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Lee JS, Shin K, Ryu SM, Jegal SG, Lee W, Yoon MA, Hong GS, Paik S, Kim N. Screening of adolescent idiopathic scoliosis using generative adversarial network (GAN) inversion method in chest radiographs. PLoS One 2023; 18:e0285489. [PMID: 37216382 DOI: 10.1371/journal.pone.0285489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVE Conventional computer-aided diagnosis using convolutional neural networks (CNN) has limitations in detecting sensitive changes and determining accurate decision boundaries in spectral and structural diseases such as scoliosis. We devised a new method to detect and diagnose adolescent idiopathic scoliosis in chest X-rays (CXRs) employing the latent space's discriminative ability in the generative adversarial network (GAN) and a simple multi-layer perceptron (MLP) to screen adolescent idiopathic scoliosis CXRs. MATERIALS AND METHODS Our model was trained and validated in a two-step manner. First, we trained a GAN using CXRs with various scoliosis severities and utilized the trained network as a feature extractor using the GAN inversion method. Second, we classified each vector from the latent space using a simple MLP. RESULTS The 2-layer MLP exhibited the best classification in the ablation study. With this model, the area under the receiver operating characteristic (AUROC) curves were 0.850 in the internal and 0.847 in the external datasets. Furthermore, when the sensitivity was fixed at 0.9, the model's specificity was 0.697 in the internal and 0.646 in the external datasets. CONCLUSION We developed a classifier for Adolescent idiopathic scoliosis (AIS) through generative representation learning. Our model shows good AUROC under screening chest radiographs in both the internal and external datasets. Our model has learned the spectral severity of AIS, enabling it to generate normal images even when trained solely on scoliosis radiographs.
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Affiliation(s)
- Jun Soo Lee
- Department of Industrial Engineering, Seoul National University, Seoul, Korea
| | - Keewon Shin
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung Min Ryu
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Seong Gyu Jegal
- Department of Biomedical Engineering, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woojin Lee
- Department of Radiology, Hanyang University Hospital, Seoul, Korea
| | - Min A Yoon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gil-Sun Hong
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sanghyun Paik
- Department of Radiology, Hanyang University Hospital, Seoul, Korea
| | - Namkug Kim
- Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Lee W, Shin K, Lee J, Yoo SJ, Yoon MA, Choi YW, Hong GS, Kim N, Paik S. Diagnosis of Scoliosis Using Chest Radiographs with a Semi-Supervised Generative Adversarial Network. J Korean Soc Radiol 2022; 83:1298-1311. [PMID: 36545424 PMCID: PMC9748451 DOI: 10.3348/jksr.2021.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 06/17/2023]
Abstract
Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.
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Sparano J, Gray R, Makower D, Albain K, Saphner T, Badve S, Wagner L, Mihalcioiu C, Desbiens C, Hayes D, Dees E, Geyer C, Olson J, Wood W, Lively T, Paik S, Ellis M, Abrams J, Sledge G. Clinical outcomes by chemotherapy regimen in patients with RS 26-100 in TAILORx. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Exposito MJ, Akce M, Alvarez J, Assenat E, Balart L, Baron A, Decaens T, Heurgue-Berlot A, Martin A, Paik S, Poulart V, Sehbai A, Shimada M, Takemura N, Yoon J. Abstract No. 526 CheckMate-9DX: phase 3, randomized, double-blind study of adjuvant nivolumab vs placebo for patients with hepatocellular carcinoma (HCC) at high risk of recurrence after curative resection or ablation. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Vicini FA, Cecchini RS, White JR, Julian TB, Arthur DW, Rabinovitch RA, Kuske RR, Parda DS, Ganz PA, Scheier MF, Winter KA, Paik S, Kuerer HM, Vallow LA, Pierce LJ, Mamounas EP, Costantino JP, Bear HD, Germaine I, Gustafson G, Grossheim L, Petersen IA, Hudes RS, Curran WJ, Wolmark N. Abstract GS4-04: Primary results of NSABP B-39/RTOG 0413 (NRG Oncology): A randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) for women with stage 0, I, or II breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs4-04] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Conventional WBI after lumpectomy for early-stage breast cancer decreases ipsilateral breast tumor recurrence (IBTR), yielding comparable results to mastectomy. Accelerated PBI appears effective in reducing IBTR by treating only the tumor bed area. As the majority of IBTR occur at or in the vicinity of the tumor bed, we hypothesized that PBI would be as effective as WBI in controlling IBTR. The primary aim of NSABP B-39/RTOG 0413 was to determine if PBI provides equivalent local tumor control post lumpectomy compared to WBI in pts with early-stage breast cancer. The equivalency test was based on a 50% margin of increase in the hazard ratio (HR=1.5). Secondary endpoints included: overall survival (OS), recurrence-free interval (RFI), distant disease-free interval (DDFI), and toxicity.
Methods: Eligible pts had lumpectomy with histologically-free margins and 0-3 positive axillary nodes. Pts were stratified by stage, menopausal status, hormone receptor status, and intent to receive chemotherapy and then randomized to PBI or WBI. PBI was 10 fractions of 3.4-3.85 Gy, given twice daily with either brachytherapy or 3D external beam radiation. WBI was 50 Gy in 2 Gy fractions given daily with a sequential boost to the surgical cavity. Follow-up was every 6 mos for 5 yrs and then annually. All analyses were by intent-to-treat.
Results: From 3-21-05 to 4-16-13, 4216 pts were randomized: 2107 PBI; 2109 WBI. 61% were postmenopausal; 81% were hormone receptor-positive; 29% intended to receive chemotherapy. Stage distribution was: DCIS, 24%; invasive pN0, 65%; invasive pN1, 10%. As of 7-31-18, median follow-up was 10.2 yrs. There were 161 IBTRs as first events: 90 PBI v 71 WBI (HR 1.22; 90%CI 0.94-1.58). Per protocol-defined margin, to declare PBI and WBI equivalent regarding IBTR risk, the 90% CI for the observed HR had to lie entirely between 0.667 and 1.5. The percent of pts IBTR-free at 10 yrs was 95.2% PBI v 95.9% WBI. A statistically significant difference in the 10-yr RFI rate favored WBI (91.9% PBI v 93.4% WBI; HR 1.32; 95%CI 1.04-1.68; p=0.02). No statistically significant differences existed between PBI and WBI in DDFI (HR 1.31; 95%CI 0.91-1.91; p=0.15), OS (HR 1.10; 95%CI 0.90-1.35; p=0.35), or DFS (HR 1.12; 95%CI 0.98-1.29; p=0.11). Grade 3 toxicity was 9.6% PBI v 7.1% WBI, and grade 4-5 toxicity was 0.5% v 0.3%, respectively.
Discussion: PBI did not meet the criteria for equivalence to WBI in controlling IBTR based on the upper limit of the hazard ratio confidence interval. However, the absolute difference in 10-yr rate of IBTR was <1% (4.8% PBI v 4.1% WBI). The risk of an RFI event was statistically significantly higher for PBI compared to WBI, but the absolute difference in 10-yr RFI rate was also small (8.1% PBI v 6.6% WBI). DDFI, OS, and DFS were not statistically different for PBI v WBI. Grade 3-5 toxicities, although low, were more common for PBI than WBI. The trial population was heterogeneous, ranging from Stage 0-2 breast cancer, and outcome by risk categories are being analyzed.
Support: U10CA180868, -180822, UG1CA189867.
Citation Format: Vicini FA, Cecchini RS, White JR, Julian TB, Arthur DW, Rabinovitch RA, Kuske RR, Parda DS, Ganz PA, Scheier MF, Winter KA, Paik S, Kuerer HM, Vallow LA, Pierce LJ, Mamounas EP, Costantino JP, Bear HD, Germaine I, Gustafson G, Grossheim L, Petersen IA, Hudes RS, Curran, Jr. WJ, Wolmark N. Primary results of NSABP B-39/RTOG 0413 (NRG Oncology): A randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) for women with stage 0, I, or II breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS4-04.
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Affiliation(s)
- FA Vicini
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - RS Cecchini
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - JR White
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - TB Julian
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - DW Arthur
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - RA Rabinovitch
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - RR Kuske
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - DS Parda
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - PA Ganz
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - MF Scheier
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - KA Winter
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - S Paik
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - HM Kuerer
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - LA Vallow
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - LJ Pierce
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - EP Mamounas
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - JP Costantino
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - HD Bear
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - I Germaine
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - G Gustafson
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - L Grossheim
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - IA Petersen
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - RS Hudes
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - WJ Curran
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
| | - N Wolmark
- NRG Oncology, Pittsburgh; MHP Radiation Oncology Institute St. Jospeh's Mercy Hopsital, Pontiac; NRG Oncology/NSABP, Pittsburgh; University of Pittsburgh, Pittsburgh; Ohio State University Comprehensive Cancer Center, Columbus; Allegheny Health Network Cancer Institute, Pittsburgh; Virginia Commonwealth University, Richmond; University of Colorado Cancer Center, Aurora; Arizona Breast Cancer Specialists /Arizona Oncology Services, Scottsdale; University of California at Los Angeles, Los Angeles; Carnegie Mellon University, Pittsburgh; American College of Radiology, Reston; Severance Biomedical Science Institute and Yonsei University College of Medicine, Seoul, Korea; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic Florida, Jacksonville; University of Michigan Health System, Ann Arbor; Orlando Health UF Health Cancer Center, Orlando; CHU de Québec – Université Laval, Pavillon Hôtel-Dieu de Québec, Quebec City; CCOP William Beaumont Hospital, Royal Oak; West Michigan Cancer Center (WMCC), K
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Pogue-Geile KL, Wang Y, Srinivasan A, Gavin PG, Kim RS, Song N, Feng H, Lipchik C, Costantino JP, Wolmark N, Lucas PC, Paik S, Jacobs SA. Abstract P3-10-04: The fully validated NSABP/NRG 8-gene signature which predicted the degree of benefit in the adjuvant setting (B-31 and NCCTG N9831) associates with pCR in the neoadjuvant setting in NSABP clinical trial FB-7. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-10-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: We previously described a predictive signature for trastuzumab benefit which was validated in the adjuvant setting in an independent cohort within NSABP B-31 (the 8-gene signature) (Pogue-Geile et al JNCI, 2013) and in Alliance/NCCTG N9831 (SABCs 2017). The 8-gene signature subtyped B-31 patients into three trastuzumab benefit groups: high HR=0.27, intermediate HR=0.56 and no benefit HR=1.56 based on disease free survival. The 8 gene signature was also predictive of trastuzumab benefit in N9831. HRs were 0.47, P<0.001, 0.6, P=0.02, and 1.54, P=0.375 in the predicted-high, -intermediate and -no benefit groups, respectively based on recurrence free survival (SABCS 2017). The interaction P-value was significant at 0.019 in adjusted Cox models. The RFS at 10 years for trastuzumab-treated pts was 83%, 83% and 72% in the high, intermediate and no benefit groups, respectively. Now we have tested the association of the 8-gene signature groups with pCR in FB-7 which was a 3 arm neoadjuvant study testing the pCR rate of HER2+ breast cancer patients treated with paclitaxel in combination with trastuzumab (T) or neratinib (N) or the combination (T + N).
Methods: RNA-Seq data from FB-7 pretreatment biopsies was used to predict the trastuzumab benefit groups (high, intermediate, and no) for each patient's tumor using the 8 gene signature using methods and cut-offs as previously described (Pogue-Geile et al 2013). The pCR rates (percentages) were tested for treatment interaction with a chi-square test.
Results: The pCR rates were 75%, 53%, and 22%, in the high (N=12), intermediate (N=32) and no benefit groups (N=9), respectively, when analyzed without regard to treatment arm. The pCR rates for the no benefit group and the high benefit groups were significantly different (p=0.030) and there was a significant treatment interaction with the 8-gene benefit group (intp=0.0081). The predicted low and intermediate groups were combined to test whether the 8 gene signature could identify a group of patients whose pCR rates might improve by adding N to T, and referred to it as the low benefit group. This was necessary due to the small numbers of patients in each group. The pCR rate in the low benefit group was higher in patients treated with T+N (9/15, 60%) than in the T arm (6/11, 45%) but these differences were not significant.
Conclusions: This is the first test of the 8-gene signature in the neoadjuvant setting and interpretations of these data should be interpreted cautiously due to the small numbers. However, if these results were validated in another neoadjuvant trial then the 8 gene signature could provide a rationale for selecting patients who would be appropriate for the addition of neratinib or other TKIs to trastuzumab and chemotherapy.
SUPPORT: PUMA Biotechnology, NCI U10CA180868, -180822, UG1-189867, and U24-196067; The Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analysis,interpretations, or conclusions.
Citation Format: Pogue-Geile KL, Wang Y, Srinivasan A, Gavin PG, Kim RS, Song N, Feng H, Lipchik C, Costantino JP, Wolmark N, Lucas PC, Paik S, Jacobs SA. The fully validated NSABP/NRG 8-gene signature which predicted the degree of benefit in the adjuvant setting (B-31 and NCCTG N9831) associates with pCR in the neoadjuvant setting in NSABP clinical trial FB-7 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-10-04.
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Affiliation(s)
- KL Pogue-Geile
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Y Wang
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - A Srinivasan
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - PG Gavin
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - RS Kim
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - N Song
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - H Feng
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - C Lipchik
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - JP Costantino
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - N Wolmark
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - PC Lucas
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - S Paik
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
| | - SA Jacobs
- NSABP/NRG Oncology, Pittsburgh, PA; The University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA; Yonsei University College of Medicine, Seoul, Republic of Korea
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Mamounas EP, Bandos H, White JR, Julian TB, Khan AJ, Shaitelman SF, Torres MA, Vicini FA, Ganz PA, McCloskey SA, Paik S, Gupta N, Li XA, DiCostanzo DJ, Curran WJ, Wolmark N. Abstract OT2-04-01: Phase III trial to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to whole breast RT post breast-conserving surgery (BCS) reduces invasive breast cancer recurrence-free interval (IBCR-FI) in patients (pts) with pathologically positive axillary (PPAx) nodes who are ypN0 after neoadjuvant chemotherapy (NC): NRG Oncology/NSABP B-51/RTOG 1304. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot2-04-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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
This phase III post-NC trial evaluates if CWRNRT post-Mx or whole breast irradiation (WBI) with RNRT after BCS significantly reduces the IBCR-FI rate in pts with PPAx nodes that are pathologically negative after NC. Secondary aims are OS, LRR-FI, DR-FI, DFS-DCIS, second primary cancer, and comparison of RT effect on cosmesis in reconstructed Mx pts. Correlative science examines RT effect by tumor subtype, molecular outcome predictors for residual disease, and predictors for the degree of reduction in loco-regional recurrence.
Methods: Clinical T1-3, N1 IBC PPAx nodes (FNA or core needle biopsy) pts complete ≥8 weeks of NC (anthracycline and/or taxane). HER2+ pts receive anti-HER2 therapy. Following NC, BCS or Mx, sentinel node biopsy (≥2 nodes) and/or Ax dissection with histologically negative nodes is performed. ER/PR and HER-2neu status before NC is required. Pts may receive appropriate adjuvant systemic therapy. Radiation credentialing with a facility questionnaire/case benchmark is required. Random assignment for Mx pts is to no CWRNRT or CWRNRT and for BCS pts to WBI or WBI+RNRT.
Statistics: 1,636 pts are to be enrolled over 5 yrs (definitive analysis at 7.5 yrs). Study is powered at 80% to test that RT reduces the annual hazard rate of events for IBCR-FI by 35% for an absolute risk reduction of 4.6% (5-yr cumulative rate). Intent-to-treat analysis with 3 interim analyses (43, 86, and 129 events) and a 4th/final analysis at 172 events. Pt-reported outcomes focusing on RT effect will be provided by 736 pts before random assignment and at 3, 6, 12, and 24 mos. Accrual as of 6-21-18 is 967 (59.11%).
Contacts: Protocol: CTSU member website https://www.ctsu.org. Questions: NRG Oncology Pgh Clin Coord Dpt: 1-800-477-7227 or ccd@nsabp.org. Pt entry: OPEN at https://open.ctsu.org or the OPEN tab on CTSU member website.
NCT01872975
Support: U10 CA-2166; -180868, -180822; 189867; Elekta
Citation Format: Mamounas EP, Bandos H, White JR, Julian TB, Khan AJ, Shaitelman SF, Torres MA, Vicini FA, Ganz PA, McCloskey SA, Paik S, Gupta N, Li XA, DiCostanzo DJ, Curran WJ, Wolmark N. Phase III trial to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to whole breast RT post breast-conserving surgery (BCS) reduces invasive breast cancer recurrence-free interval (IBCR-FI) in patients (pts) with pathologically positive axillary (PPAx) nodes who are ypN0 after neoadjuvant chemotherapy (NC): NRG Oncology/NSABP B-51/RTOG 1304 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-04-01.
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Affiliation(s)
- EP Mamounas
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - H Bandos
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - JR White
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - TB Julian
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - AJ Khan
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - SF Shaitelman
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - MA Torres
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - FA Vicini
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - PA Ganz
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - SA McCloskey
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - S Paik
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - N Gupta
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - XA Li
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - DJ DiCostanzo
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - WJ Curran
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
| | - N Wolmark
- NRG Oncology, Pittsburgh, PA; NRG Oncology/NSABP, Pittsburgh, PA; Orlando Health UF Health Cancer Center, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; Ohio State University, Columbus, OH; Allegheny Cancer Center at Allegheny General Hospital, Pittsburgh, PA; Memorial Sloan Kettering Cancer Center, New York, NY; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute at Emory University School of Medicine, Atlanta, GA; MPH Radiation Oncology Institute St. Joseph Mercy Hospital Campus, Pontiac, MI; University of California, Santa Monica, CA; Yonsei University College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI
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Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer CE, Dees EC, Goetz MP, Olson JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge GW. Abstract GS4-07: Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs4-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Black race is associated with worse outcomes in localized hormone receptor (HR)-positive breast cancer in population-based and in clinical trial cohorts, whether using self-identified race (Albain et al. JNCI 2009 [PMID: 19584328; Sparano et al. JNCI 2012 [PMID: 22250182) or genetically-identified race (Schneider et al. J Precision Oncol 2017 [PMID: 29333527]). This disparity persists after adjustment for treatment delivery parameters (Hershman et al. JCO 2009 [PMID:19307504]). We evaluated clinicopathologic characteristics, treatment delivered and clinical outcomes in the Trial Assigning Individualized Options for Treatment (TAILORx) by race and ethnicity (Sparano et al. NEJM 2018 [PMID: 29860917]).
Methods: The analysis included 9719 evaluable TAILORx participants. The association between clinical outcomes and race (white, black, Asian, other/unknown) and ethnicity (Hispanic vs. non-Hispanic) was examined, including invasive disease-free survival (iDFS), distant relapse-free interval (DRFI), relapse-free interval (RFI), and overall survival (OS). Proportional hazards models were fit including age (5 categories), tumor size (>2 cm vs. <=2 cm), histologic grade (high vs. medium vs. low vs. unknown), continuous recurrence score (RS), race, and ethnicity in the overall population and randomized treatment arms in the RS 11-25 cohort.
Results: The study population included 8189 (84%) whites, 693 (7%) blacks, 405 (4%) Asians, and 432 (4%) with other/unknown race. Regarding ethnicity, 7635 (79%) were non-Hispanic, 889 (9%) Hispanic, and 1195 (12%) unknown. There was no significant difference in RS distribution (p=0.22) in blacks compared with whites, or in median (17 vs. 17) or mean RS (19.1 vs. 18.2). There was likewise no difference in Hispanic vs. non-Hispanic ethnicity for RS distribution (p=0.72) or median (17 vs. 17) or mean RS (18.5 vs. 18.0). Black race (39% vs. 30%) and Hispanic ethnicity (39% vs. 30%) were both associated with younger age (</=50 years) at diagnosis. The use and type of adjuvant chemotherapy and endocrine therapy, and duration of endocrine therapy, were similar in black (vs. white) and Hispanic (vs. non-Hispanic) populations. In proportional hazards models, black race (compared with white race) was associated with worse clinical outcomes in the entire population and in those with a RS 11-25 (see table). Hispanic ethnicity was generally associated with better outcomes (compared with non-Hispanic ethnicity). For the cohort with a RS of 11-25, there was no evidence for chemotherapy benefit for any racial or ethnic group.
Race (black vs.white) and clinical outcomes in proportional hazards modelsClinical endpointEntire Population (N=693 black) Hazard ratio for eventRS 11-25 (N=471 black) Hazard ratio for eveniDFS1.33 (p=0.005)1.49 (p=0.001)DRFI1.21 (p=0.28)1.60 (p=0.02)RFI1.39 (p=0.02)1.80 (p<0.001)OS1.52 (p=0.005)1.67 (p=0.003
Conclusions: In patients eligible and selected for participation in TAILORx, black women had worse clinical outcomes despite similar 21-gene assay RS results and comparable systemic therapy. This adds to an emerging body of evidence suggesting a biologic basis or other factors contributing to racial disparities in HR-positive breast cancer that requires further evaluation.
Citation Format: Albain K, Gray RJ, Sparano JA, Makower DF, Pritchard KI, Hayes DF, Geyer, Jr. CE, Dees EC, Goetz MP, Olson, Jr. JA, Lively T, Badve SS, Saphner TJ, Wagner LI, Whelan TJ, Ellis MJ, Paik S, Wood WC, Ravdin PM, Keane MM, Gomez HL, Reddy PS, Goggins TF, Mayer IA, Brufsky AM, Toppmeyer DL, Kaklamani VG, Berenberg JL, Abrams J, Sledge, Jr. GW. Race, ethnicity and clinical outcomes in hormone receptor-positive, HER2-negative, node-negative breast cancer: results from the TAILORx trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS4-07.
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Affiliation(s)
- K Albain
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - RJ Gray
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Sparano
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Makower
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - KI Pritchard
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DF Hayes
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - CE Geyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - EC Dees
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MP Goetz
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JA Olson
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - T Lively
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - SS Badve
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Saphner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - LI Wagner
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TJ Whelan
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MJ Ellis
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - S Paik
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - WC Wood
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PM Ravdin
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - MM Keane
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - HL Gomez
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - PS Reddy
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - TF Goggins
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - IA Mayer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - AM Brufsky
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - DL Toppmeyer
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - VG Kaklamani
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - JL Berenberg
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - J Abrams
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
| | - GW Sledge
- Loyola University Chicago Stritch School of Medicine, Maywood, IL; Dana Farber Cancer Institute, Boston, MA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Sunnybrook Research Institute, Toronto, Canada; University of Michigan, Ann Arbor, MI; Virginia Commonwealth University School of Medicine and the Massey Cancer Center, Richmond, VA; University of North Carolina, Chapel Hill, NC; Mayo Clinic, Rochester, MN; University of Maryland School of Medicine, Baltimore, MD; National Institutes of Health, National Cancer Institute, Bethesda, MD; Indiana University School of Medicine, Indianapolis, IN; Vince Lombardi Cancer Clinic, Two Rivers, WI; Wake Forest University Health Service, Winston Salem, NC; McMaster University, Hamilton, Canada; Baylor College of Medicine, Houston, TX; Yonsei University College of Medicine, Seoul, South Korea; Emory University, Atlanta, GA; , San Antonio, TX; Cancer Trials Ireland, Dublin, Ireland; Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; C
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Racoviță AȘ, Paik S, Milian CT. CAN INNOVATION BE TAUGHT? JSS 2018. [DOI: 10.33695/jss.v5i3.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
‘We live in a world where change is exponential and we are helping to prepare students forjobs that don’t yet exist, using technologies that have not yet been invented, in order to solveproblems that we don’t know are problems yet’- Arti Kumar [1]Progress in the medical field is driven by innovation in technology. This holds true all themore when looking at the surgical discipline: for centuries, better visualization allowed for greaterunderstanding and, ultimately, more advanced instruments, procedures, and outcomes. But, as thegrowth of technology is accelerating even further, making use of the full potential of emergingtechnologies has become more and more difficult. A promising way to overcome this challenge isthe revolution of our medical education system.The IRCAD center, recognized worldwide as the reference center for Minimally InvasiveSurgery leverages this interest through a unique philosophy of incubating talents for surgicalinnovation. As such, the B.E.S.T. (Business Engineering and Surgical Technology) teachingmethod consists of two components: online and on-site.Students access MOOCs (Massive Open Online Courses) by world-renowned faculty andcorresponding quizzes, along with the possibility of interacting in a chat with the speaker [2].Afterward, among the online participants from all around the world, 15 medical and 15engineering and/or business students are selected each year for an intensive onsite experience basedon the online course results, curriculum vitae and a letter of intent. Participants learn from a mixtureof workshops in engineering and interventional radiology, form entrepreneurship team projects,train in laparoscopy, robotic surgery and flexible endoscopy on living swine models and simulators.Most remarkably, despite the course being free of charge and providing such a vast variety ofskills, the number of participants compared to that of faculty members is yet in favor of the latterwith a ratio of 30:34. Finally, experts such as surgeons, engineers, entrepreneurs, venture capitalists,and scientists assess and award the delivered team projects and provisional patents are filed.Laparoscopy skills are also quantified and rewarded. The method has been proven to be wellreceived and successful in improving students’ performances, regardless of their background [3-4].
When provided with the right resources, people are empowered to start wondering. Doubt andfear of failure recedes in the face of the possibilities lying within the challenges. Thus, informingabout this innovative teaching format serves not only as an invitation for students but also calls foraction among professionals in Romania to step to the forefront and lead the way in early medicaleducation by collaborating and establishing the needed infrastructure.
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Lee JY, Paik S. Genomic profiling of the residual disease of advanced high-grade serous ovarian cancer after neoadjuvant chemotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.165] [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: 11/12/2022] Open
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Kim S, Kim H, Kim E, Lee M, Shin EC, Paik S, Kim S. Neopepsee: accurate genome-level prediction of neoantigens by harnessing sequence and amino acid immunogenicity information. Ann Oncol 2018; 29:1030-1036. [DOI: 10.1093/annonc/mdy022] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Kim HR, Kang HN, Shim HS, Kim EY, Kim J, Kim DJ, Lee JG, Lee CY, Hong MH, Kim SM, Kim H, Pyo KH, Yun MR, Park HJ, Han JY, Youn HA, Ahn MJ, Paik S, Kim TM, Cho BC. Co-clinical trials demonstrate predictive biomarkers for dovitinib, an FGFR inhibitor, in lung squamous cell carcinoma. Ann Oncol 2018; 28:1250-1259. [PMID: 28460066 DOI: 10.1093/annonc/mdx098] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background We conducted co-clinical trials in patient-derived xenograft (PDX) models to identify predictive biomarkers for the multikinase inhibitor dovitinib in lung squamous cell carcinoma (LSCC). Methods The PDX01-02 were established from LSCC patients enrolled in the phase II trial of dovitinib (NCT01861197) and PDX03-05 were established from LSCC patients receiving surgery. These five PDX tumors were subjected to in vivo test of dovitinib efficacy, whole exome sequencing and gene expression profiling. Results The PDX tumors recapitulate histopathological properties and maintain genomic characteristics of originating tumors. Concordant with clinical outcomes of the trial enrolled-LSCC patients, dovitinib produced substantial tumor regression in PDX-01 and PDX-05, whereas it resulted in tumor progression in PDX-02. PDX-03 and -04 also displayed poor antitumor efficacy to dovitinib. Mutational and genome-wide copy number profiles revealed no correlation between genomic alterations of FGFR1-3 and sensitivity to dovitinib. Of note, gene expression profiles revealed differentially expressed genes including FGF3 and FGF19 between PDX-01 and 05 and PDX-02-04. Pathway analysis identified two FGFR signaling-related gene sets, FGFR ligand binding/activation and SHC-mediated cascade pathway were substantially up-regulated in PDX-01 and 05, compared with PDX-02-04. The comparison of gene expression profiles between dovitinib-sensitive versus -resistant lung cancer cell lines in the Cancer Cell Line Encyclopedia database also found that transcriptional activation of 18 key signaling components in FGFR pathways can predict the sensitivity to dovitinib both in cell lines and PDX tumors. These results highlight FGFR pathway activation as a key molecular determinant for sensitivity to dovitinib. Conclusions FGFR gene expression signatures are predictors for the response to dovitinib in LSCC.
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Affiliation(s)
- H R Kim
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul
| | - H N Kang
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | | | - E Y Kim
- Pulmonology, Yonsei University College of Medicine, Seoul
| | - J Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul
| | - D J Kim
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul
| | - J G Lee
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul
| | - C Y Lee
- Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul
| | - M H Hong
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul
| | - S-M Kim
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - H Kim
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - K-H Pyo
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - M R Yun
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - H J Park
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - J Y Han
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - H A Youn
- JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
| | - M-J Ahn
- Division of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S Paik
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul
| | - T-M Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - B C Cho
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul.,JE-UK Institute for Cancer Research, JEUK Co, Ltd, Gumi-City, Kyungbuk
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Mamounas EP, Bandos H, White JR, Julian TB, Khan AJ, Shaitelman SF, Torres MA, Vicini FA, Ganz PA, McCloskey SA, Paik S, Gupta N, Li XA, DiCostanzo DJ, Curran WJ, Wolmark N. Abstract OT2-03-01: NRG oncology/NSABP B-51/RTOG 1304: A phase III superiority clinical trial designed to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to breast RT post breast-conserving surgery (BCS) will reduce invasive cancer events in patients (pts) with positive axillary (Ax) nodes and convert to ypN0 after neoadjuvant chemotherapy (NC). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot2-03-01] [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
Background:
This phase III post-NC trial evaluates if CWRNRT post Mx or whole breast irradiation (WBI) with RNRT after BCS significantly reduces the invasive breast cancer recurrence-free interval (IBC-RFI) rate in pts presenting with positive Ax nodes that are pathologically negative after NC. Secondary aims are OS, LRRFI, DRFI, DFS-DCIS, and second primary cancer, as well as comparing RT effect on cosmesis in reconstructed Mx pts.
Correlative science studies examine RT effect by tumor subtype, molecular outcome predictors for residual disease pts, and predictors for the degree of reduction in loco-regional recurrence.
Methods:
Clinical T1-3, N1 IBC pts with positive Ax nodes (FNA or core needle biopsy) complete ≥8 wks of NC (anthracycline and/or taxane). HER2-positive pts receive anti-HER2 therapy (tx). After NC, BCS or Mx is performed with a sentinel node biopsy (≥2 nodes) and/or Ax dissection with histologically negative nodes. ER/PR and HER2 neu status before NC is required. Pts receive required systemic tx. Radiation credentialing with a facility questionnaire and a case benchmark is required. Randomization for Mx pts is to no CWRNRT or CWRNRT and for BCS pts to WBI or WBI+RNRT.
Statistics:
1636 pts to be enrolled over 5 yrs with definitive analysis at 7.5 yrs. Study is powered at 80% to test that RT reduces the annual hazard rate of events for IBCR-FI by 35% for an absolute risk reduction in the 5-yr cumulative rate of 4.6%. Intent-to-treat analysis with 3 interim analyses at 43, 86, and 129 events, with a 4th/final analysis at 172 events will occur. Accrual as of 6/13/16 is 356. Pt-reported outcomes focusing on RT effect will be obtained from 736 pts before randomization and at 3, 6, 12, and 24 months.
Contacts:
Protocol: CTSU member website https://www.ctsu.org. Questions: NRG Oncology Pgh Clin Coord Dpt: 1-800-477-7227 or ccd@nsabp.org. Pt entry: OPEN at https://open.ctsu.org or the OPEN tab on CTSU member website.
Support: U10 CA-2166; -180868, -180822; -189867; Elekta.
Citation Format: Mamounas EP, Bandos H, White JR, Julian TB, Khan AJ, Shaitelman SF, Torres MA, Vicini FA, Ganz PA, McCloskey SA, Paik S, Gupta N, Li XA, DiCostanzo DJ, Curran, Jr WJ, Wolmark N. NRG oncology/NSABP B-51/RTOG 1304: A phase III superiority clinical trial designed to determine if chest wall and regional nodal radiotherapy (CWRNRT) post mastectomy (Mx) or the addition of RNRT to breast RT post breast-conserving surgery (BCS) will reduce invasive cancer events in patients (pts) with positive axillary (Ax) nodes and convert to ypN0 after neoadjuvant chemotherapy (NC) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT2-03-01.
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Affiliation(s)
- EP Mamounas
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - H Bandos
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - JR White
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - TB Julian
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - AJ Khan
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - SF Shaitelman
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - MA Torres
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - FA Vicini
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - PA Ganz
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - SA McCloskey
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - S Paik
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - N Gupta
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - XA Li
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - DJ DiCostanzo
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - WJ Curran
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
| | - N Wolmark
- NRG Oncology/NSABP (NSABP Legacy Trials Are Now Part of the NRG Oncology Portfolio), Pittsburgh, PA; UF Health Cancer Center at Orlando Health, Orlando, FL; University of Pittsburgh, Pittsburgh, PA; NRG Oncology/RTOG, Philadelphia, PA; Ohio State University, Columbus, OH; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; University of Texas MD Anderson Cancer Center, Houston, TX; Winship Cancer Institute Emory University, Atlanta, GA; St. Joseph Mercy Oakland, Pontiac, MI; University of California at Los Angeles, Los Angeles, CA; Severance Biomedical Sci Inst and Yonsei Univ College of Medicine, Seoul, Korea; Medical College of Wisconsin, Milwaukee, WI; The Ohio State University Wexner Medical Center, Columbus, OH
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Kim SM, Kim H, Yun MR, Kang HN, Pyo KH, Park HJ, Lee JM, Choi HM, Ellinghaus P, Ocker M, Paik S, Kim HR, Cho BC. Activation of the Met kinase confers acquired drug resistance in FGFR-targeted lung cancer therapy. Oncogenesis 2016; 5:e241. [PMID: 27429073 PMCID: PMC5399172 DOI: 10.1038/oncsis.2016.48] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/30/2016] [Accepted: 06/06/2016] [Indexed: 12/11/2022] Open
Abstract
Aberrant fibroblast growth factor receptor (FGFR) activation/expression is a common feature in lung cancer (LC). In this study, we evaluated the antitumor activity of and the mechanisms underlying acquired resistance to two potent selective FGFR inhibitors, AZD4547 and BAY116387, in LC cell lines. The antitumor activity of AZD4547 and BAY1163877 was screened in 24 LC cell lines, including 5 with FGFR1 amplification. Two cell lines containing FGFR1 amplifications, H1581 and DMS114, were sensitive to FGFR inhibitors (IC50<250 nm). Clones of FGFR1-amplified H1581 cells resistant to AZD4547 or BAY116387 (H1581AR and H1581BR cells, respectively) were established. Receptor tyrosine kinase (RTK) array and immunoblotting analyses showed strong overexpression and activation of Met in H1581AR/BR cells, compared with that in the parental cells. Gene set enrichment analysis against the Kyoto Encyclopedia of Genes and Genomes (KEGG) database showed that cytokine-cytokine receptor interaction pathways were significantly enriched in H1581AR/BR cells, with Met contributing significantly to the core enrichment. Genomic DNA quantitative PCR and fluorescent in situ hybridization analyses showed MET amplification in H1581AR, but not in H1581BR, cells. Met amplification drives acquired resistance to AZD4547 in H1581AR cells by activating ErbB3. Combination treatment with FGFR inhibitors and an anaplastic lymphoma kinase (ALK)/Met inhibitor, crizotinib, or Met-specific short interfering RNA (siRNA) synergistically inhibited cell proliferation in both H1581AR and H1581BR cells. Conversely, ectopic expression of Met in H1581 cells conferred resistance to AZD4547 and BAY1163877. Acquired resistance to FGFR inhibitors not only altered cellular morphology, but also promoted migration and invasion of resistant clones, in part by inducing epithelial-to-mesenchymal transition. Taken together, our data suggest that Met activation is sufficient to bypass dependency on FGFR signaling. Concurrent inhibition of the Met and FGFR pathways may have synergistic clinical benefits when targeting FGFR-dependent LC.
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Affiliation(s)
- S-M Kim
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - H Kim
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - M R Yun
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - H N Kang
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - K-H Pyo
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - H J Park
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - J M Lee
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - H M Choi
- JE-UK Institute for Cancer Research, JEUK Co., Ltd., Gumi, Kyungbuk, Korea
| | - P Ellinghaus
- Bayer Pharma AG, Global Drug Discovery, Wuppertal, Germany
| | - M Ocker
- Bayer Pharma AG, Global Drug Discovery, Wuppertal, Germany
| | - S Paik
- Division of Pathology NSABP, Pittsburgh, PA, USA
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - H R Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - B C Cho
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
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Kim C, Lee JM, Park SW, Kim KS, Lee MW, Paik S, Jang AS, Kim DJ, Uh S, Kim Y, Park CS. Attenuation of Cigarette Smoke-Induced Emphysema in Mice by Apolipoprotein A-1 Overexpression. Am J Respir Cell Mol Biol 2016; 54:91-102. [PMID: 26086425 DOI: 10.1165/rcmb.2014-0305oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Chronic inflammation, oxidative stress, and proteolysis participate primarily in the pathogenesis of chronic obstructive pulmonary disease (COPD)/emphysema. COPD is a highly prevalent smoking-related disease for which no effective therapy exists to improve the disease course. Although apolipoprotein A-1 (ApoA1) has antiinflammatory and antioxidant properties as well as cholesterol efflux potential, its role in cigarette smoke (CS)-induced emphysema has not been determined. Therefore, we investigated whether human ApoA1 transgenic (TG) mice, with conditionally induced alveolar epithelium to overexpress ApoA1, are protected against the CS-induced lung inflammatory response and development of emphysema. In this study, ApoA1 levels were significantly decreased in the lungs of patients with COPD and in the lungs of mice exposed to CS. ApoA1 TG mice did not develop emphysema when chronically exposed to CS. Compared with the control TG mice, ApoA1 overexpression attenuated lung inflammation, oxidative stress, metalloprotease activation, and apoptosis in CS-exposed mouse lungs. To explore a plausible mechanism of antiapoptotic activity of ApoA1, alveolar epithelial cells (A549) were treated with CS extract (CSE). ApoA1 prevented CSE-induced translocation of Fas and downstream death-inducing signaling complex into lipid rafts, thereby inhibiting Fas-mediated apoptosis. Taken together, the data showed that ApoA1 overexpression attenuated CS-induced lung inflammation and emphysema in mice. Augmentation of ApoA1 in the lung may have therapeutic potential in preventing smoking-related COPD/emphysema.
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Affiliation(s)
- Chorong Kim
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Ji-Min Lee
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Sung-Woo Park
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Ki-Sun Kim
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Myoung Won Lee
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Sanghyun Paik
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - An Soo Jang
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Do Jin Kim
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
| | - Sootaek Uh
- 2 Division of Allergy and Respiratory Medicine, Soonchunhyang University Seoul Hospital, Hannam-dong, Yongsan-gu, Seoul; and
| | - Yonghoon Kim
- 3 Division of Allergy and Respiratory Medicine, Soonchunhyang University Cheonan Hospital, Bongmyeong-dong, Cheonan, Chungcheongnam-do, South Korea
| | - Choon-Sik Park
- 1 Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Jung-Dong, Wonmi-Ku, Bucheon, Gyeonggi-Do
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Mamounas E, Wolmark N, Baehner F, Butler S, Tang G, Jamshidian F, Sing A, Shak S, Paik S. P264 Predicting late distant recurrence risk in ER+ breast cancer after five years of tamoxifen. Breast 2015. [DOI: 10.1016/s0960-9776(15)70296-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mamounas T, Wolmark N, Baehner F, Butler S, Tang G, Jamshidian F, Sing A, Shak S, Paik S. Recurrence Score and Quantitative Er Expression Predicts Late Distant Recurrence Risk in Er+ Bc After Five Years of Tamoxifen. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.11] [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: 11/12/2022] Open
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Cho S, Kim G, Kim Y, Chung H, Lee S, Seo T, Paik S, Cho J. Percutaneous biliary stone removal: balloon sphincteroplasty and flood method. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.457] [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: 11/29/2022] Open
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Kim SB, Tsang J, Kim TY, Yap YS, Cornelio G, Gong G, Paik S, Lee S, Ng TY, Park S, Oh HS, Yau T, Lee SH, Lim JH, Choi YJ, Lee EM, Park KH, Do IG, Yeoh EM, Ro J. Abstract P4-12-28: HER2-related biomarkers in HER2+ breast cancer patients in Asia Pacific. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-12-28] [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
Recent findings suggest that HER2-related molecular markers such as PTEN deletion or downregulation, PIK3CA mutation, truncated HER2 receptor (p95HER2), and tumor HER2 mRNA levels, have the potential to predict anti-HER2 treatment response. We evaluated the distribution of these biomarkers at the time of primary diagnosis and their relationship to responsiveness to lapatinib treatment in the metastatic setting in HER2+ breast cancer patients.
We conducted an observational study of female HER2+ breast cancer patients who were initiated on lapatinib treatment following recurrence or metastases in five Asia Pacific countries. Patients were enrolled between August 2010 and December 2012. Eligible patients had a tumor biopsy specimen available from their primary breast cancer diagnosis or before they started on any anti-HER2 treatment, had not been exposed to more than two lines of anti-HER2 treatment in the metastatic setting or other experimental anti-HER2 treatment, and had no other primary tumor. Biomarkers levels at primary diagnosis were measured; PTEN levels were assessed by immunohistochemistry and PIK3CA mutations were detected by a mass spectroscopy-based approach. The primary endpoint was progression-free survival (PFS) from the initiation of first lapatinib-based regimen given in metastatic setting to disease progression from that regimen or death from any cause. PFS analysis was conducted with a data cut-off date of 31 December 2012.
A total of 162 patients were included in this study and 96% have confirmed HER2+ breast cancer primary tumor. The mean age was 52±10 years and 97% had metastases at study entry, with bone being the most common site of metastasis (48%). About a quarter had PTEN protein loss (24%), 30% had PIK3CA mutation, and 7% had both at primary diagnosis. No significant association was observed between both biomarkers or between each biomarker and estrogen receptor status or HER2 status.
Table 1. Relationship between PTEN and PIK3CA PIK3CA mutation, n (%)PIK3CA wild-type, n (%)p-valuePTEN status 0.674Loss11 (29)27 (71) Normal33 (33)68 (67)
Patients with altered PTEN expression, or PIK3CA mutation showed comparable PFS with lapatinib-based treatment as those with normal PTEN or PIK3CA expression at analysis cut-off date (median PFS 7.5 and 8.5 months respectively vs. 8.9 and 9.0 months respectively; p = 0.502 and p = 0.268 respectively). There remained no significant difference in PFS after having adjusted for significant confounders (HR 1.2 and 1.1 respectively; 95% CI 0.7–1.9 and 0.7–1.8 respectively; p = 0.481 and p = 0.730 respectively). The distribution of p95HER2 expression and tumor HER mRNA levels and their association with PFS will be included at the time of presentation.
Our preliminary findings suggest that PTEN alteration, or PIK3CA mutation may not be predictive of clinical response to lapatinib treatment in HER2+ breast cancer patients. The final PFS results with additional markers will provide more clues regarding their relationship to treatment response.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-12-28.
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Affiliation(s)
- S-B Kim
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - J Tsang
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - T-Y Kim
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - YS Yap
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - G Cornelio
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - G Gong
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - S Paik
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - S Lee
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - T-Y Ng
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - S Park
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - H-S Oh
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - T Yau
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - SH Lee
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - JH Lim
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - Y-J Choi
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - EM Lee
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - K-H Park
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - I-G Do
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - E-M Yeoh
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
| | - J Ro
- Asan Medical Center, Korea; Queen Mary Hospital, Hong Kong; Seoul National University Hospital, Korea; National Cancer Center, Singapore; San Juan De Dios Hospital, Philippines; Severance Biomedical Research Institute, Yonsei University College of Medicine, Korea; Dong-A University Medical Centre, Korea; Tuen Mun Hospital, Hong Kong; Seoul St. Mary's Hospital, Korea; GangNeung Asan Hospital, Korea; Yonsei University Medical Centre, Korea; Inha University Hospital, Korea; Pusan National University Hospital, Korea; Kosin University Gospel Hospital, Korea; Korea University Anam Hospital, Korea; Samsung Medical Center, Korea; GlaxoSmithKline Pte Ltd, Singapore; National Cancer Center, Korea
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Seol S, Park H, Lim D, Oh D, Noh J, Paik S. Treatment Outcome of Hepatic Re-irradiation in Patients With HCC. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.846] [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: 11/17/2022]
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Lu J, Jacobs SA, Buyse ME, Paik S, Wolmark N. Abstract OT1-1-12: NSABP FB-7 Trial: A Phase II Randomized Clinical Trial Evaluating Neoadjuvant Therapy Regimens with Weekly Paclitaxel and Neratinib or Trastuzumab or Neratinib and Trastuzumab Followed by Doxorubicin and Cyclophosphamide with Postoperative Trastuzumab in Women with Locally Advanced HER2-Positive Breast Cancer. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-ot1-1-12] [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
Neratinib is an oral, small molecule which acts as an irreversible inhibitor of the pan ErbB receptor tyrosine kinase. Dual ErbB blockade combined with chemotherapy improves efficacy in Her-2 positive breast cancer. Both NeoALTTO (Lancet 2012) and Neosphere (Lancet Oncol 2012) trials demonstrated higher pCR for Her-2 positive breast cancer receiving dual anti-Her-2 neoadjuvant blockade therapy. The purpose of this trial is to determine the activity and safety profile of Neratinib as mono-blockade or in combination with Trastuzumab as dual blockade in neoadjuvant therapy of locally advanced breast cancer (stage IIB, III A, B and C).
Methods: This NSABP Foundation Research Program study (FB-7) is designed as a Phase II, multi-center, three arm clinical trial for patients with Her-2 positive locally advanced breast cancer. 126 patients will be enrolled. The initial two- arm study of Neratinib or Trastuzumab in combination with Paclitaxel began in December 2010. 30 patients were enrolled by December of 2011 at which time the study was placed on hold awaiting the recommended phase II dose of the three drug combination, Neratinib, Trastuzamab and Paclitaxel (NSABP FB-8 trial), which is a Phase I dose-escalation study in women with metastatic Her-2 positive breast cancer. The amended FB −7 trial is now a three arm trial of weekly Paclitaxel and Neratinib or Trastuzumab or Neratinib and Trastuzumab for 4 cycles followed by Doxorubicin and Cyclophosphamide for 4 cycles prior to surgical resection. Patients will then receive postoperative Trastuzumb to complete one total year of Her-2 blockade therapy. The primary goal of this study is to determine the pathologic complete response in breast and axillary lymph nodes following completion of neoadjuvant therapy.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr OT1-1-12.
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Affiliation(s)
- J Lu
- State University of New York at Stony Brook, Stony Brook, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA
| | - SA Jacobs
- State University of New York at Stony Brook, Stony Brook, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA
| | - ME Buyse
- State University of New York at Stony Brook, Stony Brook, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA
| | - S Paik
- State University of New York at Stony Brook, Stony Brook, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA
| | - N Wolmark
- State University of New York at Stony Brook, Stony Brook, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA
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Yang S, Kidwell K, Costantino J, Mamounas E, Nguyen D, Kim C, Wolmark N, Paik S. 478 Prognostic Significance of pAKT Plus Estrogen Receptor Status in Adjuvant Cytotoxic Treatment of Breast Cancer. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)72276-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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O'Connell M, Lee M, Lopatin M, Yothers G, Clark-Langone K, Millward C, Paik S, Sharif S, Shak S, Wolmark N. The 12-Gene Colon Cancer Recurrence Score (RS) Predicts Recurrence in Stage II and III Colon Cancer Patients Treated with 5FU/LV (FU) and 5FU/LV + Oxaliplatin (FU + OX): Validation in NSABP C07. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33178-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fehrenbacher L, Jeong JH, Rastogi P, Geyer CE, Paik S, Ganz PA, Land SR, Costantino JP, Swain SM, Mamounas EP, Wolmark N. OT1-02-07: NSABP B-47: A Randomized Phase III Trial of Adjuvant Therapy Comparing Chemotherapy Alone (Six Cycles of Docetaxel Plus Cyclophosphamide or Four Cycles of Doxorubicin Plus Cyclophosphamide Followed by Weekly Paclitaxel) to Chemotherapy Plus Trastuzumab in Women with Node-Positive or High-Risk Node-Negative HER2−Low Invasive Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-ot1-02-07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Adjuvant studies utilizing trastuzumab in early HER2+ breast cancer demonstrated a large reduction in recurrence and death. Post-enrollment central testing showed HER2 non-amplified participants derived similar benefit. Among HER2−amplified patients, multiple studies showed no effect on benefit by degree of amplification. Extensive testing including blinded external review confirmed the non-amplified nature of the HER2 normal group. Detailed relevant background and confirmatory studies will be provided. As a result of these findings, NSABP study B-47, sponsored by the NCI, was activated January 2011. The study is NCI central IRB approved, open in the CTSU, and endorsed by SWOG as of April 2011.
Study: Selection of one of the two chemotherapy regimens is by physician choice: The non-anthracycline regimen is TC (docetaxel 75 mg/m2, cyclophosphamide 600 mg/m2) administered IV every 3 weeks for 6 cycles; the anthracycline regimen is AC followed by WP (doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 administered IV either every 3 weeks or every 2 weeks [per investigator discretion] for 4 cycles followed by paclitaxel 80 mg/m2 IV weekly for 12 doses). Patients will be randomly assigned to receive chemotherapy with or without trastuzumab therapy. For patients receiving the TC chemotherapy regimen, trastuzumab will be given every 3 weeks during and following chemotherapy until 1 year after the first trastuzumab dose (8 mg/kg loading dose; 6 mg/kg for the remaining doses). For patients receiving the AC followed by WP chemotherapy regimen, trastuzumab will begin with the first dose of weekly paclitaxel and will be given weekly for 12 doses (4 mg/kg loading dose; 2 mg/kg for the remaining weekly doses). Following completion of WP, trastuzumab therapy will continue with 6 mg/kg doses given every 3 weeks for a total of 1 year. Patients will also receive adjuvant radiation therapy and endocrine therapy, as clinically indicated.
Detailed menstrual history, concurrent medications, weight changes, and biomarkers (estrogen, stress, inflammation status) will be collected throughout the study. Collection of circulating tumor cells as an ancillary study is planned.
Eligibility: Eligibility includes: node positive or high risk node negative female breast cancer patients; HER2 IHC 1+ or 2+ scores, but non amplified by FISH; normal cardiac, renal, and liver function. Detailed eligibility will be provided.
Statistical: The primary aim is to determine whether the addition of trastuzumab to chemotherapy improves invasive disease-free survival (IDFS). 3260 patients will be enrolled to provide statistical power of 0.9 to detect a 33% reduction in the hazard rate of IDFS using a one-sided alpha level of 0.025. Projected accrual time is approximately 3 years.
Progress: Protocol was activated in January 2011. First patient was entered in February 2011. As of June 16, 2011, 115 of 3260 patients have been enrolled. Supported by NCI U10-12027, -37377, 69651, 69974, and Genentech, Inc.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT1-02-07.
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Affiliation(s)
- L Fehrenbacher
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - J-H Jeong
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - P Rastogi
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - CE Geyer
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - S Paik
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - PA Ganz
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - SR Land
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - JP Costantino
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - SM Swain
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - EP Mamounas
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
| | - N Wolmark
- 1National Surgical Adjuvant Breast and Bowel Project (NSABP) Operations and Biostatistical Centers; Kaiser Permanente, Northern California; University of Pittsburgh Graduate School of Public Health; University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine; Allegheny General Hospital; Jonsson Comprehensive Cancer Center at UCLA; Washington Cancer Institute, Washington Hospital Center; Aultman Health Foundation
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Yoon DS, Kim YH, Jung HS, Paik S, Lee JW. Importance of Sox2 in maintenance of cell proliferation and multipotency of mesenchymal stem cells in low-density culture. Cell Prolif 2011; 44:428-40. [PMID: 21951286 DOI: 10.1111/j.1365-2184.2011.00770.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES This study has aimed to repopulate 'primitive' cells from late-passage mesenchymal stem cells (MSCs) of poor multipotentiality and low cell proliferation rate, by simply altering plating density. MATERIALS AND METHODS Effects of low density culture compared t high density culture on late-passage bone marrow (BM)-derived MSCs and pluripotency markers of multipotentiality were investigated. Cell proliferation, gene expression, RNA interference and differentiation potential were assayed. RESULTS AND CONCLUSIONS We repopulated 'primitive' cells by replating late-passage MSCs at low density (17 cells/cm(2) ) regardless of donor age. Repopulated MSCs from low-density culture were smaller cells with spindle shaped morphology compared to MSCs from high-density culture. The latter had enhanced colony-forming ability, proliferation rate, and adipogenic and chondrogenic potential. Strong expression of osteogenic-related genes (Cbfa1, Dlx5, alkaline phosphatase and type Ι collagen) in late-passage MSCs was reduced by replating at low density, whereas expression of three pluripotency markers (Sox2, Nanog and Oct-4), Osterix and Msx2 reverted to levels of early-passage MSCs. Knockdown of Sox2 and Msx2 but not Nanog, using RNA interference, showed significant decrease in colony-forming ability. Specifically, knockdown of Sox2 significantly inhibited multipotentiality and cell proliferation. Our data suggest that plating density should be considered to be a critical factor for enrichment of 'primitive' cells from heterogeneous BM and that replicative senescence and multipotentiality of MSCs during in vitro expansion may be predominantly regulated through Sox2.
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Affiliation(s)
- D S Yoon
- Brain Korea 21 Project for Medical Science, Yonsei University, Seoul, South Korea
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Simon RM, Paik S, Hayes DF. Response: Re: Use of Archived Specimens in Evaluation of Prognostic and Predictive Biomarkers. J Natl Cancer Inst 2011. [DOI: 10.1093/jnci/djr332] [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: 11/13/2022] Open
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Sgroi D, Carney E, Richardson E, Steffel L, Binns SN, Finkelstein DM, Shepherd LE, Kesty NC, Schnabel C, Erlander MG, Ingle JN, Porter P, Paik S, Muss HB, Pritchard KI, Tu D, Goss PE. Prediction of late recurrences by breast cancer index in the NCIC CTG MA.17 cohort. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2 Background: The MA.17 trial demonstrated that extended adjuvant endocrine therapy with letrozole after 5-y of tamoxifen markedly reduced the risk of recurrence in women with ER+ early stage breast cancer. This trial provides an opportunity to assess the ability of biomarkers to predict late recurrences in ER+ breast cancer. The Breast Cancer Index (BCI), a continuous risk index based on the combination of HOXB13:IL17BR (H:I) and the molecular grade index (MGI), estimates the individual risk of recurrence in ER+ breast cancer patients. In this study, the prognostic utility of BCI to predict late recurrences was examined. Methods: FFPE tumor blocks were collected from patients who experienced a breast cancer recurrence up to unblinding of MA.17. Controls were matched 2:1 for age, tumor size, nodal status and prior chemotherapy, and were disease free for longer than cases. All cases were reviewed for standard histopathology and evaluated using the real-time RT-PCR BCI assay. Results: Patient characteristics for the case-control study were similar to that from the overall study. Characteristics for cases (N=83) and controls (N=166) were not significantly different except for treatment. A higher percentage of controls compared to cases tended to be categorized as low risk by BCI (58% vs 43%), while a lower percentage of controls than cases tended to be categorized as high risk by BCI (34% vs 24%). In univariate analysis, treatment, BCI, H:I and HOXB13, but not tumor grade or MGI, were significant predictors of late recurrence. After adjusting for standard variables (age, tumor grade and treatment), BCI (OR 2.37; P=0.03), H:I (OR 2.55; P=0.04) and HOXB13 (OR 1.35; P=0.02) remained significant predictors of recurrence. HOXB13 expression at diagnosis predicted patient benefit from extended endocrine therapy with letrozole. Conclusions: In this case-controlled study, the data demonstrate that BCI is a significant predictor of late recurrences in ER+ patients following 5-y of tamoxifen. The prognostic performance of BCI to predict late recurrences was largely dependent on HOXB13 expression. The integration of H:I and MGI within BCI provides prognostic utility for both early and late recurrences.
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Affiliation(s)
- D. Sgroi
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - E. Carney
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - E. Richardson
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - L. Steffel
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - S. N. Binns
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - D. M. Finkelstein
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - L. E. Shepherd
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - N. C. Kesty
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - C. Schnabel
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - M. G. Erlander
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - J. N. Ingle
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - P. Porter
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - S. Paik
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - H. B. Muss
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - K. I. Pritchard
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - D. Tu
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
| | - P. E. Goss
- Massachusetts General Hospital, Boston, MA; NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada; bioTheranostics, Inc., San Diego, CA; Mayo Clinic, Rochester, MN; Fred Hutchinson Cancer Research Center, Seattle, WA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; NCIC Clinical Trials Group, Kingston, ON,
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Sgroi DC, Finkelstein DM, Shepherd L, Ingle JN, Rimm DL, Sasano H, Porter P, Pins M, Paik S, Ristimaki A, Pritchard KI, Tu D, Goss PE. Abstract P3-10-26: Quantitative Protein and Gene Expression Biomarkers of Tamoxifen and Letrozole Recurrence in the NCIC CTG MA.17 Cohort. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-10-26] [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
Background: The MA.17 study showed that extended adjuvant endocrine therapy with letrozole (LET) after completing 5 years of tamoxifen (TAM) markedly reduced the risk of recurrence in women with ER+ early stage breast cancer and improved overall survival in women presenting with node +ve disease. The HOXB 13:IL17BR gene expression ratio (signature) has been shown to predict outcome in breast cancer patients treated with adjuvant tamoxifen monotherapy and provides additional information beyond that from known positive (ER and PR) and negative (Her-1 and Her-2) predictors of responsiveness to tamoxifen in node-ve women. We report a case control evaluation of the Breast Cancer Index (BCI; bioTheranostics, Inc.), which combines the HOXB13 and IL17BR twogene and the molecular grade index (MGI) gene expression signatures, with respect to distinguishing which patients are at risk of late recurrences and who would respond to extended endocrine therapy with LET. The prognostic and predictive utility of quantitative immunofluorescence of ER, PR, Her-2, tumor aromatase, COX-2, GATA3 and Nat1 in the TAM-PLACEBO and the TAM-LET cohorts will also be evaluated and compared to results derived by standard immunohistochemistry. Methods: FFPE tumor blocks were collected from patients who experienced a breast cancer recurrence up to unblinding of MA.17. Controls were matched 2:1 for age, tumor size, lymph node status, and prior chemotherapy, and were all disease free for longer than cases. All cases were reviewed for standard histopathology by two independent pathologists. RNA was extracted, amplified, converted to cDNA and subjected to RT-PCR with primers and probes to HOXB13, IL17BR, BUB1A, CENPA, NEK2, RACGAP1 and RRM2. ER, PR HER1, HER2, COX2, Aromatase, GATA3 and NAT1 will be analyzed by routine IHC techniques and by immunoflourescent Automated Quantitative Analysis (AQuA).
Results: 105 cases and 210 matched controls are available for evaluation. All sections are under review and tissue microarrays have been performed on all cases and controls. Detailed results on the BCI and ER, PR, Her-2 will be available at the SABCS.
Discussion: MA.17 has shown that extended adjuvant endocrine therapy after tamoxifen is effective at preventing disease recurrence given for an additional 5 years. Numerous clinical trials are exploring whether extending AIs will show this benefit, and there is an increasing need to improve the therapeutic index by distinguishing those at risk from those who are not. It is also important to determine which patients will benefit from the therapy and which will recur without benefit. The latter patients could be triaged to clinical trials of novel therapies to overcome endocrine resistance. This study will help to define these issues and pave the way for more effective selection of specific patients for adjuvant endocrine strategies.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-10-26.
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Affiliation(s)
- DC Sgroi
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - DM Finkelstein
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - L Shepherd
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - JN Ingle
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - DL Rimm
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - H Sasano
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - P Porter
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - M Pins
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S Paik
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - A Ristimaki
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - KI Pritchard
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - D Tu
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - PE Goss
- Massachusetts General Hospital, Boston, MA; Queen's University, Kingston, ON, Canada; Mayo Clinic, Rochester, MN; Yale University School of Medicine, New Haven, CT; Tohoku University School of Medicine, Japan; University of Washington Medicine, Seattle; Advocate Lutheran General Hospital, IL; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; University of Helsinki, Haartmaninkatu 8, Finland; Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Fan SQ, Fang B, Choi H, Paik S, Kim C, Jeong BS, Kim JJ, Ko J. Efficiency improvement of dye-sensitized tandem solar cell by increasing the photovoltage of the back sub-cell. Electrochim Acta 2010. [DOI: 10.1016/j.electacta.2010.03.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pogue-Geile KL, Yothers GA, Gavin P, Fumagalli D, Kim C, Colangelo LH, Geyer CE, O'Connell MJ, Wolmark N, Paik S. Use of a prognostic (prog) gene index and nodal status to identify a subset of stage II and III colon cancer patients (pts) who may not need oxaliplatin (ox)-containing adjuvant chemotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
erbB-2 protein is believed to be a cell membrane receptor for the recently identified ligand gp30. When overexpressed, erbB-2 is an indicator of poor prognosis in adenocarcinomas of breast, stomach, lung, and endometrium. Even more important, clinical data suggest that erbB-2 overexpression may be an indicator of poor response to at least some commonly used adjuvant regimens. However, there is preliminary evidence that these tumors might respond as well to doxorubicin regimen as do erbB-2 negative tumors, at least in gastric cancer. The efficacy of doxorubicin-containing regimen in the treatment of tumors with erbB-2 overexpression needs to be explored further by retrospective analysis of finished clinical trials. Combination of chemotherapeutics with reagents that block erbB-2 signal transduction pathway may be another effective approach.
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Affiliation(s)
- S Paik
- Vincent T. Lombardi Cancer Center, Georgetown University Medical Center, Washington, D.C
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Yang SX, Costantino JP, Nguyen D, Jeong J, Mamounas EP, Wolmark N, Kim C, Kidwell K, Paik S, Swain SM. Correlation of levels of Akt phosphorylation at Ser473 with benefit from paclitaxel chemotherapy in NSABP B-28 patients with node-positive breast cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
537 Background: We investigated the levels of tumor phospho-Akt(Ser473) (pAkt) and treatment outcome of patients with node-positive breast cancer after adjuvant treatment with doxorubicin/cyclophosphamide (AC) followed by four cycles of paclitaxel (PTX) (AC→PTX) compared with AC chemotherapy alone in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-28 trial. Methods: The primary tumors on B-28 tissue microarray were available from 1581 of 3060 patients enrolled. pAkt status was examined by immunohistochemistry with the antibody to pAkt(Ser473) (Cell Signaling Technology) at the National Cancer Institute. Levels of pAkt were quantitatively scored with the assistance of an Automated Digital Imaging System blinded to clinical outcome, and categorized by the staining index (intensity X % of staining /100) of > 2 (high) and ≤ 2 (low). The association between tumor pAkt level and clinical outcome at 10 years was assessed using multivariate Cox modeling adjusting for age, tumor size, number of positive nodes, tumor grade, estrogen receptor and HER2 status. Results: Among patients with low tumor pAkt levels (n = 975), there was no DFS difference between those treated with or without PTX (adjusted HR = 1.02, p = 0.81). However, among patients with high tumor pAkt levels (n = 606), those treated with AC→PTX had a 26% reduction in DFS event rate compared to those treated with AC only (adjusted HR = 0.74, p = 0.02). There was no OS difference between treatment groups for those with low pAkt cancer (HR = 0.97, p = 0.80). In patients with high pAkt cancer, those treated with AC→PTX had a 20% reduction in death rate compared to those treated with AC only but this difference did not reach statistical significance (adjusted HR = 0.80, p = 0.17). Conclusions: High levels of Akt phosphorylation at Ser473 independently predict a DFS benefit from the sequential addition of paclitaxel to adjuvant doxorubicin plus cyclophosphamide in node-positive breast cancer. Patients with low levels of pAkt breast cancer may not benefit from the sequential addition of PTX to doxorubicin plus cyclophosphamide. [Table: see text]
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Affiliation(s)
- S. X. Yang
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - J. P. Costantino
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - D. Nguyen
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - J. Jeong
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - E. P. Mamounas
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - N. Wolmark
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - C. Kim
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - K. Kidwell
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - S. Paik
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
| | - S. M. Swain
- National Cancer Institute, Bethesda, MD; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; Aultman Health Foundation, Canton, OH; Washington Hospital Center, Washington, DC
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Rugo H, Kaufman P, Tan-Chiu E, Ulcickas Yood M, Paik S, Yardley D, Brufsky A, Mayer M, Birkner M, Wang L, Brammer M, Tripathy D. Survival of patients with HER2+ metastatic breast cancer and use of trastuzumab following progression: analysis of RegistHER. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-3142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #3142
Background: Most HER2+ metastatic breast cancer (MBC) patients who initially respond to trastuzumab (T)-based therapies will experience disease progression (PD). Standard practice is to discontinue the cytotoxic agent on which disease progressed, however there is evidence that tumors may remain sensitive to HER2 targeting and that there may be a potentiating effect of T on chemotherapy. We examined the treatment history of a large population of HER2+ MBC patients to assess outcomes associated with continuation of T beyond PD.
 Methods: This analysis was carried out on patients enrolled in registHER, a prospective observational study of 1023 patients with newly diagnosed (within 6 months) HER2+ MBC. Median f/u from MBC diagnosis is 25 months at the time of data cut-off (12/31/07). For those treated with T prior to first PD, we compared demographics and baseline tumor characteristics for those patients treated with or without T following first PD. Treatment with T was defined as a minimum of 21 days of therapy prior to PD. In addition, we evaluated time to second PD, and overall survival post PD (both endpoints calculated from initial PD). Overall survival (OS) was also calculated from the date of treatment initiation to death for the entire treated cohort.
 Results: Of 1023 evaluable patients, 873 (85%) were treated with any T-based first-line therapy. 622 T-treated patients progressed and 500 were subsequently treated with T following first PD. Patients who received T post first PD tended to be younger (<50 years of age, 45.2% vs 29.5%) and have hormone receptor positive disease (51.4% vs 42.0%) compared with patients who did not receive T post first PD. Among all treated patients the median overall survival was 35.6 mo (25th-75th-ile:18.6-63.1 mo). Median survival post PD in the 500 patients treated with trastuzumab following first PD was 21.2 mo (25th-75th-ile:11.8-35.8mo).
 Conclusions: OS in patients on the prospective observational study registHER is longer than the OS of 25.1 months noted in the pivotal trial of first-line HER2+ MBC patients treated with T plus chemotherapy. We will present data on the association between various pre- and post-treatment factors, including the use of T beyond PD, and PFS and OS. This will include a multivariate analysis that specifically examines the association between T use in later lines and survival.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3142.
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Affiliation(s)
- H Rugo
- 1 UCSF Comprehensive Cancer Center, San Francisco
| | - P Kaufman
- 2 Dartmouth-Hitchcock Medical Center, Lebanon
| | | | - M Ulcickas Yood
- 4 EpiSource, LLC, Yale University School of Medicine, New Haven
| | - S Paik
- 5 National Surgical Breast and Bowel Project, Pittsburgh
| | - D Yardley
- 6 Sarah Cannon Research Institute, Nashville
| | - A Brufsky
- 7 University of Pittsburgh Cancer Center, Pittsburgh
| | - M Mayer
- 8 Patient Advocate, New York
| | - M Birkner
- 9 Genentech, Inc., South San Francisco
| | - L Wang
- 9 Genentech, Inc., South San Francisco
| | - M Brammer
- 9 Genentech, Inc., South San Francisco
| | - D Tripathy
- 10 University of Texas Southwestern Medical Center, Dallas
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Pusztai L, Jeong J, Gong Y, Ross JS, Kim C, Hortobagyi GN, Paik S, Symmans WF. Evaluation of microtubule associated protein tau expression as prognostic and predictive marker in the NSABP-B 28 randomized clinical trial. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #54
Objective: We assessed Tau protein expression in patients who participated in the National Surgical Breast and Bowel Project (NSABP)-B28 clinical trial using immunohistochemistry. Expression levels were correlated with disease-free (DFS) and overall survival (OS) and we also examined if there is interaction between this marker and paclitaxel efficacy. Patients and Methods: Tissue microarrays were available for 1942 patients (63 % of all trial participants) who were included in the NSABP-B28 clinical trial and were randomized to receive either 4 courses of doxorubicin/cyclophosphamide (AC) or AC followed by 4 additional courses of paclitaxel (ACT) adjuvant chemotherapy. All patients with hormone receptor positive tumors also received adjuvant endocrine treatment. Immunohistochemistry for Tau was performed at MD Anderson Cancer Center blinded to clinical outcome. Correlation with survival was performed by the NSABP Statistical Center. Results: Forty-three percent of tumors were Tau-positive defined as equal or greateer staining than in normal breast epithelium. Tau expression correlated strongly with estrogen receptor (ER)-positive status (p<0.0001). In univariate analyses, Tau, ER and HER-2 expression as well as grade, tumor size and nodal status were each independently and significantly associated with DFS and OS (p<0.003). In multivariate analysis, the same variables except HER2 remained significant. However, there was no significant interaction between Tau expression and benefit from paclitaxel in the entire population or among the ER-positive or ER-negative subsets, respectively. Conclusion: High Tau protein expression is associated with better prognosis including longer disease-free and overall survival in patients treated with adjuvant anthracyline and paclitaxel chemotherapy and endocrine therapy. However, we could not detect a statistically significant interaction between Tau expression and paclitaxel benefit.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 54.
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Affiliation(s)
- L Pusztai
- 1 Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, TX
| | - J Jeong
- 2 Biostatistics Center, National Adjuvant Bowel and Breast Project, Pittsburgh, PA
| | - Y Gong
- 3 Pathology, UT MD Anderson Cancer Center, Houston, TX
| | - JS Ross
- 4 Pathology and Laboratory Medicine, Albany Medical College, Albany, NY
| | - C Kim
- 2 Biostatistics Center, National Adjuvant Bowel and Breast Project, Pittsburgh, PA
| | - GN Hortobagyi
- 1 Breast Medical Oncology, UT MD Anderson Cancer Center, Houston, TX
| | - S Paik
- 2 Biostatistics Center, National Adjuvant Bowel and Breast Project, Pittsburgh, PA
| | - WF Symmans
- 3 Pathology, UT MD Anderson Cancer Center, Houston, TX
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Reinholz MM, Dueck AC, Lingle WL, Allen Ziegler KL, Wiktor AE, Paik S, Jenkins RB, Perez EA. The concordance between NCCTG's and NSABP's C-myc FISH assays. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Paik S, Kim C, Jeong J, Geyer CE, Romond EH, Mejia-Mejia O, Mamounas EP, Wickerham D, Costantino JP, Wolmark N. Benefit from adjuvant trastuzumab may not be confined to patients with IHC 3+ and/or FISH-positive tumors: Central testing results from NSABP B-31. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.511] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [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
511 Background: Trastuzumab is a humanized monoclonal antibody targeted to HER2 protein and currently indicated for HER2-positive breast cancer defined by overexpression of HER2 protein (3+ IHC staining by HercepTest™) or HER2 gene amplification (HER2/CEP17 ratio over 2 by PathVysion® FISH assay). These criteria were determined for advanced disease but have not been formally tested in the adjuvant setting. We examined these tests’ ability to predict benefit from adjuvant trastuzumab in NSABP trial B-31. Methods: All available tumor tissue blocks from the B-31 trial were subjected to HercepTest and PathVysion assay as defined in the B-31 protocol. Formal statistical test of interaction between HER2 levels measured by these two tests and benefit from trastuzumab was performed. Results: 207 of 1,795 cases (11.5%) showed gene amplification as determined by PathVysion, and 255 of 1,662 (15.3 %) showed overexpression as determined by HercepTest. 161 of 1,662 (9.7%) had neither gene amplification nor overexpression. There was a consistent benefit from trastuzumab in every subset defined by IHC or FISH. No statistical interaction was found between DFS benefit from trastuzumab and levels of protein (p=0.26) or HER2 gene copy number (p=0.60). Benefit was observed in patients with tumors that were negative for FISH and had less than 3+ staining intensity on IHC by HercepTest (RR=0.36 [CI: 0.14–0.92] p=0.032). Conclusion: Current definition of HER2 overexpression/gene amplification based on data from advanced disease may need to be modified for the adjuvant setting. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- S. Paik
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - C. Kim
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - J. Jeong
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - C. E. Geyer
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - E. H. Romond
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - O. Mejia-Mejia
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - E. P. Mamounas
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - D. Wickerham
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - J. P. Costantino
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
| | - N. Wolmark
- NSABP Operations, Pittsburgh, PA; NSABP Biosttistical Center; Univ of Pittsburgh, Pittsbugh, PA; NSABP; Allegheny General Hospital, Pittsburgh, PA; University of Kentucky, Lexington, KY; Ntheastrn OH Univ Cllg of Med, Aultman Ca Cntr, Canton, OH; Allegheny General Hospital, Pittsburgh, PA
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Yardley DA, Kaufman PA, Mayer M, Ulcickas Yood M, Tan-Chiu E, Brufsky AM, Rugo HS, Tripathy D, Paik S, Brammer MG. registHER: Patient characteristics, treatment patterns, and preliminary outcomes in patients with HER2-positive (HER2+), hormone receptor-positive (HR+) metastatic breast cancer (MBC). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.21007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
21007 Background: Approximately 50% of HER2+ breast cancers are HR+, however, the interaction between HER2 and HR is not completely understood. Patients with HR+/HER2+ or HR-/HER2+ tumors treated with trastuzumab + chemotherapy (CT) achieve similar clinical benefit. Retrospective analyses suggest that HER2+ tumors are resistant to hormone therapy (HT), particularly anti-estrogens, possibly due to estrogen receptor /HER2 interactions and quantitatively lower HR expression in HER2+/HR+ tumors. Conducting randomized clinical trials in HER2+/HR+ MBC is challenging given the small patient population. Methods: registHER is a prospective observational study of approximately 1000 patients with newly diagnosed (<6 months) HER2+ MBC treated in community or academic settings. Baseline characteristics and treatment patterns in patients with HR+ vs HR-, HER2+ MBC receiving first-line therapy were studied in this analysis. The influence of adjuvant HT on disease-free intervals (DFI) from time of diagnosis and MBC treatment selection in patients with HR+/HER2+ tumors was examined. Results: Of 976 patients with HER2+ MBC and recorded tumor HR status, those with HR+ MBC (54.9%) tended to be white (81.7% vs 77.0%), were more likely to have bone only metastases (18.1% vs 6.4%), less likely to have CNS metastases (2.8% vs 8.2%), and have fewer metastatic sites at diagnosis (49.1% vs 43.2%) than those with HR- MBC. Of patients with HR+ MBC, who were stage I- III at initial diagnosis, 51.3% received adjuvant HT, of which 73.2% received tamoxifen. Median DFI was 48.8 vs 29.4 mo for patients receiving tamoxifen vs an aromatase inhibitor. First-line MBC treatment regimens included: HT only (13.8%); HT + trastuzumab (8.4%); HT + trastuzumab + CT (6.2%); trastuzumab only (6.0%); CT only (11.0%); trastuzumab + CT (53.5%). Analyses of progression-free survival by HR status and first-line treatments (HT only, trastuzumab ± HT or ± CT), are ongoing and will be described. Conclusions: registHER represents the largest dataset of patients with HER2+/HR+ MBC and provides a unique opportunity to characterize treatment patterns, efficacy and safety, and the natural history of this subset of breast cancer patients. [Table: see text]
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Affiliation(s)
- D. A. Yardley
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - P. A. Kaufman
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - M. Mayer
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - M. Ulcickas Yood
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - E. Tan-Chiu
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - A. M. Brufsky
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - H. S. Rugo
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - D. Tripathy
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - S. Paik
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
| | - M. G. Brammer
- Sarah Cannon Research Institute, Nashville, TN; Dartmouth Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; Yale University School of Medicine, New Haven, CT; Florida Cancer Care, Tamarac, FL; University of Pittsburgh Cancer Center, Pittsburgh, PA; UCSF Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX; National Surgical Breast and Bowel Project, Pittsburgh, PA; Genentech, Inc., South San Francisco, CA
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Ross DT, Kim C, Tang G, Mejia OM, Beck RA, Ring BZ, Seitz RS, Paik S, Constantino JP, Wolmark N. Chemosensitivity and stratification by a five monoclonal antibody IHC test in the NSABP B20 trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
529 Background: We previously reported the association between a five monoclonal antibody test staining p53, NDRG1, SLC7A5, CEACAM5 and HTF9C and recurrence-free interval (RFI) in 711 ER+ N- breast cancer patients from Tamoxifen (Tam) arm of the NSABP trials B14 and B20 (SABCS 2006). In this study, we examined interaction between the test and chemotherapy in the B20 trial. Subjects and Methods: Tissue array sections from B20 paraffin blocks were stained using standard IHC protocols (N=457). Pre-defined scoring rules and cut- points were applied. RFI was defined as time from entry to any local, regional or distant recurrence. Log-rank test was applied to assess the effect of chemotherapy for each risk stratum pre-defined by this IHC test. Interaction between risk strata and treatment was assessed by the likelihood ratio test in a Cox model with age and clinical tumor size adjusted. Results: The IHC test identified high and low risk groups that both showed significant improvement upon treatment with cytotoxic chemotherapy. The moderate risk group was poorly populated and showed no significant difference between chemo-treated and Tam-only patients. Conclusion: It appears that five monoclonal antibodies may be able to identify groups of ER+, node negative patients who have greater absolute benefit from adjuvant Chemo compared to un-stratified patient populations. However, the formal test for interaction between Chemo and the risk group was not significant (p- value=0.127). This may be due to small sample size and a lack of statistical power. The results suggest that this test deserves further evaluation as a method for identifying subsets of patients who may receive more benefit from Chemo. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- D. T. Ross
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - C. Kim
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - G. Tang
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - O. M. Mejia
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - R. A. Beck
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - B. Z. Ring
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - R. S. Seitz
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - S. Paik
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - J. P. Constantino
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
| | - N. Wolmark
- Applied Genomics Inc, Burlingame, CA; NSABP, Pittsburgh, PA; NSABP and University of Pittsburgh, Pittsburgh, PA; Applied Genomics Inc, Huntsville, AL; NSABP and Allegheny General Hospital, Pitttsburgh, PA
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Abstract
An unusual and rare gastric mucosal lesion histologically consisting of a localised accumulation of Russell bodies and Russell body-containing plasma cells, the so-called Mott cells, has been recognised only recently and termed as "Russell body gastritis". This lesion, despite its densely monomorphous appearance is easily confirmed to be non-neoplastic by its polyclonal immunoreactive pattern to immunoglobulin light chains. However, the aetiology of Russell body gastritis is controversial and hence the optimal treatment for this disease has not been established. Two cases of Russell body gastritis associated with Helicobacter pylori infection are reported, and the possible role of H pylori infection in the pathogenesis is discussed.
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Affiliation(s)
- S Paik
- Department of Diagnostic Pathology, Bundang Jesaeng General Hospital, Sungnam-si, Kyungki-do, Korea
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Koh J, Sohn D, Kim D, Kim H, Paik S, Lee J. MP-12.11. Urology 2006. [DOI: 10.1016/j.urology.2006.08.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kaufman P, Mayer M, Paik S, Ulcickas Yood M, Yardley D, Tan-Chiu E, Brufsky AM, Rugo H, Tripathy D, Wang L. registHER: Baseline characteristics of a cohort of HER2-positive metastatic breast cancer (MBC) patients. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.20095] [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
20095 Background: HER2 is amplified in 25% of breast cancers and is associated with poor survival. registHER captures the natural history, treatment patterns and outcomes in 1000 newly-diagnosed HER2-positive MBC patients (pts) throughout the U.S. This observational study recruits pts in both academic and community centers. Methods: This ongoing prospective cohort study collects clinical, pathologic and treatment data at enrollment, quarterly until death, loss to follow-up or 3 years after the last enrollment. We describe baseline pt and clinical characteristics in registHER compared with HER2-positive MBC pts in the phase III pivotal trial (Slamon DJ, et al. N Engl J Med. 2001;344:783–792). Results: Between December 2003 and September 2005, 813 eligible pts were enrolled at 280 study sites. Most pts were seen at community-based (76%) vs academic (18%) clinics; a few pts did not fall into either category (6%). A comparison of baseline characteristics is shown below. Conclusions: registHER pts tended to have a shorter disease-free interval and more estrogen receptor positive disease than pts in the pivotal trial. Reasons for these differences could reflect trial referral and/or diagnostic testing differences. Fewer registHER patients were white, but other characteristics were similar between the two groups. These findings support the hypothesis that observational studies describe a broad patient population which may not exactly duplicate clinical trials. Within registHER, there was some variation between academic vs community clinics (eg. nodal status and adjuvant therapy). Treatment pattern analyses are ongoing. [Table: see text] [Table: see text]
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Affiliation(s)
- P. Kaufman
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - M. Mayer
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - S. Paik
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - M. Ulcickas Yood
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - D. Yardley
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - E. Tan-Chiu
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - A. M. Brufsky
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - H. Rugo
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - D. Tripathy
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
| | - L. Wang
- Dartmouth-Hitchcock Medical Center, Lebanon, NH; Patient Advocate, New York, NY; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; EpiSource and Yale University School of Medicine, New Haven, CT; Sarah Cannon Cancer Center, Nashville, TN; Cancer Research Network, Plantation, FL; University of Pittsburgh Cancer Centers, Pittsburgh, PA; University of California, San Francisco Comprehensive Cancer Center, San Francisco, CA; University of Texas Southwestern Medical Center, Dallas, TX
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O’Connell MJ, Paik S, Yothers G, Costantino JP, Cowens JW, Clark KM, Baker J, Hackett J, Watson D, Wolmark N. Relationship between tumor gene expression and recurrence in stage II/III colon cancer: Quantitative RT-PCR assay of 757 genes in fixed paraffin-embedded (FPE) tissue. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3518 Background: As an initial step in developing abetter method of assessing prognosis following potentially curative surgery for colon cancer, we performed an exploratory gene identification study. Methods: RNA was extracted from three 10-micron sections of the FPE tumor tissue obtained at the initial diagnosis from 353 patients entered between 1977 and 1984 into the surgery-only or surgery-plus BCG arms of NSABP C-01/C-02. Expression was quantified for 757 cancer-related and reference genes with RT-PCR. Results: Blocks from 270 patients were evaluable after pre-specified exclusions: 128 were stage II and 142 were stage III. All patients had ≥ 5-year follow up. In univariate Cox proportional hazard analyses, 148 genes exhibited a nominally significant (unadjusted p-value <0.05) linear association with recurrence-free interval (RFI) (7 genes p≤0.001, 66 genes 0.001<p<0.01; 75 genes 0.01≤p<0.05). False discovery rate calculations suggest that about 25% of the 148 genes are expected to be false positives. Higher expression was associated with shorter RFI for 118 genes including SERPINB5, DUSP1, AKT3, TIMP1, ANXA2, RHOB (p≤ 0.001) and with longer RFI for 30 genes including BRCA1 (p≤0.001). The relationship between gene expression and RFI was similar for stage II and stage III patients for 143 of the 148 genes found to be significant. The largest cluster of genes is functionally related to extracellular matrix remodeling. The magnitude of the hazard ratios is similar to that observed in the early Oncotype DX studies in breast cancer and should allow clinically useful separation into low/intermediate/high risk groups. Conclusions: Quantitative RT-PCR assay of FPE colon cancer tissue can be used to identify large numbers of genes associated with RFI in patients with stage II and III colon cancer. If these results are confirmed by additional studies in progress, this technique has promise to improve selection of colon cancer patients for adjuvant chemotherapy. Funded in part as a collaborative arrangement under contract between the NSABP Foundation, Inc., and Genomic Health, Inc. [Table: see text]
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Affiliation(s)
- M. J. O’Connell
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - S. Paik
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - G. Yothers
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - J. P. Costantino
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - J. W. Cowens
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - K. M. Clark
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - J. Baker
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - J. Hackett
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - D. Watson
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
| | - N. Wolmark
- National Surgical Adjuvant Breast & Bowel Project, Allegheny General Hospital, Pittsburgh, PA; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; NSABP Biostatistical Center, University of Pittsburgh, Pittsburgh, PA; Genomic Health, Inc., Redwood City, CA
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Paik S. Development and validation of multi-gene prognostic assay for ER+ breast cancer. Pharmacotherapy 2005. [DOI: 10.1016/s0753-3322(05)80089-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Paik S, Shak S, Tang G, Kim C, Baker J, Cronin M, Watson D, Bryant J, Costantino J, Wolmark N. Expression of the 21 genes in the Recurrence Score assay and tamoxifen clinical benefit in the NSABP study B-14 of node negative, estrogen receptor positive breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.510] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Paik
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - S. Shak
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - G. Tang
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - C. Kim
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - J. Baker
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - M. Cronin
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - D. Watson
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - J. Bryant
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - J. Costantino
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
| | - N. Wolmark
- NSABP, Pittsburgh, PA; Genomic Health, Inc, Redwood City, CA; Allegheny General Hospital, Pittsburgh, PA
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Tanchiu E, Kaufman PA, Paik S, Ulcickas-Yood M, Mayer M, Tripathy D, Rugo H, Brufsky A. registHER: A prospective, longitudinal cohort study of women with HER2 positive metastatic breast cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- E. Tanchiu
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - P. A. Kaufman
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - S. Paik
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - M. Ulcickas-Yood
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - M. Mayer
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - D. Tripathy
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - H. Rugo
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
| | - A. Brufsky
- Cancer Research Network, Plantation, FL; Dartmouth Hitchcock Medcl Ctr, Lebanon, NH; NSABP, Pittsburgh, PA; Episource LLC, Hamden, CT; Patient Advocate, New York, NY; Univ of Texas Southwestern Medcl Ctr, Dallas, TX; Univ of CA San Francisco, San Francisco, CA; Univ of Pittsburg Cancer Institute, Pittsburgh, PA
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Paik S. Methods for gene expression profiling in clinical trials for breast cancer. Breast Cancer Res 2005. [PMCID: PMC4231887 DOI: 10.1186/bcr1207] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Henke RT, Maitra A, Paik S, Wellstein A. Gene expression analysis in sections and tissue microarrays of archival tissues by mRNA in situ hybridization. Histol Histopathol 2005; 20:225-37. [PMID: 15578441 DOI: 10.14670/hh-20.225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Altered expression of genes in diseased tissues can prognosticate a distinct natural progression of the disease as well as predict sensitivity or resistance to particular therapies. Archival tissues from patients with a known medical history and treatments are an invaluable resource to validate the utility of candidate genes for prognosis and prediction of therapy outcomes. However, stored tissues with associated long-term follow-up information typically are formalin-fixed, paraffin-embedded specimen and this can severely restrict the methods applicable for gene expression analysis. We report here on the utility of tissue microarrays (TMAs) that use valuable tissues sparingly and provide a platform for simultaneous analysis of gene expression in several hundred samples. In particular, we describe a stable method applicable to mRNA expression screening in such archival tissues. TMAs are constructed from sections of small drill cores, taken from tissue blocks of archival tissues and multiple samples can thus be arranged on a single microscope slide. We used mRNA in situ hybridization (ISH) on >500 full sections and >100 TMAs for >10 different cDNAs that yielded >10,000 data points. We provide detailed experimental protocols that can be implemented without major hurdles in a molecular pathology laboratory and discuss quantitative analysis and the advantages and limitations of ISH. We conclude that gene expression analysis in archival tissues by ISH is reliable and particularly useful when no protein detection methods are available for a candidate gene.
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Affiliation(s)
- R T Henke
- Lombardi Cancer Center, Georgetown University, Washington, DC 20057, USA
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Affiliation(s)
- S Paik
- Division of Pathology, NSABP, Pittsburgh, PA 15212, USA.
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50
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Sheen Y, Joung K, Min K, Kim J, Gu K, Paik S, Hong S, Kang S, Kim H, Cho S. 672 Establishment of calux bioassay system for estrogens and dioxins. Toxicol Lett 2003. [DOI: 10.1016/s0378-4274(03)90671-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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