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Wang A, Shen J, Rodriguez AA, Saunders EJ, Chen F, Janivara R, Darst BF, Sheng X, Xu Y, Chou AJ, Benlloch S, Dadaev T, Brook MN, Plym A, Sahimi A, Hoffman TJ, Takahashi A, Matsuda K, Momozawa Y, Fujita M, Laisk T, Figuerêdo J, Muir K, Ito S, Liu X, Uchio Y, Kubo M, Kamatani Y, Lophatananon A, Wan P, Andrews C, Lori A, Choudhury PP, Schleutker J, Tammela TL, Sipeky C, Auvinen A, Giles GG, Southey MC, MacInnis RJ, Cybulski C, Wokolorczyk D, Lubinski J, Rentsch CT, Cho K, Mcmahon BH, Neal DE, Donovan JL, Hamdy FC, Martin RM, Nordestgaard BG, Nielsen SF, Weischer M, Bojesen SE, Røder A, Stroomberg HV, Batra J, Chambers S, Horvath L, Clements JA, Tilly W, Risbridger GP, Gronberg H, Aly M, Szulkin R, Eklund M, Nordstrom T, Pashayan N, Dunning AM, Ghoussaini M, Travis RC, Key TJ, Riboli E, Park JY, Sellers TA, Lin HY, Albanes D, Weinstein S, Cook MB, Mucci LA, Giovannucci E, Lindstrom S, Kraft P, Hunter DJ, Penney KL, Turman C, Tangen CM, Goodman PJ, Thompson IM, Hamilton RJ, Fleshner NE, Finelli A, Parent MÉ, Stanford JL, Ostrander EA, Koutros S, Beane Freeman LE, Stampfer M, Wolk A, Håkansson N, Andriole GL, Hoover RN, Machiela MJ, Sørensen KD, Borre M, Blot WJ, Zheng W, Yeboah ED, Mensah JE, Lu YJ, Zhang HW, Feng N, Mao X, Wu Y, Zhao SC, Sun Z, Thibodeau SN, McDonnell SK, Schaid DJ, West CM, Barnett G, Maier C, Schnoeller T, Luedeke M, Kibel AS, Drake BF, Cussenot O, Cancel-Tassin G, Menegaux F, Truong T, Koudou YA, John EM, Grindedal EM, Maehle L, Khaw KT, Ingles SA, Stern MC, Vega A, Gómez-Caamaño A, Fachal L, Rosenstein BS, Kerns SL, Ostrer H, Teixeira MR, Paulo P, Brandão A, Watya S, Lubwama A, Bensen JT, Butler EN, Mohler JL, Taylor JA, Kogevinas M, Dierssen-Sotos T, Castaño-Vinyals G, Cannon-Albright L, Teerlink CC, Huff CD, Pilie P, Yu Y, Bohlender RJ, Gu J, Strom SS, Multigner L, Blanchet P, Brureau L, Kaneva R, Slavov C, Mitev V, Leach RJ, Brenner H, Chen X, Holleczek B, Schöttker B, Klein EA, Hsing AW, Kittles RA, Murphy AB, Logothetis CJ, Kim J, Neuhausen SL, Steele L, Ding YC, Isaacs WB, Nemesure B, Hennis AJ, Carpten J, Pandha H, Michael A, Ruyck KD, Meerleer GD, Ost P, Xu J, Razack A, Lim J, Teo SH, Newcomb LF, Lin DW, Fowke JH, Neslund-Dudas CM, Rybicki BA, Gamulin M, Lessel D, Kulis T, Usmani N, Abraham A, Singhal S, Parliament M, Claessens F, Joniau S, den Broeck TV, Gago-Dominguez M, Castelao JE, Martinez ME, Larkin S, Townsend PA, Aukim-Hastie C, Bush WS, Aldrich MC, Crawford DC, Srivastava S, Cullen J, Petrovics G, Casey G, Wang Y, Tettey Y, Lachance J, Tang W, Biritwum RB, Adjei AA, Tay E, Truelove A, Niwa S, Yamoah K, Govindasami K, Chokkalingam AP, Keaton JM, Hellwege JN, Clark PE, Jalloh M, Gueye SM, Niang L, Ogunbiyi O, Shittu O, Amodu O, Adebiyi AO, Aisuodionoe-Shadrach OI, Ajibola HO, Jamda MA, Oluwole OP, Nwegbu M, Adusei B, Mante S, Darkwa-Abrahams A, Diop H, Gundell SM, Roobol MJ, Jenster G, van Schaik RH, Hu JJ, Sanderson M, Kachuri L, Varma R, McKean-Cowdin R, Torres M, Preuss MH, Loos RJ, Zawistowski M, Zöllner S, Lu Z, Van Den Eeden SK, Easton DF, Ambs S, Edwards TL, Mägi R, Rebbeck TR, Fritsche L, Chanock SJ, Berndt SI, Wiklund F, Nakagawa H, Witte JS, Gaziano JM, Justice AC, Mancuso N, Terao C, Eeles RA, Kote-Jarai Z, Madduri RK, Conti DV, Haiman CA. Characterizing prostate cancer risk through multi-ancestry genome-wide discovery of 187 novel risk variants. Nat Genet 2023; 55:2065-2074. [PMID: 37945903 PMCID: PMC10841479 DOI: 10.1038/s41588-023-01534-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/15/2023] [Indexed: 11/12/2023]
Abstract
The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry (P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups.
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Affiliation(s)
- Anqi Wang
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jiayi Shen
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Fei Chen
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rohini Janivara
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Burcu F. Darst
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Xin Sheng
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yili Xu
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alisha J. Chou
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sara Benlloch
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology,University of Cambridge, Cambridge, UK
| | | | | | - Anna Plym
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Urology Division, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Sahimi
- Department of Population and Public Health Sciences, Keck School of Medicine,University of Southern California, Los Angeles, CA, USA
| | - Thomas J. Hoffman
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
| | - Atushi Takahashi
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Genomic Medicine, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Koichi Matsuda
- Department of Computational Biology and Medical Sciences, Laboratory of Clinical Genome Sequencing,Graduate school of Frontier Sciences,The University of Tokyo, Tokyo, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center of Integrative Medical Sciences, Yokohama, Japan
| | - Masashi Fujita
- Laboratory for Cancer Genomics, RIKEN Center of Integrative Medical Sciences, Yokohama, Japan
| | - Triin Laisk
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Jéssica Figuerêdo
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Shuji Ito
- Department of Orthopaedics, Shimane University, Izumo, Shimane, Japan
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Xiaoxi Liu
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - The Biobank Japan Project
- Corresponding Author: Christopher A. Haiman, Harlyne J. Norris Cancer Research Tower, USC Norris Comprehensive Cancer Center, 1450 Biggy Street, Rm 1504, Los Angeles, CA 90033 or
| | - Yuji Uchio
- Department of Orthopaedics, Shimane University, Izumo, Shimane, Japan
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester, UK
| | - Peggy Wan
- Department of Population and Public Health Sciences, Keck School of Medicine,University of Southern California, Los Angeles, CA, USA
| | - Caroline Andrews
- Harvard TH Chan School of Public Health and Division of Population Sciences,Dana Farber Cancer Institute, Boston, MA, USA
| | - Adriana Lori
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
| | | | - Johanna Schleutker
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Medical Genetics, Genomics, Laboratory Division, Turku University Hospital, Turku, Finland
| | | | - Csilla Sipeky
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Anssi Auvinen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Graham G. Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health,The University of Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Melissa C. Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert J. MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health,The University of Melbourne, Victoria, Australia
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Dominika Wokolorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Christopher T. Rentsch
- Yale School of Medicine, New Haven, CT, USA
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kelly Cho
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | | | - David E. Neal
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK
- University of Cambridge, Department of Oncology, Addenbrooke’s Hospital, Cambridge, UK
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Jenny L. Donovan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Freddie C. Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Faculty of Medical Science, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Richard M. Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Borge G. Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Copenhagen, Denmark
| | - Sune F. Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Copenhagen, Denmark
| | - Maren Weischer
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Copenhagen, Denmark
| | - Stig E. Bojesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Copenhagen, Denmark
| | - Andreas Røder
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Hein V. Stroomberg
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jyotsna Batra
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | | | - Lisa Horvath
- Chris O’Brien Lifehouse (COBLH), Camperdown, Sydney, NSW, Australia, Sydney, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Judith A. Clements
- Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Wayne Tilly
- Dame Roma Mitchell Cancer Research Laboratories, University of Adelaide, Adelaide, Australia
| | - Gail P. Risbridger
- Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
- Prostate Cancer Translational Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Henrik Gronberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Markus Aly
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Urology, Karolinska University Hospital, Solna, Stockholm, Sweden
- Department of Urology, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Szulkin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- SDS Life Sciences, Stockholm, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Tobias Nordstrom
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Nora Pashayan
- University College London, Department of Applied Health Research, London, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Laboratory, Cambridge, UK
- Department of Applied Health Research, University College London, London, UK
| | - Alison M. Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Laboratory, Cambridge, UK
| | - Maya Ghoussaini
- Open Targets, Wellcome Sanger Institute, Hinxton, Saffron Walden, Hinxton, UK
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tim J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Thomas A. Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hui-Yi Lin
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH,, Bethesda, MD, USA
| | - Lorelei A. Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sara Lindstrom
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David J. Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn L. Penney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
| | - Constance Turman
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Catherine M. Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Phyllis J. Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ian M. Thompson
- CHRISTUS Santa Rosa Hospital – Medical Center, San Antonio, TX, USA
| | - Robert J. Hamilton
- Dept. of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Canada
- Dept. of Surgery (Urology), University of Toronto, Toronto, Canada
| | - Neil E. Fleshner
- Dept. of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Antonio Finelli
- Division of Urology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Laval, QC, Canada
| | - Janet L. Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Elaine A. Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Meir Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital/Harvard Medical School, Boston, MA, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Niclas Håkansson
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gerald L. Andriole
- Brady Urological Institute in National Capital Region, Johns Hopkins University, Baltimore, MD, USA
| | - Robert N. Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mitchell J. Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Karina Dalsgaard Sørensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Borre
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - William J. Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- International Epidemiology Institute, Rockville, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - James E. Mensah
- University of Ghana Medical School, Accra, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | | | - Ninghan Feng
- Wuxi Second Hospital, Nanjing Medical University, Wuxi, Jiangzhu Province, China
| | - Xueying Mao
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | - Yudong Wu
- Department of Urology, First Affiliated Hospital, The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Shan-Chao Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zan Sun
- The People’s Hospital of Liaoning Proviouce, The People’s Hospital of China Medical University, Shenyang, China, Shenyang, China
| | - Stephen N. Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Daniel J. Schaid
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Catharine M.L. West
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Radiotherapy Related Research, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Gill Barnett
- University of Cambridge Department of Oncology, Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | | | - Adam S. Kibel
- Division of Urologic Surgery, Brigham and Womens Hospital, Boston, MA, USA
| | | | - Olivier Cussenot
- GRC 5 Predictive Onco-Urology, Sorbonne Université, Paris, France
- CeRePP, Paris, France
| | | | - Florence Menegaux
- Exposome and Heredity, CESP (UMR 1018), Paris-Saclay Medical School, Paris-Saclay University, Inserm, Gustave Roussy, Villejuif, France
| | - Thérèse Truong
- Exposome and Heredity, CESP (UMR 1018), Paris-Saclay Medical School, Paris-Saclay University, Inserm, Gustave Roussy, Villejuif, France
| | - Yves Akoli Koudou
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif Cédex, France
| | - Esther M. John
- Department of Medicine, Stanford Cancer Institute,Stanford University School of Medicine, Stanford, CA, USA
| | | | - Lovise Maehle
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, UK
| | - Sue A. Ingles
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Mariana C Stern
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago De Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago De Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Laura Fachal
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago De Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Spain
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain
| | - Barry S. Rosenstein
- Department of Radiation Oncology and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah L. Kerns
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Harry Ostrer
- Professor of Pathology and Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Manuel R. Teixeira
- Department of Laboratory Genetics, Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center, Porto, Portugal
- Cancer Genetics Group, IPO Porto Research Center (CI-IPOP) / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center, Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Paula Paulo
- Cancer Genetics Group, IPO Porto Research Center (CI-IPOP) / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center, Porto, Portugal
| | - Andreia Brandão
- Cancer Genetics Group, IPO Porto Research Center (CI-IPOP) / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center, Porto, Portugal
| | | | | | - Jeannette T. Bensen
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ebonee N. Butler
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James L. Mohler
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jack A. Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Laboratory of Molecular Carcinogenesis, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Trinidad Dierssen-Sotos
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria-IDIVAL, Santander, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lisa Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Craig C. Teerlink
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Chad D. Huff
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Patrick Pilie
- Department of Genitourinary Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Yao Yu
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Ryan J. Bohlender
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Jian Gu
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Sara S. Strom
- The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Luc Multigner
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Rennes, France
| | - Pascal Blanchet
- CHU de Pointe-à-Pitre, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Pointe-à-Pitre, France
| | - Laurent Brureau
- CHU de Pointe-à-Pitre, Univ Antilles, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Pointe-à-Pitre, France
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Chavdar Slavov
- Department of Urology and Alexandrovska University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Vanio Mitev
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Robin J. Leach
- Department of Cell Systems and Anatomy and Mays Cancer Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Xuechen Chen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric A. Klein
- Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
- Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ann W. Hsing
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Adam B. Murphy
- Department of Urology, Northwestern University, Chicago, IL, USA
| | - Christopher J. Logothetis
- The University of Texas M. D. Anderson Cancer Center, Department of Genitourinary Medical Oncology, Houston, TX, USA
| | - Jeri Kim
- The University of Texas M. D. Anderson Cancer Center, Department of Genitourinary Medical Oncology, Houston, TX, USA
| | - Susan L. Neuhausen
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - William B. Isaacs
- James Buchanan Brady Urological Institute, Johns Hopkins Hospital and Medical Institution, Baltimore, MD, USA
| | - Barbara Nemesure
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anselm J.M. Hennis
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
- Chronic Disease Research Centre and Faculty of Medical Sciences, University of the West Indies, Bridgetown, Barbados
| | - John Carpten
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Kim De Ruyck
- Ghent University, Faculty of Medicine and Health Sciences, Basic Medical Sciences, Ghent, Belgium
| | - Gert De Meerleer
- Ghent University Hospital, Department of Radiotherapy, Ghent, Belgium
| | - Piet Ost
- Ghent University Hospital, Department of Radiotherapy, Ghent, Belgium
| | - Jianfeng Xu
- Program for Personalized Cancer Care and Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA
| | - Azad Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Cancer Research Malaysia (CRM), Outpatient Centre, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Lisa F. Newcomb
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Daniel W. Lin
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Jay H. Fowke
- Department of Preventive Medicine, Division of Epidemiology,The University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Benjamin A. Rybicki
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, Detroit, MI, USA
| | - Marija Gamulin
- Division of Medical Oncology, Urogenital Unit, Department of Oncology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Davor Lessel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Nawaid Usmani
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Aswin Abraham
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Sandeep Singhal
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Parliament
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Van den Broeck
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Leuven, Belgium
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, Santiago de Compostela, Spain
- University of California San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica Galicia Sur (IISGS), Vigo (Pontevedra), Spain
| | - Maria Elena Martinez
- University of California San Diego, Moores Cancer Center, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Samantha Larkin
- Scientific Education Support, Thames Ditton, Surrey, Formerly Cancer Sciences, University of Southampton, Southampton, UK
| | - Paul A. Townsend
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | | | - William S. Bush
- Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Melinda C. Aldrich
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dana C. Crawford
- Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
| | - Shiv Srivastava
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University Medical Center, Washington, DC, USA
| | - Jennifer Cullen
- Department of Population and Quantitative Health Sciences, Cleveland Institute for Computational Biology, Case Western Reserve University, Cleveland, OH, USA
- Department of Surgery, Center for Prostate Disease Research,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Gyorgy Petrovics
- Department of Surgery, Center for Prostate Disease Research,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Graham Casey
- Department of Public Health Science, Center for Public Health Genomics,University of Virginia, Charlottesville, VA, USA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Kennesaw, GA, USA
| | - Yao Tettey
- Korle Bu Teaching Hospital, Accra, Ghana
- Department of Pathology, University of Ghana, Accra, Ghana
| | - Joseph Lachance
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Wei Tang
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | | | - Andrew A. Adjei
- Department of Pathology, University of Ghana Medical School, Accra, Ghana
| | - Evelyn Tay
- Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | - Kosj Yamoah
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | | | | | - Jacob M. Keaton
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Center for Precision Health Research, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jacklyn N. Hellwege
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Nashville, TN, USA
| | - Peter E. Clark
- Atrium Health/Levine Cancer Institute, Charlotte, NC, USA
| | | | | | | | - Olufemi Ogunbiyi
- Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olayiwola Shittu
- Department of Surgery, College of Medicine, University of Ibadan and Univerity College Hospital, Ibadan, Nigeria
| | - Olukemi Amodu
- Institute of Child Health, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Akindele O. Adebiyi
- Clinical Epidemiology Unit, Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oseremen I. Aisuodionoe-Shadrach
- College of Health Sciences, University of Abuja, University of Abuja Teaching Hospital and Cancer Science Center, Abuja, Nigeria
| | - Hafees O. Ajibola
- College of Health Sciences, University of Abuja, University of Abuja Teaching Hospital and Cancer Science Center, Abuja, Nigeria
| | - Mustapha A. Jamda
- College of Health Sciences, University of Abuja, University of Abuja Teaching Hospital and Cancer Science Center, Abuja, Nigeria
| | - Olabode P. Oluwole
- College of Health Sciences, University of Abuja, University of Abuja Teaching Hospital and Cancer Science Center, Abuja, Nigeria
| | - Maxwell Nwegbu
- College of Health Sciences, University of Abuja, University of Abuja Teaching Hospital and Cancer Science Center, Abuja, Nigeria
| | | | | | | | - Halimatou Diop
- Laboratoires Bacteriologie et Virologie, Hôpital Aristide Le Dantec, Dakar, Senegal
| | - Susan M. Gundell
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Monique J. Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Guido Jenster
- Department of Urology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ron H.N. van Schaik
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Jennifer J. Hu
- The University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA
| | - Linda Kachuri
- Department of Epidemiology and Population Health, Stanford Cancer Institute, Stanford, CA, USA
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Roberta McKean-Cowdin
- Department of Population and Public Health Sciences, Keck School of Medicine,University of Southern California, Los Angeles, CA, USA
| | - Mina Torres
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Michael H. Preuss
- The Charles Bronfman Institute for Personalized Medicine,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruth J.F. Loos
- The Charles Bronfman Institute for Personalized Medicine,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew Zawistowski
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Sebastian Zöllner
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Zeyun Lu
- Department of Population and Public Health Sciences, Keck School of Medicine,University of Southern California, Los Angeles, CA, USA
| | | | - Douglas F. Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology,, Cambridge, UK
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Todd L. Edwards
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Reedik Mägi
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Timothy R. Rebbeck
- Harvard TH Chan School of Public Health and Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, USA
| | - Lars Fritsche
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Sonja I. Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Hidewaki Nakagawa
- Laboratory for Cancer Genomics, RIKEN Center of Integrative Medical Sciences, Yokohama, Japan
| | - John S. Witte
- Department of Epidemiology and Population Health, Stanford Cancer Institute, Stanford, CA, USA
- Departments of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - J. Michael Gaziano
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | | | - Nick Mancuso
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Clinical Research Center, Shizuoka General Hospital, Shizuoka, Japan
- The Department of Applied Genetics, School of Pharmaceutical Sciences, Shizuoka, Japan
| | - Rosalind A. Eeles
- The Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | | | | | - David V. Conti
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christopher A. Haiman
- Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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2
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Naderi E, Aguado-Barrera ME, Schack LMH, Dorling L, Rattay T, Fachal L, Summersgill H, Martínez-Calvo L, Welsh C, Dudding T, Odding Y, Varela-Pazos A, Jena R, Thomson DJ, Steenbakkers RJHM, Dennis J, Lobato-Busto R, Alsner J, Ness A, Nutting C, Gómez-Caamaño A, Eriksen JG, Thomas SJ, Bates AM, Webb AJ, Choudhury A, Rosenstein BS, Taboada-Valladares B, Herskind C, Azria D, Dearnaley DP, de Ruysscher D, Sperk E, Hall E, Stobart H, Chang-Claude J, De Ruyck K, Veldeman L, Altabas M, De Santis MC, Farcy-Jacquet MP, Veldwijk MR, Sydes MR, Parliament M, Usmani N, Burnet NG, Seibold P, Symonds RP, Elliott RM, Bultijnck R, Gutiérrez-Enríquez S, Mollà M, Gulliford SL, Green S, Rancati T, Reyes V, Carballo A, Peleteiro P, Sosa-Fajardo P, Parker C, Fonteyne V, Johnson K, Lambrecht M, Vanneste B, Valdagni R, Giraldo A, Ramos M, Diergaarde B, Liu G, Leal SM, Chua MLK, Pring M, Overgaard J, Cascallar-Caneda LM, Duprez F, Talbot CJ, Barnett GC, Dunning AM, Vega A, Andreassen CN, Langendijk JA, West CML, Alizadeh BZ, Kerns SL. Large-scale meta-genome-wide association study reveals common genetic factors linked to radiation-induced acute toxicities across cancer types. JNCI Cancer Spectr 2023; 7:pkad088. [PMID: 37862240 PMCID: PMC10653584 DOI: 10.1093/jncics/pkad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/18/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND This study was designed to identify common genetic susceptibility and shared genetic variants associated with acute radiation-induced toxicity across 4 cancer types (prostate, head and neck, breast, and lung). METHODS A genome-wide association study meta-analysis was performed using 19 cohorts totaling 12 042 patients. Acute standardized total average toxicity (STATacute) was modelled using a generalized linear regression model for additive effect of genetic variants, adjusted for demographic and clinical covariates (rSTATacute). Linkage disequilibrium score regression estimated shared single-nucleotide variation (SNV-formerly SNP)-based heritability of rSTATacute in all patients and for each cancer type. RESULTS Shared SNV-based heritability of STATacute among all cancer types was estimated at 10% (SE = 0.02) and was higher for prostate (17%, SE = 0.07), head and neck (27%, SE = 0.09), and breast (16%, SE = 0.09) cancers. We identified 130 suggestive associated SNVs with rSTATacute (5.0 × 10‒8 < P < 1.0 × 10‒5) across 25 genomic regions. rs142667902 showed the strongest association (effect allele A; effect size ‒0.17; P = 1.7 × 10‒7), which is located near DPPA4, encoding a protein involved in pluripotency in stem cells, which are essential for repair of radiation-induced tissue injury. Gene-set enrichment analysis identified 'RNA splicing via endonucleolytic cleavage and ligation' (P = 5.1 × 10‒6, P = .079 corrected) as the top gene set associated with rSTATacute among all patients. In silico gene expression analysis showed that the genes associated with rSTATacute were statistically significantly up-regulated in skin (not sun exposed P = .004 corrected; sun exposed P = .026 corrected). CONCLUSIONS There is shared SNV-based heritability for acute radiation-induced toxicity across and within individual cancer sites. Future meta-genome-wide association studies among large radiation therapy patient cohorts are worthwhile to identify the common causal variants for acute radiotoxicity across cancer types.
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Affiliation(s)
- Elnaz Naderi
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
- Center for Statistical Genetics, Gertrude H. Sergievsky Center, and the Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Miguel E Aguado-Barrera
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
| | - Line M H Schack
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Oncology, Gødstrup Hospital, Herning, Denmark
- NIDO | Centre for Research and Education, Gødstrup Hospital, Herning, Denmark
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tim Rattay
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Laura Fachal
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Holly Summersgill
- Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK
| | - Laura Martínez-Calvo
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ceilidh Welsh
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Tom Dudding
- Bristol Dental School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Yasmin Odding
- Bristol Cancer Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Ana Varela-Pazos
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Rajesh Jena
- Department of Oncology, Addenbrooke’s Hospital, University of Cambridge, Cambridge, UK
| | - David J Thomson
- Division of Cancer Sciences, University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Roel J H M Steenbakkers
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Ramón Lobato-Busto
- Department of Medical Physics, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Andy Ness
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Chris Nutting
- Head and Neck Unit, The Royal Marsden Hospital, London, UK
| | - Antonio Gómez-Caamaño
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Jesper G Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Steve J Thomas
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Amy M Bates
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Adam J Webb
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Ananya Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Begona Taboada-Valladares
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Carsten Herskind
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - David Azria
- Fédération Universitaire d’Oncologie Radiothérapie d’Occitanie Méditérranée, Département d’Oncologie Radiothérapie, ICM Montpellier, INSERM U1194 IRCM, University of Montpellier, Montpellier, France
| | - David P Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Dirk de Ruysscher
- MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Elena Sperk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Hilary Stobart
- Patient Advocate, Independent Cancer Patients’ Voice, London, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kim De Ruyck
- Departments of Basic Medical Sciences and Radiotherapy, Ghent University Hospital, Ghent, Belgium
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Manuel Altabas
- Radiation Oncology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | - Marie-Pierre Farcy-Jacquet
- Fédération Universitaire d’Oncologie Radiothérapie d’Occitanie Méditérranée, Département d’Oncologie Radiothérapie, CHU Carémeau, Nîmes, France
| | - Marlon R Veldwijk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Matthew Parliament
- Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | - Nawaid Usmani
- Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | | | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - R Paul Symonds
- Cancer Research Centre, University of Leicester, Leicester, UK
| | - Rebecca M Elliott
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Sara Gutiérrez-Enríquez
- Hereditary Cancer Genetics Group, Vall d’Hebron Institute of Oncology, Vall d’Hebron Hospital Campus, Barcelona, Spain
| | - Meritxell Mollà
- Radiation Oncology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sarah L Gulliford
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Sheryl Green
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Tiziana Rancati
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Victoria Reyes
- Radiation Oncology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ana Carballo
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Paula Peleteiro
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Paloma Sosa-Fajardo
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Chris Parker
- Department of Medical Physics and Biomedical Engineering, University College London, UK
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Kerstie Johnson
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | | | - Ben Vanneste
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
- Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Riccardo Valdagni
- Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alexandra Giraldo
- Radiation Oncology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Mónica Ramos
- Radiation Oncology Department, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Brenda Diergaarde
- Department of Human Genetics, School of Public Health, University of Pittsburgh, UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, Temerty Faculty of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Suzanne M Leal
- Center for Statistical Genetics, Gertrude H. Sergievsky Center, and the Department of Neurology, Columbia University Medical Center, New York, NY, USA
- Taub Institute for Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Melvin L K Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore
- Duke-NUS Medical School, Oncology Academic Clinical Programme, Singapore
| | - Miranda Pring
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Luis M Cascallar-Caneda
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Fréderic Duprez
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Christopher J Talbot
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Gillian C Barnett
- Department of Oncology, Addenbrooke’s Hospital, University of Cambridge, Cambridge, UK
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Christian Nicolaj Andreassen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Johannes A Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Catharine M L West
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust Hospital, Manchester, UK
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Sarah L Kerns
- Department of Radiation Oncology, The Medical College of Wisconsin, Milwaukee, WI, USA
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3
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Kerns SL, Hall WA, Marples B, West CML. Normal Tissue Toxicity Prediction: Clinical Translation on the Horizon. Semin Radiat Oncol 2023; 33:307-316. [PMID: 37331785 DOI: 10.1016/j.semradonc.2023.03.010] [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: 06/20/2023]
Abstract
Improvements in radiotherapy delivery have enabled higher therapeutic doses and improved efficacy, contributing to the growing number of long-term cancer survivors. These survivors are at risk of developing late toxicity from radiotherapy, and the inability to predict who is most susceptible results in substantial impact on quality of life and limits further curative dose escalation. A predictive assay or algorithm for normal tissue radiosensitivity would allow more personalized treatment planning, reducing the burden of late toxicity, and improving the therapeutic index. Progress over the last 10 years has shown that the etiology of late clinical radiotoxicity is multifactorial and informs development of predictive models that combine information on treatment (eg, dose, adjuvant treatment), demographic and health behaviors (eg, smoking, age), co-morbidities (eg, diabetes, collagen vascular disease), and biology (eg, genetics, ex vivo functional assays). AI has emerged as a useful tool and is facilitating extraction of signal from large datasets and development of high-level multivariable models. Some models are progressing to evaluation in clinical trials, and we anticipate adoption of these into the clinical workflow in the coming years. Information on predicted risk of toxicity could prompt modification of radiotherapy delivery (eg, use of protons, altered dose and/or fractionation, reduced volume) or, in rare instances of very high predicted risk, avoidance of radiotherapy. Risk information can also be used to assist treatment decision-making for cancers where efficacy of radiotherapy is equivalent to other treatments (eg, low-risk prostate cancer) and can be used to guide follow-up screening in instances where radiotherapy is still the best choice to maximize tumor control probability. Here, we review promising predictive assays for clinical radiotoxicity and highlight studies that are progressing to develop an evidence base for clinical utility.
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Affiliation(s)
- Sarah L Kerns
- Department of Radiation Oncology, the Medical College of Wisconsin, Milwaukee, WI.
| | - William A Hall
- Department of Radiation Oncology, the Medical College of Wisconsin, Milwaukee, WI
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY
| | - Catharine M L West
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
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4
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Groves AM, Paris N, Hernady E, Johnston CJ, Aljitawi O, Lee YF, Kerns SL, Marples B. Prevention of Radiation-Induced Bladder Injury: A Murine Study Using Captopril. Int J Radiat Oncol Biol Phys 2023; 115:972-982. [PMID: 36400304 DOI: 10.1016/j.ijrobp.2022.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE Pelvic radiation therapy (RT) can cause debilitating bladder toxicities but few clinical interventions exist to prevent injury or alleviate symptoms. From a large genome-wide association study in patients with prostate cancer it was previously reported that SNPs tagging AGT, part of the renin-angiotensin system (RAS), correlated with patient-reported late hematuria, identifying a potential targetable pathway to prevent RT-induced bladder injury. To investigate this association, we performed a preclinical study to determine whether RAS modulation protected the bladder against RT injury. METHODS AND MATERIALS C57BL/6 male mice were treated with an oral angiotensin converting enzyme inhibitor (ACEi: 0.3g/L captopril) 5 days before focal bladder X-irradiation with either single dose (SD) 30 Gy or 3 fractions of 8 Gy (8 Gy × 3 in 5 days). RT was delivered using XStrahl SARRP Muriplan CT-image guidance with parallel-opposed lateral beams. ACEi was maintained for 20 weeks post RT. Bladder toxicity was assessed using assays to identify local injury that included urinalysis, functional micturition, bladder-released exosomes, and histopathology, as well as an assessment of systemic changes in inflammatory-mediated circulating immune cells. RESULTS SD and fractionated RT increased urinary frequency and reduced the volume of individual voids at >14 weeks, but not at 4 weeks, compared with nonirradiated animals. Urothelial layer width was positively correlated with mean volume of individual voids (P = .0428) and negatively correlated with number of voids (P = .028), relating urothelial thinning to changes in RT-mediated bladder dysfunction. These chronic RT-induced changes in micturition patterns were prevented by captopril treatment. Focal bladder irradiation significantly increased the mean particle count of urine extracellular vesicles and the monocyte and neutrophil chemokines CCL2 and MIP-2, and the proportions of circulating inflammatory-mediated neutrophils and monocytes, which was also prevented by captopril. Exploratory transcriptomic analysis of bladder tissue implicated inflammatory and erythropoietic pathways. CONCLUSIONS This study demonstrated that systemic modulation of the RAS protected against and alleviated RT-induced late bladder injury but larger confirmatory studies are needed.
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Affiliation(s)
- Angela M Groves
- Departments of Radiation Oncology, University of Rochester, Rochester, New York
| | - Nicole Paris
- Departments of Radiation Oncology, University of Rochester, Rochester, New York
| | - Eric Hernady
- Departments of Radiation Oncology, University of Rochester, Rochester, New York
| | - Carl J Johnston
- Departments of Pediatrics, University of Rochester, Rochester, New York
| | - Omar Aljitawi
- Departments of Medicine, Hematology/Oncology, University of Rochester, Rochester, New York
| | - Yi-Fen Lee
- Departments of Urology, University of Rochester, Rochester, New York
| | - Sarah L Kerns
- Departments of Radiation Oncology, University of Rochester, Rochester, New York
| | - Brian Marples
- Departments of Radiation Oncology, University of Rochester, Rochester, New York.
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5
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Kerns SL, Williams JP, Marples B. Modeling normal bladder injury after radiation therapy. Int J Radiat Biol 2023; 99:1046-1054. [PMID: 36854008 PMCID: PMC10330568 DOI: 10.1080/09553002.2023.2182000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE For decades, Dr. John Moulder has been a leading radiation biologist and one of the few who consistently supported the study of normal tissue responses to radiation. His meticulous modeling and collaborations across the field have offered a prime example of how research can be taken from the bench to the bedside and back, with the ultimate goal of providing benefit to patients. Much of the focus of John's work was on mitigating damage to the kidney, whether as the result of accidental or deliberate clinical exposures. Following in his footsteps, we offer here a brief overview of work conducted in the field of radiation-induced bladder injury. We then describe our own preclinical experimental studies which originated as a response to reports from a clinical genome-wide association study (GWAS) investigating genomic biomarkers of normal tissue toxicity in prostate cancer patients treated with radiotherapy. In particular, we discuss the use of Renin-Angiotensin System (RAS) inhibitors as modulators of injury, agents championed by the Moulder group, and how RAS inhibitors are associated with a reduction in some measures of toxicity. Using a murine model, along with precise CT-image guided irradiation of the bladder using single and fractionated dosing regimens, we have been able to demonstrate radiation-induced functional injury to the bladder and mitigation of this functional damage by an inhibitor of angiotensin-converting enzyme targeting the RAS, an experimental approach akin to that used by the Moulder group. We consider our scientific trajectory as a bedside-to-bench approach because the observation was made clinically and investigated in a preclinical model; this experimental approach aligns with the exemplary career of Dr. John Moulder. CONCLUSIONS Despite the differences in functional endpoints, recent findings indicate a commonality between bladder late effects and the work in kidney pioneered by Dr. John Moulder. We offer evidence that targeting the RAS pathway may provide a targetable pathway to reducing late bladder toxicity.
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Affiliation(s)
- Sarah L. Kerns
- Department of Department of Radiation Oncology, the Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jacqueline P. Williams
- Departments of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
- Departments of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Brian Marples
- Departments of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
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Heumann P, Aguado-Barrera ME, Avuzzi B, Azria D, Briers E, Bultijnck R, Choudhury A, De Ruysscher D, Farcy-Jacquet MP, Fonteyne V, Gómez Caamaño A, Helmbold I, Johnson K, Kerns SL, Lambrecht M, Lingard Z, Rancati T, Rosenstein BS, Sperk E, Paul Symonds R, Talbot C, Valdagni R, Vega A, Veldeman L, Ward T, Webb A, West CM, Chang-Claude J, Seibold P. Comparing symptom reporting by prostate cancer patients and healthcare professionals in the international multicentre REQUITE study. Radiother Oncol 2023; 178:109426. [PMID: 36442608 DOI: 10.1016/j.radonc.2022.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Previous studies showed that healthcare professionals and patients had only moderate to low agreement on their assessment of treatment-related symptoms. We aimed to determine the levels of agreement in a large cohort of prostate cancer patients. METHODS Analyses were made of data from 1,756 prostate cancer patients treated with external beam radiotherapy (RT) and/or brachytherapy in Europe and the USA and recruited into the prospective multicentre observational REQUITE study. Eleven pelvic symptoms at the end of RT were compared after translating patient-reported outcomes (PROs) into CTCAE-based healthcare professional ratings. Gwet's AC2 agreement coefficient and 95% confidence intervals were calculated for each symptom. To compare severity of grading between patients and healthcare professionals, percent agreement and deviations for each symptom were graphically depicted. Stratified and sensitivity analyses were conducted to identify potential influencing factors and to assess heterogeneity and robustness of results. RESULTS The agreement for the 11 pelvic symptoms varied from very good (AC2 > 0.8: haematuria, rectal bleeding, management of sphincter control) to poor agreement (AC2 ≤ 0.2: proctitis and urinary urgency). Fatigue had a negative impact on the agreement. Patients tended to grade symptoms more severely than healthcare professionals. Information on sexual dysfunction was missing more frequently in healthcare professional assessment than PROs. CONCLUSION Agreement was better for observable than subjective symptoms, with patients usually grading symptoms more severely than healthcare professionals. Our findings emphasize that PROs should complement symptom assessment by healthcare professionals and be taken into consideration for clinical decision-making to incorporate the patient perspective.
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Affiliation(s)
- Philipp Heumann
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
| | - Miguel E Aguado-Barrera
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica (FPGMX), Santiago de Compostela, Spain.
| | - Barbara Avuzzi
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - David Azria
- Federation Universitaire d'Oncologie Radiothérapie d'Occitanie Méditerranée, Univ Montpellier, INSERM U1194 IRCM, Institut du Cancer Montpellier (ICM), Montpellier, France.
| | | | - Renée Bultijnck
- Ghent University Hospital, Belgium; Ghent University, Ghent, Belgium.
| | | | | | - Marie-Pierre Farcy-Jacquet
- Federation Universitaire d'Oncologie Radiothérapie d'Occitanie Méditerranée, Institut du Cancer Du Gard (ICG), CHU Carémeau, Nîmes, France.
| | - Valérie Fonteyne
- Ghent University Hospital, Belgium; Ghent University, Ghent, Belgium.
| | - Antonio Gómez Caamaño
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain.
| | - Irmgard Helmbold
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
| | - Kerstie Johnson
- Department of Genetics & Cancer Sciences, University of Leicester, UK.
| | | | | | - Zoe Lingard
- University of Manchester, Christie Hospital, Manchester, UK.
| | - Tiziana Rancati
- Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Barry S Rosenstein
- The Department of Radiation Oncology and the Department of Genetics & Genomic Sciences, Icahn School of Medicine, New York, USA.
| | - Elena Sperk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - R Paul Symonds
- Department of Genetics & Cancer Sciences, University of Leicester, UK.
| | | | - Riccardo Valdagni
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.
| | - Ana Vega
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica (FPGMX), Santiago de Compostela, Spain; Biomedical Network on Rare Diseases (CIBERER), Spain.
| | - Liv Veldeman
- Ghent University Hospital, Belgium; Ghent University, Ghent, Belgium.
| | | | - Adam Webb
- Department of Genetics & Cancer Sciences, University of Leicester, UK.
| | | | - Jenny Chang-Claude
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany; University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany.
| | - Petra Seibold
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany.
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7
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van der Weijst L, Azria D, Berkovic P, Boisselier P, Briers E, Bultijnck R, Chang-Claude J, Choudhury A, Defraene G, Demontois S, Elliott RM, Ennis D, Faivre-Finn C, Franceschini M, Giandini T, Giraldo A, Gutiérrez-Enríquez S, Herskind C, Higginson DS, Kerns SL, Johnson K, Lambrecht M, Lang P, Ramos M, Rancati T, Rimner A, Rosenstein BS, De Ruysscher D, Salem A, Sangalli C, Seibold P, Sosa Fajardo P, Sperk E, Stobart H, Summersgill H, Surmont V, Symonds P, Taboada-Valladares B, Talbot CJ, Vega A, Veldeman L, Veldwijk MR, Ward T, Webb A, West CML, Lievens Y. The correlation between pre-treatment symptoms, acute and late toxicity and patient-reported health-related quality of life in non-small cell lung cancer patients: Results of the REQUITE study. Radiother Oncol 2022; 176:127-137. [PMID: 36195214 PMCID: PMC10404651 DOI: 10.1016/j.radonc.2022.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/16/2022] [Accepted: 09/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE To investigate the association between clinician-scored toxicities and patient-reported health-related quality of life (HRQoL), in early-stage (ES-) and locally-advanced (LA-) non-small cell lung cancer (NSCLC) patients receiving loco-regional radiotherapy, included in the international real-world REQUITE study. MATERIALS AND METHODS Clinicians scored eleven radiotherapy-related toxicities (and baseline symptoms) with the Common Terminology Criteria for Adverse Events version 4. HRQoL was assessed with the European Organization for Research and Treatment of Cancer core HRQoL questionnaire (EORTC-QLQ-C30). Statistical analyses used the mixed-model method; statistical significance was set at p = 0.01. Analyses were performed for baseline and subsequent time points up to 2 years after radiotherapy and per treatment modality, radiotherapy technique and disease stage. RESULTS Data of 435 patients were analysed. Pre-treatment, overall symptoms, dyspnea, chest wall pain, dysphagia and cough impacted overall HRQoL and specific domains. At subsequent time points, cough and dysphagia were overtaken by pericarditis in affecting HRQoL. Toxicities during concurrent chemo-radiotherapy and 3-dimensional radiotherapy had the most impact on HRQoL. Conversely, toxicities in sequential chemo-radiotherapy and SBRT had limited impact on patients' HRQoL. Stage impacts the correlations: LA-NSCLC patients are more adversely affected by toxicity than ES-NSCLC patients, mimicking the results of radiotherapy technique and treatment modality. CONCLUSION Pre-treatment symptoms and acute/late toxicities variously impact HRQoL of ES- and LA-NSCLC patients undergoing different treatment approaches and radiotherapy techniques. Throughout the disease, dyspnea seems crucial in this association, highlighting the additional effect of co-existing comorbidities. Our data call for optimized radiotherapy limiting toxicities that may affect patients' HRQoL.
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Affiliation(s)
- Lotte van der Weijst
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium.
| | - David Azria
- Federation Universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, Univ Montpellier, IRCM Inserm U1194, ICM, Montpellier, France
| | - Patrick Berkovic
- Department of Radiotherapy-oncology, Leuvens Kanker Instituut, UZ Leuven, Leuven, Belgium
| | - Pierre Boisselier
- Federation Universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, Univ Montpellier, IRCM Inserm U1194, ICM, Montpellier, France
| | | | - Renée Bultijnck
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany
| | - Ananya Choudhury
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, United Kingdom
| | - Gilles Defraene
- Laboratory of Experimental Radiotherapy, Department of Oncology, KULEUVEN, Leuven, Belgium
| | - Sylvian Demontois
- Federation Universitaire d'oncologie radiothérapie d'Occitanie Méditerranée, Univ Montpellier, IRCM Inserm U1194, ICM, Montpellier, France
| | - Rebecca M Elliott
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, United Kingdom
| | - Dawn Ennis
- Royal Derby Hospital, Derby DE22 3NE, United Kingdom
| | - Corinne Faivre-Finn
- University of Manchester, UK, The Christie NHS Foundation Trust, United Kingdom
| | - Marzia Franceschini
- Unit of Radiation Oncology 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tommaso Giandini
- Unit of Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alexandra Giraldo
- Radiation Oncology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sara Gutiérrez-Enríquez
- Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Carsten Herskind
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel S Higginson
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, United States
| | - Sarah L Kerns
- Departments of Radiation Oncology and Surgery, University of Rochester Medical Center, Rochester, New York, NY, United States
| | - Kerstie Johnson
- Leicester Cancer Research Centre, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Maarten Lambrecht
- Department of Radiotherapy-oncology, Leuvens Kanker Instituut, UZ Leuven, Leuven, Belgium
| | - Philippe Lang
- Federation Universitaire d'oncologie radiothérapie d'Occitanie, ICG CHU Caremeau, Nîmes, France
| | - Mónica Ramos
- Radiation Oncology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andreas Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, United States
| | - Barry S Rosenstein
- Department of Radiation Oncology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Dirk De Ruysscher
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Ahmed Salem
- University of Manchester, UK, The Christie NHS Foundation Trust, United Kingdom; Department of Basic Medical Sciences, School of Medicine, Hashemite University, Zarqa, Jordan
| | - Claudia Sangalli
- Unit of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paloma Sosa Fajardo
- Department of Radiation Oncology, Hospital Clínico Universitario de Santiago, SERGAS.Instituto de Investigación Sanitaria de Santiago de Compostela, Spain
| | - Elena Sperk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Holly Summersgill
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, United Kingdom
| | - Veerle Surmont
- Department of Respiratory Medicine, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Paul Symonds
- Leicester Cancer Research Centre, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Begoña Taboada-Valladares
- Department of Radiation Oncology, Hospital Clínico Universitario de Santiago, SERGAS.Instituto de Investigación Sanitaria de Santiago de Compostela, Spain
| | - Christopher J Talbot
- Leicester Cancer Research Centre, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica, Grupo de Medicina Xenómica (USC), Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Biomedical Network on Rare Diseases (CIBERER), Spain
| | - Liv Veldeman
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
| | - Marlon R Veldwijk
- Department of Radiation Oncology, Universitätsklinikum Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tim Ward
- Trustee Pelvic Radiation Disease Association, NCRI CTRad Consumer, United Kingdom
| | - Adam Webb
- Department of Genetics and Genome Biology, University of Leicester, United Kingdom
| | - Catharine M L West
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, United Kingdom
| | - Yolande Lievens
- Department of Radiation Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium
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8
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Barnett GC, Kerns SL, Dorling L, Fachal L, Aguado-Barrera ME, Martínez-Calvo L, Jandu HK, Welsh C, Tyrer J, Coles CE, Haviland JS, Parker C, Gómez-Caamaño A, Calvo-Crespo P, Sosa-Fajardo P, Burnet NG, Summersgill H, Webb A, De Ruysscher D, Seibold P, Chang-Claude J, Talbot CJ, Rattay T, Parliament M, De Ruyck K, Rosenstein BS, Pharoah PDP, Dunning AM, Vega A, West CML. No Association Between Polygenic Risk Scores for Cancer and Development of Radiation Therapy Toxicity. Int J Radiat Oncol Biol Phys 2022; 114:494-501. [PMID: 35840111 DOI: 10.1016/j.ijrobp.2022.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/16/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Our aim was to test whether updated polygenic risk scores (PRS) for susceptibility to cancer affect risk of radiation therapy toxicity. METHODS AND MATERIALS Analyses included 9,717 patients with breast (n=3,078), prostate (n=5,748) or lung (n=891) cancer from Radiogenomics and REQUITE Consortia cohorts. Patients underwent potentially curative radiation therapy and were assessed prospectively for toxicity. Germline genotyping involved genome-wide single nucleotide polymorphism (SNP) arrays with nontyped SNPs imputed. PRS for each cancer were generated by summing literature-identified cancer susceptibility risk alleles: 352 breast, 136 prostate, and 24 lung. Weighted PRS were generated using log odds ratio (ORs) for cancer susceptibility. Standardized total average toxicity (STAT) scores at 2 and 5 years (breast, prostate) or 6 to 12 months (lung) quantified toxicity. Primary analysis tested late STAT, secondary analyses investigated acute STAT, and individual endpoints and SNPs using multivariable regression. RESULTS Increasing PRS did not increase risk of late toxicity in patients with breast (OR, 1.000; 95% confidence interval [CI], 0.997-1.002), prostate (OR, 0.99; 95% CI, 0.98-1.00; weighted PRS OR, 0.93; 95% CI, 0.83-1.03), or lung (OR, 0.93; 95% CI, 0.87-1.00; weighted PRS OR, 0.68; 95% CI, 0.45-1.03) cancer. Similar results were seen for acute toxicity. Secondary analyses identified rs138944387 associated with breast pain (OR, 3.05; 95% CI, 1.86-5.01; P = 1.09 × 10-5) and rs17513613 with breast edema (OR, 0.94; 95% CI, 0.92-0.97; P = 1.08 × 10-5). CONCLUSIONS Patients with increased polygenic predisposition to breast, prostate, or lung cancer can safely undergo radiation therapy with no anticipated excess toxicity risk. Some individual SNPs increase the likelihood of a specific toxicity endpoint, warranting validation in independent cohorts and functional studies to elucidate biologic mechanisms.
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Affiliation(s)
- Gillian C Barnett
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, United Kingdom.
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Laura Fachal
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom; Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Miguel E Aguado-Barrera
- Fundación Pública Galega de Medicina Xenómica (FPGMX)-SERGAS, Santiago de Compostela, A Coruña, Spain; Grupo Genética en Cáncer y Enfermedades Raras, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Laura Martínez-Calvo
- Fundación Pública Galega de Medicina Xenómica (FPGMX)-SERGAS, Santiago de Compostela, A Coruña, Spain; Grupo Genética en Cáncer y Enfermedades Raras, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain
| | - Harkeran K Jandu
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Ceilidh Welsh
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Jonathan Tyrer
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Charlotte E Coles
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, United Kingdom
| | - Joanne S Haviland
- Clinical Trials and Statistics Unit, Institute of Cancer Research, London, United Kingdom
| | - Christopher Parker
- Institute of Cancer Research & Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain
| | - Patricia Calvo-Crespo
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain
| | - Paloma Sosa-Fajardo
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain
| | - Neil G Burnet
- Proton Beam Therapy Centre, Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Holly Summersgill
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Adam Webb
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Dirk De Ruysscher
- Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands; Radiation Oncology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany
| | - Christopher J Talbot
- Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Tim Rattay
- Leicester Cancer Research Centre, University of Leicester, Leicester, United Kingdom
| | - Matthew Parliament
- Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Kim De Ruyck
- Departments of Basic Medical Sciences and Radiotherapy, Ghent University Hospital, Ghent, Belgium
| | - Barry S Rosenstein
- Departments of Radiation Oncology and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom
| | - Ana Vega
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom; Fundación Pública Galega de Medicina Xenómica (FPGMX)-SERGAS, Santiago de Compostela, A Coruña, Spain; Biomedical Network on Rare Diseases (CIBERER), Spain
| | - Catharine M L West
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom
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9
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Webb AJ, Harper E, Rattay T, Aguado-Barrera ME, Azria D, Bourgier C, Brengues M, Briers E, Bultijnck R, Chang-Claude J, Choudhury A, Cicchetti A, De Ruysscher D, De Santis MC, Dunning AM, Elliott RM, Fachal L, Gómez-Caamaño A, Gutiérrez-Enríquez S, Johnson K, Lobato-Busto R, Kerns SL, Post G, Rancati T, Reyes V, Rosenstein BS, Seibold P, Seoane A, Sosa-Fajardo P, Sperk E, Taboada-Valladares B, Valdagni R, Vega A, Veldeman L, Ward T, West CM, Symonds RP, Talbot CJ. Treatment time and circadian genotype interact to influence radiotherapy side-effects. A prospective European validation study using the REQUITE cohort. EBioMedicine 2022; 84:104269. [PMID: 36130474 PMCID: PMC9486558 DOI: 10.1016/j.ebiom.2022.104269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 08/11/2022] [Accepted: 08/31/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Circadian rhythm impacts broad biological processes, including response to cancer treatment. Evidence conflicts on whether treatment time affects risk of radiotherapy side-effects, likely because of differing time analyses and target tissues. We previously showed interactive effects of time and genotypes of circadian genes on late toxicity after breast radiotherapy and aimed to validate those results in a multi-centre cohort. METHODS Clinical and genotype data from 1690 REQUITE breast cancer patients were used with erythema (acute; n=340) and breast atrophy (two years post-radiotherapy; n=514) as primary endpoints. Local datetimes per fraction were converted into solar times as predictors. Genetic chronotype markers were included in logistic regressions to identify primary endpoint predictors. FINDINGS Significant predictors for erythema included BMI, radiation dose and PER3 genotype (OR 1.27(95%CI 1.03-1.56); P < 0.03). Effect of treatment time effect on acute toxicity was inconclusive, with no interaction between time and genotype. For late toxicity (breast atrophy), predictors included BMI, radiation dose, surgery type, treatment time and SNPs in CLOCK (OR 0.62 (95%CI 0.4-0.9); P < 0.01), PER3 (OR 0.65 (95%CI 0.44-0.97); P < 0.04) and RASD1 (OR 0.56 (95%CI 0.35-0.89); P < 0.02). There was a statistically significant interaction between time and genotypes of circadian rhythm genes (CLOCK OR 1.13 (95%CI 1.03-1.23), P < 0.01; PER3 OR 1.1 (95%CI 1.01-1.2), P < 0.04; RASD1 OR 1.15 (95%CI 1.04-1.28), P < 0.008), with peak time for toxicity determined by genotype. INTERPRETATION Late atrophy can be mitigated by selecting optimal treatment time according to circadian genotypes (e.g. treat PER3 rs2087947C/C genotypes in mornings; T/T in afternoons). We predict triple-homozygous patients (14%) reduce chance of atrophy from 70% to 33% by treating in mornings as opposed to mid-afternoon. Future clinical trials could stratify patients treated at optimal times compared to those scheduled normally. FUNDING EU-FP7.
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Affiliation(s)
- Adam J Webb
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Emily Harper
- Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Tim Rattay
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Miguel E Aguado-Barrera
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain
| | - David Azria
- Department of Radiation Oncology, Montpellier Cancer Institute, Université Montpellier, Inserm U1194, Montpellier, France
| | - Celine Bourgier
- Department of Radiation Oncology, Montpellier Cancer Institute, Université Montpellier, Inserm U1194, Montpellier, France
| | - Muriel Brengues
- Institut de Recherche en Cancérologie de Montpellier, Université Montpellier, Inserm U1194, Montpellier, France
| | | | - Renée Bultijnck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ananya Choudhury
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Alessandro Cicchetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Dirk De Ruysscher
- Maastricht University Medical Center, Department of Radiation Oncology (Maastro clinic), GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - Maria Carmen De Santis
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Rebecca M Elliott
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Laura Fachal
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK; Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Antonio Gómez-Caamaño
- Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Sara Gutiérrez-Enríquez
- Hereditary Cancer Genetics Group, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Kerstie Johnson
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Ramón Lobato-Busto
- Department of Medical Physics, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Sarah L Kerns
- Departments of Radiation Oncology and Surgery, University of Rochester Medical Center, Rochester, New York, NY, United States
| | - Giselle Post
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Victoria Reyes
- Radiation Oncology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Barry S Rosenstein
- Department of Radiation Oncology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alejandro Seoane
- Medical Physics Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Paloma Sosa-Fajardo
- Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Elena Sperk
- Department of Radiation Oncology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Begoña Taboada-Valladares
- Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Haematology-Oncology, Universita degli Studi di Milano, Italy
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Biomedical Network on Rare Diseases (CIBERER), Spain
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Tim Ward
- Patient advocate, NCRI CTRad consumer, UK
| | - Catharine M West
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - R Paul Symonds
- Leicester Cancer Research Centre, University of Leicester, Leicester, UK
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10
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Kerns SL, Amidon Morlang A, Lee SM, Peterson DR, Marples B, Zhang H, Bylund K, Rosenzweig D, Hall W, De Ruyck K, Rosenstein BS, Stock RG, Gómez-Caamaño A, Vega A, Sosa-Fajardo P, Taboada-Valladares B, Aguado-Barrera ME, Parker C, Veldeman L, Fonteyne V, Bultijnck R, Talbot CJ, Symonds RP, Johnson K, Rattay T, Webb A, Lambrecht M, de Ruysscher D, Vanneste B, Choudhury A, Elliott RM, Sperk E, Herskind C, Veldwijk MR, Rancati T, Avuzzi B, Valdagni R, Azria D, Farcy Jacquet MP, Chang-Claude J, Seibold P, West C, Janelsins M, Chen Y, Messing E, Morrow G. Use of angiotensin converting enzyme inhibitors is associated with reduced risk of late bladder toxicity following radiotherapy for prostate cancer. Radiother Oncol 2022; 168:75-82. [PMID: 35077710 PMCID: PMC8986577 DOI: 10.1016/j.radonc.2022.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Genome-wide association studies (GWAS) of late hematuria following prostate cancer radiotherapy identified single nucleotide polymorphisms (SNPs) near AGT, encoding angiotensinogen. We tested the hypothesis that patients taking angiotensin converting enzyme inhibitors (ACEi) have a reduced risk of late hematuria. We additionally tested genetically-defined hypertension. MATERIALS AND METHODS Prostate cancer patients undergoing potentially-curative radiotherapy were enrolled onto two multi-center observational studies, URWCI (N = 256) and REQUITE (N = 1,437). Patients were assessed pre-radiotherapy and followed prospectively for development of toxicity for up to four years. The cumulative probability of hematuria was estimated by the Kaplan-Meier method. Multivariable grouped relative risk models assessed the effect of ACEi on time to hematuria adjusting for clinical factors and stratified by enrollment site. A polygenic risk score (PRS) for blood pressure was tested for association with hematuria in REQUITE and our Radiogenomics Consortium GWAS. RESULTS Patients taking ACEi during radiotherapy had a reduced risk of hematuria (HR 0.51, 95%CI 0.28 to 0.94, p = 0.030) after adjusting for prior transurethral prostate and/or bladder resection, heart disease, pelvic node radiotherapy, and bladder volume receiving 70 Gy, which are associated with hematuria. A blood pressure PRS was associated with hypertension (odds ratio per standard deviation 1.38, 95%CI 1.31 to 1.46, n = 5,288, p < 0.001) but not hematuria (HR per standard deviation 0.96, 95%CI 0.87 to 1.06, n = 5,126, p = 0.41). CONCLUSIONS Our study is the first to show a radioprotective effect of ACEi on bladder in an international, multi-site study of patients receiving pelvic radiotherapy. Mechanistic studies are needed to understand how targeting the angiotensin pathway protects the bladder.
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Affiliation(s)
- Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States.
| | - Ashley Amidon Morlang
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - Sharon M Lee
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - Derick R Peterson
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, United States
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - Hong Zhang
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - Kevin Bylund
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - Doug Rosenzweig
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - William Hall
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, United States
| | - Kim De Ruyck
- Department of Radiation Oncology, Ghent University Hospital and Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, United States; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Richard G Stock
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Ana Vega
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica-Servizo Galego de Saude (SERGAS), Santiago de Compostela, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Santiago de Compostela, Spain
| | - Paloma Sosa-Fajardo
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica-Servizo Galego de Saude (SERGAS), Santiago de Compostela, Spain
| | - Begoña Taboada-Valladares
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Miguel E Aguado-Barrera
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica-Servizo Galego de Saude (SERGAS), Santiago de Compostela, Spain
| | - Chris Parker
- Department of Uro-oncology, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, United Kingdom
| | - Liv Veldeman
- Department of Radiation Oncology, Ghent University Hospital and Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Valérie Fonteyne
- Department of Radiation Oncology, Ghent University Hospital and Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Renée Bultijnck
- Department of Radiation Oncology, Ghent University Hospital and Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | | | - R Paul Symonds
- Leicester Cancer Research Centre, University of Leicester, United Kingdom
| | - Kerstie Johnson
- Leicester Cancer Research Centre, University of Leicester, United Kingdom
| | - Tim Rattay
- Leicester Cancer Research Centre, University of Leicester, United Kingdom
| | - Adam Webb
- Department of Genetics and Genome Biology, University of Leicester, United Kingdom
| | | | - Dirk de Ruysscher
- KU Leuven, Radiation Oncology, Leuven, Belgium; Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - Ben Vanneste
- KU Leuven, Radiation Oncology, Leuven, Belgium; Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands
| | - Ananya Choudhury
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, the Netherlands
| | - Rebecca M Elliott
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, the Netherlands
| | - Elena Sperk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Carsten Herskind
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Marlon R Veldwijk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Barbara Avuzzi
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Valdagni
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Milan, Italy
| | - David Azria
- Department of Radiation Oncology, Montpellier Cancer Institute, Université Montpellier, Inserm U1194, France
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Cancer Epidemiology Group, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Germany
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Catharine West
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, the Netherlands
| | - Michelle Janelsins
- Department of Surgery, University of Rochester Medical Center, Rochester, United States
| | - Yuhchyau Chen
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, United States
| | - Edward Messing
- Department of Urology, University of Rochester Medical Center, Rochester, United States
| | - Gary Morrow
- Department of Surgery, University of Rochester Medical Center, Rochester, United States
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11
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Franco NR, Massi MC, Ieva F, Manzoni A, Paganoni AM, Zunino P, Veldeman L, Ost P, Fonteyne V, Talbot CJ, Rattay T, Webb A, Johnson K, Lambrecht M, Haustermans K, De Meerleer G, de Ruysscher D, Vanneste B, Van Limbergen E, Choudhury A, Elliott RM, Sperk E, Veldwijk MR, Herskind C, Avuzzi B, Noris Chiorda B, Valdagni R, Azria D, Farcy-Jacquet MP, Brengues M, Rosenstein BS, Stock RG, Vega A, Aguado-Barrera ME, Sosa-Fajardo P, Dunning AM, Fachal L, Kerns SL, Payne D, Chang-Claude J, Seibold P, West CML, Rancati T. Development of a method for generating SNP interaction-aware polygenic risk scores for radiotherapy toxicity. Radiother Oncol 2021; 159:241-248. [PMID: 33838170 PMCID: PMC8754257 DOI: 10.1016/j.radonc.2021.03.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/19/2021] [Accepted: 03/17/2021] [Indexed: 12/03/2022]
Abstract
AIM To identify the effect of single nucleotide polymorphism (SNP) interactions on the risk of toxicity following radiotherapy (RT) for prostate cancer (PCa) and propose a new method for polygenic risk score incorporating SNP-SNP interactions (PRSi). MATERIALS AND METHODS Analysis included the REQUITE PCa cohort that received external beam RT and was followed for 2 years. Late toxicity endpoints were: rectal bleeding, urinary frequency, haematuria, nocturia, decreased urinary stream. Among 43 literature-identified SNPs, the 30% most strongly associated with each toxicity were tested. SNP-SNP combinations (named SNP-allele sets) seen in ≥10% of the cohort were condensed into risk (RS) and protection (PS) scores, respectively indicating increased or decreased toxicity risk. Performance of RS and PS was evaluated by logistic regression. RS and PS were then combined into a single PRSi evaluated by area under the receiver operating characteristic curve (AUC). RESULTS Among 1,387 analysed patients, toxicity rates were 11.7% (rectal bleeding), 4.0% (urinary frequency), 5.5% (haematuria), 7.8% (nocturia) and 17.1% (decreased urinary stream). RS and PS combined 8 to 15 different SNP-allele sets, depending on the toxicity endpoint. Distributions of PRSi differed significantly in patients with/without toxicity with AUCs ranging from 0.61 to 0.78. PRSi was better than the classical summed PRS, particularly for the urinary frequency, haematuria and decreased urinary stream endpoints. CONCLUSIONS Our method incorporates SNP-SNP interactions when calculating PRS for radiotherapy toxicity. Our approach is better than classical summation in discriminating patients with toxicity and should enable incorporating genetic information to improve normal tissue complication probability models.
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Affiliation(s)
| | - Michela Carlotta Massi
- MOX, Department of Mathematics, Politecnico di Milano, Italy; CADS-Center for Analysis, Decisions and Society, Human Technopole, Milan, Italy.
| | - Francesca Ieva
- MOX, Department of Mathematics, Politecnico di Milano, Italy; CADS-Center for Analysis, Decisions and Society, Human Technopole, Milan, Italy; CHRP-National Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
| | - Andrea Manzoni
- MOX, Department of Mathematics, Politecnico di Milano, Italy.
| | - Anna Maria Paganoni
- MOX, Department of Mathematics, Politecnico di Milano, Italy; CADS-Center for Analysis, Decisions and Society, Human Technopole, Milan, Italy; CHRP-National Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
| | - Paolo Zunino
- MOX, Department of Mathematics, Politecnico di Milano, Italy.
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Valérie Fonteyne
- Department of Human Structure and Repair, Ghent University, Belgium; Department of Radiation Oncology, Ghent University Hospital, Belgium.
| | - Christopher J Talbot
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, United Kingdom.
| | - Tim Rattay
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, United Kingdom.
| | - Adam Webb
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, United Kingdom.
| | - Kerstie Johnson
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, United Kingdom.
| | - Maarten Lambrecht
- Department of Radiation Oncology, University Hospitals Leuven, Belgium.
| | - Karin Haustermans
- Department of Radiation Oncology, University Hospitals Leuven, Belgium.
| | - Gert De Meerleer
- Department of Radiation Oncology, University Hospitals Leuven, Belgium.
| | - Dirk de Ruysscher
- Maastricht University Medical Center, the Netherlands; Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, the Netherlands.
| | - Ben Vanneste
- Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, the Netherlands.
| | - Evert Van Limbergen
- Maastricht University Medical Center, the Netherlands; Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, the Netherlands.
| | - Ananya Choudhury
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, UK.
| | - Rebecca M Elliott
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, UK.
| | - Elena Sperk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - Marlon R Veldwijk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - Carsten Herskind
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
| | - Barbara Avuzzi
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Barbara Noris Chiorda
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Riccardo Valdagni
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milan, Italy; Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - David Azria
- Department of Radiation Oncology, University Federation of Radiation Oncology, Montpellier Cancer Institute, Univ Montpellier MUSE, France.
| | - Marie-Pierre Farcy-Jacquet
- Department of Radiation Oncology, University Federation of Radiation Oncology, Institut de Cancérologie du Gard, Nimes, France.
| | - Muriel Brengues
- Department of Radiation Oncology, University Federation of Radiation Oncology, Montpellier Cancer Institute, Univ Montpellier MUSE, France.
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, USA.
| | - Richard G Stock
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, USA.
| | - Ana Vega
- Grupo de Medicina Xenómica (USC), Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Biomedical Network on Rare Diseases (CIBERER), Spain.
| | - Miguel E Aguado-Barrera
- Grupo de Medicina Xenómica (USC), Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain.
| | - Paloma Sosa-Fajardo
- Grupo de Medicina Xenómica (USC), Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela, Spain; Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Labs, UK.
| | - Laura Fachal
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Labs, UK; Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK.
| | - Sarah L Kerns
- Departments of Radiation Oncology and Surgery, University of Rochester Medical Center, Rochester, USA.
| | - Debbie Payne
- Centre for Integrated Genomic Medical Research (CIGMR), University of Manchester, UK.
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Germany.
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Catharine M L West
- Translational Radiobiology Group, Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, UK.
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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Conti DV, Darst BF, Moss LC, Saunders EJ, Sheng X, Chou A, Schumacher FR, Olama AAA, Benlloch S, Dadaev T, Brook MN, Sahimi A, Hoffmann TJ, Takahashi A, Matsuda K, Momozawa Y, Fujita M, Muir K, Lophatananon A, Wan P, Le Marchand L, Wilkens LR, Stevens VL, Gapstur SM, Carter BD, Schleutker J, Tammela TLJ, Sipeky C, Auvinen A, Giles GG, Southey MC, MacInnis RJ, Cybulski C, Wokołorczyk D, Lubiński J, Neal DE, Donovan JL, Hamdy FC, Martin RM, Nordestgaard BG, Nielsen SF, Weischer M, Bojesen SE, Røder MA, Iversen P, Batra J, Chambers S, Moya L, Horvath L, Clements JA, Tilley W, Risbridger GP, Gronberg H, Aly M, Szulkin R, Eklund M, Nordström T, Pashayan N, Dunning AM, Ghoussaini M, Travis RC, Key TJ, Riboli E, Park JY, Sellers TA, Lin HY, Albanes D, Weinstein SJ, Mucci LA, Giovannucci E, Lindstrom S, Kraft P, Hunter DJ, Penney KL, Turman C, Tangen CM, Goodman PJ, Thompson IM, Hamilton RJ, Fleshner NE, Finelli A, Parent MÉ, Stanford JL, Ostrander EA, Geybels MS, Koutros S, Freeman LEB, Stampfer M, Wolk A, Håkansson N, Andriole GL, Hoover RN, Machiela MJ, Sørensen KD, Borre M, Blot WJ, Zheng W, Yeboah ED, Mensah JE, Lu YJ, Zhang HW, Feng N, Mao X, Wu Y, Zhao SC, Sun Z, Thibodeau SN, McDonnell SK, Schaid DJ, West CML, Burnet N, Barnett G, Maier C, Schnoeller T, Luedeke M, Kibel AS, Drake BF, Cussenot O, Cancel-Tassin G, Menegaux F, Truong T, Koudou YA, John EM, Grindedal EM, Maehle L, Khaw KT, Ingles SA, Stern MC, Vega A, Gómez-Caamaño A, Fachal L, Rosenstein BS, Kerns SL, Ostrer H, Teixeira MR, Paulo P, Brandão A, Watya S, Lubwama A, Bensen JT, Fontham ETH, Mohler J, Taylor JA, Kogevinas M, Llorca J, Castaño-Vinyals G, Cannon-Albright L, Teerlink CC, Huff CD, Strom SS, Multigner L, Blanchet P, Brureau L, Kaneva R, Slavov C, Mitev V, Leach RJ, Weaver B, Brenner H, Cuk K, Holleczek B, Saum KU, Klein EA, Hsing AW, Kittles RA, Murphy AB, Logothetis CJ, Kim J, Neuhausen SL, Steele L, Ding YC, Isaacs WB, Nemesure B, Hennis AJM, Carpten J, Pandha H, Michael A, De Ruyck K, De Meerleer G, Ost P, Xu J, Razack A, Lim J, Teo SH, Newcomb LF, Lin DW, Fowke JH, Neslund-Dudas C, Rybicki BA, Gamulin M, Lessel D, Kulis T, Usmani N, Singhal S, Parliament M, Claessens F, Joniau S, Van den Broeck T, Gago-Dominguez M, Castelao JE, Martinez ME, Larkin S, Townsend PA, Aukim-Hastie C, Bush WS, Aldrich MC, Crawford DC, Srivastava S, Cullen JC, Petrovics G, Casey G, Roobol MJ, Jenster G, van Schaik RHN, Hu JJ, Sanderson M, Varma R, McKean-Cowdin R, Torres M, Mancuso N, Berndt SI, Van Den Eeden SK, Easton DF, Chanock SJ, Cook MB, Wiklund F, Nakagawa H, Witte JS, Eeles RA, Kote-Jarai Z, Haiman CA. Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction. Nat Genet 2021; 53:65-75. [PMID: 33398198 PMCID: PMC8148035 DOI: 10.1038/s41588-020-00748-0] [Citation(s) in RCA: 205] [Impact Index Per Article: 68.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/05/2020] [Indexed: 01/28/2023]
Abstract
Prostate cancer is a highly heritable disease with large disparities in incidence rates across ancestry populations. We conducted a multiancestry meta-analysis of prostate cancer genome-wide association studies (107,247 cases and 127,006 controls) and identified 86 new genetic risk variants independently associated with prostate cancer risk, bringing the total to 269 known risk variants. The top genetic risk score (GRS) decile was associated with odds ratios that ranged from 5.06 (95% confidence interval (CI), 4.84-5.29) for men of European ancestry to 3.74 (95% CI, 3.36-4.17) for men of African ancestry. Men of African ancestry were estimated to have a mean GRS that was 2.18-times higher (95% CI, 2.14-2.22), and men of East Asian ancestry 0.73-times lower (95% CI, 0.71-0.76), than men of European ancestry. These findings support the role of germline variation contributing to population differences in prostate cancer risk, with the GRS offering an approach for personalized risk prediction.
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Affiliation(s)
- David V Conti
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Burcu F Darst
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Lilit C Moss
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | - Xin Sheng
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Alisha Chou
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Fredrick R Schumacher
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center, University Hospitals, Cleveland, OH, USA
| | - Ali Amin Al Olama
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Sara Benlloch
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | | | | | - Ali Sahimi
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Thomas J Hoffmann
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Atushi Takahashi
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Genomic Medicine, National Cerebral and Cardiovascular Center Research Institute, Suita, Japan
| | - Koichi Matsuda
- Laboratory of Clinical Genome Sequencing, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
- Biobank, Tokyo, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center of Integrative Medical Sciences, Yokohama, Japan
| | - Masashi Fujita
- Laboratory for Cancer Genomics, RIKEN Center of Integrative Medical Sciences, Yokohama, Japan
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Peggy Wan
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Victoria L Stevens
- Behavioral and Epidemiology Research Group, Research Program, American Cancer Society, Atlanta, GA, USA
| | - Susan M Gapstur
- Behavioral and Epidemiology Research Group, Research Program, American Cancer Society, Atlanta, GA, USA
| | - Brian D Carter
- Behavioral and Epidemiology Research Group, Research Program, American Cancer Society, Atlanta, GA, USA
| | - Johanna Schleutker
- Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Medical Genetics, Genomics, Laboratory Division, Turku University Hospital, Turku, Finland
| | - Teuvo L J Tammela
- Department of Urology, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Csilla Sipeky
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Anssi Auvinen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Dominika Wokołorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - David E Neal
- Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- University of Cambridge, Department of Oncology, Addenbrooke's Hospital, Cambridge, UK
- Cancer Research UK, Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Jenny L Donovan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
- Faculty of Medical Science, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Biomedical Research Centre, University of Bristol, Bristol, UK
- Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sune F Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maren Weischer
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Stig E Bojesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Martin Andreas Røder
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jyotsna Batra
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | | | - Leire Moya
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Lisa Horvath
- Chris O'Brien Lifehouse (COBLH), Camperdown, Sydney, New South Wales, Australia
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Judith A Clements
- Australian Prostate Cancer Research Centre-Queensland, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
| | - Wayne Tilley
- Dame Roma Mitchell Cancer Research Laboratories, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Gail P Risbridger
- Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia
- Prostate Cancer Translational Research Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Henrik Gronberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Markus Aly
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Urology, Karolinska University Hospital, Solna, Stockholm, Sweden
- Department of Urology, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Szulkin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- SDS Life Science, Danderyd, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Tobias Nordström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Sciences at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Nora Pashayan
- Department of Applied Health Research, University College London, London, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Laboratory, Cambridge, UK
- Department of Applied Health Research, University College London, London, UK
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Laboratory, Cambridge, UK
| | | | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tim J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hui-Yi Lin
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sara Lindstrom
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kathryn L Penney
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Constance Turman
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Catherine M Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Phyllis J Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ian M Thompson
- CHRISTUS Santa Rosa Hospital - Medical Center, San Antonio, TX, USA
| | - Robert J Hamilton
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
- Department of Surgery (Urology), University of Toronto, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, Laval, Quebec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Elaine A Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Milan S Geybels
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Meir Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Niclas Håkansson
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Karina Dalsgaard Sørensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Borre
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - William J Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- International Epidemiology Institute, Rockville, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Edward D Yeboah
- University of Ghana Medical School, Accra, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
| | - James E Mensah
- University of Ghana Medical School, Accra, Ghana
- Korle Bu Teaching Hospital, Accra, Ghana
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | | | - Ninghan Feng
- Wuxi Second Hospital, Nanjing Medical University, Wuxi, China
| | - Xueying Mao
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, London, UK
| | - Yudong Wu
- Department of Urology, First Affiliated Hospital, The Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Shan-Chao Zhao
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zan Sun
- The People's Hospital of Liaoning Province, The People's Hospital of China Medical University, Shenyang, China
| | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Shannon K McDonnell
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Daniel J Schaid
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Catharine M L West
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Radiotherapy Related Research, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - Neil Burnet
- Division of Cancer Sciences, University of Manchester, Manchester Cancer Research Centre, Manchester Academic Health Science Centre, and The Christie NHS Foundation Trust, Manchester, UK
| | - Gill Barnett
- University of Cambridge Department of Oncology, Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | | | - Adam S Kibel
- Division of Urologic Surgery, Brigham and Womens Hospital, Boston, MA, USA
| | | | | | | | - Florence Menegaux
- Exposome and Heredity, CESP (UMR 1018), Paris-Saclay Medical School, Paris-Saclay University, Inserm, Gustave Roussy, Villejuif, France
| | - Thérèse Truong
- Exposome and Heredity, CESP (UMR 1018), Paris-Saclay Medical School, Paris-Saclay University, Inserm, Gustave Roussy, Villejuif, France
| | - Yves Akoli Koudou
- CESP (UMR 1018), Paris-Saclay Medical School, Paris-Saclay University, Inserm, Villejuif, France
| | - Esther M John
- Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Lovise Maehle
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, UK
| | - Sue A Ingles
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Ana Vega
- Fundación Pública Galega Medicina Xenómica, Santiago De Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago De Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Laura Fachal
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Fundación Pública Galega Medicina Xenómica, Santiago De Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago De Compostela, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Barry S Rosenstein
- Department of Radiation Oncology and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Harry Ostrer
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Paula Paulo
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
- Cancer Genetics Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
| | - Andreia Brandão
- Department of Genetics, Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
- Cancer Genetics Group, IPO-Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO-Porto), Porto, Portugal
| | | | | | - Jeannette T Bensen
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth T H Fontham
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - James Mohler
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Urology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Jack A Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
- Laboratory of Molecular Carcinogenesis, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria-IDIVAL, Santander, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lisa Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Craig C Teerlink
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Chad D Huff
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Sara S Strom
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Luc Multigner
- University of Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health), Rennes, France
| | - Pascal Blanchet
- CHU de Pointe-à-Pitre, University of the French Antilles, University of Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health), Pointe-à-Pitre, France
| | - Laurent Brureau
- CHU de Pointe-à-Pitre, University of the French Antilles, University of Rennes, Inserm, EHESP, Irset (Research Institute for Environmental and Occupational Health), Pointe-à-Pitre, France
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Chavdar Slavov
- Department of Urology and Alexandrovska University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Vanio Mitev
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Robin J Leach
- Department of Urology, Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Brandi Weaver
- Department of Urology, Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Katarina Cuk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Kai-Uwe Saum
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric A Klein
- Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
- Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ann W Hsing
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Rick A Kittles
- Division of Health Equities, Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Adam B Murphy
- Department of Urology, Northwestern University, Chicago, IL, USA
| | - Christopher J Logothetis
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Jeri Kim
- Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - William B Isaacs
- James Buchanan Brady Urological Institute, Johns Hopkins Hospital and Medical Institution, Baltimore, MD, USA
| | - Barbara Nemesure
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Anselm J M Hennis
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
- Chronic Disease Research Centre and Faculty of Medical Sciences, University of the West Indies, Bridgetown, Barbados
| | - John Carpten
- Department of Translational Genomics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hardev Pandha
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
| | - Agnieszka Michael
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
| | - Kim De Ruyck
- Department of Basic Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Gert De Meerleer
- Department of Radiotherapy, Ghent University Hospital, Gent, Belgium
| | - Piet Ost
- Department of Radiotherapy, Ghent University Hospital, Gent, Belgium
| | - Jianfeng Xu
- Program for Personalized Cancer Care and Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA
| | - Azad Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Cancer Research Malaysia (CRM), Outpatient Centre, Subang Jaya Medical Centre, Subang Jaya, Malaysia
| | - Lisa F Newcomb
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Daniel W Lin
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Jay H Fowke
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | | | - Benjamin A Rybicki
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Marija Gamulin
- Department of Oncology, University Hospital Centre Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Davor Lessel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Nawaid Usmani
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Sandeep Singhal
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew Parliament
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Van den Broeck
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, Leuven, Belgium
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Manuela Gago-Dominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, Santiago de Compostela, Spain
- University of California San Diego, Moores Cancer Center, La Jolla, CA, USA
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica Galicia Sur (IISGS), Vigo, Spain
| | - Maria Elena Martinez
- Moores Cancer Center, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA
| | - Samantha Larkin
- The University of Southampton, Southampton General Hospital, Southampton, UK
| | - Paul A Townsend
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
- Division of Cancer Sciences, Manchester Cancer Research Centre, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, Health Innovation Manchester, University of Manchester, Manchester, UK
| | - Claire Aukim-Hastie
- Faculty of Health and Medical Sciences, The University of Surrey, Guildford, UK
| | - William S Bush
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Melinda C Aldrich
- Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dana C Crawford
- Cleveland Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Shiv Srivastava
- Center for Prostate Disease Research, Uniformed Services University, Bethesda, MD, USA
| | - Jennifer C Cullen
- Center for Prostate Disease Research, Uniformed Services University, Bethesda, MD, USA
| | - Gyorgy Petrovics
- Center for Prostate Disease Research, Uniformed Services University, Bethesda, MD, USA
| | - Graham Casey
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Guido Jenster
- Department of Urology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jennifer J Hu
- The University of Miami School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Maureen Sanderson
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Roberta McKean-Cowdin
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Mina Torres
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Nicholas Mancuso
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephen K Van Den Eeden
- Division of Research, Kaiser Permanente, Northern California, Oakland, CA, USA
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Hidewaki Nakagawa
- Laboratory for Cancer Genomics, RIKEN Center of Integrative Medical Sciences, Yokohama, Japan
| | - John S Witte
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, CA, USA
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Rosalind A Eeles
- The Institute of Cancer Research, London, UK
- Royal Marsden NHS Foundation Trust, London, UK
| | | | - Christopher A Haiman
- Center for Genetic Epidemiology, Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
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13
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Massi MC, Gasperoni F, Ieva F, Paganoni AM, Zunino P, Manzoni A, Franco NR, Veldeman L, Ost P, Fonteyne V, Talbot CJ, Rattay T, Webb A, Symonds PR, Johnson K, Lambrecht M, Haustermans K, De Meerleer G, de Ruysscher D, Vanneste B, Van Limbergen E, Choudhury A, Elliott RM, Sperk E, Herskind C, Veldwijk MR, Avuzzi B, Giandini T, Valdagni R, Cicchetti A, Azria D, Jacquet MPF, Rosenstein BS, Stock RG, Collado K, Vega A, Aguado-Barrera ME, Calvo P, Dunning AM, Fachal L, Kerns SL, Payne D, Chang-Claude J, Seibold P, West CML, Rancati T. A Deep Learning Approach Validates Genetic Risk Factors for Late Toxicity After Prostate Cancer Radiotherapy in a REQUITE Multi-National Cohort. Front Oncol 2020; 10:541281. [PMID: 33178576 PMCID: PMC7593843 DOI: 10.3389/fonc.2020.541281] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 09/02/2020] [Indexed: 12/23/2022] Open
Abstract
Background: REQUITE (validating pREdictive models and biomarkers of radiotherapy toxicity to reduce side effects and improve QUalITy of lifE in cancer survivors) is an international prospective cohort study. The purpose of this project was to analyse a cohort of patients recruited into REQUITE using a deep learning algorithm to identify patient-specific features associated with the development of toxicity, and test the approach by attempting to validate previously published genetic risk factors. Methods: The study involved REQUITE prostate cancer patients treated with external beam radiotherapy who had complete 2-year follow-up. We used five separate late toxicity endpoints: ≥grade 1 late rectal bleeding, ≥grade 2 urinary frequency, ≥grade 1 haematuria, ≥ grade 2 nocturia, ≥ grade 1 decreased urinary stream. Forty-three single nucleotide polymorphisms (SNPs) already reported in the literature to be associated with the toxicity endpoints were included in the analysis. No SNP had been studied before in the REQUITE cohort. Deep Sparse AutoEncoders (DSAE) were trained to recognize features (SNPs) identifying patients with no toxicity and tested on a different independent mixed population including patients without and with toxicity. Results: One thousand, four hundred and one patients were included, and toxicity rates were: rectal bleeding 11.7%, urinary frequency 4%, haematuria 5.5%, nocturia 7.8%, decreased urinary stream 17.1%. Twenty-four of the 43 SNPs that were associated with the toxicity endpoints were validated as identifying patients with toxicity. Twenty of the 24 SNPs were associated with the same toxicity endpoint as reported in the literature: 9 SNPs for urinary symptoms and 11 SNPs for overall toxicity. The other 4 SNPs were associated with a different endpoint. Conclusion: Deep learning algorithms can validate SNPs associated with toxicity after radiotherapy for prostate cancer. The method should be studied further to identify polygenic SNP risk signatures for radiotherapy toxicity. The signatures could then be included in integrated normal tissue complication probability models and tested for their ability to personalize radiotherapy treatment planning.
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Affiliation(s)
- Michela Carlotta Massi
- Modelling and Scientific Computing Laboratory, Math Department, Politecnico di Milano, Milan, Italy
- Center for Analysis, Decisions and Society, Human Technopole, Milan, Italy
| | - Francesca Gasperoni
- Medical Research Council-Biostatistic Unit, University of Cambridge, Cambridge, United Kingdom
| | - Francesca Ieva
- Modelling and Scientific Computing Laboratory, Math Department, Politecnico di Milano, Milan, Italy
- Center for Analysis, Decisions and Society, Human Technopole, Milan, Italy
- CHRP-National Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Anna Maria Paganoni
- Modelling and Scientific Computing Laboratory, Math Department, Politecnico di Milano, Milan, Italy
- Center for Analysis, Decisions and Society, Human Technopole, Milan, Italy
- CHRP-National Center for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Paolo Zunino
- Modelling and Scientific Computing Laboratory, Math Department, Politecnico di Milano, Milan, Italy
| | - Andrea Manzoni
- Modelling and Scientific Computing Laboratory, Math Department, Politecnico di Milano, Milan, Italy
| | - Nicola Rares Franco
- Modelling and Scientific Computing Laboratory, Math Department, Politecnico di Milano, Milan, Italy
| | - Liv Veldeman
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Valérie Fonteyne
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Christopher J. Talbot
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Tim Rattay
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Adam Webb
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Paul R. Symonds
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Kerstie Johnson
- Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom
| | - Maarten Lambrecht
- Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Karin Haustermans
- Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Gert De Meerleer
- Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Dirk de Ruysscher
- Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, Netherlands
| | - Ben Vanneste
- Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, Netherlands
| | - Evert Van Limbergen
- Maastricht University Medical Center, Maastricht, Netherlands
- Department of Radiation Oncology (Maastro), GROW Institute for Oncology and Developmental Biology, Maastricht, Netherlands
| | - Ananya Choudhury
- Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, Christie Hospital, University of Manchester, Manchester, United Kingdom
| | - Rebecca M. Elliott
- Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, Christie Hospital, University of Manchester, Manchester, United Kingdom
| | - Elena Sperk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carsten Herskind
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marlon R. Veldwijk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Barbara Avuzzi
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tommaso Giandini
- Department of Medical Physics, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Riccardo Valdagni
- Department of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Cicchetti
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - David Azria
- Department of Radiation Oncology, University Federation of Radiation Oncology, Montpellier Cancer Institute, Univ Montpellier MUSE, Grant INCa_Inserm_DGOS_12553, Inserm U1194, Montpellier, France
| | - Marie-Pierre Farcy Jacquet
- Department of Radiation Oncology, University Federation of Radiation Oncology, CHU Caremeau, Nîmes, France
| | - Barry S. Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Richard G. Stock
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kayla Collado
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica, Grupo de Medicina Xenómica (USC), Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Miguel Elías Aguado-Barrera
- Fundación Pública Galega de Medicina Xenómica, Grupo de Medicina Xenómica (USC), Santiago de Compostela, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia Calvo
- Instituto de Investigación Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Alison M. Dunning
- Strangeways Research Labs, Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
| | - Laura Fachal
- Strangeways Research Labs, Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, United Kingdom
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Sarah L. Kerns
- Departments of Radiation Oncology and Surgery, University of Rochester Medical Center, Rochester, New York, NY, United States
| | - Debbie Payne
- Centre for Integrated Genomic Medical Research (CIGMR), University of Manchester, Manchester, United Kingdom
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Catharine M. L. West
- Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, Christie Hospital, University of Manchester, Manchester, United Kingdom
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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14
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Collado K, Kerns SL, Diefenbach MA, Peterson-Roth E, Koski R, Ostrer H, Stock RG, Mattessich M, Kaplan P, Rosenstein BS. Survey of Radiation Oncologists to Assess Interest and Potential Use of a Genetic Test Predicting Susceptibility for the Development of Toxicities After Prostate Cancer Radiation Therapy. Adv Radiat Oncol 2020; 5:897-904. [PMID: 33083651 PMCID: PMC7557145 DOI: 10.1016/j.adro.2020.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/05/2020] [Accepted: 03/17/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE A genetic test predicting susceptibility for the development of toxicities after prostate cancer radiation therapy is in development. This test intends to help physicians with treatment decision making. METHODS AND MATERIALS Radiation oncologists were surveyed using a web-based questionnaire to gauge their interest in using a genetic test predictive of increased risk of radiation therapy toxicities as an aid in determining therapy for men with prostate cancer. Responses were summarized using frequencies, and a χ2 test compared responses among participants. Multivariable ordinal regression identified factors associated with anticipated adoption or nonadoption of such a genetic test by radiation oncologists. RESULTS Among 204 radiation oncologists (64% from the United States, 36% from other countries), 86.3% would order a genetic test and 80.2% said the test would be useful for treatment discussions. There was wide acceptance (76.7%) to offer a genetic test to all patients considering radiation therapy for prostate cancer. Additionally, 98.1% indicated that patients would be receptive to the test information. There were no significant differences in the likelihood of ordering a genetic test based on practice setting, familiarity with scientific literature, time spent on research, or geographic location (all P > .05). CONCLUSIONS Radiation oncologists who treat prostate cancer are interested in and willing to order a genetic test predictive of susceptibility to radiation therapy toxicity to aid their treatment decision making.
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Affiliation(s)
- Kayla Collado
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sarah L. Kerns
- University of Rochester Medical Center, Rochester, New York
| | | | | | | | - Harry Ostrer
- Albert Einstein College of Medicine, New York, New York
| | - Richard G. Stock
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | - Barry S. Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
- Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
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Kang J, Coates JT, Strawderman RL, Rosenstein BS, Kerns SL. Genomics models in radiotherapy: From mechanistic to machine learning. Med Phys 2020; 47:e203-e217. [PMID: 32418335 PMCID: PMC8725063 DOI: 10.1002/mp.13751] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/28/2019] [Accepted: 07/17/2019] [Indexed: 12/28/2022] Open
Abstract
Machine learning (ML) provides a broad framework for addressing high-dimensional prediction problems in classification and regression. While ML is often applied for imaging problems in medical physics, there are many efforts to apply these principles to biological data toward questions of radiation biology. Here, we provide a review of radiogenomics modeling frameworks and efforts toward genomically guided radiotherapy. We first discuss medical oncology efforts to develop precision biomarkers. We next discuss similar efforts to create clinical assays for normal tissue or tumor radiosensitivity. We then discuss modeling frameworks for radiosensitivity and the evolution of ML to create predictive models for radiogenomics.
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Affiliation(s)
- John Kang
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - James T. Coates
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford OX3 7DQ, UK
| | - Robert L. Strawderman
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY 14642, USA
| | - Barry S. Rosenstein
- Department of Radiation Oncology and the Department of Genetics and Genomic Sciences, Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sarah L. Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA
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Kerns SL, Fung C, Fossa SD, Dinh PC, Monahan P, Sesso HD, Frisina RD, Feldman DR, Hamilton RJ, Vaughn D, Martin N, Huddart R, Kollmannsberger C, Sahasrabudhe D, Ardeshir-Rouhani-Fard S, Einhorn L, Travis LB. Relationship of Cisplatin-Related Adverse Health Outcomes With Disability and Unemployment Among Testicular Cancer Survivors. JNCI Cancer Spectr 2020; 4:pkaa022. [PMID: 32704617 PMCID: PMC7368467 DOI: 10.1093/jncics/pkaa022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background Few data exist on the relationship of cisplatin-related adverse health outcomes (AHOs) with disability, unemployment, and self-reported health (SRH) among testicular cancer survivors (TCS). Methods A total of 1815 TCS at least 1 year postchemotherapy underwent clinical examination and completed questionnaires. Treatment data were abstracted from medical records. A cumulative burden of morbidity score (CBMPt) encompassed the number and severity of platinum-related AHOs (peripheral sensory neuropathy [PSN], hearing loss, tinnitus, renal disease). Multivariable regression assessed the association of AHOs and CBMPt with employment status and SRH, adjusting for sociodemographic and clinical characteristics. Unemployment was compared with a male normative population of similar age, race, and ethnicity. Results Almost 1 in 10 TCS was out of work (2.4%, disability leave; 6.8%, unemployed) at a median age of 37 years (median follow-up = 4 years). PSN (odds ratio [OR] = 2.89, 95% confidence interval [CI] = 1.01 to 8.26, grade 3 vs 0, P = .048), renal dysfunction defined by estimated glomerular filtration rate (OR = 12.1, 95% CI = 2.06 to 70.8, grade 2 vs 0, P = .01), pain (OR = 10.6, 95% CI = 4.40 to 25.40, grade 2 or 3 vs 0, P < .001), and CBMPt (OR = 1.46, 95% CI = 1.03 to 2.08, P = .03) were associated with disability leave; pain strongly correlated with PSN (r2 = 0.40, P < .001). Statistically significantly higher percentages of TCS were unemployed vs population norms (age-adjusted OR = 2.67, 95% CI = 2.49 to 3.02, P < .001). PSN (OR = 2.44, 95% CI = 1.28 to 4.62, grade 3 vs 0, P = .006), patient-reported hearing loss (OR = 1.82, 95% CI = 1.04 to 3.17, grade 2 or 3 vs 0, P = .04), and pain (OR = 3.75, 95% CI = 2.06 to 6.81, grade 2 or 3 vs 0, P < .001) were associated with unemployment. Increasing severity of most cisplatin-related AHOs and pain were associated with statistically significantly worse SRH. Conclusions Our findings have important implications regarding treatment-associated productivity losses and socioeconomic costs in this young population. Survivorship care strategies should include inquiries about disability and unemployment status, with efforts made to assist affected TCS in returning to the workforce.
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Affiliation(s)
- Sarah L Kerns
- University of Rochester Medical Center, Rochester, NY, USA
| | - Chunkit Fung
- University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | | | | | | | | | - David Vaughn
- University of Pennsylvania, Philadelphia, PA, USA
| | - Neil Martin
- Dana-Farber Cancer Institute, Boston, MA, USA
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Kerns SL, Fachal L, Dorling L, Barnett GC, Baran A, Peterson DR, Hollenberg M, Hao K, Narzo AD, Ahsen ME, Pandey G, Bentzen SM, Janelsins M, Elliott RM, Pharoah PDP, Burnet NG, Dearnaley DP, Gulliford SL, Hall E, Sydes MR, Aguado-Barrera ME, Gómez-Caamaño A, Carballo AM, Peleteiro P, Lobato-Busto R, Stock R, Stone NN, Ostrer H, Usmani N, Singhal S, Tsuji H, Imai T, Saito S, Eeles R, DeRuyck K, Parliament M, Dunning AM, Vega A, Rosenstein BS, West CML. Radiogenomics Consortium Genome-Wide Association Study Meta-Analysis of Late Toxicity After Prostate Cancer Radiotherapy. J Natl Cancer Inst 2020; 112:179-190. [PMID: 31095341 PMCID: PMC7019089 DOI: 10.1093/jnci/djz075] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/20/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A total of 10%-20% of patients develop long-term toxicity following radiotherapy for prostate cancer. Identification of common genetic variants associated with susceptibility to radiotoxicity might improve risk prediction and inform functional mechanistic studies. METHODS We conducted an individual patient data meta-analysis of six genome-wide association studies (n = 3871) in men of European ancestry who underwent radiotherapy for prostate cancer. Radiotoxicities (increased urinary frequency, decreased urinary stream, hematuria, rectal bleeding) were graded prospectively. We used grouped relative risk models to test associations with approximately 6 million genotyped or imputed variants (time to first grade 2 or higher toxicity event). Variants with two-sided Pmeta less than 5 × 10-8 were considered statistically significant. Bayesian false discovery probability provided an additional measure of confidence. Statistically significant variants were evaluated in three Japanese cohorts (n = 962). All statistical tests were two-sided. RESULTS Meta-analysis of the European ancestry cohorts identified three genomic signals: single nucleotide polymorphism rs17055178 with rectal bleeding (Pmeta = 6.2 × 10-10), rs10969913 with decreased urinary stream (Pmeta = 2.9 × 10-10), and rs11122573 with hematuria (Pmeta = 1.8 × 10-8). Fine-scale mapping of these three regions was used to identify another independent signal (rs147121532) associated with hematuria (Pconditional = 4.7 × 10-6). Credible causal variants at these four signals lie in gene-regulatory regions, some modulating expression of nearby genes. Previously identified variants showed consistent associations (rs17599026 with increased urinary frequency, rs7720298 with decreased urinary stream, rs1801516 with overall toxicity) in new cohorts. rs10969913 and rs17599026 had similar effects in the photon-treated Japanese cohorts. CONCLUSIONS This study increases the understanding of the architecture of common genetic variants affecting radiotoxicity, points to novel radio-pathogenic mechanisms, and develops risk models for testing in clinical studies. Further multinational radiogenomics studies in larger cohorts are worthwhile.
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Affiliation(s)
- Sarah L Kerns
- Departments of Radiation Oncology and Surgery, University of Rochester Medical Center, Rochester, NY
| | | | | | - Gillian C Barnett
- Department of Public Health and Primary Care
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK; Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Andrea Baran
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | - Derick R Peterson
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY
| | | | - Ke Hao
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Antonio Di Narzo
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mehmet Eren Ahsen
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Gaurav Pandey
- Department of Genetics and Genomic Sciences and Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland Greenebaum Cancer Center, School of Medicine, University of Maryland, Baltimore
| | - Michelle Janelsins
- Departments of Radiation Oncology and Surgery, University of Rochester Medical Center, Rochester, NY
| | - Rebecca M Elliott
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge, UK; Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Neil G Burnet
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - David P Dearnaley
- Academic Urooncology Unit, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Sarah L Gulliford
- Academic Urooncology Unit, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Matthew R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - Miguel E Aguado-Barrera
- Fundación Pública Galega de Medicina Xenómica-Servizo Galego de Saude (SERGAS & Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | | | | | | | | | - Richard Stock
- Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain; Department of Radiation Oncology
| | | | - Harry Ostrer
- Icahn School of Medicine at Mount Sinai, New York, NY; Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, NY
| | - Nawaid Usmani
- Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Sandeep Singhal
- Department of Pathology and Cell Biology, Columbia University, New York, NY
| | - Hiroshi Tsuji
- National Institute of Radiological Science, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Takashi Imai
- National Institute of Radiological Science, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Shiro Saito
- Department of Urology, National Tokyo Medical Center, Tokyo, Japan
| | - Rosalind Eeles
- Division of Genetics and Epidemiology, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Kim DeRuyck
- Departments of Basic Medical Sciences and Radiotherapy, Ghent University Hospital, Ghent, Belgium
| | - Matthew Parliament
- Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | | | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-Servizo Galego de Saude (SERGAS & Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Barry S Rosenstein
- Departments of Radiation Oncology & Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Catharine M L West
- Division of Cancer Sciences, the University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
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Bergom C, West CM, Higginson DS, Abazeed ME, Arun B, Bentzen SM, Bernstein JL, Evans JD, Gerber NK, Kerns SL, Keen J, Litton JK, Reiner AS, Riaz N, Rosenstein BS, Sawakuchi GO, Shaitelman SF, Powell SN, Woodward WA. The Implications of Genetic Testing on Radiation Therapy Decisions: A Guide for Radiation Oncologists. Int J Radiat Oncol Biol Phys 2019; 105:698-712. [PMID: 31381960 DOI: 10.1016/j.ijrobp.2019.07.026] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 06/21/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
The advent of affordable and rapid next-generation DNA sequencing technology, along with the US Supreme Court ruling invalidating gene patents, has led to a deluge of germline and tumor genetic variant tests that are being rapidly incorporated into clinical cancer decision-making. A major concern for clinicians is whether the presence of germline mutations may increase the risk of radiation toxicity or secondary malignancies. Because scarce clinical data exist to inform decisions at this time, the American Society for Radiation Oncology convened a group of radiation science experts and clinicians to summarize potential issues, review relevant data, and provide guidance for adult patients and their care teams regarding the impact, if any, that genetic testing should have on radiation therapy recommendations. During the American Society for Radiation Oncology workshop, several main points emerged, which are discussed in this manuscript: (1) variants of uncertain significance should be considered nondeleterious until functional genomic data emerge to demonstrate otherwise; (2) possession of germline alterations in a single copy of a gene critical for radiation damage responses does not necessarily equate to increased risk of radiation-induced toxicity; (3) deleterious ataxia-telangiesctasia gene mutations may modestly increase second cancer risk after radiation therapy, and thus follow-up for these patients after indicated radiation therapy should include second cancer screening; (4) conveying to patients the difference between relative and absolute risk is critical to decision-making; and (5) more work is needed to assess the impact of tumor somatic alterations on the probability of response to radiation therapy and the potential for individualization of radiation doses. Data on radiosensitivity related to specific genetic mutations is also briefly discussed.
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Affiliation(s)
- Carmen Bergom
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Catharine M West
- Division of Cancer Sciences, National Institute for Health Research Manchester Biomedical Research Centre, University of Manchester, Christie National Health Service Foundation Trust Hospital, Manchester, UK
| | - Daniel S Higginson
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mohamed E Abazeed
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio; Department of Translational Hematology Oncology Research, Cleveland Clinic, Cleveland, Ohio
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Soren M Bentzen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jonine L Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jaden D Evans
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota; Department of Radiation Oncology and Precision Genomics, Intermountain Healthcare, Ogden, Utah
| | - Naamit K Gerber
- Department of Radiation Oncology, New York University Langone Health, New York, New York
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester, Rochester, New York
| | - Judy Keen
- Scientific Affairs, American Society for Radiation Oncology, Arlington, Virginia
| | - Jennifer K Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anne S Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nadeem Riaz
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Gabriel O Sawakuchi
- Department of Radiation Physics The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Simona F Shaitelman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Simon N Powell
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Wendy A Woodward
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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19
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Kerns SL, Fung C, Fossa SD, Dinh PC, Monahan PO, Sesso HD, Frisina RD, Feldman DR, Hamilton RJ, Vaughn DJ, Martin NE, Huddart RA, Kollmannsberger CK, Sahasrabudhe DM, Ardeshirrouhanifard S, Einhorn LH, Travis LB. Impact of cisplatin-related adverse health outcomes (AHOs) on employment outcomes and self-reported health (SRH) among testicular cancer survivors (TCS). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e16058] [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
e16058 Background: We aim to provide new information on cisplatin-related AHOs and employment status in TCS and evaluate impact on SRH. Methods: 1,815 TCS ³1 year post-chemotherapy underwent physical exam, audiometry, renal function evaluation, and completed questionnaires. Therapy data were obtained from medical records. A cumulative burden of morbidity score (CBMPt) assessed the number and severity of platinum-related AHOs (peripheral sensory neuropathy (PSN), hearing loss, tinnitus, and renal function) with grading per CTCAE v4.03. Multivariable regression assessed relations between CBMPt score, individual AHOs and employment status as well as SRH, adjusting for sociodemographic/clinical factors. Unemployment in TCS was compared with subjects in the Behavioral Risk Factor Surveillance System (BRFSS) of similar age/race/ethnicity. Results: Almost 1 in 10 TCS were either on disability leave (2.4%) or unemployed (6.8%) at a median age of 37 yr (median follow-up: 4 yr). TCS with tinnitus (OR = 3.1, grade 3 vs. 0, P = 0.04), renal dysfunction (OR = 13.5, grade 3 vs. 0, P = 0.01), or pain (OR = 7.2 and 40.9, grade 2 or 3 vs. 0, respectively; P < 0.001 each) had significantly greater odds of disability leave vs. full-time employment after adjusting for sociodemographic/clinical factors; pain was strongly correlated with PSN (Pearson r2= 0.40; P < 0.001). CBMPt score was associated with disability leave (OR = 1.5, P = 0.04), but not with unemployment. A significantly higher percentage of TCS were unemployed vs. BRFSS norms (e.g. 3.6% of TCS age 35-39 vs. 2.0% in BRFSS). PSN (OR = 2.2, grade 3 vs. 0, P = 0.02), self-reported hearing loss (OR = 1.8, grade 2/3 vs. 0, P = 0.04), and pain (OR = 2.8 and 8.5, grade 2 or 3 vs. 0, respectively; P < 0.01 each) were each associated with increased odds of unemployment vs. full-time employment. Cisplatin-related AHOs and pain were associated with significantly worse SRH (P < 0.05). Conclusions: Our findings have new, important implications regarding productivity loss and socioeconomic costs in TCS. Survivorship care strategies should include inquiries about employment status, and every effort made to assist affected TCS in returning to the work force.
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Affiliation(s)
| | - Chunkit Fung
- University of Rochester Medical Center, Rochester, NY
| | | | - Paul C Dinh
- Indiana University School of Medicine, Indianapolis, IN
| | | | - Howard D. Sesso
- Division of Preventive Medicine, Harvard Medical School, Boston, MA
| | | | | | | | | | - Neil E. Martin
- Dana-Farber Cancer Institute/Brigham & Women's Hospital, Boston, MA
| | - Robert A Huddart
- The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, Surrey, United Kingdom
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Peppone LJ, Inglis JE, Mustian KM, Heckler CE, Padula GDA, Mohile SG, Kamen CS, Culakova E, Lin PJ, Kerns SL, Cole S, Janelsins MC. Multicenter Randomized Controlled Trial of Omega-3 Fatty Acids Versus Omega-6 Fatty Acids for the Control of Cancer-Related Fatigue Among Breast Cancer Survivors. JNCI Cancer Spectr 2019; 3:pkz005. [PMID: 31119206 PMCID: PMC6512349 DOI: 10.1093/jncics/pkz005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 07/09/2018] [Revised: 11/27/2018] [Accepted: 02/11/2019] [Indexed: 01/06/2023] Open
Abstract
Background Cancer-related fatigue (CRF) is a common side effect of adjuvant therapy and becomes a chronic problem for approximately one-third of survivors. Omega-3 polyunsaturated fatty acids (O3-PUFA) demonstrated preliminary antifatigue effects in previous research, but have not been investigated in fatigued cancer survivors. Methods Breast cancer survivors 4–36 months posttreatment with a CRF score of 4 or more of 10 using the symptom inventory (SI) were randomly assigned to O3-PUFA (fish oil, 6 g/d), omega-6 PUFA (O6-PUFA; soybean oil, 6 g/d), or a low-dose combination of O3-/O6-PUFA (3 g/d O3-PUFA and O6-PUFA) for 6 weeks. CRF was assessed by the SI (screening question), the Brief Fatigue Inventory, and the Multidimensional Fatigue Symptom Index. Protein and mRNA levels of inflammatory and antioxidant biomarkers, along with fatty acid and lipid levels, were assessed at baseline and week 6. Statistical tests were two-sided. Results A total of 108 breast cancer survivors consented; 97 subjects were randomly assigned and 81 completed the trial. The SI CRF score decreased by 2.51 points at week 6 with O6-PUFA and by 0.93 points with O3-PUFA, with statistically significant between-group difference (effect size = −0.86, P < .01). Similar changes were observed for the Brief Fatigue Inventory and Multidimensional Fatigue Symptom Index but were not statistically significant. Stratified analyses showed the largest benefit was observed in those with severe baseline CRF (≥7). Compared with O3-PUFA, O6-PUFA supplementation statistically significantly decreased proinflammatory markers in the TNF-α signaling pathway. Conclusion Contrary to our original hypothesis, O6-PUFA statistically significantly reduced CRF compared with O3-PUFA. Further research is needed to confirm these findings and to elucidate mechanisms of action.
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Affiliation(s)
- Luke J Peppone
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Julia E Inglis
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Karen M Mustian
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Charles E Heckler
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Gilbert D A Padula
- Cancer Research Consortium of West Michigan, Grand Rapids, MI, URMC, Rochester, NY
| | | | - Charles S Kamen
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Po-Ju Lin
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
| | - Sarah L Kerns
- Department of Radiation Oncology, URMC, Rochester, NY
| | - Sharon Cole
- Dayton Clinical Oncology Program, Dayton, OH
| | - Michelle C Janelsins
- Department of Surgery, University of Rochester Medical Center (URMC), Rochester, NY
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Schumacher FR, Olama AAA, Berndt SI, Benlloch S, Ahmed M, Saunders EJ, Dadaev T, Leongamornlert D, Anokian E, Cieza-Borrella C, Goh C, Brook MN, Sheng X, Fachal L, Dennis J, Tyrer J, Muir K, Lophatananon A, Stevens VL, Gapstur SM, Carter BD, Tangen CM, Goodman PJ, Thompson IM, Batra J, Chambers S, Moya L, Clements J, Horvath L, Tilley W, Risbridger GP, Gronberg H, Aly M, Nordström T, Pharoah P, Pashayan N, Schleutker J, Tammela TLJ, Sipeky C, Auvinen A, Albanes D, Weinstein S, Wolk A, Håkansson N, West CML, Dunning AM, Burnet N, Mucci LA, Giovannucci E, Andriole GL, Cussenot O, Cancel-Tassin G, Koutros S, Beane Freeman LE, Sorensen KD, Orntoft TF, Borre M, Maehle L, Grindedal EM, Neal DE, Donovan JL, Hamdy FC, Martin RM, Travis RC, Key TJ, Hamilton RJ, Fleshner NE, Finelli A, Ingles SA, Stern MC, Rosenstein BS, Kerns SL, Ostrer H, Lu YJ, Zhang HW, Feng N, Mao X, Guo X, Wang G, Sun Z, Giles GG, Southey MC, MacInnis RJ, FitzGerald LM, Kibel AS, Drake BF, Vega A, Gómez-Caamaño A, Szulkin R, Eklund M, Kogevinas M, Llorca J, Castaño-Vinyals G, Penney KL, Stampfer M, Park JY, Sellers TA, Lin HY, Stanford JL, Cybulski C, Wokolorczyk D, Lubinski J, Ostrander EA, Geybels MS, Nordestgaard BG, Nielsen SF, Weischer M, Bisbjerg R, Røder MA, Iversen P, Brenner H, Cuk K, Holleczek B, Maier C, Luedeke M, Schnoeller T, Kim J, Logothetis CJ, John EM, Teixeira MR, Paulo P, Cardoso M, Neuhausen SL, Steele L, Ding YC, De Ruyck K, De Meerleer G, Ost P, Razack A, Lim J, Teo SH, Lin DW, Newcomb LF, Lessel D, Gamulin M, Kulis T, Kaneva R, Usmani N, Singhal S, Slavov C, Mitev V, Parliament M, Claessens F, Joniau S, Van den Broeck T, Larkin S, Townsend PA, Aukim-Hastie C, Gago-Dominguez M, Castelao JE, Martinez ME, Roobol MJ, Jenster G, van Schaik RHN, Menegaux F, Truong T, Koudou YA, Xu J, Khaw KT, Cannon-Albright L, Pandha H, Michael A, Thibodeau SN, McDonnell SK, Schaid DJ, Lindstrom S, Turman C, Ma J, Hunter DJ, Riboli E, Siddiq A, Canzian F, Kolonel LN, Le Marchand L, Hoover RN, Machiela MJ, Cui Z, Kraft P, Amos CI, Conti DV, Easton DF, Wiklund F, Chanock SJ, Henderson BE, Kote-Jarai Z, Haiman CA, Eeles RA. Author Correction: Association analyses of more than 140,000 men identify 63 new prostate cancer susceptibility loci. Nat Genet 2019; 51:363. [PMID: 30622367 DOI: 10.1038/s41588-018-0330-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the version of this article initially published, the name of author Manuela Gago-Dominguez was misspelled as Manuela Gago Dominguez. The error has been corrected in the HTML and PDF version of the article.
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Affiliation(s)
- Fredrick R Schumacher
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center, University Hospitals, Cleveland, OH, USA
- Royal Marsden NHS Foundation Trust, London, UK
| | - Ali Amin Al Olama
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK.
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
- Royal Marsden NHS Foundation Trust, London, UK.
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
- Royal Marsden NHS Foundation Trust, London, UK
| | - Sara Benlloch
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Institute of Cancer Research, London, UK
| | | | | | | | | | | | | | - Chee Goh
- Institute of Cancer Research, London, UK
| | | | - Xin Sheng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Laura Fachal
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica, CIBERER, IDIS, Santiago de Compostela, Spain
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jonathan Tyrer
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Victoria L Stevens
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Brian D Carter
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Catherine M Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Phyllis J Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ian M Thompson
- CHRISTUS Santa Rosa Hospital-Medical Center, San Antonio, TX, USA
| | - Jyotsna Batra
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Translational Research Institute, Brisbane, Queensland, Australia
| | - Suzanne Chambers
- Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Leire Moya
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Translational Research Institute, Brisbane, Queensland, Australia
| | - Judith Clements
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Translational Research Institute, Brisbane, Queensland, Australia
| | - Lisa Horvath
- Chris O'Brien Lifehouse (COBLH), Camperdown, New South Wales, Australia
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Wayne Tilley
- Dame Roma Mitchell Cancer Research Centre, University of Adelaide, Adelaide, South Australia, Australia
| | - Gail P Risbridger
- Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Program, Department of Anatomy and Developmental Biology, Monash University, Victoria, Australia
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Henrik Gronberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Markus Aly
- Department of Urology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Nordström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences at Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Paul Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Nora Pashayan
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
- Department of Applied Health Research, University College London, London, UK
| | - Johanna Schleutker
- Institute of Biomedicine, University of Turku, Turku, Finland
- Tyks Microbiology and Genetics, Department of Medical Genetics, Turku University Hospital, Turku, Finland
| | - Teuvo L J Tammela
- Department of Urology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Csilla Sipeky
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Anssi Auvinen
- Department of Epidemiology, School of Health Sciences, University of Tampere, Tampere, Finland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Niclas Håkansson
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Catharine M L West
- Division of Cancer Sciences, Manchester Cancer Research Centre, Manchester Academic Health Science Centre and Christie NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Neil Burnet
- Department of Oncology, Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H., Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H., Chan School of Public Health, Boston, MA, USA
| | | | - Olivier Cussenot
- UPMC Sorbonne Universités, GRC no. 5 ONCOTYPE-URO, Tenon Hospital, Paris, France
- CeRePP, Tenon Hospital, Paris, France
| | - Géraldine Cancel-Tassin
- UPMC Sorbonne Universités, GRC no. 5 ONCOTYPE-URO, Tenon Hospital, Paris, France
- CeRePP, Tenon Hospital, Paris, France
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Karina Dalsgaard Sorensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Torben Falck Orntoft
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Borre
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Lovise Maehle
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | | | - David E Neal
- Department of Oncology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Cancer Research UK, Cambridge Research Institute, Cambridge, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK, Faculty of Medical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK, Faculty of Medical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tim J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robert J Hamilton
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sue Ann Ingles
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Harry Ostrer
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | | | - Ninghan Feng
- Wuxi Second Hospital, Nanjing Medical University, Wuxi, China
| | - Xueying Mao
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Xin Guo
- Department of Urology, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Guomin Wang
- Department of Urology, Zhongshan Hospital, Fudan University Medical College, Shanghai, China
| | - Zan Sun
- People's Hospital of Liaoning Province, People's Hospital of China Medical University, Shenyang, China
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Liesel M FitzGerald
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Adam S Kibel
- Division of Urologic Surgery, Brigham and Womens Hospital, Boston, MA, USA
| | - Bettina F Drake
- Washington University School of Medicine, St. Louis, MO, USA
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica, CIBERER, IDIS, Santiago de Compostela, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Robert Szulkin
- Division of Family Medicine, Department of Neurobiology, Care Science and Society, Karolinska, Institutet, Huddinge, Sweden
- Scandinavian Development Services, Danderyd, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manolis Kogevinas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria-IDIVAL, Santander, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Kathryn L Penney
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Meir Stampfer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Dominika Wokolorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Elaine A Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Milan S Geybels
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Sune F Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Maren Weischer
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Rasmus Bisbjerg
- Department of Urology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Martin Andreas Røder
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Katarina Cuk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Christiane Maier
- Institute for Human Genetics, University Hospital Ulm, Ulm, Germany
| | - Manuel Luedeke
- Institute for Human Genetics, University Hospital Ulm, Ulm, Germany
| | | | - Jeri Kim
- Department of Genitourinary Medical Oncology, University of Texas-MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher J Logothetis
- Department of Genitourinary Medical Oncology, University of Texas-MD Anderson Cancer Center, Houston, TX, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA
- Department of Health Research & Policy (Epidemiology) and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Paula Paulo
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Marta Cardoso
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Kim De Ruyck
- Faculty of Medicine and Health Sciences, Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Gert De Meerleer
- Faculty of Medicine and Health Sciences, Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Piet Ost
- Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium
| | - Azad Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Cancer Research Malaysia (CRM), Outpatient Centre, Subang Jaya Medical Centre, Selangor, Malaysia
| | - Daniel W Lin
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Lisa F Newcomb
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Davor Lessel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marija Gamulin
- Department of Oncology, Division of Medical Oncology, Urogenital Unit, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Nawaid Usmani
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Sandeep Singhal
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Chavdar Slavov
- Department of Urology and Alexandrovska University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Vanio Mitev
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Matthew Parliament
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Van den Broeck
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Samantha Larkin
- University of Southampton, Southampton General Hospital, Southampton, UK
| | - Paul A Townsend
- Division of Cancer Sciences, Manchester Cancer Research Centre, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Center, NIHR Manchester Biomedical Research Centre, Health Innovation Manchester, University of Manchester, Manchester, UK
| | | | - Manuela Gago-Dominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Instituto de Investigación Biomédica Galicia Sur (IISGS), Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Maria Elena Martinez
- Department of Family Medicine and Public Health, Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Guido Jenster
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Florence Menegaux
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Thérèse Truong
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Yves Akoli Koudou
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Jianfeng Xu
- Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, IL, USA
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, UK
| | - Lisa Cannon-Albright
- Division of Genetic Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | | | | | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Shannon K McDonnell
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Daniel J Schaid
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Sara Lindstrom
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Constance Turman
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jing Ma
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - David J Hunter
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Afshan Siddiq
- Genomics England, Queen Mary University of London, London, UK
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Laurence N Kolonel
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Zuxi Cui
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher I Amos
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Brian E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Rosalind A Eeles
- Institute of Cancer Research, London, UK.
- Royal Marsden NHS Foundation Trust, London, UK.
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22
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Inglis JE, Lin PJ, Kerns SL, Kleckner IR, Kleckner AS, Castillo DA, Mustian KM, Peppone LJ. Nutritional Interventions for Treating Cancer-Related Fatigue: A Qualitative Review. Nutr Cancer 2019; 71:21-40. [PMID: 30688088 DOI: 10.1080/01635581.2018.1513046] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cancer-related fatigue (CRF) is a debilitating syndrome that persists for many cancer survivors for years after treatment. Symptoms include early and persistent fatigue, functional decline, depression, and cognitive difficulties. Inflammation, assessed using pro-inflammatory biomarkers, is increased in cancer survivors with fatigue and treatments for fatigue are often aimed at reducing inflammation. Additionally, cancer and its treatment lead to nutritional complications, changes in body composition, and nutritional deficiencies that potentially weaken the cancer survivor and impact CRF. We conducted a qualitative review of clinical trials that assessed nutritional interventions for preventing and treating CRF. Further studies were examined that used nutritional interventions to address inflammation and fatigue, due to the dearth of nutrition research directly related to CRF. Dietary intake prior to, during, and after cancer treatment appears to affect fatigue levels. Increased protein intake may help preserve lean mass and body composition. Dietary patterns that reduce inflammation, such as the Mediterranean diet and other plant-based diets, appear tolerable to cancer survivors and may reduce fatigue. Supplementation with ginseng, ginger, or probiotics may improve cancer survivors' energy levels. Nutritional interventions, alone or in combination with other interventions should be considered as therapy for fatigue in cancer survivors.
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Affiliation(s)
- Julia E Inglis
- a Department of Surgery , University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Po-Ju Lin
- a Department of Surgery , University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Sarah L Kerns
- b Department of Radiation Oncology , University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Ian R Kleckner
- a Department of Surgery , University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Amber S Kleckner
- a Department of Surgery , University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Daniel A Castillo
- c Edward G. Miner Library, University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Karen M Mustian
- a Department of Surgery , University of Rochester Medical Center (URMC) , Rochester , New York , USA
| | - Luke J Peppone
- a Department of Surgery , University of Rochester Medical Center (URMC) , Rochester , New York , USA
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23
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Morton LM, Kerns SL, Dolan ME. Role of Germline Genetics in Identifying Survivors at Risk for Adverse Effects of Cancer Treatment. Am Soc Clin Oncol Educ Book 2018; 38:775-786. [PMID: 30231410 DOI: 10.1200/edbk_201391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The growing population of cancer survivors often faces adverse effects of treatment, which have a substantial impact on morbidity and mortality. Although certain adverse effects are thought to have a significant heritable component, much work remains to be done to understand the role of germline genetic factors in the development of treatment-related toxicities. In this article, we review current understanding of genetic susceptibility to a range of adverse outcomes among cancer survivors (e.g., fibrosis, urinary and rectal toxicities, ototoxicity, chemotherapy-induced peripheral neuropathy, subsequent malignancies). Most previous research has been narrowly focused, investigating variation in candidate genes and pathways such as drug metabolism, DNA damage and repair, and inflammation. Few of the findings from these earlier candidate gene studies have been replicated in independent populations. Advances in understanding of the genome, improvements in technology, and reduction in laboratory costs have led to recent genome-wide studies, which agnostically interrogate common and/or rare variants across the entire genome. Larger cohorts of patients with homogeneous treatment exposures and systematic ascertainment of well-defined outcomes as well as replication in independent study populations are essential aspects of the study design and are increasingly leading to the discovery of variants associated with each of the adverse outcomes considered in this review. In the long-term, validated germline genetic associations hold tremendous promise for more precisely identifying patients at highest risk for developing adverse treatment effects, with implications for frontline therapy decision-making, personalization of long-term follow-up guidelines, and potential identification of targets for prevention or treatment of the toxicity.
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Affiliation(s)
- Lindsay M Morton
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL
| | - Sarah L Kerns
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL
| | - M Eileen Dolan
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL
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Schumacher FR, Al Olama AA, Berndt SI, Benlloch S, Ahmed M, Saunders EJ, Dadaev T, Leongamornlert D, Anokian E, Cieza-Borrella C, Goh C, Brook MN, Sheng X, Fachal L, Dennis J, Tyrer J, Muir K, Lophatananon A, Stevens VL, Gapstur SM, Carter BD, Tangen CM, Goodman PJ, Thompson IM, Batra J, Chambers S, Moya L, Clements J, Horvath L, Tilley W, Risbridger GP, Gronberg H, Aly M, Nordström T, Pharoah P, Pashayan N, Schleutker J, Tammela TLJ, Sipeky C, Auvinen A, Albanes D, Weinstein S, Wolk A, Håkansson N, West CML, Dunning AM, Burnet N, Mucci LA, Giovannucci E, Andriole GL, Cussenot O, Cancel-Tassin G, Koutros S, Beane Freeman LE, Sorensen KD, Orntoft TF, Borre M, Maehle L, Grindedal EM, Neal DE, Donovan JL, Hamdy FC, Martin RM, Travis RC, Key TJ, Hamilton RJ, Fleshner NE, Finelli A, Ingles SA, Stern MC, Rosenstein BS, Kerns SL, Ostrer H, Lu YJ, Zhang HW, Feng N, Mao X, Guo X, Wang G, Sun Z, Giles GG, Southey MC, MacInnis RJ, FitzGerald LM, Kibel AS, Drake BF, Vega A, Gómez-Caamaño A, Szulkin R, Eklund M, Kogevinas M, Llorca J, Castaño-Vinyals G, Penney KL, Stampfer M, Park JY, Sellers TA, Lin HY, Stanford JL, Cybulski C, Wokolorczyk D, Lubinski J, Ostrander EA, Geybels MS, Nordestgaard BG, Nielsen SF, Weischer M, Bisbjerg R, Røder MA, Iversen P, Brenner H, Cuk K, Holleczek B, Maier C, Luedeke M, Schnoeller T, Kim J, Logothetis CJ, John EM, Teixeira MR, Paulo P, Cardoso M, Neuhausen SL, Steele L, Ding YC, De Ruyck K, De Meerleer G, Ost P, Razack A, Lim J, Teo SH, Lin DW, Newcomb LF, Lessel D, Gamulin M, Kulis T, Kaneva R, Usmani N, Singhal S, Slavov C, Mitev V, Parliament M, Claessens F, Joniau S, Van den Broeck T, Larkin S, Townsend PA, Aukim-Hastie C, Gago-Dominguez M, Castelao JE, Martinez ME, Roobol MJ, Jenster G, van Schaik RHN, Menegaux F, Truong T, Koudou YA, Xu J, Khaw KT, Cannon-Albright L, Pandha H, Michael A, Thibodeau SN, McDonnell SK, Schaid DJ, Lindstrom S, Turman C, Ma J, Hunter DJ, Riboli E, Siddiq A, Canzian F, Kolonel LN, Le Marchand L, Hoover RN, Machiela MJ, Cui Z, Kraft P, Amos CI, Conti DV, Easton DF, Wiklund F, Chanock SJ, Henderson BE, Kote-Jarai Z, Haiman CA, Eeles RA. Association analyses of more than 140,000 men identify 63 new prostate cancer susceptibility loci. Nat Genet 2018; 50:928-936. [PMID: 29892016 PMCID: PMC6568012 DOI: 10.1038/s41588-018-0142-8] [Citation(s) in RCA: 498] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/05/2018] [Indexed: 02/06/2023]
Abstract
Genome-wide association studies (GWAS) and fine-mapping efforts to date have identified more than 100 prostate cancer (PrCa)-susceptibility loci. We meta-analyzed genotype data from a custom high-density array of 46,939 PrCa cases and 27,910 controls of European ancestry with previously genotyped data of 32,255 PrCa cases and 33,202 controls of European ancestry. Our analysis identified 62 novel loci associated (P < 5.0 × 10-8) with PrCa and one locus significantly associated with early-onset PrCa (≤55 years). Our findings include missense variants rs1800057 (odds ratio (OR) = 1.16; P = 8.2 × 10-9; G>C, p.Pro1054Arg) in ATM and rs2066827 (OR = 1.06; P = 2.3 × 10-9; T>G, p.Val109Gly) in CDKN1B. The combination of all loci captured 28.4% of the PrCa familial relative risk, and a polygenic risk score conferred an elevated PrCa risk for men in the ninetieth to ninety-ninth percentiles (relative risk = 2.69; 95% confidence interval (CI): 2.55-2.82) and first percentile (relative risk = 5.71; 95% CI: 5.04-6.48) risk stratum compared with the population average. These findings improve risk prediction, enhance fine-mapping, and provide insight into the underlying biology of PrCa1.
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Affiliation(s)
- Fredrick R Schumacher
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
- Seidman Cancer Center, University Hospitals, Cleveland, OH, USA.
| | - Ali Amin Al Olama
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK.
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Sara Benlloch
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Institute of Cancer Research, London, UK
| | | | | | | | | | | | | | - Chee Goh
- Institute of Cancer Research, London, UK
| | | | - Xin Sheng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Laura Fachal
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica, CIBERER, IDIS, Santiago de Compostela, Spain
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jonathan Tyrer
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Victoria L Stevens
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Brian D Carter
- Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA
| | - Catherine M Tangen
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Phyllis J Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ian M Thompson
- CHRISTUS Santa Rosa Hospital-Medical Center, San Antonio, TX, USA
| | - Jyotsna Batra
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Translational Research Institute, Brisbane, Queensland, Australia
| | - Suzanne Chambers
- Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
- Cancer Council Queensland, Fortitude Valley, Queensland, Australia
| | - Leire Moya
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Translational Research Institute, Brisbane, Queensland, Australia
| | - Judith Clements
- Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Prostate Cancer Research Centre-Qld, Translational Research Institute, Brisbane, Queensland, Australia
| | - Lisa Horvath
- Chris O'Brien Lifehouse (COBLH), Camperdown, New South Wales, Australia
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Wayne Tilley
- Dame Roma Mitchell Cancer Research Centre, University of Adelaide, Adelaide, South Australia, Australia
| | - Gail P Risbridger
- Monash Biomedicine Discovery Institute Cancer Program, Prostate Cancer Research Program, Department of Anatomy and Developmental Biology, Monash University, Victoria, Australia
- Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Henrik Gronberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Markus Aly
- Department of Urology, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Nordström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences at Danderyds Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Paul Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Nora Pashayan
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
- Department of Applied Health Research, University College London, London, UK
| | - Johanna Schleutker
- Institute of Biomedicine, University of Turku, Turku, Finland
- Tyks Microbiology and Genetics, Department of Medical Genetics, Turku University Hospital, Turku, Finland
| | - Teuvo L J Tammela
- Department of Urology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Csilla Sipeky
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Anssi Auvinen
- Department of Epidemiology, School of Health Sciences, University of Tampere, Tampere, Finland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Stephanie Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Alicja Wolk
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Niclas Håkansson
- Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Catharine M L West
- Division of Cancer Sciences, Manchester Cancer Research Centre, Manchester Academic Health Science Centre and Christie NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Neil Burnet
- Department of Oncology, Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, University of Cambridge, Cambridge, UK
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Olivier Cussenot
- UPMC Sorbonne Universités, GRC no. 5 ONCOTYPE-URO, Tenon Hospital, Paris, France
- CeRePP, Tenon Hospital, Paris, France
| | - Géraldine Cancel-Tassin
- UPMC Sorbonne Universités, GRC no. 5 ONCOTYPE-URO, Tenon Hospital, Paris, France
- CeRePP, Tenon Hospital, Paris, France
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Karina Dalsgaard Sorensen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Torben Falck Orntoft
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Michael Borre
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Urology, Aarhus University Hospital, Aarhus, Denmark
| | - Lovise Maehle
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | | | - David E Neal
- Department of Oncology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
- Cancer Research UK, Cambridge Research Institute, Cambridge, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK, Faculty of Medical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Jenny L Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK, Faculty of Medical Science, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - Richard M Martin
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Tim J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Robert J Hamilton
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Neil E Fleshner
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Antonio Finelli
- Division of Urology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sue Ann Ingles
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Mariana C Stern
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Harry Ostrer
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | | | - Ninghan Feng
- Wuxi Second Hospital, Nanjing Medical University, Wuxi, China
| | - Xueying Mao
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Xin Guo
- Department of Urology, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Guomin Wang
- Department of Urology, Zhongshan Hospital, Fudan University Medical College, Shanghai, China
| | - Zan Sun
- People's Hospital of Liaoning Province, People's Hospital of China Medical University, Shenyang, China
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Liesel M FitzGerald
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Adam S Kibel
- Division of Urologic Surgery, Brigham and Womens Hospital, Boston, MA, USA
| | - Bettina F Drake
- Washington University School of Medicine, St. Louis, MO, USA
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica, CIBERER, IDIS, Santiago de Compostela, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | - Robert Szulkin
- Division of Family Medicine, Department of Neurobiology, Care Science and Society, Karolinska, Institutet, Huddinge, Sweden
- Scandinavian Development Services, Danderyd, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manolis Kogevinas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Javier Llorca
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- University of Cantabria-IDIVAL, Santander, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- IMIM (Hospital del Mar Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Kathryn L Penney
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Meir Stampfer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jong Y Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Thomas A Sellers
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Janet L Stanford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Dominika Wokolorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Elaine A Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Milan S Geybels
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Sune F Nielsen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Maren Weischer
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Rasmus Bisbjerg
- Department of Urology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Martin Andreas Røder
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Peter Iversen
- Copenhagen Prostate Cancer Center, Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Katarina Cuk
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Christiane Maier
- Institute for Human Genetics, University Hospital Ulm, Ulm, Germany
| | - Manuel Luedeke
- Institute for Human Genetics, University Hospital Ulm, Ulm, Germany
| | | | - Jeri Kim
- Department of Genitourinary Medical Oncology, University of Texas-MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher J Logothetis
- Department of Genitourinary Medical Oncology, University of Texas-MD Anderson Cancer Center, Houston, TX, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA
- Department of Health Research & Policy (Epidemiology) and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Paula Paulo
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Marta Cardoso
- Department of Genetics, Portuguese Oncology Institute of Porto, Porto, Portugal
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, USA
| | - Kim De Ruyck
- Faculty of Medicine and Health Sciences, Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Gert De Meerleer
- Faculty of Medicine and Health Sciences, Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Piet Ost
- Department of Radiotherapy, Ghent University Hospital, Ghent, Belgium
| | - Azad Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo-Hwang Teo
- Cancer Research Malaysia (CRM), Outpatient Centre, Subang Jaya Medical Centre, Selangor, Malaysia
| | - Daniel W Lin
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Lisa F Newcomb
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Davor Lessel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marija Gamulin
- Department of Oncology, Division of Medical Oncology, Urogenital Unit, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Tomislav Kulis
- Department of Urology, University Hospital Center Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Radka Kaneva
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Nawaid Usmani
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Sandeep Singhal
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Chavdar Slavov
- Department of Urology and Alexandrovska University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Vanio Mitev
- Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, Bulgaria
| | - Matthew Parliament
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Van den Broeck
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Samantha Larkin
- University of Southampton, Southampton General Hospital, Southampton, UK
| | - Paul A Townsend
- Division of Cancer Sciences, Manchester Cancer Research Centre, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Center, NIHR Manchester Biomedical Research Centre, Health Innovation Manchester, University of Manchester, Manchester, UK
| | | | - Manuela Gago-Dominguez
- Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, Santiago de Compostela, Spain
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Jose Esteban Castelao
- Genetic Oncology Unit, CHUVI Hospital, Instituto de Investigación Biomédica Galicia Sur (IISGS), Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - Maria Elena Martinez
- Department of Family Medicine and Public Health, Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Monique J Roobol
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Guido Jenster
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Florence Menegaux
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Thérèse Truong
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Yves Akoli Koudou
- Cancer & Environment Group, Center for Research in Epidemiology and Population Health (CESP), INSERM, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Jianfeng Xu
- Program for Personalized Cancer Care, NorthShore University HealthSystem, Evanston, IL, USA
| | - Kay-Tee Khaw
- Clinical Gerontology Unit, University of Cambridge, Cambridge, UK
| | - Lisa Cannon-Albright
- Division of Genetic Epidemiology, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | | | | | - Stephen N Thibodeau
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Shannon K McDonnell
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Daniel J Schaid
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Sara Lindstrom
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Constance Turman
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jing Ma
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - David J Hunter
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Afshan Siddiq
- Genomics England, Queen Mary University of London, London, UK
| | - Federico Canzian
- Genomic Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Laurence N Kolonel
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Mitchell J Machiela
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Zuxi Cui
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Peter Kraft
- Program in Genetic Epidemiology and Statistical Genetics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Christopher I Amos
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Douglas F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Laboratory, University of Cambridge, Cambridge, UK
| | - Fredrik Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, USA
| | - Brian E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | | | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Rosalind A Eeles
- Institute of Cancer Research, London, UK.
- Royal Marsden NHS Foundation Trust, London, UK.
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Kang J, Rancati T, Lee S, Oh JH, Kerns SL, Scott JG, Schwartz R, Kim S, Rosenstein BS. Machine Learning and Radiogenomics: Lessons Learned and Future Directions. Front Oncol 2018; 8:228. [PMID: 29977864 PMCID: PMC6021505 DOI: 10.3389/fonc.2018.00228] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/04/2018] [Indexed: 12/25/2022] Open
Abstract
Due to the rapid increase in the availability of patient data, there is significant interest in precision medicine that could facilitate the development of a personalized treatment plan for each patient on an individual basis. Radiation oncology is particularly suited for predictive machine learning (ML) models due to the enormous amount of diagnostic data used as input and therapeutic data generated as output. An emerging field in precision radiation oncology that can take advantage of ML approaches is radiogenomics, which is the study of the impact of genomic variations on the sensitivity of normal and tumor tissue to radiation. Currently, patients undergoing radiotherapy are treated using uniform dose constraints specific to the tumor and surrounding normal tissues. This is suboptimal in many ways. First, the dose that can be delivered to the target volume may be insufficient for control but is constrained by the surrounding normal tissue, as dose escalation can lead to significant morbidity and rare. Second, two patients with nearly identical dose distributions can have substantially different acute and late toxicities, resulting in lengthy treatment breaks and suboptimal control, or chronic morbidities leading to poor quality of life. Despite significant advances in radiogenomics, the magnitude of the genetic contribution to radiation response far exceeds our current understanding of individual risk variants. In the field of genomics, ML methods are being used to extract harder-to-detect knowledge, but these methods have yet to fully penetrate radiogenomics. Hence, the goal of this publication is to provide an overview of ML as it applies to radiogenomics. We begin with a brief history of radiogenomics and its relationship to precision medicine. We then introduce ML and compare it to statistical hypothesis testing to reflect on shared lessons and to avoid common pitfalls. Current ML approaches to genome-wide association studies are examined. The application of ML specifically to radiogenomics is next presented. We end with important lessons for the proper integration of ML into radiogenomics.
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Affiliation(s)
- John Kang
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, United States
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sangkyu Lee
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Sarah L. Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, United States
| | - Jacob G. Scott
- Department of Translational Hematology and Oncology Research, Cleveland Clinic, Cleveland, OH, United States
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, United States
| | - Russell Schwartz
- Computational Biology Department, Carnegie Mellon School of Computer Science, Pittsburgh, PA, United States
- Department of Biological Sciences, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Seyoung Kim
- Computational Biology Department, Carnegie Mellon School of Computer Science, Pittsburgh, PA, United States
| | - Barry S. Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Kerns SL, Chuang KH, Hall W, Werner Z, Chen Y, Ostrer H, West C, Rosenstein B. Radiation biology and oncology in the genomic era. Br J Radiol 2018; 91:20170949. [PMID: 29888979 DOI: 10.1259/bjr.20170949] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Radiobiology research is building the foundation for applying genomics in precision radiation oncology. Advances in high-throughput approaches will underpin increased understanding of radiosensitivity and the development of future predictive assays for clinical application. There is an established contribution of genetics as a risk factor for radiotherapy side effects. An individual's radiosensitivity is an inherited polygenic trait with an architecture that includes rare mutations in a few genes that confer large effects and common variants in many genes with small effects. Current thinking is that some will be tissue specific, and future tests will be tailored to the normal tissues at risk. The relationship between normal and tumor cell radiosensitivity is poorly understood. Data are emerging suggesting interplay between germline genetic variation and epigenetic modification with growing evidence that changes in DNA methylation regulate the radiosensitivity of cancer cells and histone acetyltransferase inhibitors have radiosensitizing effects. Changes in histone methylation can also impair DNA damage response signaling and alter radiosensitivity. An important effort to advance radiobiology in the genomic era was establishment of the Radiogenomics Consortium to enable the creation of the large radiotherapy cohorts required to exploit advances in genomics. To address challenges in harmonizing data from multiple cohorts, the consortium established the REQUITE project to collect standardized data and genotyping for ~5,000 patients. The collection of detailed dosimetric data is important to produce validated multivariable models. Continued efforts will identify new genes that impact on radiosensitivity to generate new knowledge on toxicity pathogenesis and tests to incorporate into the clinical decision-making process.
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Affiliation(s)
- Sarah L Kerns
- 1 Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY , USA.,2 Department of Surgery, University of Rochester Medical Center , Rochester, NY , USA
| | - Kuang-Hsiang Chuang
- 1 Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY , USA
| | - William Hall
- 3 Department of Radiation Oncology, Medical College of Wisconsin and Clement J Zablocki VA Medical Center Milwaukee , Milwaukee, WI , USA
| | - Zachary Werner
- 1 Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY , USA.,2 Department of Surgery, University of Rochester Medical Center , Rochester, NY , USA
| | - Yuhchyau Chen
- 1 Department of Radiation Oncology, University of Rochester Medical Center , Rochester, NY , USA
| | - Harry Ostrer
- 4 Departments of Pathology and Pediatrics, Albert Einstein College of Medicine , Bronx, NY , USA
| | - Catharine West
- 5 Division of Cancer Sciences, University of Manchester, Christie Hospital , Manchester , UK
| | - Barry Rosenstein
- 6 Departments of Radiation Oncology, Genetics and Genomic Sciences, and Dermatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA
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Kerns SL, Fung C, Monahan PO, Ardeshir-Rouhani-Fard S, Abu Zaid MI, Williams AM, Stump TE, Sesso HD, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Huddart RA, Kim J, Kollmannsberger C, Sahasrabudhe DM, Cook R, Fossa SD, Einhorn LH, Travis LB. Cumulative Burden of Morbidity Among Testicular Cancer Survivors After Standard Cisplatin-Based Chemotherapy: A Multi-Institutional Study. J Clin Oncol 2018; 36:1505-1512. [PMID: 29617189 DOI: 10.1200/jco.2017.77.0735] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among > 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs). Patients and Methods Participants were ≤ 55 years of age at diagnosis, finished first-line chemotherapy ≥ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred. Results Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen ( P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (χ2 P < .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8). Conclusion Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.
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Affiliation(s)
- Sarah L Kerns
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Chunkit Fung
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Patrick O Monahan
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Shirin Ardeshir-Rouhani-Fard
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Mohammad I Abu Zaid
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - AnnaLynn M Williams
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Timothy E Stump
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Howard D Sesso
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Darren R Feldman
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Robert J Hamilton
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - David J Vaughn
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Clair Beard
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Robert A Huddart
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Jeri Kim
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Christian Kollmannsberger
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Deepak M Sahasrabudhe
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Ryan Cook
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Sophie D Fossa
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Lawrence H Einhorn
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
| | - Lois B Travis
- Sarah L. Kerns, Chunkit Fung, AnnaLynn M. Williams, and Deepak M. Sahasrabudhe, University of Rochester Medical Center, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Mohammad I. Abu Zaid, Timothy E. Stump, Ryan Cook, Lawrence H. Einhorn, and Lois B. Travis, Indiana University, Indianapolis, IN; Howard D. Sesso, Brigham and Women's Hospital; Clair Beard, Dana-Farber Cancer Institute, Boston, MA; Robert J. Hamilton, Princess Margaret Cancer Centre, Toronto, Ontario; Christian Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Robert A. Huddart, The Royal Marsden Hospital, London, United Kingdom; Jeri Kim, MD Anderson Cancer Center, Houston, TX; and Sophie D. Fossa, Oslo University Hospital, Oslo, Norway
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Termer NK, Richardson M, Adams MJ, Alongi A, Bellohusen P, Bruckner LB, Cowen R, Fritsch S, Hettler D, Kerns SL, Pandya C, Williams A, Constine LS. Meeting requirements for survivorship visits: Interventions for patient identification. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.7_suppl.59] [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
59 Background: A major challenge in providing quality survivorship care to cancer patients is efficiently and effectively identifying and scheduling patients who need a Survivorship Visit (SV). While the Commission on Cancer (CoC) Standard 3.3 defines which patients require a Survivorship Care Plan (SCP), staff need to operationalize the definition and search the clinic’s patient records on a regular basis to accurately identify eligible patients. This is a challenge for a busy cancer center. Methods: In July 2017 the Judy DiMarzo Cancer Survivorship Program instituted a full time Data Analyst (DA) to assist in identifying survivors using the OncoLog Cancer Registry and the Electronic Medical Record (EMR). Previously the identification process was limited to the EMR, and the Survivorship Program Nurse Coordinator (NC) was a combined role overseeing metrics, identifying patients and assisting with SVs. Currently the DA has piloted a method extracting data monthly from OncoLog and the EMR to assess eligibility of Standard 3.3. The data is compiled and sent to the NC who assists the cancer-specific service lines responsible for the patients identified to ensure SVs occur in a timely manner. Results: Our pilot intervention resulted in a 283% increase in SVs per month, from an average of 30 SVs to 115 SVs per month. The overall achievement for the CoC SV delivery requirement increased from 16% prior to the intervention to 33% in just 3 months. GI increased from 5% to 20%. Lung increased from 16% to 39%. The average SV was 3 months after the end of treatment. Approximately 60 hours was dedicated to establishing this method and 35 hours per month in the eligibility, identification process. Conclusions: By adding a DA role, extracting data from Oncolog and the EMR, as well as increasing accountability at the service line level to improve identification and scheduling of eligible patients, the delivery of SCPs to eligible patients substantially increased. Nevertheless this process is time consuming and will likely not be sufficient to ensure that all eligible survivors receive appropriate care. Consequently, additional, systematic improvements in this process should be explored such as EMR methodologies to automate patient identification.
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Affiliation(s)
| | | | - M Jacob Adams
- University of Rochester Medical Center, Rochester, NY
| | | | | | | | - Richard Cowen
- University of Rochester Medical Center, Rochester, NY
| | - Susan Fritsch
- University of Rochester Medical Center, Rochester, NY
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Abstract
Advances in patient-specific information and biotechnology have contributed to a new era of computational medicine. Radiogenomics has emerged as a new field that investigates the role of genetics in treatment response to radiation therapy. Radiation oncology is currently attempting to embrace these recent advances and add to its rich history by maintaining its prominent role as a quantitative leader in oncologic response modeling. Here, we provide an overview of radiogenomics starting with genotyping, data aggregation, and application of different modeling approaches based on modifying traditional radiobiological methods or application of advanced machine learning techniques. We highlight the current status and potential for this new field to reshape the landscape of outcome modeling in radiotherapy and drive future advances in computational oncology.
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Affiliation(s)
- Issam El Naqa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States of America
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30
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Peppone LJ, Mustian KM, Peoples AR, Kerns SL, Reschke JE, Cole C, Janelsins MC, Asare M, Kamen CS, Culakova E, Zhang H, Fung C, Lin PJ, Mohile SG. A phase II RCT of high-dose vitamin D supplementation for androgen deprivation therapy (ADT)-induced bone loss among older prostate cancer (PCa) patients. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.10113] [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
10113 Background: ADT is the most commonly used systemic therapy for treating locally advanced and metastatic PCa. ADT use causes hypogonadism, which can result in accelerated bone loss and fragility fractures. Vitamin D (VITD) may protect against bone loss; however it remains unclear if the recommended daily allowance (RDA) of VITD is sufficient to reduce bone loss or whether higher doses are needed. The aim of this phase II RCT was to collect preliminary data on the effect of high-dose VITD on bone mineral density (BMD) in ADT-treated PCa patients compared to the RDA of VITD. Methods: Older PCa patients (≥60 years old) with VITD insufficiency ( < 32 ng/ml), within 6 months of starting ADT and with 6 more planned months of ADT were randomized 1:1 to high-dose VITD (hVITD; 600 IU/daily plus 50,000 IU/weekly) or RDA of VITD (rVITD; 600 IU/daily plus placebo weekly) for 24 weeks. All subjects received 100% of the RDA for calcium (1,000 mg/day). BMD was assessed at the total hip (TH) and lumbar spine (LS) via DXA at pre- and post-intervention. ANCOVA was used to test the change in BMD between groups. Results: 59 PCa patients were accrued (85% white; mean age = 67.6). Serum analyses confirmed high compliance in both groups (25-OH VITD change: hVITD = +32.0 ng/ml vs rVITD = +4.3 ng/ml; p < 0.01). The safety of hVITD was similar to rVITD (Grade I hypercalcemia: hVITD: n = 1 vs rVITD: n = 0). Bone loss was significantly reduced for the hVITD group compared to rVITD group for total hip (TH BMD% change: hVITD = −1.5% vs rVITD = −4.1%; p = 0.02), with a trend for the femoral neck (BMD% change: hVITD = −1.7% vs rVITD = −4.3%; p = 0.06) and trochanter (BMD% change: hVITD = −1.0% vs rVITD = −2.8%; p = 0.10). There was no difference between groups for LS bone loss (LS BMD% change: hVITD = −0.8% vs rVITD = −0.6%; p = 0.75). Conclusions: High-dose VITD supplementation produced significantly greater reductions in hip BMD loss among older PCa patients receiving ADT compared to rVITD. Clinically, higher doses of VITD may be necessary to effectively prevent ADT-induced bone loss. A definitive phase III RCT is needed to confirm these findings. Funding: NCI R21CA175793, K07CA168911 & UG1CA189961. Bio-Tech Pharmacal Inc. supplied all agents. Clinical trial information: NCT02064946.
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Affiliation(s)
| | | | | | | | | | - Calvin Cole
- University of Rochester Medical Center, Rochester, NY
| | | | - Matthew Asare
- University of Rochester Medical Center, Rochester, NY
| | | | - Eva Culakova
- University of Rochester Medical Center, Rochester, NY
| | - Hong Zhang
- University of Rochester Medical Center, Rochester, NY
| | - Chunkit Fung
- University of Rochester Medical Center, Rochester, NY
| | - Po-Ju Lin
- University of Rochester Medical Center, Rochester, NY
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Kerns SL, Fung C, Williams A, Abu Zaid MI, Sesso HD, Monahan P, Ardeshirrouhanifard S, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Huddart RA, Kim J, Kollmannsberger CK, Sahasrabudhe DM, Morlang AA, Cook R, Fossa SD, Einhorn LH, Travis LB. Clinical, sociodemographic, and behavioral factors associated with cumulative burden of morbidity (CBM) among testicular cancer survivors (TCS) in the Platinum study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.10075] [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
10075 Background: TCS are an important group in which to characterize late effects of cancer and its therapy given their young age at diagnosis and high cure rate. We comprehensively evaluated CBM and identified associated clinical, sociodemographic, and behavioral risk factors among TCS given cisplatin based chemotherapy in a multicenter study. Methods: TCS completed a comprehensive health questionnaire. Responses were grouped into 22 adverse health outcomes (AHO) and graded by severity. A CBM score was calculated based on AHO number and severity, following Geenen et al (JAMA 2007). Multivariable ordinal logistic regression examined the association of clinical, sociodemographic, and behavioral factors with CBM. Variable-based hierarchical clustering identified individual AHOs that co-occurred. Results: Among 1,215 TCS (median age at evaluation 38 y, range 19-68 y; time since chemotherapy 4.6 y), over 20% had a CBM score of high (17%), very high (4%) or severe (0.4%). Most TCS, however, had CBM scores of low (37%), medium (28%), very low (9%) or none (5%). In a multivariable model controlling for time since chemotherapy, older attained age (OR 1.2; 95% CI 1.1 - 1.3), being widowed/divorced/separated (OR 1.8; 95% CI 1.1 - 3.1), having less than college-level education (OR 1.7; 95% CI 1.3 - 2.2), being retired/on disability (OR 2.5; 95% CI 1.2 - 5.3), and receipt of 4 cycles of BEP vs. 4 cycles of EP or 3 cycles of BEP (OR 1.3; 95% CI 1.01 - 1.8) were associated with increased odds of a worse CBM score; vigorous exercise (OR 0.7; 95% CI 0.5 - 0.9) and non-white race (OR 0.6; 95% CI 0.4 - 0.9) were associated with decreased odds. A separate cluster analysis revealed five groups of AHOs: those known to be cisplatin-related (e.g. neuropathy, ototoxicity); metabolic abnormalities (e.g. hypercholesterolemia, diabetes); vascular damage (e.g. stroke); testicular cancer-related (e.g. hypogonadism); and other (e.g. thyroid disease). Conclusions: TCS with factors associated with worse CBM may be candidates for closer monitoring. If confirmed, our cluster analysis showing that groups of conditions tend to co-occur in TCS could provide guidance for survivorship care plans.
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Affiliation(s)
| | - Chunkit Fung
- University of Rochester Medical Center, Rochester, NY
| | | | | | - Howard D. Sesso
- Division of Preventive Medicine, Harvard Medical School, Boston, MA
| | | | | | | | | | | | - Clair Beard
- Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA
| | | | - Jeri Kim
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Ryan Cook
- Indiana University School of Medicine, Indianapolis, IN
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Azria D, Lapierre A, Gourgou S, De Ruysscher D, Colinge J, Lambin P, Brengues M, Ward T, Bentzen SM, Thierens H, Rancati T, Talbot CJ, Vega A, Kerns SL, Andreassen CN, Chang-Claude J, West CML, Gill CM, Rosenstein BS. Data-Based Radiation Oncology: Design of Clinical Trials in the Toxicity Biomarkers Era. Front Oncol 2017; 7:83. [PMID: 28497027 PMCID: PMC5406456 DOI: 10.3389/fonc.2017.00083] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/13/2017] [Indexed: 12/15/2022] Open
Abstract
The ability to stratify patients using a set of biomarkers, which predict that toxicity risk would allow for radiotherapy (RT) modulation and serve as a valuable tool for precision medicine and personalized RT. For patients presenting with tumors with a low risk of recurrence, modifying RT schedules to avoid toxicity would be clinically advantageous. Indeed, for the patient at low risk of developing radiation-associated toxicity, use of a hypofractionated protocol could be proposed leading to treatment time reduction and a cost-utility advantage. Conversely, for patients predicted to be at high risk for toxicity, either a more conformal form or a new technique of RT, or a multidisciplinary approach employing surgery could be included in the trial design to avoid or mitigate RT when the potential toxicity risk may be higher than the risk of disease recurrence. In addition, for patients at high risk of recurrence and low risk of toxicity, dose escalation, such as a greater boost dose, or irradiation field extensions could be considered to improve local control without severe toxicities, providing enhanced clinical benefit. In cases of high risk of toxicity, tumor control should be prioritized. In this review, toxicity biomarkers with sufficient evidence for clinical testing are presented. In addition, clinical trial designs and predictive models are described for different clinical situations.
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Affiliation(s)
- David Azria
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Ariane Lapierre
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Sophie Gourgou
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Dirk De Ruysscher
- Department of Radiation Oncology, Maastricht University Medical Centre, MAASTRO Clinic, Maastricht, Netherlands
- Radiation Oncology, KU Leuven, Leuven, Belgium
| | - Jacques Colinge
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Philippe Lambin
- Department of Radiation Oncology, Maastricht University Medical Centre, MAASTRO Clinic, Maastricht, Netherlands
| | - Muriel Brengues
- Department of Radiation Oncology, Radiobiology Unit, Biometric and Bio-informatic Divisions, Montpellier Cancer Institute (ICM), IRCM, INSERM U1194, Montpellier, France
| | - Tim Ward
- Patient Advocate, Manchester, UK
| | - Søren M. Bentzen
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Tiziana Rancati
- Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Ana Vega
- Fundacion Publica Galega de Medicina Xenomica-SERGAS, Grupo de Medicina Xenomica-USC, IDIS, CIBERER, Santiago de Compostela, Spain
| | - Sarah L. Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Catharine M. L. West
- Division of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital NHS Trust, Manchester, UK
| | - Corey M. Gill
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barry S. Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Fung C, Sesso HD, Williams AM, Kerns SL, Monahan P, Abu Zaid M, Feldman DR, Hamilton RJ, Vaughn DJ, Beard CJ, Kollmannsberger CK, Cook R, Althouse S, Ardeshir-Rouhani-Fard S, Lipshultz SE, Einhorn LH, Fossa SD, Travis LB. Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy. J Clin Oncol 2017; 35:1211-1222. [PMID: 28240972 DOI: 10.1200/jco.2016.70.3108] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking ( P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased ( P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.
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Affiliation(s)
- Chunkit Fung
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Howard D Sesso
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Annalynn M Williams
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Sarah L Kerns
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Patrick Monahan
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Mohammad Abu Zaid
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Darren R Feldman
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Robert J Hamilton
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - David J Vaughn
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Clair J Beard
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Christian K Kollmannsberger
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Ryan Cook
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Sandra Althouse
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Shirin Ardeshir-Rouhani-Fard
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Steve E Lipshultz
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Lawrence H Einhorn
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Sophie D Fossa
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Lois B Travis
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children's Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
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Constine LS, Termer NK, Holub D, Fung C, Adams MJ, Dhakal S, Bruckner LB, Marsh B, Kerns SL, Noyes K, Williams A, Fritsch S, Lustig C, Lynch C, Nelson S, Menchel HL, Sahler OJ, Milano MT, Galka E, Shayne M. An integrative approach to personalized cancer survivorship care at an academic medical center. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.5_suppl.37] [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
37 Background: Quality cancer survivorship care has multiple missions 1) develop personalized disease-specific treatment summaries (TS) and evidence-based survivorship plans (SPs), 2) foster recognition amongst Primary Care Providers (PCPs) of the consequences of cancer and its therapy, 3) coordinate care amongst providers, 4) use technology to foster communication and mining data, 5) train residents/fellows, 6) determine knowledge gaps for research, 7) engage community health providers, 8) publicize and raise funds, and 9) develop metrics to assess outcomes. Here we describe initial steps toward these goals. Methods: The University of Rochester Judy DiMarzo Cancer Survivorship program is a multidisciplinary effort across 7 centers involving oncologists, PCPs, social workers, integrated oncology, legal/financial services, and survivors. Survivors are identified at two critical time points: after (1) completion of primary curative therapy = transition visit, (2) discontinuation of routine oncologic follow-up and transition of care to their PCP = shared care visit. These visits are staffed within each cancer discipline. Trainees (15-20/year) probe existing evidence and draft TS/SP templates that are vetted by that cancer discipline. Patient needs are surveyed; institutional and community resources are identified. Results: In 3 years, 1037 patients had survivorship visits - 859 transition visits, 178 shared care visits. Cancers include breast (31%), head & neck (17%), lymphoma (15%), GI (15%), GU (11%), GYN (7%), lung (3%), melanoma and sarcoma (1%) with continuing refinement of systematic patient identification. Visits by year were: 120 in 2013, 266 in 2014, and 470 in 2015. Amongst the 1037 patients, the 6 most common needs were exercise, emotional, return to work, nutrition, financial, and pain. Conclusions: Our program is systematically embracing challenges to deliver evidence-based, individualized TS/SPs for survivors, as well as train future oncology providers in survivorship care. Current areas of focus are better engaging PCPs, ensuring program sustainability, improving technology use to mine data, measuring outcomes, establishing rural outreach, and fostering survivorship research.
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Affiliation(s)
| | | | - David Holub
- University of Rochester Medical Center, Rochester, NY
| | - Chunkit Fung
- University of Rochester Medical Center, Rochester, NY
| | | | | | | | - Bethany Marsh
- University of Rochester Medical Center, Rochester, NY
| | | | | | - AnnaLynn Williams
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Susan Fritsch
- University of Rochester Medical Center, Rochester, NY
| | - Carol Lustig
- University of Rochester Medical Center, Rochester, NY
| | - Claire Lynch
- University of Rochester Medical Center, Rochester, NY
| | - Susan Nelson
- University of Rochester Medical Center, Rochester, NY
| | | | | | | | - Eva Galka
- University of Rochester Medical Center, Rochester, NY
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35
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Andreassen CN, Rosenstein BS, Kerns SL, Ostrer H, De Ruysscher D, Cesaretti JA, Barnett GC, Dunning AM, Dorling L, West CML, Burnet NG, Elliott R, Coles C, Hall E, Fachal L, Vega A, Gómez-Caamaño A, Talbot CJ, Symonds RP, De Ruyck K, Thierens H, Ost P, Chang-Claude J, Seibold P, Popanda O, Overgaard M, Dearnaley D, Sydes MR, Azria D, Koch CA, Parliament M, Blackshaw M, Sia M, Fuentes-Raspall MJ, Ramon Y Cajal T, Barnadas A, Vesprini D, Gutiérrez-Enríquez S, Mollà M, Díez O, Yarnold JR, Overgaard J, Bentzen SM, Alsner J. Individual patient data meta-analysis shows a significant association between the ATM rs1801516 SNP and toxicity after radiotherapy in 5456 breast and prostate cancer patients. Radiother Oncol 2016; 121:431-439. [PMID: 27443449 PMCID: PMC5559879 DOI: 10.1016/j.radonc.2016.06.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/18/2016] [Accepted: 06/29/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Several small studies have indicated that the ATM rs1801516 SNP is associated with risk of normal tissue toxicity after radiotherapy. However, the findings have not been consistent. In order to test this SNP in a well-powered study, an individual patient data meta-analysis was carried out by the International Radiogenomics Consortium. MATERIALS AND METHODS The analysis included 5456 patients from 17 different cohorts. 2759 patients were given radiotherapy for breast cancer and 2697 for prostate cancer. Eight toxicity scores (overall toxicity, acute toxicity, late toxicity, acute skin toxicity, acute rectal toxicity, telangiectasia, fibrosis and late rectal toxicity) were analyzed. Adjustments were made for treatment and patient related factors with potential impact on the risk of toxicity. RESULTS For all endpoints except late rectal toxicity, a significantly increased risk of toxicity was found for carriers of the minor (Asn) allele with odds ratios of approximately 1.5 for acute toxicity and 1.2 for late toxicity. The results were consistent with a co-dominant pattern of inheritance. CONCLUSION This study convincingly showed a significant association between the ATM rs1801516 Asn allele and increased risk of radiation-induced normal tissue toxicity.
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Affiliation(s)
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, USA; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Harry Ostrer
- Departments of Pathology and Pediatrics, Albert Einstein College of Medicine, New York, USA
| | - Dirk De Ruysscher
- Department of Radiotherapy (Maastro Clinic), Maastricht University Medical Center, The Netherlands
| | | | - Gillian C Barnett
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK; Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, UK
| | - Alison M Dunning
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK; Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, UK
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, UK
| | - Catharine M L West
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, UK
| | - Neil G Burnet
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Rebecca Elliott
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Charlotte Coles
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, UK
| | - Emma Hall
- Clinical Trials & Statistics Unit (ICR-CTSU), The Institute of Cancer Research, London, UK
| | - Laura Fachal
- Fundacion Publica Galega de Medicina Xenomica-SERGAS, Grupo de Medicina Xenomica-USC, IDIS, CIBERER, Santiago de Compostela, Spain
| | - Ana Vega
- Fundacion Publica Galega de Medicina Xenomica-SERGAS, Grupo de Medicina Xenomica-USC, IDIS, CIBERER, Santiago de Compostela, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, SERGAS, Santiago de Compostela, Spain
| | | | - R Paul Symonds
- Department of Cancer Studies, University of Leicester, UK
| | - Kim De Ruyck
- Department of Basic Medical Sciences, Ghent University, Belgium
| | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Belgium
| | - Piet Ost
- Department of Radiotherapy, Ghent University Hospital, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg, University (UCCH), University Medical Center Hamburg-Eppendorf, Germany
| | - Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Odilia Popanda
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marie Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
| | - David Dearnaley
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | - David Azria
- Department of Radiation Oncology and Medical Physics, Institut regional du Cancer Montpellier, France
| | - Christine Anne Koch
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Matthew Parliament
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Michael Blackshaw
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Michael Sia
- Department of Radiation Oncology, British Columbia Cancer Agency Abbotsford Clinic, Canada
| | | | - Teresa Ramon Y Cajal
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Agustin Barnadas
- Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Danny Vesprini
- Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Sara Gutiérrez-Enríquez
- Oncogenetics Group, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Spain
| | - Meritxell Mollà
- Department of Radiation Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Orland Díez
- Oncogenetics Group, Vall d'Hebron Institute of Oncology (VHIO), Area of Clinical and Molecular Genetics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - John R Yarnold
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Jens Overgaard
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
| | - Søren M Bentzen
- Greenebaum Cancer Center and Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark
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36
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Herskind C, Talbot CJ, Kerns SL, Veldwijk MR, Rosenstein BS, West CML. Radiogenomics: A systems biology approach to understanding genetic risk factors for radiotherapy toxicity? Cancer Lett 2016; 382:95-109. [PMID: 26944314 PMCID: PMC5016239 DOI: 10.1016/j.canlet.2016.02.035] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 02/06/2023]
Abstract
Adverse reactions in normal tissue after radiotherapy (RT) limit the dose that can be given to tumour cells. Since 80% of individual variation in clinical response is estimated to be caused by patient-related factors, identifying these factors might allow prediction of patients with increased risk of developing severe reactions. While inactivation of cell renewal is considered a major cause of toxicity in early-reacting normal tissues, complex interactions involving multiple cell types, cytokines, and hypoxia seem important for late reactions. Here, we review 'omics' approaches such as screening of genetic polymorphisms or gene expression analysis, and assess the potential of epigenetic factors, posttranslational modification, signal transduction, and metabolism. Furthermore, functional assays have suggested possible associations with clinical risk of adverse reaction. Pathway analysis incorporating different 'omics' approaches may be more efficient in identifying critical pathways than pathway analysis based on single 'omics' data sets. Integrating these pathways with functional assays may be powerful in identifying multiple subgroups of RT patients characterised by different mechanisms. Thus 'omics' and functional approaches may synergise if they are integrated into radiogenomics 'systems biology' to facilitate the goal of individualised radiotherapy.
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Affiliation(s)
- Carsten Herskind
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany.
| | | | - Sarah L Kerns
- Department of Radiation Oncology, Mount Sinai School of Medicine, New York, USA; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, USA
| | - Marlon R Veldwijk
- Department of Radiation Oncology, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Barry S Rosenstein
- Department of Radiation Oncology, Mount Sinai School of Medicine, New York, USA; Department of Radiation Oncology, New York University School of Medicine, USA; Department of Dermatology, Mount Sinai School of Medicine, New York, USA
| | - Catharine M L West
- Institute of Cancer Sciences, University of Manchester, Christie Hospital, Manchester, UK
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37
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Kerns SL, Dorling L, Fachal L, Bentzen S, Pharoah PDP, Barnes DR, Gómez-Caamaño A, Carballo AM, Dearnaley DP, Peleteiro P, Gulliford SL, Hall E, Michailidou K, Carracedo Á, Sia M, Stock R, Stone NN, Sydes MR, Tyrer JP, Ahmed S, Parliament M, Ostrer H, Rosenstein BS, Vega A, Burnet NG, Dunning AM, Barnett GC, West CML. Meta-analysis of Genome Wide Association Studies Identifies Genetic Markers of Late Toxicity Following Radiotherapy for Prostate Cancer. EBioMedicine 2016; 10:150-63. [PMID: 27515689 PMCID: PMC5036513 DOI: 10.1016/j.ebiom.2016.07.022] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/08/2016] [Accepted: 07/18/2016] [Indexed: 12/31/2022] Open
Abstract
Nearly 50% of cancer patients undergo radiotherapy. Late radiotherapy toxicity affects quality-of-life in long-term cancer survivors and risk of side-effects in a minority limits doses prescribed to the majority of patients. Development of a test predicting risk of toxicity could benefit many cancer patients. We aimed to meta-analyze individual level data from four genome-wide association studies from prostate cancer radiotherapy cohorts including 1564 men to identify genetic markers of toxicity. Prospectively assessed two-year toxicity endpoints (urinary frequency, decreased urine stream, rectal bleeding, overall toxicity) and single nucleotide polymorphism (SNP) associations were tested using multivariable regression, adjusting for clinical and patient-related risk factors. A fixed-effects meta-analysis identified two SNPs: rs17599026 on 5q31.2 with urinary frequency (odds ratio [OR] 3.12, 95% confidence interval [CI] 2.08-4.69, p-value 4.16×10(-8)) and rs7720298 on 5p15.2 with decreased urine stream (OR 2.71, 95% CI 1.90-3.86, p-value=3.21×10(-8)). These SNPs lie within genes that are expressed in tissues adversely affected by pelvic radiotherapy including bladder, kidney, rectum and small intestine. The results show that heterogeneous radiotherapy cohorts can be combined to identify new moderate-penetrance genetic variants associated with radiotherapy toxicity. The work provides a basis for larger collaborative efforts to identify enough variants for a future test involving polygenic risk profiling.
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Affiliation(s)
- Sarah L Kerns
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leila Dorling
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Laura Fachal
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK; Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Søren Bentzen
- Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, Baltimore, USA; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Daniel R Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Ana M Carballo
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - David P Dearnaley
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5NG, UK
| | - Paula Peleteiro
- Department of Radiation Oncology, Complexo Hospitalario Universitario de Santiago, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Sarah L Gulliford
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey SM2 5NG, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London SM2 5NG, UK
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Ángel Carracedo
- Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servizo Galego de Saúde (SERGAS), 15706 Santiago de Compostela, Spain
| | - Michael Sia
- Department of Radiation Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, Canada
| | - Richard Stock
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nelson N Stone
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew R Sydes
- Cancer and Other Non-Infectious Diseases, MRC Clinical Trials Unit, London WC2B 6NH, UK
| | - Jonathan P Tyrer
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Shahana Ahmed
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Matthew Parliament
- Division of Radiation Oncology, Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Canada
| | - Harry Ostrer
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Radiation Oncology, New York University School of Medicine, New York, NY, USA
| | - Ana Vega
- Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Department of Radiation Oncology, Tom Baker Cancer Center, University of Calgary, Calgary, Canada
| | - Neil G Burnet
- University of Cambridge, Department of Oncology, Cambridge Biomedical Campus, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK
| | - Gillian C Barnett
- Department of Oncology, Centre for Cancer Genetic Epidemiology, Strangeways Research Laboratory, University of Cambridge, Cambridge CB1 8RN, UK; Department of Oncology, Box 193, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB0 0QQ, UK
| | - Catharine M L West
- Institute of Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester M20 4BX, UK.
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Frisina RD, Wheeler HE, Fossa SD, Kerns SL, Fung C, Sesso HD, Monahan PO, Feldman DR, Hamilton R, Vaughn DJ, Beard CJ, Budnick A, Johnson EM, Ardeshir-Rouhani-Fard S, Einhorn LH, Lipshultz SE, Dolan ME, Travis LB. Comprehensive Audiometric Analysis of Hearing Impairment and Tinnitus After Cisplatin-Based Chemotherapy in Survivors of Adult-Onset Cancer. J Clin Oncol 2016; 34:2712-20. [PMID: 27354478 DOI: 10.1200/jco.2016.66.8822] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Cisplatin is widely used but highly ototoxic. Effects of cumulative cisplatin dose on hearing loss have not been comprehensively evaluated in survivors of adult-onset cancer. PATIENTS AND METHODS Comprehensive audiological measures were conducted on 488 North American male germ cell tumor (GCT) survivors in relation to cumulative cisplatin dose, including audiograms (0.25 to 12 kHz), tests of middle ear function, and tinnitus. American Speech-Language-Hearing Association criteria defined hearing loss severity. The geometric mean of hearing thresholds (0.25 to 12 kHz) summarized overall hearing status consistent with audiometric guidelines. Patients were sorted into quartiles of hearing thresholds of age- and sex-matched controls. RESULTS Increasing cumulative cisplatin dose (median, 400 mg/m(2); range, 200 to 800 mg/m(2)) was significantly related to hearing loss at 4, 6, 8, 10, and 12 kHz (P trends, .021 to < .001): every 100 mg/m(2) increase resulted in a 3.2-dB impairment in age-adjusted overall hearing threshold (4 to 12 kHz; P < .001). Cumulative cisplatin doses > 300 mg/m(2) were associated with greater American Speech-Language-Hearing Association-defined hearing loss severity (odds ratio, 1.59; P = .0066) and worse normative-matched quartiles (odds ratio, 1.33; P = .093) compared with smaller doses. Almost one in five (18%) patients had severe to profound hearing loss. Tinnitus (40% patients) was significantly correlated with reduced hearing at each frequency (P < .001). Noise-induced damage (10% patients) was unaffected by cisplatin dose (P = .59). Hypertension was significantly related (P = .0066) to overall hearing threshold (4 to 12 kHz) in age- and cisplatin dose-adjusted analyses. Middle ear deficits occurred in 22.3% of patients but, as expected, were not related to cytotoxic drug dosage. CONCLUSION Follow-up of adult-onset cancer survivors given cisplatin should include routine inquiry for hearing status and tinnitus, referral to audiologists as clinically indicated, and hypertension control. Patients should be urged to avoid noise exposure, ototoxic drugs, and other factors that further damage hearing.
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Affiliation(s)
- Robert D Frisina
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Heather E Wheeler
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Sophie D Fossa
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Sarah L Kerns
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Chunkit Fung
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Howard D Sesso
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Patrick O Monahan
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Darren R Feldman
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Robert Hamilton
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - David J Vaughn
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Clair J Beard
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Amy Budnick
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Eileen M Johnson
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Shirin Ardeshir-Rouhani-Fard
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Lawrence H Einhorn
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI.
| | - Steven E Lipshultz
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - M Eileen Dolan
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
| | - Lois B Travis
- Robert D. Frisina, University of South Florida, Tampa, FL; Heather E. Wheeler, Loyola University Chicago; M. Eileen Dolan, University of Chicago, Chicago, IL; Sophie D. Fossa, Oslo University Hospital, Radiumhospital, Oslo, Norway; Sarah L. Kerns, Chunkit Fung, and Eileen M. Johnson, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester; Darren R. Feldman and Amy Budnick, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women's Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick O. Monahan, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert Hamilton, Princess Margaret Cancer Centre, Toronto, ON; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; and Steven E. Lipshultz, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI
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Kerns SL, Fung C, Williams A, Abu Zaid MI, Sesso HD, Monahan P, Ardeshir-Rouhani-Fard S, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Sahasrabudhe DM, Fossa SD, Einhorn LH, Travis LB. Cumulative burden of morbidity (CBM) among testicular cancer survivors (TCS) in the Platinum study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.10089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - AnnaLynn Williams
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Howard D. Sesso
- Division of Preventive Medicine, Harvard Medical School, Boston, MA
| | | | | | | | | | - David J. Vaughn
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA
| | - Clair Beard
- Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA
| | | | | | | | - Lois B. Travis
- Department of Medical Oncology, Indiana University, Indianapolis, IN
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Abu Zaid MI, Fung C, Williams A, Sesso HD, Kerns SL, Ardeshir-Rouhani-Fard S, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Monahan P, Fossa SD, Einhorn LH, Travis LB. Cardiovascular disease (CVD) risk factors and health behaviors after cisplatin-based chemotherapy (CHEM): A multi-institutional study of testicular cancer survivors (TCS) in the Platinum study. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.10087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - AnnaLynn Williams
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Howard D. Sesso
- Division of Preventive Medicine, Harvard Medical School, Boston, MA
| | | | | | | | | | - David J. Vaughn
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA
| | - Clair Beard
- Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA
| | | | | | | | - Lois B. Travis
- Department of Medical Oncology, Indiana University, Indianapolis, IN
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Knoll MA, Salvatore M, Sheu RD, Knoll AD, Kerns SL, Lo YC, Rosenzweig KE. The use of isodose levels to interpret radiation induced lung injury: a quantitative analysis of computed tomography changes. Quant Imaging Med Surg 2016; 6:35-41. [PMID: 26981453 DOI: 10.3978/j.issn.2223-4292.2016.02.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients treated with stereotactic body radiation therapy (SBRT) for lung cancer are often found to have radiation-induced lung injury (RILI) surrounding the treated tumor. We investigated whether treatment isodose levels could predict RILI. METHODS Thirty-seven lung lesions in 32 patients were treated with SBRT and received post-treatment follow up (FU) computed tomography (CT). Each CT was fused with the original simulation CT and treatment isodose levels were overlaid. The RILI surrounding the treated lesion was contoured. The RILI extension index [fibrosis extension index (FEI)] was defined as the volume of RILI extending outside a given isodose level relative to the total volume of RILI and was expressed as a percentage. RESULTS Univariate analysis revealed that the planning target volume (PTV) was positively correlated with RILI volume at FU: correlation coefficient (CC) =0.628 and P<0.0001 at 1(st) FU; CE =0.401 and P=0.021 at 2(nd) FU; CE =0.265 and P=0.306 at 3(rd) FU. FEI -40 Gy at 1(st) FU was significantly positively correlated with FEI -40 Gy at subsequent FU's (CC =0.689 and P=6.5×10(-5) comparing 1(st) and 2(nd) FU; 0.901 and P=0.020 comparing 2(nd) and 3(rd) FU. Ninety-six percent of the RILI was found within the 20 Gy isodose line. Sixty-five percent of patients were found to have a decrease in RILI on the second 2(nd) CT. CONCLUSIONS We have shown that RILI evolves over time and 1(st) CT correlates well with subsequent CTs. Ninety-six percent of the RILI can be found to occur within the 20 Gy isodose lines, which may prove beneficial to radiologists attempting to distinguish recurrence vs. RILI.
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Affiliation(s)
- Miriam A Knoll
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Mary Salvatore
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Ren Dih Sheu
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Abraham D Knoll
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Sarah L Kerns
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Yeh-Chi Lo
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
| | - Kenneth E Rosenzweig
- 1 Department of Radiation Oncology, 2 Department of Radiology, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029, USA
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Abu Zaid MI, Fung C, Williams A, Sesso HD, Kerns SL, Feldman DR, Hamilton RJ, Vaughn DJ, Beard C, Liu H, Fossa SD, Einhorn LH, Travis LB. Cardiovascular disease (CVD) risk factors and health behaviors following cisplatin-based chemotherapy (CHEM): A multi-institutional study of testicular cancer survivors (TCS). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.3_suppl.129] [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
129 Background: TCS are at increased risk of CVD, but few clinical studies have comprehensively evaluated CVD risk factors through physical exams, lipid panels, and health behaviors in North American patients. Methods: Eligible TCS were < 50 y at diagnosis and treated with only first line CHEM. TCS underwent physical exams, had fasting lipid panels, and completed questionnaires regarding co-morbidities and health behaviors. Age, race, and educational status-matched controls (1:1) were chosen from the general population using the 2011-2012 National Health and Nutrition Examination Survey. Odds ratios (OR) of outcomes among TCS versus matched controls were estimated using logistic regression models. Results: We evaluated 680 consecutively enrolled TCS. Median age at diagnosis was 31 y (range, 15-49) and at clinical evaluation 38 y (range, 19-68). Median time since CHEM was 4.3 y (range, 1-30). Compared to normative controls, TCS were more likely to be overweight (OR = 1.65; 95% CI 1.26-2.16), have total cholesterol ≥ 240 mg/dL (OR = 2.19; 95% CI 1.12-4.28) and LDL ≥ 160 mg/dL (OR = 3.05; 95% CI 1.03-9.00), and report alcohol use > 2 days/week (OR = 2.13; 95% CI 1.64-2.77). In contrast, they were more likely to have a waist circumference < 40 inches (OR = 1.32; 95% CI 1.04-1.66); engage in vigorous (OR = 2.64; 95% CI 2.11-3.29) or moderate (OR = 1.62; 95% CI 1.30-2.03) physical activity, and not smoke (OR = 2.95; 95% CI 2.14-4.08). TCS were about 3 times more likely overall to report excellent, very good, or good health compared to controls (P < 0.05). No significant differences were found comparing HDL, triglycerides, or self-reported hypertension (P > 0.05). Conclusions: Although North American TCS appear more likely to exercise and abstain from smoking compared to normative controls, a greater proportion are overweight and have higher fasting total cholesterol and LDL levels. Health care providers should screen TCS for CVD risk factors, and encourage practices consistent with a healthy lifestyle. Future research should elucidate mechanisms of increased CVD risk and ultimately develop customized prevention and intervention strategies.
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Affiliation(s)
| | | | - AnnaLynn Williams
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Howard D. Sesso
- Division of Preventive Medicine, Harvard Medical School, Boston, MA
| | - Sarah L Kerns
- University of Rochester Medical Center, Rochester, NY
| | | | | | - David J. Vaughn
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA
| | - Clair Beard
- Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA
| | - Hai Liu
- Indiana University School of Medicine, Indianapolis, IN
| | | | | | - Lois B. Travis
- University of Rochester School of Medicine and Dentistry, Rochester, NY
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Barnett GC, Kerns SL, Noble DJ, Dunning AM, West CML, Burnet NG. Incorporating Genetic Biomarkers into Predictive Models of Normal Tissue Toxicity. Clin Oncol (R Coll Radiol) 2015; 27:579-87. [PMID: 26166774 DOI: 10.1016/j.clon.2015.06.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/08/2015] [Accepted: 06/12/2015] [Indexed: 12/25/2022]
Abstract
There is considerable variation in the level of toxicity patients experience for a given dose of radiotherapy, which is associated with differences in underlying individual normal tissue radiosensitivity. A number of syndromes have a large effect on clinical radiosensitivity, but these are rare. Among non-syndromic patients, variation is less extreme, but equivalent to a ±20% variation in dose. Thus, if individual normal tissue radiosensitivity could be measured, it should be possible to optimise schedules for individual patients. Early investigations of in vitro cellular radiosensitivity supported a link with tissue response, but individual studies were equivocal. A lymphocyte apoptosis assay has potential, and is currently under prospective validation. The investigation of underlying genetic variation also has potential. Although early candidate gene studies were inconclusive, more recent genome-wide association studies are revealing definite associations between genotype and toxicity and highlighting the potential for future genetic testing. Genetic testing and individualised dose prescriptions could reduce toxicity in radiosensitive patients, and permit isotoxic dose escalation to increase local control in radioresistant individuals. The approach could improve outcomes for half the patients requiring radical radiotherapy. As a number of patient- and treatment-related factors also affect the risk of toxicity for a given dose, genetic testing data will need to be incorporated into models that combine patient, treatment and genetic data.
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Affiliation(s)
- G C Barnett
- Oncology Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
| | - S L Kerns
- Rubin Center for Cancer Survivorship, Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - D J Noble
- Oncology Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - C M L West
- Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - N G Burnet
- University of Cambridge Department of Oncology, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, UK
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Seibold P, Behrens S, Schmezer P, Helmbold I, Barnett G, Coles C, Yarnold J, Talbot CJ, Imai T, Azria D, Koch CA, Dunning AM, Burnet N, Bliss JM, Symonds RP, Rattay T, Suga T, Kerns SL, Bourgier C, Vallis KA, Sautter-Bihl ML, Claßen J, Debus J, Schnabel T, Rosenstein BS, Wenz F, West CM, Popanda O, Chang-Claude J. XRCC1 Polymorphism Associated With Late Toxicity After Radiation Therapy in Breast Cancer Patients. Int J Radiat Oncol Biol Phys 2015; 92:1084-1092. [PMID: 26072091 DOI: 10.1016/j.ijrobp.2015.04.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/23/2015] [Accepted: 04/06/2015] [Indexed: 12/27/2022]
Abstract
PURPOSE To identify single-nucleotide polymorphisms (SNPs) in oxidative stress-related genes associated with risk of late toxicities in breast cancer patients receiving radiation therapy. METHODS AND MATERIALS Using a 2-stage design, 305 SNPs in 59 candidate genes were investigated in the discovery phase in 753 breast cancer patients from 2 prospective cohorts from Germany. The 10 most promising SNPs in 4 genes were evaluated in the replication phase in up to 1883 breast cancer patients from 6 cohorts identified through the Radiogenomics Consortium. Outcomes of interest were late skin toxicity and fibrosis of the breast, as well as an overall toxicity score (Standardized Total Average Toxicity). Multivariable logistic and linear regression models were used to assess associations between SNPs and late toxicity. A meta-analysis approach was used to summarize evidence. RESULTS The association of a genetic variant in the base excision repair gene XRCC1, rs2682585, with normal tissue late radiation toxicity was replicated in all tested studies. In the combined analysis of discovery and replication cohorts, carrying the rare allele was associated with a significantly lower risk of skin toxicities (multivariate odds ratio 0.77, 95% confidence interval 0.61-0.96, P=.02) and a decrease in Standardized Total Average Toxicity scores (-0.08, 95% confidence interval -0.15 to -0.02, P=.016). CONCLUSIONS Using a stage design with replication, we identified a variant allele in the base excision repair gene XRCC1 that could be used in combination with additional variants for developing a test to predict late toxicities after radiation therapy in breast cancer patients.
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Affiliation(s)
- Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Peter Schmezer
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center, Heidelberg, Germany
| | - Irmgard Helmbold
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Gillian Barnett
- Department of Oncology, Oncology Centre, Cambridge University Hospital NHS Foundation Trust, United Kingdom (UK)
| | - Charlotte Coles
- Department of Oncology, Oncology Centre, Cambridge University Hospital NHS Foundation Trust, United Kingdom (UK)
| | - John Yarnold
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | | | - Takashi Imai
- Advanced Radiation Biology Research Program, National Institute of Radiological Sciences, Chiba, Japan
| | - David Azria
- Department of Radiation Oncology and Medical Physics, I.C.M. - Institut regional du Cancer Montpellier, Montpellier, France
| | - C Anne Koch
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Neil Burnet
- Department of Oncology, Oncology Centre, Cambridge University Hospital NHS Foundation Trust, University of Cambridge, Cambridge, UK
| | - Judith M Bliss
- The Institute of Cancer Research, Clinical Trials and Statistics Unit, Sutton, UK
| | - R Paul Symonds
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Tim Rattay
- Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Tomo Suga
- Advanced Radiation Biology Research Program, National Institute of Radiological Sciences, Chiba, Japan
| | - Sarah L Kerns
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NH
| | - Celine Bourgier
- Department of Radiation Oncology and Medical Physics, I.C.M. - Institut regional du Cancer Montpellier, Montpellier, France
| | - Katherine A Vallis
- Cancer Research UK/Medical Research Council Oxford Institute for Radiation Oncology, Oxford University, Oxford, UK
| | | | - Johannes Claßen
- Clinic for Radiation Therapy and Radiation Oncology, St. Vincentius-Kliniken gAG, Karlsruhe, Germany
| | - Juergen Debus
- Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Schnabel
- Clinic for Radiotherapy and Radiation Oncology, Klinikum Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NH
| | - Frederik Wenz
- Department of Radiation Oncology, University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Catharine M West
- Institute of Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Odilia Popanda
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center, Heidelberg, Germany
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany.
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Kerns SL, West CML, Andreassen CN, Barnett GC, Bentzen SM, Burnet NG, Dekker A, De Ruysscher D, Dunning A, Parliament M, Talbot C, Vega A, Rosenstein BS. Radiogenomics: the search for genetic predictors of radiotherapy response. Future Oncol 2014; 10:2391-406. [PMID: 25525847 DOI: 10.2217/fon.14.173] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
'Radiogenomics' is the study of genetic variation associated with response to radiotherapy. Radiogenomics aims to uncover the genes and biologic pathways responsible for radiotherapy toxicity that could be targeted with radioprotective agents and; identify genetic markers that can be used in risk prediction models in the clinic. The long-term goal of the field is to develop single nucleotide polymorphism-based risk models that can be used to stratify patients to more precisely tailored radiotherapy protocols. The field has evolved over the last two decades in parallel with advances in genomics, moving from narrowly focused candidate gene studies to large, collaborative genome-wide association studies. Several confirmed genetic variants have been identified and the field is making progress toward clinical translation.
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Affiliation(s)
- Sarah L Kerns
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kerns SL, Guevara-Aguirre J, Andrew S, Geng J, Guevara C, Guevara-Aguirre M, Guo M, Oddoux C, Shen Y, Zurita A, Rosenfeld RG, Ostrer H, Hwa V, Dauber A. A novel variant in CDKN1C is associated with intrauterine growth restriction, short stature, and early-adulthood-onset diabetes. J Clin Endocrinol Metab 2014; 99:E2117-22. [PMID: 25057881 PMCID: PMC4184067 DOI: 10.1210/jc.2014-1949] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT CDKN1C, a cyclin-dependent kinase inhibitor and negative regulator of cellular proliferation, is paternally imprinted and has been shown to regulate β-cell proliferation. CDKN1C mutations are associated with growth disorders, including Beckwith-Wiedemann syndrome and IMAGe syndrome. OBJECTIVE To investigate the genetic basis for a familial disorder characterized by intrauterine growth restriction, short stature, and early-adulthood-onset diabetes. DESIGN, SETTING, AND PARTICIPANTS Genomic DNA samples (15 affected and 26 unaffected from a six-generation pedigree) were analyzed by genome-wide single nucleotide polymorphism arrays, whole exome and Sanger sequencing, and multiplex ligation-dependent probe amplification. MAIN OUTCOME MEASURE(S) Subjects were assessed for height, weight, adrenal gland size, ACTH, diabetes status, and testis volume. Linkage and sequence analyses were performed, and the identified genetic variant was functionally evaluated in reconstitution studies. RESULTS The pedigree followed a paternally imprinted pattern of inheritance, and genetic linkage analysis identified a single significant 2.6-megabase locus on chromosome 11p15, within the imprinting center region 2. Multiplex ligation-dependent probe amplification did not detect copy number variants or methylation abnormalities. Whole exome sequencing revealed a single novel variant in the proliferating cell nuclear antigen-binding region of CDKN1C (c.842G>T, p.R281I) that co-segregated with affected status and, unlike variants found in IMAGe, did not entirely abrogate proliferating cell nuclear antigen binding. Clinical assessments revealed that affected individuals had low testicular volume but normal adrenal function. CONCLUSIONS We report a novel CDKN1C mutation associated with features of IMAGe syndrome, but without adrenal insufficiency or metaphyseal dysplasia, and characterized by early-adulthood-onset diabetes. Our data expand the range of phenotypes observed with CDKN1C defects and suggest that CDKN1C mutations may represent a novel monogenic form of diabetes.
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Fachal L, Gómez-Caamaño A, Barnett GC, Peleteiro P, Carballo AM, Calvo-Crespo P, Kerns SL, Sánchez-García M, Lobato-Busto R, Dorling L, Elliott RM, Dearnaley DP, Sydes MR, Hall E, Burnet NG, Carracedo Á, Rosenstein BS, West CML, Dunning AM, Vega A. A three-stage genome-wide association study identifies a susceptibility locus for late radiotherapy toxicity at 2q24.1. Nat Genet 2014; 46:891-4. [PMID: 24974847 DOI: 10.1038/ng.3020] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 06/05/2014] [Indexed: 12/11/2022]
Abstract
There is increasing evidence supporting the role of genetic variants in the development of radiation-induced toxicity. However, previous candidate gene association studies failed to elucidate the common genetic variation underlying this phenotype, which could emerge years after the completion of treatment. We performed a genome-wide association study on a Spanish cohort of 741 individuals with prostate cancer treated with external beam radiotherapy (EBRT). The replication cohorts consisted of 633 cases from the UK and 368 cases from North America. One locus comprising TANC1 (lowest unadjusted P value for overall late toxicity=6.85×10(-9), odds ratio (OR)=6.61, 95% confidence interval (CI)=2.23-19.63) was replicated in the second stage (lowest unadjusted P value for overall late toxicity=2.08×10(-4), OR=6.17, 95% CI=2.25-16.95; Pcombined=4.16×10(-10)). The inclusion of the third cohort gave unadjusted Pcombined=4.64×10(-11). These results, together with the role of TANC1 in regenerating damaged muscle, suggest that the TANC1 locus influences the development of late radiation-induced damage.
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Affiliation(s)
- Laura Fachal
- 1] Fundación Pública Galega de Medicina Xenómica, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain. [2] Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - Antonio Gómez-Caamaño
- Department of Radiation Oncology, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Gillian C Barnett
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Paula Peleteiro
- Department of Radiation Oncology, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Ana M Carballo
- Department of Radiation Oncology, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Patricia Calvo-Crespo
- Department of Radiation Oncology, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Sarah L Kerns
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Manuel Sánchez-García
- Department of Medical Physics, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Ramón Lobato-Busto
- Department of Medical Physics, USC University Hospital Complex, SERGAS, Santiago de Compostela, Spain
| | - Leila Dorling
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Rebecca M Elliott
- Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - David P Dearnaley
- Institute of Cancer Research and Royal Marsden National Health Service (NHS) Foundation Trust, Sutton, UK
| | - Matthew R Sydes
- Cancer and Other Non-Infectious Diseases, Medical Research Council (MRC) Clinical Trials Unit, London, UK
| | - Emma Hall
- Clinical Trials and Statistics Unit, Institute of Cancer Research, London, UK
| | - Neil G Burnet
- Department of Oncology, University of Cambridge, Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ángel Carracedo
- 1] Fundación Pública Galega de Medicina Xenómica, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain. [2] Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain. [3] Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Catharine M L West
- Institute of Cancer Sciences, University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Ana Vega
- 1] Fundación Pública Galega de Medicina Xenómica, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain. [2] Grupo de Medicina Xenómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
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Rosenstein BS, West CM, Bentzen SM, Alsner J, Andreassen CN, Azria D, Barnett GC, Baumann M, Burnet N, Chang-Claude J, Chuang EY, Coles CE, Dekker A, De Ruyck K, De Ruysscher D, Drumea K, Dunning AM, Easton D, Eeles R, Fachal L, Gutiérrez-Enríquez S, Haustermans K, Henríquez-Hernández LA, Imai T, Jones GDD, Kerns SL, Liao Z, Onel K, Ostrer H, Parliament M, Pharoah PDP, Rebbeck TR, Talbot CJ, Thierens H, Vega A, Witte JS, Wong P, Zenhausern F. Radiogenomics: radiobiology enters the era of big data and team science. Int J Radiat Oncol Biol Phys 2014; 89:709-13. [PMID: 24969789 PMCID: PMC5119272 DOI: 10.1016/j.ijrobp.2014.03.009] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/19/2014] [Accepted: 03/06/2014] [Indexed: 11/16/2022]
Affiliation(s)
- Barry S Rosenstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York; Departments of Genetics and Genomic Sciences, Dermatology, and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Radiation Oncology, New York University School of Medicine, New York, New York.
| | - Catharine M West
- Translational Radiobiology Group, Institute of Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, UK
| | - Søren M Bentzen
- Division of Biostatistics and Bioinformatics, University of Maryland Greenebaum Cancer Center, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jan Alsner
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - David Azria
- Department of Radiation Oncology, Institute of Cancer of Montpellier (INSERM), Center for Cancer Research, Montpellier, France
| | - Gillian C Barnett
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Michael Baumann
- Department of Radiation Oncology and OncoRay National Center for Radiation Research in Oncology, Technische Universität Dresden, and Helmholtz-Zentrum Dresden-Rossendorf Dresden, Germany
| | - Neil Burnet
- University of Cambridge Department of Oncology, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eric Y Chuang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | | | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kim De Ruyck
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Dirk De Ruysscher
- Radiation Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Belgium
| | - Karen Drumea
- Department of Oncology, Rambam Health Care Campus, Haifa, Israel
| | - Alison M Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Douglas Easton
- Department of Public Health and Primary Care and Department of Oncology, University of Cambridge, Cambridge, UK
| | - Rosalind Eeles
- Division of Cancer Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Laura Fachal
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | - Sara Gutiérrez-Enríquez
- Oncogenetics Group, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Karin Haustermans
- Radiation Oncology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Belgium
| | | | - Takashi Imai
- Advanced Radiation Biology Research Program, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
| | - George D D Jones
- Department Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Sarah L Kerns
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zhongxing Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kenan Onel
- Department of Pediatrics, The University of Chicago, Chicago, Illinois
| | - Harry Ostrer
- Departments of Pathology, Genetics and Pediatrics, Albert Einstein College of Medicine at Yeshiva University, New York, New York
| | - Matthew Parliament
- Department of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Paul D P Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Timothy R Rebbeck
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, and Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Hubert Thierens
- Department of Basic Medical Sciences, Ghent University, Ghent, Belgium
| | - Ana Vega
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
| | - John S Witte
- Department of Epidemiology and Biostatistics, Institute for Human Genetics, University of California, San Francisco, California
| | - Philip Wong
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - Frederic Zenhausern
- Department of Basic Medical Sciences, Center for Applied Nanobioscience and Medicine, College of Medicine Phoenix, University of Arizona, Phoenix, Arizona
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Kerns SL, Ostrer H, Rosenstein BS. Radiogenomics: using genetics to identify cancer patients at risk for development of adverse effects following radiotherapy. Cancer Discov 2014; 4:155-65. [PMID: 24441285 DOI: 10.1158/2159-8290.cd-13-0197] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
UNLABELLED Normal-tissue adverse effects following radiotherapy are common and significantly affect quality of life. These effects cannot be accounted for by dosimetric, treatment, or demographic factors alone, and evidence suggests that common genetic variants are associated with radiotherapy adverse effects. The field of radiogenomics has evolved to identify such genetic risk factors. Radiogenomics has two goals: (i) to develop an assay to predict which patients with cancer are most likely to develop radiation injuries resulting from radiotherapy, and (ii) to obtain information about the molecular pathways responsible for radiation-induced normal-tissue toxicities. This review summarizes the history of the field and current research. SIGNIFICANCE A single-nucleotide polymorphism–based predictive assay could be used, along with clinical and treatment factors, to estimate the risk that a patient with cancer will develop adverse effects from radiotherapy. Such an assay could be used to personalize therapy and improve quality of life for patients with cancer.
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Affiliation(s)
- Sarah L Kerns
- Departments of 1Radiation Oncology and 2Dermatology, Preventive Medicine and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai; 3Department of Radiation Oncology, New York University School of Medicine, New York; Departments of 4Pathology, and 5Genetics and Pediatrics, Albert Einstein College of Medicine, Bronx, New York
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Kerns SL, de Ruysscher D, Andreassen CN, Azria D, Barnett GC, Chang-Claude J, Davidson S, Deasy JO, Dunning AM, Ostrer H, Rosenstein BS, West CML, Bentzen SM. STROGAR - STrengthening the Reporting Of Genetic Association studies in Radiogenomics. Radiother Oncol 2014; 110:182-8. [PMID: 23993398 PMCID: PMC4786020 DOI: 10.1016/j.radonc.2013.07.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 07/16/2013] [Accepted: 07/29/2013] [Indexed: 01/14/2023]
Abstract
Despite publication of numerous radiogenomics studies to date, positive single nucleotide polymorphism (SNP) associations have rarely been reproduced in independent validation studies. A major reason for these inconsistencies is a high number of false positive findings because no adjustments were made for multiple comparisons. It is also possible that some validation studies were false negatives due to methodological shortcomings or a failure to reproduce relevant details of the original study. Transparent reporting is needed to ensure these flaws do not hamper progress in radiogenomics. In response to the need for improving the quality of research in the area, the Radiogenomics Consortium produced an 18-item checklist for reporting radiogenomics studies. It is recognised that not all studies will have recorded all of the information included in the checklist. However, authors should report on all checklist items and acknowledge any missing information. Use of STROGAR guidelines will advance the field of radiogenomics by increasing the transparency and completeness of reporting.
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Affiliation(s)
- Sarah L Kerns
- Department of Radiation Oncology, Mount Sinai School of Medicine, New York, USA; Department of Pathology, Albert Einstein College of Medicine, New York, USA; Department of Genetics, Albert Einstein College of Medicine, New York, USA
| | - Dirk de Ruysscher
- Department of Radiation Oncology, University Hospitals Leuven/KU Leuven, Belgium
| | | | - David Azria
- Montpellier Cancer Institute, Montpellier University, France
| | - Gillian C Barnett
- Department of Oncology, Cambridge University Hospital NHS Foundation Trust, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Susan Davidson
- Department of Clinical Oncology, Christie NHS Foundation Trust Hospital, Manchester, UK
| | - Joseph O Deasy
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | | - Harry Ostrer
- Department of Pathology, Albert Einstein College of Medicine, New York, USA; Department of Genetics, Albert Einstein College of Medicine, New York, USA
| | - Barry S Rosenstein
- Department of Radiation Oncology, Mount Sinai School of Medicine, New York, USA
| | | | - Søren M Bentzen
- Department of Human Oncology, University of Wisconsin, Madison, USA.
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