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van den Bosch C, Moree J, Peeters S, Lankheet M, van der Steeg A, Wijnen M, van de Wetering M, van der Bruggen J. The effect of taurolidine on the time-to-positivity of blood cultures. Infect Prev Pract 2024; 6:100352. [PMID: 38510847 PMCID: PMC10950745 DOI: 10.1016/j.infpip.2024.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
Background Taurolidine containing lock solutions (TL) are a promising method for the prevention of central line associated bloodstream infections. Per accident, the TL may not always be aspirated from the central venous catheter (CVC) before blood cultures are obtained. The TL could, unintentionally, end up in a blood culture vial, possibly altering the results. The aim of this study was to investigate the effect of the TLs on the detection of microbial growth in blood culture vials. Methods Different lock solutions (taurolidine-citrate-heparin (TCHL), taurolidine, heparin, citrate or NaCl) were added to BD BACTECTM blood culture vials (Plus Aerobic/F, Lytic/10 Anaerobic/F or Peds Plus/F) before spiking with Staphylococcus aureus (ATCC 29213 or a clinical strain) or Escherichia coli (ATCC 25922 or a clinical strain) in the presence and absence of blood. Subsequently, blood culture vials were incubated in the BD BACTEC FX instrument with Time-to-positivity (TTP) as primary outcome. In addition, the effect of the TCHL on a variety of other micro-organisms was tested. Discussion In the presence of taurolidine, the TTP was considerably delayed or vials even remained negative as compared to vials containing heparin, citrate or NaCl. This effect was dose-dependent. The delayed TTP was much less pronounced in the presence of blood, but still notable. Conclusion This study stresses the clinical importance of discarding TLs from the CVC before obtaining a blood culture.
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Affiliation(s)
- C.H. van den Bosch
- Princess Máxima Centre for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - J.E.P. Moree
- Princess Máxima Centre for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - S. Peeters
- Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M. Lankheet
- Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - A.F.W. van der Steeg
- Princess Máxima Centre for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - M.H.W.A. Wijnen
- Princess Máxima Centre for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - M.D. van de Wetering
- Princess Máxima Centre for Paediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - J.T. van der Bruggen
- Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Molenberghs F, Verschuuren M, Vandeweyer L, Peeters S, Bogers JJ, Novo CP, Vanden Berghe W, De Reu H, Cools N, Schelhaas M, De Vos WH. Lamin B1 curtails early human papillomavirus infection by safeguarding nuclear compartmentalization and autophagic capacity. Cell Mol Life Sci 2024; 81:141. [PMID: 38485766 PMCID: PMC10940392 DOI: 10.1007/s00018-024-05194-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
Human papillomavirus (HPV) infection is a primary cause of cervical and head-and-neck cancers. The HPV genome enters the nucleus during mitosis when the nuclear envelope disassembles. Given that lamins maintain nuclear integrity during interphase, we asked to what extent their loss would affect early HPV infection. To address this question, we infected human cervical cancer cells and keratinocytes lacking the major lamins with a HPV16 pseudovirus (HP-PsV) encoding an EGFP reporter. We found that a sustained reduction or complete loss of lamin B1 significantly increased HP-PsV infection rate. A corresponding greater nuclear HP-PsV load in LMNB1 knockout cells was directly related to their prolonged mitotic window and extensive nuclear rupture propensity. Despite the increased HP-PsV presence, EGFP transcript levels remained virtually unchanged, indicating an additional defect in protein turnover. Further investigation revealed that LMNB1 knockout led to a substantial decrease in autophagic capacity, possibly linked to the persistent activation of cGAS by cytoplasmic chromatin exposure. Thus, the attrition of lamin B1 increases nuclear perviousness and attenuates autophagic capacity, creating an environment conducive to unrestrained accumulation of HPV capsids. Our identification of lower lamin B1 levels and nuclear BAF foci in the basal epithelial layer of several human cervix samples suggests that this pathway may contribute to an increased individual susceptibility to HPV infection.
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Affiliation(s)
- Freya Molenberghs
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Marlies Verschuuren
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Lauran Vandeweyer
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Sarah Peeters
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Johannes J Bogers
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Claudina Perez Novo
- Cell Death Signaling Lab, Integrated Personalized and Precision Oncology Network (IPPON), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Wim Vanden Berghe
- Cell Death Signaling Lab, Integrated Personalized and Precision Oncology Network (IPPON), Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Hans De Reu
- Laboratory of Experimental Hematology, Faculty Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Nathalie Cools
- Laboratory of Experimental Hematology, Faculty Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Mario Schelhaas
- Institute of Cellular Virology, University of Münster, Münster, Germany
| | - Winnok H De Vos
- Laboratory of Cell Biology and Histology, Department of Veterinary Sciences and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
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Peeters S, Wang C, Bijnens EM, Bullens DMA, Fokkens WJ, Bachert C, Hellings PW, Nawrot TS, Seys SF. Association between outdoor air pollution and chronic rhinosinusitis patient reported outcomes. Environ Health 2022; 21:134. [PMID: 36544141 PMCID: PMC9769041 DOI: 10.1186/s12940-022-00948-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The aetiology of chronic rhinosinusitis (CRS) is multifactorial with a complex interplay between environmental, microbial endogenous and genetic factors. The impact of outdoor air pollution on prevalence or severity of CRS remains largely unknown. METHODS Real-life geolocation data (2017-2018, Belgium) from 278 CRS patients (2576 health records) using the mySinusitisCoach mobile application were analysed to calculate the patients' individual exposure to outdoor air pollutants (ozone (O3), black carbon (BC), nitrogen dioxide (NO2) and particulate matter with diameter < 2.5 μm (PM2.5)) and to associate these pollutants with the patients' sinus related symptoms measured at multiple occasions by visual analogue scale (VAS). RESULTS The adjusted seasonal model for the spring-summer (n = 1000 health entries, N = 83 patients) population revealed an increase of 6.07 (p < 0.0001) in overall CRS symptom scoring for an interquartile range (IQR) increase in exposure to O3 (26.9 μg/m3). An increase of 1.69 (p = 0.05) in total CRS symptom scoring was observed for an IQR increase of PM2.5 (7.1 µg/m3) exposure. Sex-stratified analysis in the spring-summer population showed significant interaction between air pollution and sex with male patients having higher total CRS symptom scores for an IQR increase in exposure to PM2.5 (3.52, p = 0.001), and O3 (8.33, p < 0.0001), while no significant association with symptom severity was seen in the female patients. In the analysis stratified by comorbid asthma, CRS patients with comorbid asthma had higher total CRS symptoms for an IQR increase in exposure to PM2.5 (2.58, p = 0.04) and O3 (7.72, p < 0.0001) while the patients without comorbid asthma had no significant symptom increases. CONCLUSION Exposure to outdoor air pollution is associated with increased symptom severity in CRS patients. The extent to which CRS patients are sensitive to outdoor air pollution exposure varies per season and depends on their sex and comorbid asthma status. mHealth technology has the potential to reveal novel insights on the patients' exposome and disease severity in the real-life situation.
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Affiliation(s)
- S Peeters
- Department of Microbiology, Allergy and Clinical Immunology Research Group, Immunology & Transplantation, Herestraat 49/811, 3000, Louvain, KU, Belgium
| | - C Wang
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - E M Bijnens
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - D M A Bullens
- Department of Microbiology, Allergy and Clinical Immunology Research Group, Immunology & Transplantation, Herestraat 49/811, 3000, Louvain, KU, Belgium
- Clinical Division of Paediatrics, UZ Leuven, Leuven, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands
| | - C Bachert
- Department of Otorhinolaryngology, Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
- Department of Clinical Science, Intervention and Technology, Division of ENT Diseases, Karolinska Institutet, Stockholm, Sweden
| | - P W Hellings
- Department of Microbiology, Allergy and Clinical Immunology Research Group, Immunology & Transplantation, Herestraat 49/811, 3000, Louvain, KU, Belgium
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, Location AMC, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Leuven, Belgium
| | - T S Nawrot
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
- Department of Public Health and Primary Care, Environment and Health Unit, KU Leuven, Leuven, Belgium
| | - S F Seys
- Department of Microbiology, Allergy and Clinical Immunology Research Group, Immunology & Transplantation, Herestraat 49/811, 3000, Louvain, KU, Belgium.
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Angrisani A, Houben R, Marcuse F, Hochstenbag M, Maessen J, De Ruysscher D, Peeters S. PO-1240 “Radiotherapy for Thymic Epithelial Tumors: What Is The Optimal Dose? A Systematic Review.”. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03204-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Benevello C, Laaidi A, Peeters S, Moiraghi A, Tauziede-Espariat A, Oppenheim C, Pallud J. Spinal epidural capillary hemangioma: a systematic literature review and an illustrative case. Neurochirurgie 2022; 68:697-701. [PMID: 35477014 DOI: 10.1016/j.neuchi.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/27/2022] [Accepted: 03/21/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Spinal hemangiomas are rare vascular malformations resulting from proliferation of vascular endothelial cells. The cavernous form is the most common and represents 5-12% of spinal vascular malformations, while the capillary form is rare. CASE DESCRIPTION A 56-year-old patient with no past medical history presented with progressive spinal cord compression symptoms localizing to the T10 level with MRC grade 4 proximal paraparesis. Preoperative MRI demonstrated a well-delineated, dumbbell-shaped, epidural lesion, without bony involvement, resulting in spinal cord compression at the T7 and T8 levels. The patient underwent gross total surgical resection of the lesion. At the one month follow up, the patient's strength improved to MRC grade 5, and sensation had fully returned. The histopathological diagnosis was a capillary hemangioma. Exclusively epidural capillary hemangiomas are extremely rare with only 26 cases reported in the literature. They are mainly located at the thoracic level (T4-T6). The MRI features include a well-circumscribed mass, hyperintense on T2-weighted sequence in 92% of cases, isointense on T1-weighted sequence in 88% of cases, and homogeneous contrast enhancement in 100% of cases. No tumor recurrence has been observed after gross total surgical removal. CONCLUSIONS When evaluating progressive spinal cord compression by a purely epidural spinal lesion, the differential diagnosis should include capillary hemangioma, in addition to schwannoma, meningioma, and lymphoma. Early and complete surgical removal is the first line treatment.
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Affiliation(s)
- C Benevello
- Department of Neurosurgery, GHU site Sainte-Anne, Paris, France; Université de Paris, 102-108 rue de la Santé, 75014 Paris, France
| | - A Laaidi
- Department of Neurosurgery, GHU site Sainte-Anne, Paris, France; Université de Paris, 102-108 rue de la Santé, 75014 Paris, France
| | - S Peeters
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - A Moiraghi
- Department of Neurosurgery, GHU site Sainte-Anne, Paris, France; Université de Paris, 102-108 rue de la Santé, 75014 Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, Inserm, IMA-BRAIN, Paris, France
| | - A Tauziede-Espariat
- Université de Paris, 102-108 rue de la Santé, 75014 Paris, France; Department of Neuropathology, GHU site Sainte-Anne, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, Inserm, IMA-BRAIN, Paris, France
| | - C Oppenheim
- Université de Paris, 102-108 rue de la Santé, 75014 Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, Inserm, IMA-BRAIN, Paris, France; Department of Neuroradiology, GHU site Sainte-Anne, Paris, France
| | - J Pallud
- Department of Neurosurgery, GHU site Sainte-Anne, Paris, France; Université de Paris, 102-108 rue de la Santé, 75014 Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR S1266, Inserm, IMA-BRAIN, Paris, France.
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Cortiula F, De Ruysscher D, Dursun S, Steens M, Bootsma G, Canters R, Rinaldi I, Taasti V, Houben R, Reynders K, Peeters S, Angrisani A, Hattu D, Hendriks L. 113P Proton-therapy and concurrent chemotherapy in stage III NSCLC: Effects on durvalumab eligibility and safety profile. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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7
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Angrisani A, Houben R, Marcuse F, Hochstenbag M, Maessen J, De Ruysscher D, Peeters S. “Radiotherapy for Thymic Epithelial Tumors: What Is The Optimal Dose? A Systematic Review.”. Clin Transl Radiat Oncol 2022; 34:67-74. [PMID: 35360004 PMCID: PMC8960904 DOI: 10.1016/j.ctro.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/13/2022] [Indexed: 11/21/2022] Open
Abstract
Thymic epithelial tumors(TETs) often require a multimodal approach, including RT. RT dose recommendations largely derive from old data, where 2D RT was widely used. This systematic review focused on the optimal dose for TETs with modern RT. 5 eligible studies reporting dose response were analyzed and synthesized. Current guidelines remain valid, this work might be an eye-opener fostering new data.
Thymic epithelial tumors (TETs) are rare thoracic tumors, often requiring multimodal approaches. Surgery represents the first step of the treatment, possibly followed by adjuvant radiotherapy (RT) and, less frequently, chemotherapy. For unresectable tumors, a combination of chemotherapy and RT is often used. Currently, the optimal dose for patients undergoing radiation is not clearly defined. Current guidelines on RT are based on studies with a low level of evidence, where 2D RT was widely used. We aim to shed light on the optimal radiation dose for patients with TETs undergoing RT through a systematic review of the recent literature, including reports using modern RT techniques such as 3D-CRT, IMRT/VMAT, or proton-therapy. A comprehensive literature search of four databases was conducted following the PRISMA guidelines. Two investigators independently screened and reviewed the retrieved references. Reports with < 20 patients, 2D-RT use only, median follow-up time < 5 years, and reviews were excluded. Two studies fulfilled all the criteria and therefore were included. Loosening the follow-up time criteria to > 3 years, three additional studies could be evaluated. A total of 193 patients were analyzed, stratified for prognostic factors (histology, stage, and completeness of resection), and synthesized according to the synthesis without meta-analysis (SWIM) method. The paucity and heterogeneity of eligible studies led to controversial results. The optimal RT dose neither for postoperative, nor primary RT in the era of modern RT univocally emerged. Conversely, this overview can spark new evidence to define the optimal RT dose for each TETs category.
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Angrisani A, Hattu D, Hendriks L, Peeters S, Reymen B, Van Loon J, Verhoeven K, In ‘t Ven L, Dhont J, De Ruysscher D. PD-0844 Sarcopenia evolution in stage III lung cancer treated with photon or proton chemo-radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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Vaassen F, Hazelaar C, Canters R, Peeters S, Petit S, van Elmpt W. PD-0751 The effect of organ-at-risk contour variations on automatically generated treatment plans for NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Vince O, Peeters S, Johanssen VA, Gray M, Smart S, Sibson NR, Stride E. Microbubbles Containing Lysolipid Enhance Ultrasound-Mediated Blood-Brain Barrier Breakdown In Vivo. Adv Healthc Mater 2021; 10:e2001343. [PMID: 33191662 DOI: 10.1002/adhm.202001343] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/09/2020] [Indexed: 12/13/2022]
Abstract
Ultrasound and microbubbles (MBs) offer a noninvasive method of temporarily enhancing blood-brain barrier (BBB) permeability to therapeutics. To reduce off-target effects, it is desirable to minimize the ultrasound pressures required. It has been shown that a new formulation of MBs containing lysolipids (Lyso-MBs) can increase the cellular uptake of a model drug in vitro. The aim of this study is to investigate whether Lyso-MBs can also enhance BBB permeability in vivo. Female BALB/c mice are injected with either Lyso-MBs or control MBs and gadolinium-DTPA (Gd-DTPA) and exposed to ultrasound (500 kHz, 1 Hz pulse repetition frequency, 1 ms pulse length, peak-negative pressures 160-480 kPa) for 2 min. BBB permeabilization is measured via magnetic resonance imaging (7.0 T) of Gd-DTPA extravasation and subsequent histological examination of brain tissue to assess serum immunoglobulin G (IgG) extravasation (n = 8 per group). An approximately twofold enhancement in BBB permeability is produced by the Lyso-MBs at the highest ultrasound pressure compared with the control. These findings indicate that modifying the composition of phospholipid-shelled MBs has the potential to improve the efficiency of BBB opening, without increasing the ultrasound pressure amplitude required. This is particularly relevant for delivery of therapeutics deep within the brain.
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Affiliation(s)
- Oliver Vince
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, UK
| | - Sarah Peeters
- Medical Research Council Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - Vanessa A Johanssen
- Medical Research Council Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - Michael Gray
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, UK
| | - Sean Smart
- Medical Research Council Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - Nicola R Sibson
- Medical Research Council Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK
| | - Eleanor Stride
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, OX3 7DQ, UK
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Vilches Freixas G, Vaniqui A, Vaassen F, Hazelaar C, Öllers M, Canisius S, Tissen D, Van Enckevort E, Rousch E, Verhoeven K, Van Loon J, De Ruysscher D, Bosmans G, Van Elmpt W, Rinaldi I, Peeters S. PO-1614: Breath hold characteristics and intra-fraction motion during nasal high flow therapy assisted RT. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01632-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Verhoeven K, Vilches-Freixas G, Limpens K, Mannens J, Van der Klugt K, Velders M, Visser F, Peeters S, Bosmans G, Boersma L. PO-1573: First clinical experience with model-based selection for breast cancer proton therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01591-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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LeenderS M, Robeers R, Hendriks L, Van Loon J, Bootsma G, Wanders R, Pitz C, Reymen B, Houben R, Van Baardwijk A, Verhoeven K, Peeters S, De Ruysscher D. PO-1025: Prognostic factors for PFS and OS in radically treated patients with oligometastatic NSCLC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01042-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Peeters S, Canisius S, Tissen D, Van Enckevort E, Rousch E, Öllers M, Bosmans G, Verhoeven K, Overhof C, Van Loon J, De Ruysscher D, Vilches-Freixas G. PO-1014: Mitigating breathing motion with nasal high flow therapy (NHFT) in lung cancer: A prospective study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01031-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Verhoeven K, Opbroek T, Vilches-Freixas G, Limpens K, Mannens J, Pijls M, Van der Klugt K, Velders M, Visser F, Peeters S, Reymen B, Van Baardwijk A, Van Loon J, Bosmans G, Boersma L. Prospectively registered acute toxicity in breast cancer patients undergoing adjuvant intensity modulated proton therapy. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Murgano D, Khalil A, Prefumo F, Mieghem TV, Rizzo G, Heyborne KD, Melchiorre K, Peeters S, Lewi L, Familiari A, Lopriore E, Oepkes D, Murata M, Anselem O, Buca D, Liberati M, Hack K, Nappi L, Baxi LV, Scambia G, Acharya G, D'antonio F. Outcome of twin-to-twin transfusion syndrome in monochorionic monoamniotic twin pregnancy: systematic review and meta-analysis. Ultrasound Obstet Gynecol 2020; 55:310-317. [PMID: 31595578 DOI: 10.1002/uog.21889] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/15/2019] [Accepted: 09/18/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To explore the outcome of monochorionic monoamniotic (MCMA) twin pregnancies affected by twin-to-twin transfusion syndrome (TTTS). METHODS MEDLINE and EMBASE databases were searched for studies reporting the outcome of MCMA twin pregnancies complicated by TTTS. The primary outcome was intrauterine death (IUD); secondary outcomes were miscarriage, single IUD, double IUD, neonatal death (NND), perinatal death (PND), survival of at least one twin, survival of both twins and preterm birth (PTB) before 32 weeks' gestation. Outcomes were assessed in MCMA twins affected by TTTS not undergoing intervention and in those treated with amniodrainage, laser therapy or cord occlusion. Subgroup analysis was performed including cases diagnosed before 24 weeks. Random-effects meta-analysis of proportions was used to analyze the data. RESULTS Fifteen cohort studies, including 888 MCMA twin pregnancies, of which 44 were affected by TTTS, were included in the review. There was no randomized trial comparing the different management options in MCMA twin pregnancies complicated by TTTS. In cases not undergoing intervention, miscarriage occurred in 11.0% of fetuses, while the incidence of IUD, NND and PND was 25.2%, 12.2% and 31.2%, respectively. PTB complicated 50.5% of these pregnancies. In cases treated by laser surgery, the incidence of miscarriage, IUD, NND and PND was 19.6%, 27.4%, 7.4% and 35.9%, respectively, and the incidence of PTB before 32 weeks' gestation was 64.9%. In cases treated with amniodrainage, the incidence of IUD, NND and PND was 31.3%, 13.5% and 45.7% respectively, and PTB complicated 76.2% of these pregnancies. Analysis of cases undergoing cord occlusion was affected by the very small number of included cases. Miscarriage occurred in 19.2%, while there was no case of IUD or NND of the surviving twin. PTB before 32 weeks occurred in 50.0% of these cases. CONCLUSIONS MCMA twin pregnancies complicated by TTTS are at high risk of perinatal mortality and PTB. Further studies are needed in order to elucidate the optimal type of prenatal treatment in these pregnancies. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- D Murgano
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK; and Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - F Prefumo
- Department of Obstetrics and Gynecology, Spedali Riunit, Brescia, Italy
| | - T Van Mieghem
- Department of Obstetrics and Gynecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada
| | - G Rizzo
- Division of Maternal and Fetal Medicine, Ospedale Cristo Re, University of Rome Tor Vergata, Rome, Italy
| | - K D Heyborne
- Department of Obstetrics and Gynecology, Denver Health and Hospital Authority, Denver, CO, USA; Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, CO, USA
| | - K Melchiorre
- Department of Obstetrics and Gynecology, 'Spirito Santo' Hospital, Pescara, Italy
| | - S Peeters
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - L Lewi
- Department of Obstetrics and Gynecology, University Hospitals of KU Leuven, Leuven, Belgium
| | - A Familiari
- Department of Obstetrics and Gynecology, Fondazione IRCCS, Ca Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - E Lopriore
- Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands
| | - D Oepkes
- Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M Murata
- Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - O Anselem
- Maternité Port-Royal, Groupe Hospitalier Cochin-Broca-Hôtel-Dieu, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - D Buca
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - M Liberati
- Department of Obstetrics and Gynecology, University of Chieti, Chieti, Italy
| | - K Hack
- Department of Obstetrics and Gynecology, Gelre Hospitals, Apeldoorn, The Netherlands
| | - L Nappi
- Department of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - L V Baxi
- School of Medicine, Columbia University, New York, USA
| | - G Scambia
- Department of Obstetrics and Gynecology, Catholic University of The Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy
| | - G Acharya
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - F D'antonio
- Department of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Le Goff C, Gendebien A, Ferrante N, Peeters S, Cavalier E. Evaluation of a new magnetic bead-based biological sample preparation kits for vitamin D analysis by LC-MS/MS. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Le Goff C, Peeters S, Nix C, Gendebien A, Cavalier E. Evaluation of a new magnetic bead-based biological sample preparation kits for a panel of 11 steroids determined by LC-MS/MS. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Le Goff C, Nyssen L, Ferrante N, Peeters S, Delanaye P, Cavalier E. Validation of the serum iohexol LC-MS/MS method using iohexol deuterated (D5) as internal standard. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bayani J, Poncet C, Yao CQ, Crozier C, Anouk N, Piper T, Cunningham C, Sobol M, Aebi S, Benstead K, Bogler O, Dal Lago L, Fraser J, Hilbers FH, Hedenfalk I, Korde L, Linderholm B, Martens J, Middleton L, Murray M, Kelly C, Nilsson C, Nowaczyk M, Peeters S, Peric A, Porter P, Schröder C, Rubio IT, Ruddy KJ, van Asperen C, Van Den Weyngaert D, van Deurzen C, van Leeuwen-Stok E, Vermeij J, Winer E, Boutros PC, Giordano SH, Cardoso F, Bartlett JM. Abstract P6-19-01: Evaluation of multiple transcriptomic gene risk signatures in male breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-19-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Male breast cancer (MBC) is a rare disease accounting for less than 1% of all breast cancers (BC) and 1% of all cancers in males. The clinical management is largely extrapolated from female BC. Several multigene assays are increasingly used to guide clinical treatment decisions in female BC, however there is little data on the utility of these tests in MBC.
Methods: Here we present the gene expression results of 380 M0, ER+ve, HER2-ve MBCs enrolled in the Part 1 (retrospective joint analysis) International Male Breast Cancer Program of 1483 patients diagnosed between 1990-2010 (Cardoso et al. Annals of Oncology, 2018). Using a custom Nanostring™ panel comprised of the genes from the commercial risk tests Prosigna®, OncotypeDx® and Mammaprint®, risk scores and intrinsic subtyping data were generated to recapitulate the commercial tests as described by Bayani and Yao et al (npjBreast Cancer, 2017). Survival outcomes by risk classification were analyzed using Cox models with time-dependent covariates when the proportional hazard assumption was not met and adjusted for clinical and treatment variables.
Results: Prosigna-like risk scores identified 99 (26.1%) as low-risk, 159 (41.8%) as intermediate-risk, and 122 (32.1%) as high-risk. Using the TAILORx cut-off (25) for OncotypeDx-like risk of recurrence scoring, 158 (41.6%) were identified as low-risk, while 222 (58.4%) were identified as high-risk. MammaPrint-like results identified 175 (46.1%) as low-risk and 205 (53.9%) as high-risk. Overall, patients classified as high-risk had higher grade, more nodal involvement, larger tumors, and more frequently treated with chemotherapy than low-risk patients. Survival analyses demonstrated clear clinical utility for each test, showing patients at high-risk with poor relapse-free survival (RFS) as compared to patients classified as low-risk: Prosigna-like RFS at 3-years (HR=2.20, 95% CI, 1.28-3.80); Oncotype-like RFS at 3-years (HR=1.92, 95% CI, 1.17-3.17); MammaPrint-like RFS (HR=1.51, 95% CI, 1.00-2.27); with similar findings for distant relapse-free survival (DRFS) and overall survival (OS). Across outcomes and all gene signatures, patients with concordant Low/Low risk classification had better prognosis than those with concordant High/High risk classification. PAM50 intrinsic subtyping identified 147 (38.7%) as Luminal A, 57 (15.0%) as Luminal B, 80 (21.1%) as Her2-enriched and 96 (25.3%) as Basal-like; showing overall 34.5% concordance to clinic-pathological subtyping by central pathology (95% CI, 29.7%-39.5%). Comparison between the tests in the MBC cohort and a comparable cohort of female BC from the Tamoxifen Exemestane Adjuvant Multinational (TEAM) trial processed in the same way will be presented.
Conclusion: Common transcriptomic assays designed to assess residual risk, validated in female BC, provide similar information in male BC patients. Not surprisingly, disagreement between test results at the individual patient level was observed. To our knowledge, this is the largest study of MBC assayed to generate risk scores of the current commercial BC tests to demonstrate their clinical utility and their differences and similarity to female BC.
This work has been funded by the Breast Cancer Research Foundation (BCRF).
Citation Format: Bayani J, Poncet C, Yao CQ, Crozier C, Anouk N, Piper T, Cunningham C, Sobol M, Aebi S, Benstead K, Bogler O, Dal Lago L, Fraser J, Hilbers FH, Hedenfalk I, Korde L, Linderholm B, Martens J, Middleton L, Murray M, Kelly C, Nilsson C, Nowaczyk M, Peeters S, Peric A, Porter P, Schröder C, Rubio IT, Ruddy KJ, van Asperen C, Van Den Weyngaert D, van Deurzen C, van Leeuwen-Stok E, Vermeij J, Winer E, Boutros PC, Giordano SH, Cardoso F, Bartlett JM. Evaluation of multiple transcriptomic gene risk signatures in male breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-19-01.
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Affiliation(s)
- J Bayani
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Poncet
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - CQ Yao
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Crozier
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - N Anouk
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - T Piper
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Cunningham
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - M Sobol
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - S Aebi
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - K Benstead
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - O Bogler
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - L Dal Lago
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - J Fraser
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - FH Hilbers
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - I Hedenfalk
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - L Korde
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - B Linderholm
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - J Martens
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - L Middleton
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - M Murray
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Kelly
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Nilsson
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - M Nowaczyk
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - S Peeters
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - A Peric
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - P Porter
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C Schröder
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - IT Rubio
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - KJ Ruddy
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C van Asperen
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - D Van Den Weyngaert
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - C van Deurzen
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - E van Leeuwen-Stok
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - J Vermeij
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - E Winer
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - PC Boutros
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - SH Giordano
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - F Cardoso
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
| | - JM Bartlett
- Ontario Institute for Cancer Research, Toronto, ON, Canada; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University of Edinburgh, Edinburgh, United Kingdom; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Cheltenham General Hospital, Gloucestershire, United Kingdom; Global Academic Programs, University of Texas MD Anderson Cancer Center, Houston, TX; Jules Bordet Institute, Brussels, Belgium; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Breast International Group, Brussels, Belgium; Lund University, Lund, Sweden; University of Washington, Seattle, WA; Sahlgrenska University Hospital, Gothenburg, Sweden; Medical Oncology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; University of Texas MD Anderson Cancer Center, Houston, TX; Memorial Sloan Kettering Cancer Center, New York, NY; All Ireland Cooperative Oncology Research Group (ICORG), Dublin, United Kingdom; Västmanlands Hospital, Västerås, Sweden; Speci
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Peeters S, Chris B, Jacques B, Martijn S, Dirk D. PV-0041: Hand grip strength: independent prognostic selection test for OS in stage I NSCLC treated with SBRT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30351-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Martens JWM, Sieuwerts A, Ponchet C, Smid M, de Weerd V, Slaets L, Piper T, van Deurzen CHM, Schroder CP, Stangle C, Kloosterman W, van Leeuwen-Stok E, Nilsson C, Vermeij J, Peeters S, Goulioti T, Nowaczyk M, Aebi S, Rubio IT, Kelly C, Bayani J, Porter P, Murray M, Hudis C, Middleton L, Korde L, Ruddy K, Winer E, Bogler O, van den Weyngaert D, dal Lago L, Fraser J, Benstead K, van Asperen C, Linderholm B, Hedenfalk I, Tryfonidis K, Giordano S, Bartlett J, Cardoso F. Abstract PD7-12: Molecular subtyping of male breast cancer by the International male breast cancer program (IMBC): EORTC 10085/TBCRC 0-29/BIG 2-07/NABCG/BOOG 2009-04. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd7-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction. Male breast cancer (male BC) is a rare disease for which disease management is extrapolated from females. IMBC, an international consortium, which previously reported on clinico-pathological aspects, now reports on molecular subgroups revealed by RNA sequencing and their relation to patient outcome.
Methods. Tumor samples from the retrospective MALE BC registry diagnosed between 1990-2010 and with pathology and outcome data (relapse-free- (RFS) and overall survival (OS)) were included (n=699). To allow the discovery of prognostic features, we selected, stratified for known risk factors (TN stage, grade, age at diagnose and adjuvant endocrine treatment), from the cohort 152 cases with poor (RFS <= 4 yrs) and good outcome (RFS > 7yrs) evenly distributed. Here, we report RNA sequencing results of the first 73 cases, 38 with poor and 35 with good outcome. RNA sequencing reads were used to generate gene expression values and to report transcripts carrying driver mutations. Unsupervised clustering identified subgroups and within subgroups differentially expressed genes were identified. The reported prognostic male BC subgroups M1 and M2 (Johansson BCR 2012(14):R31) were also annotated. All identified subgroups were related to outcome using logistic regression (p-value using Wald test).
Results. Unsupervised clustering revealed 2 main subgroups of which group 1 was enriched for expression of ER target genes, WNT3 and genes from amplicons known for female BC, e.g. 19p13 (CCNE1), 8q24 (MYC), and 11q13 (CCND1). The biology of the smaller group 2 was less defined but TGFβ2 expression was high as were various kallikreins (KLK) including interestingly KLK3 (prostate specific antigen). Other known amplified regions [(8p11 (FGFR1), 20q13 (ZNF217) and 12q15 (MDM2)] and mutated transcripts [PIK3CA (H1047R/L/Q; E542K, E545K, N345K; 16% of cases), TP53 and SF3B1 (K700E) (2% of cases)] were identified. Profound tumor infiltrate gene expression was present in 5% of cases and one third of cases expressed proliferation markers. Except for TP53, none of these latter characteristics were unevenly distributed among the 2 main subgroups. ER and AR were highly correlated, particularly in group 1. The two main groups could be further subdivided. Group 1 comprised 3 subgroups of which subgroup 1a expressed TFF1/3 and NAT1, well-known ER targets, while subgroups 1b and 1c expressed other ER targets,respectively BEX1 and PITX1. HOXC cluster expression differentiated subgroup 1b from 1a and 1c. None of these intrinsic subgroups were, however, related to RFS. The previously reported M2 subgroup, which largely segregated with subclusters 1a and 1b, was associated with a better RFS than the M1 subgroup (OR=2.9; 95%CI 1.1-7.5; p-value=0.03).
Conclusions. 1) Intrinsic subtypes of male BC were revealed and their subgrouping is defined by ER associated subsets of genes. 2) The association of the reported M2 subgroup of male BC with longer RFS was validated; 3) Currently identified biological characteristics of male BC may improve future treatments. The full report on 152 cases including a comparison to female BC will be presented at the conference.
This research was funded by Breast Cancer Research Foundation
Citation Format: Martens JWM, Sieuwerts A, Ponchet C, Smid M, de Weerd V, Slaets L, Piper T, van Deurzen CHM, Schroder CP, Stangle C, Kloosterman W, van Leeuwen-Stok E, Nilsson C, Vermeij J, Peeters S, Goulioti T, Nowaczyk M, Aebi S, Rubio IT, Kelly C, Bayani J, Porter P, Murray M, Hudis C, Middleton L, Korde L, Ruddy K, Winer E, Bogler O, van den Weyngaert D, dal Lago L, Fraser J, Benstead K, van Asperen C, Linderholm B, Hedenfalk I, Tryfonidis K, Giordano S, Bartlett J, Cardoso F. Molecular subtyping of male breast cancer by the International male breast cancer program (IMBC): EORTC 10085/TBCRC 0-29/BIG 2-07/NABCG/BOOG 2009-04 [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD7-12.
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Affiliation(s)
- JWM Martens
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - A Sieuwerts
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Ponchet
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - M Smid
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - V de Weerd
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L Slaets
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - T Piper
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - CHM van Deurzen
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - CP Schroder
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Stangle
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - W Kloosterman
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - E van Leeuwen-Stok
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Nilsson
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Vermeij
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - S Peeters
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - T Goulioti
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - M Nowaczyk
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - S Aebi
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - IT Rubio
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Kelly
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Bayani
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - P Porter
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - M Murray
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C Hudis
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L Middleton
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L Korde
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - K Ruddy
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - E Winer
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - O Bogler
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - D van den Weyngaert
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - L dal Lago
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Fraser
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - K Benstead
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - C van Asperen
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - B Linderholm
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - I Hedenfalk
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - K Tryfonidis
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - S Giordano
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - J Bartlett
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
| | - F Cardoso
- Erasmus Medical Center, Rotterdam, ZH, Netherlands; European Organization for Research and Treatment of Cancer, Brussels, Belgium; Ontario Institute for Cancer Research, Toronto, Canada; Erasmus Medical Center, Rotterdam, Netherlands; University Medical Center, Groningen, Netherlands; University Medical Center, Utrecht, Netherlands; Dutch Breast Cancer Research Group (BOOG), Netherlands; Västmanlands Hospital, Vateras, Sweden; ZNA Jan Palfijn, Belgium; UZ Leuven, Leuven, Belgium; Breast International Group, Brussels, Belgium; Specialist Hospital. St. Wojciech, Gdansk, Poland; Swiss Group for Clinical Cancer Research, Switzerland; Hospital Universitario Vall d´Hebron, Barcelona, Spain; All Ireland Cooperative Oncology Research Group, Ireland; University of Washington, Seattle; Memorial Sloan Kettering Cancer Center, New York; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York; University of Texas MD Anderson Cancer Center, Houston; Mayo Clinic, Rochester; Dana-Farber Cancer Ins
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Hens W, Vissers D, Hansen D, Peeters S, Gielen J, Van Gaal L, Taeymans J. The effect of diet or exercise on ectopic adiposity in children and adolescents with obesity: a systematic review and meta-analysis. Obes Rev 2017; 18:1310-1322. [PMID: 28913977 DOI: 10.1111/obr.12577] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/26/2017] [Accepted: 05/14/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Ectopic fat depostion in youth with obesity is associated with an increased cardiovascular disease risk. The aim of this meta-analysis was to summarize the evidence for the use of diet and/or exercise on ectopic adiposity in this population. METHODS A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Clinical trials that assessed ectopic fat deposition and included study arms with diet and/or exercise were searched in PubMed, PEDro and the Cochrane database. RESULTS Hepatic fat content and intramyocellular lipid content were described in nine studies and three studies, respectively. Most studies included teenagers, and study duration ranged between 3 and 12 months without follow-up. Using random-effects weights, the standardized mean difference of the change in hepatic adiposity (totalling 320 subjects) was -0.54 Hedges' g (95% confidence interval: -0.69 to -0.38 with p < 0.0001). By re-expressing this effect size, it is seen that diet and/or exercise results in an absolute reduction of intrahepatic lipid with 2%, which accords with a relative reduction up to 70%. Although there were significant ameliorations of insulin sensitivity, no significant changes in intramyocellular lipid were observed. CONCLUSIONS This meta-analysis showed that diet and/or exercise is effective to reduce hepatic adiposity in youth with obesity.
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Affiliation(s)
- W Hens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - D Vissers
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - D Hansen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,REVAL-Rehabilitation Research Centre, Diepenbeek, Belgium.,Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - S Peeters
- Flemish Working Group from AXXON, Antwerp, Belgium
| | - J Gielen
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
| | - L Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - J Taeymans
- Health, Bern University of Applied Sciences-Health, Bern, Switzerland.,Faculty of Sport and Rehabilitation Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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Botticella A, Defraene G, Billiet C, Draulans C, Nackaerts K, Deroose C, Coolen J, Nafteux P, Peeters S, De Ruysscher D. PO-0694: Lung toxicity modelling in thoracic post-operative RT for NSCLC and pleural mesothelioma. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31944-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Van den Bosch L, Defraene G, Peeters S, Dooms C, De Wever W, Deroose C, De Ruysscher D. EP-1246: Is there a different dose-effect relation between the tumour and involved lymph nodes in NSCLC? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32496-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reynders K, Wauters E, Vansteenkiste J, Decaluwé H, De Leyn P, Nackaerts K, Peeters S, Dooms C, Janssens W, Lambrechts D, De Ruysscher D. OC-0047: PD-L1/PD-L2 gene expression differs in tumor vs. lung tissue in non-small cell lung cancer patients. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31296-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Billiet C, Peeters S, Decaluwé H, Vansteenkiste J, Dooms C, Deroose C, Hendrikx M, Péchoux CL, Mebis J, Ruysscher DD. 126P: Outcome after post-operative radiotherapy (PORT) in ypN2 or R1/R2 versus no PORT in ypN0 stage III-N2 non-small cell lung cancer after induction chemotherapy and resection. J Thorac Oncol 2016. [DOI: 10.1016/s1556-0864(16)30239-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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28
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Billiet C, De Ruysscher D, Peeters S, Decaluwé H, Vansteenkiste J, Dooms C, Deroose C, Hendrikx M, Mebis J. PO-0688: Patterns of LR for stage III N2 NSCLC patients after chemotherapy and surgery: implications for PORT. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31938-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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29
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Botticella A, Defraene G, Nackaerts K, Deroose C, Nafteux P, Peeters S, De Ruysscher D. EP-1871: Optimization of gross tumour volume definition in lungsparing VMAT for pleural mesothelioma. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33122-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Borowski E, Poppe A, Laenen A, Remmerie C, Van Asten K, Nevelsteen I, Smeets A, Weltens C, Peeters S, Leunen K, Berteloot P, Amant F, Vergote I, Van Limbergen E, Christiaens MR, Wildiers H, Floris G, Poppe W, Neven P. Abstract P6-09-12: Breast cancer characteristics and the levonorgestrel intrauterine device. A monocentric retrospective study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-09-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The levonorgestrel-intrauterine device (LNG-IUD) is a widely used contraceptive method. It is not clear if LNG-IUD users are more likely to develop breast cancer. Breast cancer growth through the estrogen and/or the human epidermal growth factor receptor 2 (HER2) pathway could be influenced by a continuous low systemic dose of levonorgestrel. In this study, we compare breast cancer characteristics and the receptor expression of estrogen (ER), progesterone (PR) and HER2 in women with and without a LNG- IUD at the time of diagnosis.
METHODS: In this retrospective, observational study, we included 2599 consecutive breast cancer patients who were younger than 55 years at diagnosis and treated between 2000 and 2014 in the University Hospitals Leuven for a primary invasive, non-metastatic tumor. The non LNG-IUD group was matched by age and parity at diagnosis. ER, PR and HER2 status were reported according to ASCO/CAP guidelines. The Chi-square test was used to compare receptor status between groups. All tests were two-sided, and a 5% significance level was assumed. An additional analysis was performed to detect the occurrence of HER 2 expression with or without intake of oral contraception by diagnosis in the control group.
RESULTS: 366 LNG-IUD users and 2233 women without a LNG-IUD were included. Compared to the control group, the LNG-IUD users had a lower Nottingham prognostic index (4.2 vs 4.4; p=0.048), more PR expression (79.2% vs 73.4%; p=0.021) but less HER2 expression (11.6% vs 17.2%; p=0.009). A significant higher rate of ER+PR+HER2- was observed in the LNG-IUD group (63.26 % vs 73.46%; p<0.001). These differences in receptor expression were mainly observed in the age group 45-49 years at diagnosis. Additionally, a trend of more HER2 positivity associated with oral contraceptive use was noticed in the control group.
CONCLUSION: We found in a breast cancer population, matched for age and parity, significant differences in the PR and HER2 expression according to use of LNG-IUD at time of diagnosis. ER positive, PR positive and HER2 negative breast cancers are more frequently seen in LNG-IUD users. There is a trend of less HER 2 positivity in LNG-IUD users and it is more common seen in oral contraception users.
Citation Format: Borowski E, Poppe A, Laenen A, Remmerie C, Van Asten K, Nevelsteen I, Smeets A, Weltens C, Peeters S, Leunen K, Berteloot P, Amant F, Vergote I, Van Limbergen E, Christiaens M-R, Wildiers H, Floris G, Poppe W, Neven P. Breast cancer characteristics and the levonorgestrel intrauterine device. A monocentric retrospective study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-09-12.
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Affiliation(s)
- E Borowski
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - A Poppe
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - A Laenen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - C Remmerie
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - K Van Asten
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - I Nevelsteen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - A Smeets
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - C Weltens
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - S Peeters
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - K Leunen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - P Berteloot
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - F Amant
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - I Vergote
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - E Van Limbergen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - M-R Christiaens
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - H Wildiers
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - G Floris
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - W Poppe
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - P Neven
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
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31
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Poppe A, Brouckaert O, Laenen A, Soubry A, Remmerie C, Floris G, Leunen K, Berteloot P, Amant F, Vergote I, Nevelsteen I, Smeets A, Christiaens MR, Weltens C, Peeters S, Van Limbergen E, Wildiers H, Neven P. Abstract P6-09-11: Independent prognostic value of age depends on breast cancer subtype. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Young women present more often with aggressive breast cancer phenotypes and have worse prognosis. It remains controversial whether age is an independent prognostic factor in early stage breast cancer. Arbitrarily chosen age cut-off values have been proposed in different studies. Furthermore, few studies have examined the impact of breast cancer subtypes on the prognostic value of age. This abstract represents an update of a prior analysis (San Antonio Breast Cancer Symposium, December 4-8 2012, P06-07-29).
Methods: We included all primary operable female breast cancer patients from our prospectively managed database in UZ Leuven, Belgium. We assessed the effect of age on locoregional free interval (LRRFI), distant metastasis interval (DMFI) and breast cancer specific survival (BCSS). In univariate analysis, using Cox regression models, we determined the best categorization of age at diagnosis into two or three age groups by considering all possible combinations of cut-off values. Best categorization was obtained with three age groups. We further determined, using multivariate analysis (correcting for phenotype, tumor size, nodal status, adjuvant chemo -, hormone – and radiotherapy, type of surgery and procedure of axillary staging), whether age at diagnosis remains an independent predictor of outcome (LRRFI, DMFI and BCSS). We further explored whether age at diagnosis is an independent predictor of event risk (LRRFI, DMFI and BCSS) in different breast cancer subtypes. Luminal A-like (grade I or II, ER and/or PR positive, HER 2 positive), Luminal B-like (idem but grade III), Luminal HER 2 like (ER and/or PR positive, HER 2 positive), HER 2 like (ER/PR negative, HER 2 positive), triple negative (ER/PR negative, HER 2 negative).
Results: We included 4180 patients with a mean/median age of 58/57 year and with a median follow up of 8.9 year. Multivariate analysis confirmed age as an independent prognostic variable for LRRFI, DMFI and BCSS.
Results multivariable analysis with age in 3 groups (HR (95% CI) P-VALUE) LRRFIDMFIBCSSYoungest versus middle1.61 (1.18-2.18) 0.00251.54 (1.23-1.93) 0.00021.72 (1.26-2.36) 0.0007Youngest versus oldest3.45 (1.85-6.45) 0.00011.25 (0.89-1.77) 0.19821.31 (0.85-2.02) 0.2220Middle versus oldest2.15 (1.22-3.79) 0.00820.81 (0.61-1.09) 0,17060.76 (0.55-1.06) 0.1014
We found optimal cut-off values for LRRFI at 44y and 72y, for DMFI at 47y and 71y and for BCSS at 41y and 70y.
In an exploratory analysis, with age as continuous variable, by subtype we found a significant independent association between age and LRRFI (P=0.0169), DMFI (P=0.0344) in luminal A-like, LRRFI (P=0.0022) in luminal B-like and DMFI (P=0.0010) and BCSS (P=0.0053) in triple negative breast cancer. No significant associations were found in luminal HER2 and HER2 like breast cancers.
Conclusion:
This study has shown that young age is an independent prognostic factor for LRRFI, DMFI and BCSS after correction for the most important clinical prognostic factors. The prognostic effect is most important in luminal A and triple negative subtypes. Additional analyses for subtypes with age as a categorical variable will be performed and optimal cut off values will be defined.
Citation Format: Poppe A, Brouckaert O, Laenen A, Soubry A, Remmerie C, Floris G, Leunen K, Berteloot P, Amant F, Vergote I, Nevelsteen I, Smeets A, Christiaens M-R, Weltens C, Peeters S, Van Limbergen E, Wildiers H, Neven P. Independent prognostic value of age depends on breast cancer subtype. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-09-11.
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Affiliation(s)
- A Poppe
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - O Brouckaert
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - A Laenen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - A Soubry
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - C Remmerie
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - G Floris
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - K Leunen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - P Berteloot
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - F Amant
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - I Vergote
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - I Nevelsteen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - A Smeets
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - M-R Christiaens
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - C Weltens
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - S Peeters
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - E Van Limbergen
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - H Wildiers
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
| | - P Neven
- University Hospitals Leuven, Leuven, Vlaams Brabant, Belgium; Jan Yperman Ziekenhuis, Ieper, West Vlaanderen, Belgium; Catholic University Leuven, Leuven, Vlaams Brabant, Belgium
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Brouckaert O, Poppe A, Laenen A, Floris G, Leunen K, Berteloot P, Amant F, Vergote I, Smeets A, Weltens C, Peeters S, Van Limbergen E, Wildiers H, Christiaens MR, Neven P. Abstract P6-10-06: The impact of body mass index on age at breast cancer diagnosis and breast cancer phenotype. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-10-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Evidence suggests that premenopausal obesity decreases and postmenopausal obesity increases breast cancer risk. While it has been hypothesized that carcinogenesis may be accelerated by a disrupted metabolic homeostasis in obese women, it is unclear why this dual relationship is observed. We here study whether body mass index (BMI) affects (a) age at breast cancer diagnosis and (b) the probability of being diagnosed with a specific breast cancer phenotype, taking menopausal status into account.
Patients and methods
All patients with non-metastatic operable breast cancer from UZ Leuven diagnosed between January 1, 2000 and December 31, 2013 were included (n=7020). Luminal A like (= grade 1 or 2, ER and/or PR positive, HER2 negative), Luminal B like (= grade 3 ER and/or PR positive, HER2 negative), Luminal HER2 like (ER and/or PR positive, HER2 positive), HER2 like (ER and PR negative, HER2 positive) and triple negative breast cancer (TNBC = ER and PR and HER2 negative). For statistical analysis, linear models and logistic regression were used to study respectively the association between BMI and age at diagnosis and BMI and breast cancer phenotype by menopausal status.
Results
There was a quadratic relationship between BMI and age at breast cancer diagnosis studying the overall population (p<0.0001). A 5kg/m2 increase in BMI was associated with the following increases in age at diagnosis: +1.8y (95% CI 1.4-2.3y) at BMI=18, +1.2y (95% CI 0.95-1.5y) at BMI=23 and +0.6y (95% CI 0.4-0.9y) at BMI=28 (corrected for menopause). This relationship was independent of the menopausal status, ER or HER2 status, histology and breast cancer phenotype.
We observed a linear relationship between BMI and the probability of being diagnosed with Luminal B like, Luminal HER2 like and HER2 like breast cancer (table 1). This linear relationship interacts with menopausal status for Luminal B like and HER2 like breast cancers (table 1).
Table 1: Probability of being diagnosed with a certain breast cancer phenotype by BMI (linear model) and the impact of menopausal status.Effect of BMI on the probabilityLinear modelof being diagnosed withp-valueeffectLuminal A like0.4430n/aLuminal B like0.0276BMI +5kg/m2 OR 1.07 (95% CI 1.01-1.14)Luminal HER2 like0.0367BMI +5kg/m2 OR 0.91 (95% CI 0.83-1.00)HER2 like0.0219BMI +5kg/m2 OR 0.88 (95% CI 0.78-0.98)TNBC0.5454n/aInteraction with menopausal statusp-valueeffectLuminal A0,2204n/aLuminal B0,0487Premenopausal OR 0,996 (CI 0,974-1,019), p=0,7449; Postmenopausal OR 1,023 (CI 1,008-1,038), p=0.0023Luminal HER20,2571n/aHER2 like0,0031Premenopausal OR 1,020 (CI 0,983-1,059), p=0,2923; Postmenopausal OR 0,947 (CI 0,919-0,976), p=0.0004TNBC0,1638n/a
Conclusion
We could not confirm the hypothesis that increasing BMI decreases (increases) age at diagnosis in postmenopausal (premenopausal) women. Obesity does affect the probability of being diagnosed with certain breast cancer phenotypes, but for certain breast cancer phenotypes an interaction with menopause was observed. We presume a potential biological link through BMI between Luminal B and HER2 like breast cancer that needs further exploration.
Citation Format: Brouckaert O, Poppe A, Laenen A, Floris G, Leunen K, Berteloot P, Amant F, Vergote I, Smeets A, Weltens C, Peeters S, Van Limbergen E, Wildiers H, Christiaens M-R, Neven P. The impact of body mass index on age at breast cancer diagnosis and breast cancer phenotype. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-10-06.
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Affiliation(s)
- O Brouckaert
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - A Poppe
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - A Laenen
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - G Floris
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - K Leunen
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - P Berteloot
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - F Amant
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - I Vergote
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - A Smeets
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - C Weltens
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - S Peeters
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - E Van Limbergen
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - H Wildiers
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - M-R Christiaens
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - P Neven
- Jan Yperman Hospital, Ypres, Belgium; Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
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Peeters S, Offeciers FE, Joris P, Moeneclaey L. The Laura cochlear implant programmed with the continuous interleaved and phase-locked continuous interleaved strategies. Adv Otorhinolaryngol 2015; 48:261-8. [PMID: 8273492 DOI: 10.1159/000422595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- S Peeters
- Medical Electronics Laboratory, University of Antwerp, Belgium
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Botticella A, Defraene G, Nackaerts K, Deroose C, Coolen J, Nafteux P, Peeters S, De Ruysscher D. Optimization of Gross Tumour Volume Definition and Treatment Planning in Lung-Sparing Volumetric Modulated Arc Therapy for Pleural Mesothelioma. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv052.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Botticella A, Defraene G, Nackaerts K, Deroose C, Coolen J, Nafteux P, Peeters S, De Ruysscher D. PO-0803: Optimization of GTV definition and treatment planning in lung-sparing VMAT for pleural mesothelioma. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40795-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Verhoeven K, Petillion S, Erven K, Peeters S, Janssen H, Van Limbergen E, Laenen A, Christiaens M, Neven P, Weltens C. Boost Delineation in Breast Radiation Therapy: Isotropic Versus Anisotropic Margin Expansion. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Botticella A, Defraene G, Nackaerts K, Deroose C, Coolen J, Nafteux P, Peeters S, De Ruysscher D. Optimal Definition of Target Volumes in Lung-Sparing Pleural Radiotherapy for Malignant Pleural Mesothelioma (Mpm). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu357.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cavalier E, Bekaert AC, Lukas P, Peeters S, Gadisseur R, Le Goff C, Delanaye P. Les résultats des formules de calcul de la vitamine D libre varient (entre autres) en fonction des méthodes de dosage de la 25-hydroxyvitamine D. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Billiet C, Gouw Z, Defraene G, Decaluwe H, Peeters S, Vansteenkiste J, De Leyn P, Dooms C, De Ruysscher D. Postoperative Radiotherapy in Resected Ypn2 Stage Iii-N2 Non-Small Cell Lung Cancer: Can Modern Conformal Radiotherapy Compensate for the Poor Outcome? Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Peeters S, Dooms C, Vansteenkiste J, Decaluwe H, De Leyn P, Nackaerts K, De Wever W, Deroose C, De Ruysscher D. Selective Mediastinal Node Irradiation in Nsclc in the Imrt/Vmat Era: Added Value of Ebus-Tbna-Mapping to Pet-Ct. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu348.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cavalier E, Dubois B, Bekaert AC, Lukas P, Peeters S, Gadisseur R, Le Goff C, Krzesinski JM, Delanaye P. La membrane de dialyse peut-elle avoir un impact sur le statut vitaminique D du patient ? Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Le Goff C, Devaux S, Brevers E, Peeters S, Kaux JF, Cavalier E. P255Galectin-3: a new promising cardiac biomarker in sports endurance? Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu082.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Peeters S, Biemans R, Dubois L, Hart C, Lambin P, Lieuwes N, van Stiphout R, Zegers C. 153: Antitumor activity of combination therapy with TH-302 and irradiation in a rat rhabdomyosarcoma model. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)34174-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Peeters S, Panth K, Lieuwes N, Bussink J, Van Dongen G, Dubois L, Lambin P. PO-0785: 89Zr-Cetuximab uptake in primary head and neck xenografts is independent of the expression of EGFR and perfusion. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30903-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Reynders K, Wauters E, Vansteenkiste J, Decaluwé H, Nackaerts K, Peeters S, Dooms C, Janssens W, Lambrechts D, De Ruysscher D. EP-1149: Influence of histology and smoking status on PD-L1, PD1 and CTLA4 expression of tumor vs. normal lung tissue in NSCLC. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peeters S, Dooms C, Vansteenkiste J, Decaluwe H, De Leyn P, Nackaerts K, De Wever W, Deroose C, De Ruysscher D. OC-0064: Selective mediastinal node irradiation in NSCLC in the IMRT/VMAT era: added value of EBUS-TBNA-mapping to PET-CT. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Peeters S, Zegers C, Lieuwes N, van Elmpt W, Hoebers F, Sharifi H, Reymen B, Öllers M, Mottaghy F, Eriksson J, Windhorst A, van Dongen G, de Ruysscher D, Dubois L, Lambin P. Abstract B144: Hypoxia imaging with [18F]HX4 PET compared with [18F]FMISO and [18F]FAZA: From preclinical to clinical studies. Mol Cancer Ther 2013. [DOI: 10.1158/1535-7163.targ-13-b144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Tumor hypoxia is an important prognostic factor in overall survival for chemotherapy and radiotherapy. Quantifying and localizing hypoxia non-invasively is therefore important. At present, hypoxia PET tracers lack high tumor-to-background (TBR) ratios. The nitroimidazole [18F]HX4, has shown promise in pre-clinical (Dubois et al. PNAS 2011) and phase I human setting (van Loon et al. EJNMMI 2010). However, until now no comparative research has been conducted between the latest promising hypoxia tracers in order to define the best marker. In a pre-clinical study [18F]HX4 was compared to the hypoxia tracers [18F]FMISO and [18F]FAZA on 3 endpoints; optimal imaging time point, spatial reproducibility and oxygen dependency. Clinical studies investigated the optimal time point and spatial-temporal stability for [18F]HX4 imaging.
Methods: In pre-clinical experiments, WAG/Rij rats bearing rhabdomyosarcoma R1 tumors were injected with 20 ± 4 MBq of [18F]HX4, [18F]FMISO or [18F]FAZA, followed by PET/CT imaging up to 6h post-injection (h p.i.). For each tracer TBR was calculated and reproducibility was investigated by voxel-to-voxel analysis or a DICE similarity coefficient. Oxygen sensitivity was studied by altering the tumoral hypoxia status either by carbogen/nicotinamide treatment or 7% oxygen breathing. In clinical trials, NSCLC (N=15) [NCT01024829, NCT01210378] and HNSCC (N=10) [NCT01347281] patients were injected with 403 ± 53 MBq [18F]HX4 and PET/CT imaging was performed at several time points up to 4h p.i.. Tumor uptake (TBR>1.4), image contrast changes over time, hypoxic fraction (HF) and spatial-temporal stability were evaluated.
Results: In pre-clinical setting, [18F]HX4 uptake reached a stabilized and maximal TBR at 3h p.i. (TBR=7.2) which is significantly higher compared to the plateau phase of [18F]FAZA reached at 2h p.i. (TBR=3.9, P<0.05). [18F]FMISO did not reach a plateau. Voxel-to-voxel comparisons and DICE similarity coefficient calculations showed a high short- and long-term spatial reproducibility except for [18F]FAZA, which performed poor on a 48 hour interval. Increasing the hypoxic fraction by 7% oxygen breathing resulted in enhanced mean standardized uptake values for both [18F]HX4 (P<0.01) and [18F]FAZA (P<0.05). Only [18F]FMISO uptake was found to be reversible upon reoxygenation using nicotinamide and carbogen. In patients, a TBR>1.4 was observed in 72% of NSCLC and in 74% of HNSCC target lesions, with average HF of 14 ± 17% and 25 ± 22%, respectively. In the hypoxic lesions, TBR increased up to 4h p.i., providing a better contrast at the latest time-points. [18F]HX4 uptake was stable in time and space for the heterogeneous pattern in NSCLC lesions (2h vs. 4h p.i.: r = 0.77 ± 0.10).
Conclusions: Both pre-clinical and clinical studies support [18F]HX4 as a robust hypoxia tracer, with the highest image contrast from 3h p.i. onwards, sensitivity to hypoxia and high reproducibility.
Citation Information: Mol Cancer Ther 2013;12(11 Suppl):B144.
Citation Format: Sarah Peeters, Catharina Zegers, Natasja Lieuwes, Wouter van Elmpt, Frank Hoebers, Hoda Sharifi, Bart Reymen, Michel Öllers, Felix Mottaghy, Jonas Eriksson, Albert Windhorst, Guus van Dongen, Dirk de Ruysscher, Ludwig Dubois, Philippe Lambin. Hypoxia imaging with [18F]HX4 PET compared with [18F]FMISO and [18F]FAZA: From preclinical to clinical studies. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr B144.
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Affiliation(s)
- Sarah Peeters
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Natasja Lieuwes
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Frank Hoebers
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | - Hoda Sharifi
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | - Bart Reymen
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | - Michel Öllers
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | - Felix Mottaghy
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | | | | | | | | | - Ludwig Dubois
- 1Maastricht University Medical Center, Maastricht, Netherlands
| | - Philippe Lambin
- 1Maastricht University Medical Center, Maastricht, Netherlands
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Verhoeven K, Petillion S, Erven K, Janssen H, Peeters S, Van Limbergen E, Laenen A, Christiaens M, Neven P, Weltens C. Is There Benefit to Using a Preoperative Computed Tomography to Reduce the Interobserver Variability of the Boost CTV Delineation for Breast Radiation Therapy? Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Peeters S, Gilmore AB. Understanding the tobacco industry’s interests in smokeless tobacco and harm reduction in order to inform EU health policy. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt124.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Verhoeven K, Laenen A, Janssen H, Peeters S, Van Limbergen E, Christiaens M, Neven P, Weltens C. PD-0321: Risk factors for local-regional recurrences after mastectomy and adjuvant radiotherapy for breast cancer. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)32627-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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