutation data. Associations between TP53 mutation status, genomic features, and mutational processes were analyzed. RESULTS A total of 269 patients were identified for inclusion in the cohort. Among 185 response-assessable patients with pretreatment specimens, TP53 alterations were the most common event associated with decreased first-line progression-free survival and decreased overall survival, along with DNMT3A, KEAP1, and ASXL1 alterations. Reduced progression-free survival on later-line osimertinib in 33 patients was associated with MET, APC, and ERBB4 alterations. Further investigation of the effect of TP53 alterations revealed an association with worse outcomes even in patients with good initial radiographic response, and faster acquisition of T790M and other resistance mechanisms. TP53-mutated tumors had higher mutational burdens and increased mutagenesis with exposure to therapy and tobacco. Cell cycle alterations were not independently predictive, but portended worse OS in conjunction with TP53 alterations. CONCLUSIONS TP53 alterations associate with faster resistance evolution independent of mechanism in EGFR-mutant NSCLC and may cooperate with other genomic events to mediate acquisition of resistance mutations to EGFR tyrosine kinase inhibitors.
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Affiliation(s)
- Natalie I Vokes
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Emily Chambers
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Tom Nguyen
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Alexis Coolidge
- Department of Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Christine A Lydon
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Xiuning Le
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lynette Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | - John V Heymach
- Department of Thoracic and Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Eliezer M Van Allen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts; Broad Institute of Harvard and Massachusetts Institute of Technology, Boston, Massachusetts
| | - Pasi A Jänne
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
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50
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Ricciuti B, Elkrief A, Alessi JVM, Wang X, Barrichello APDC, Pecci F, Lamberti G, Lindsay J, Sharma B, Felt K, Nishino M, Sholl LM, Rodig SJ, Schoenfeld AJ, Awad MM. Three-year outcomes and correlative analyses in patients with non–small cell lung cancer (NSCLC) and a very high PD-L1 tumor proportion score (TPS) ≥ 90% treated with first-line pembrolizumab. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.9043] [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
9043 Background: Although 1st-line PD-1 monotherapy has improved survival in advanced NSCLC with a PD-L1 TPS ≥50%, responses occur in ̃45% of patients (pts). We previously showed that among pts treated with 1st-line pembrolizumab, clinical outcomes were significantly improved in those with a PD-L1 TPS of ≥90% compared to a TPS of 50-89%. Here, we report the 3-year survival analysis to 1st-line pembrolizumab in pts with a PD-L1 TPS ≥90% vs 50-89%, and characterize genomic and immunophenotypic differences between these PD-L1 expression groups. Methods: Pts with stage IV EGFR/ALK wild-type NSCLC and PD-L1 TPS ≥50% who received 1st-line pembrolizumab at the Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSKCC), with a minimum follow-up of 3 years were included. Comprehensive tumor genomic profiling and multiplexed immunofluorescence (mIF) were performed to examine genomic and immunophenotypic correlates of very high PD-L1 expression on separate cohorts of NSCLC at the DFCI. Results: Among 396 pts, median age was 69, 53.3% were women, 90.1% had a history of tobacco use, 83.6% had a ECOG performance status of 0-1, and 28.8% had a KRAS mutation. At a median follow-up of 42.6 months, median progression-free (mPFS) and overall survival (mOS) in the entire cohort were 5.1 months, and 19.0 months, respectively. When compared to pts with a PD-L1 TPS of 50-89% (N = 252), those with PD-L1 TPS ≥90% (N = 144) had a significantly longer mPFS (6.0 vs 4.5 months, HR 0.67, p < 0.001), and longer mOS (30.2 vs 16.9 months, HR 0.66, p < 0.01). Kaplan-Meier estimates of the 3-year PFS and OS were 24.9% and 47.0% in the PD-L1 TPS ≥90% groups, and 9.4% and 27.7% in the PD-L1 TPS 50-89% group, respectively. A PD-L1 TPS ≥90% was confirmed to be an independent predictor of improved PFS (HR 0.68, p < 0.01) and OS (HR 0.67, p < 0.01) in multivariable analysis. Tumor genomic profiling from a separate cohort of 500 NSCLC samples revealed that mutations in STK11, KEAP1, FBXW7, and CTNNB1 were significantly more frequent in tumors with a PD-L1 TPS of 50-89% compared to those with a PD-L1 TPS ≥90% (q < 0.05). mIF on 91 NSCLCs identified significantly higher CD8+PD1+ T cells and PD-L1+ immune cells in tumors with PD-L1 TPS ≥90% vs 50-89% (p < 0.05). Conclusions: Pembrolizumab monotherapy continues to demonstrate a meaningful long-term survival benefit in pts with advanced NSCLC and a PD-L1 TPS ≥90%. NSCLCs with very high PD-L1 TPS may have a more favorable genomic and immunophenotypic profile. These findings have implications for treatment selection and clinical trial interpretation and design.
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Affiliation(s)
- Biagio Ricciuti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | | | | | - Federica Pecci
- Lowe Center For Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Giuseppe Lamberti
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Kristen Felt
- ImmunoProfile, Dana-Farber Cancer Institute, Boston, MA
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA
| | - Lynette M. Sholl
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Scott J. Rodig
- Department of Pathology and Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Mark M. Awad
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA
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