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Gambaro K, Marques M, McNamara S, Couetoux du Tertre M, Hoffert C, Srivastava A, Schab A, Alcindor T, Langleben A, Sideris L, Abdelsalam M, Tehfe M, Couture F, Batist G, Kavan P. A Phase II Exploratory Study to Identify Biomarkers Predictive of Clinical Response to Regorafenib in Patients with Metastatic Colorectal Cancer Who Have Failed First-Line Therapy. Int J Mol Sci 2023; 25:43. [PMID: 38203214 PMCID: PMC10778949 DOI: 10.3390/ijms25010043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
Single-agent regorafenib is approved in Canada for metastatic colorectal cancer (mCRC) patients who have failed previous lines of therapy. Identifying prognostic biomarkers is key to optimizing therapeutic strategies for these patients. In this clinical study (NCT01949194), we evaluated the safety and efficacy of single-agent regorafenib as a second-line therapy for mCRC patients who received it after failing first-line therapy with an oxaliplatin or irinotecan regimen with or without bevacizumab. Using various omics approaches, we also investigated putative biomarkers of response and resistance to regorafenib in metastatic lesions and blood samples in the same cohort. Overall, the safety profile of regorafenib seemed similar to the CORRECT trial, where regorafenib was administered as ≥ 2 lines of therapy. While the mutational landscape showed typical mutation rates for the top five driver genes (APC, KRAS, BRAF, PIK3CA, and TP53), KRAS mutations were enriched in intrinsically resistant lesions. Additional exploration of genomic-phenotype associations revealed several biomarker candidates linked to unfavorable prognoses in patients with mCRC using various approaches, including pathway analysis, cfDNA profiling, and copy number analysis. However, further research endeavors are necessary to validate the potential utility of these promising genes in understanding patients' responses to regorafenib treatment.
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Affiliation(s)
- Karen Gambaro
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Consortium de Recherche en Oncologie Clinique du Québec (Q-CROC), Quebec, QC G1V 3X8, Canada
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Maud Marques
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Suzan McNamara
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Consortium de Recherche en Oncologie Clinique du Québec (Q-CROC), Quebec, QC G1V 3X8, Canada
| | - Mathilde Couetoux du Tertre
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Consortium de Recherche en Oncologie Clinique du Québec (Q-CROC), Quebec, QC G1V 3X8, Canada
| | - Cyrla Hoffert
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Consortium de Recherche en Oncologie Clinique du Québec (Q-CROC), Quebec, QC G1V 3X8, Canada
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Archana Srivastava
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Consortium de Recherche en Oncologie Clinique du Québec (Q-CROC), Quebec, QC G1V 3X8, Canada
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Anna Schab
- Canadian National Centres of Excellence-Exactis Innovations, Montreal, QC H3T 1Y6, Canada; (K.G.); (M.M.); (S.M.)
- Consortium de Recherche en Oncologie Clinique du Québec (Q-CROC), Quebec, QC G1V 3X8, Canada
| | | | | | - Lucas Sideris
- Hôpital Maisonneuve Rosemont, Montreal, QC H1T 2M4, Canada
| | | | - Mustapha Tehfe
- Hematology-Oncology, Oncology Center-Centre Hospitalier de l’Université de Montreal, Montreal, QC H2X 0C1, Canada
| | | | - Gerald Batist
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Petr Kavan
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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Gambaro K, Groleau M, McNamara S, Awan A, Salem M, Abdelsalam M, St-Hilaire E, Vincent F, Carrier J, MacKay H, Provencher L, Boudreau D, Hamilou Z, Saad F, Ferrario C, Batist G, Marques M. Third-line treatment patterns in HER2-positive metastatic breast cancer: a retrospective analysis of real-world data in Canada. J Pharm Pharm Sci 2023; 26:12078. [PMID: 38152647 PMCID: PMC10751338 DOI: 10.3389/jpps.2023.12078] [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] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
There is an increasing demand for real-world data pertaining to the usage of cancer treatments, especially in settings where no standard treatment is specifically recommended. This study presents the first real-world analysis of third-line treatment patterns in HER2-positive metastatic breast cancer (mBC) patients in Canada. The purpose was to assess evolution of clinical practice and identify unmet needs in post-second-line therapy. Retrospective data from medical records of 66 patients who received third-line treatment before 31st October 2018, and data from 56 patients who received third-line treatment after this date, extracted from the Personalize My Treatment (PMT) cancer patient registry, were analyzed. In the first cohort, the study revealed heterogeneity in the third-line setting, with trastuzumab, lapatinib, and T-DM1 being the main treatment options. Even though data were collected before the wide availability of tucatinib, neratinib and trastuzumab deruxtecan in Canada, the PMT cohort revealed the emergence of new therapeutic combinations and a shift from lapatinib usage to T-DM1 choice was observed. These findings underscore the evolving nature of third-line treatment strategies in Canada, a facet that is intrinsically tied to the availability of new drugs. The absence of a consensus on post-second-line treatment highlights the pressing need for more efficient therapeutic alternatives beyond the currently available options. This study not only offers valuable insights into the present landscape of third-line treatment in Canada but validates the significance and effectiveness of the PMT registry as a tool for generating pan-Canadian real-world evidence in oncology and its capacity to provide information on evolution of therapeutic practices.
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Affiliation(s)
- Karen Gambaro
- Canadian National Centres of Excellence-Exactis Innovation, Montreal, QC, Canada
| | | | - Suzan McNamara
- Canadian National Centres of Excellence-Exactis Innovation, Montreal, QC, Canada
| | - Arif Awan
- The Ottawa Hospital, Ottawa, ON, Canada
| | - Maged Salem
- Horizon Health Network-The Moncton Hospital, Moncton, NB, Canada
| | | | - Eve St-Hilaire
- Centre Hospitalier Universitaire Dr. Georges-L.-Dumont, Moncton, NB, Canada
| | - François Vincent
- Centre Hospitalier Régional de Trois-Riviéres, Trois-Riviéres, QC, Canada
| | - Julie Carrier
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Helen MacKay
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | | | - Zineb Hamilou
- Centre Hospitalier Universitaire de Montréal, Montreal, QC, Canada
| | - Fred Saad
- Centre Hospitalier Universitaire de Montréal, Montreal, QC, Canada
| | | | - Gerald Batist
- Segal Cancer Centre-Jewish General Hospital, Montreal, QC, Canada
| | - Maud Marques
- Canadian National Centres of Excellence-Exactis Innovation, Montreal, QC, Canada
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McNamara S, Vajda J, Cassidy J, Bridges G, Guillette C, Sistek K, Goffin B, Brunson A, Ong T. 97 Improving oral glucose tolerance testing rate through a cross-disciplinary quality improvement collaboration. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00788-3] [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: 11/06/2022]
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Rosenfeld M, Ong T, Carlin K, McNamara S, Gorry S, Kanter A, Gibson R, Cassidy J, Greene L, Choi M, Reonal R, Culley L, Thompson J. 68: Improving timeliness of CF diagnosis following a positive CF newborn screen in Washington State. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01493-4] [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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Cassidy J, McNamara S, Gorry S, Hughes R, Vajda J, Hill L, Akers M, Greene L, Ong T. 144: Quality improvement process to improve home spirometer use in a pediatric CF care center. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01569-1] [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: 10/20/2022]
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6
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Stratman S, Schneider C, McNamara S, Lev-Tov H. 389 Association of multiparity and venous insufficiency in Hispanic women. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.411] [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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Gambaro K, Marques M, McNamara S, Couetoux du Tertre M, Diaz Z, Hoffert C, Srivastava A, Hébert S, Samson B, Lespérance B, Ko Y, Dalfen R, St‐Hilaire E, Sideris L, Couture F, Burkes R, Harb M, Camlioglu E, Gologan A, Pelsser V, Constantin A, Greenwood CM, Tejpar S, Kavan P, Kleinman CL, Batist G. Copy number and transcriptome alterations associated with metastatic lesion response to treatment in colorectal cancer. Clin Transl Med 2021; 11:e401. [PMID: 33931971 PMCID: PMC8087915 DOI: 10.1002/ctm2.401] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Therapeutic resistance is the main cause of death in metastatic colorectal cancer. To investigate genomic plasticity, most specifically of metastatic lesions, associated with response to first-line systemic therapy, we collected longitudinal liver metastatic samples and characterized the copy number aberration (CNA) landscape and its effect on the transcriptome. METHODS Liver metastatic biopsies were collected prior to treatment (pre, n = 97) and when clinical imaging demonstrated therapeutic resistance (post, n = 43). CNAs were inferred from whole exome sequencing and were correlated with both the status of the lesion and overall patient progression-free survival (PFS). We used RNA sequencing data from the same sample set to validate aberrations as well as independent datasets to prioritize candidate genes. RESULTS We identified a significantly increased frequency gain of a unique CN, in liver metastatic lesions after first-line treatment, on chr18p11.32 harboring 10 genes, including TYMS, which has not been reported in primary tumors (GISTIC method and test of equal proportions, FDR-adjusted p = 0.0023). CNA lesion profiles exhibiting different treatment responses were compared and we detected focal genomic divergences in post-treatment resistant lesions but not in responder lesions (two-tailed Fisher's Exact test, unadjusted p ≤ 0.005). The importance of examining metastatic lesions is highlighted by the fact that 15 out of 18 independently validated CNA regions found to be associated with PFS in this study were only identified in the metastatic lesions and not in the primary tumors. CONCLUSION This investigation of genomic-phenotype associations in a large colorectal cancer liver metastases cohort identified novel molecular features associated with treatment response, supporting the clinical importance of collecting metastatic samples in a defined clinical setting.
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Affiliation(s)
- Karen Gambaro
- Canadian National Centres of Excellence—Exactis Innovation5450 Cote‐des‐NeigesMontrealQuebecH3T 1Y6Canada
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Maud Marques
- Canadian National Centres of Excellence—Exactis Innovation5450 Cote‐des‐NeigesMontrealQuebecH3T 1Y6Canada
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Suzan McNamara
- Canadian National Centres of Excellence—Exactis Innovation5450 Cote‐des‐NeigesMontrealQuebecH3T 1Y6Canada
| | | | - Zuanel Diaz
- Canadian National Centres of Excellence—Exactis Innovation5450 Cote‐des‐NeigesMontrealQuebecH3T 1Y6Canada
| | - Cyrla Hoffert
- Canadian National Centres of Excellence—Exactis Innovation5450 Cote‐des‐NeigesMontrealQuebecH3T 1Y6Canada
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Archana Srivastava
- Canadian National Centres of Excellence—Exactis Innovation5450 Cote‐des‐NeigesMontrealQuebecH3T 1Y6Canada
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Steven Hébert
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Benoit Samson
- Charles LeMoyne Hospital3120 Taschereau Blvd.Greenfield ParkQuebecJ4V 2H1Canada
| | | | - Yoo‐Joung Ko
- Sunnybrook Health Science Centre2075 Bayview Ave.TorontoOntarioM4N 3M5Canada
| | - Richard Dalfen
- St. Mary's Hospital3830 LacombeMontrealQuebecH3T 1M5Canada
| | - Eve St‐Hilaire
- Georges Dumont Hospital220 Avenue UniversiteMonctonNew BrunswickE1C 2Z3Canada
| | - Lucas Sideris
- Hôpital Maisonneuve Rosemont5415 Assumption BlvdMontrealQuebecH1T 2M4Canada
| | - Felix Couture
- Hôtel‐Dieu de Quebec11 Cote du PalaisMontrealQuebecG1R 2J6Canada
| | - Ronald Burkes
- Mount Sinai Hospital600 University AvenueTorontoOntarioM5G 1X5Canada
| | - Mohammed Harb
- Moncton Hospital135 Macbeath AveMonctonNew BrunswickE1C 6Z8Canada
| | - Errol Camlioglu
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Adrian Gologan
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Vincent Pelsser
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - André Constantin
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Celia M.T. Greenwood
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
- Gerald Bronfman Department of OncologyMcGill University3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill University3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Sabine Tejpar
- Digestive Oncology UnitKatholieke Universiteit LeuvenOude Markt 13Leuven3000Belgium
| | - Petr Kavan
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Claudia L. Kleinman
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
- Department of Human GeneticsLady Davis Research Institute, McGill University3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
| | - Gerald Batist
- McGill University‐Segal Cancer Centre, Jewish General Hospital3755 Côte Ste‐CatherineMontrealQuebecH3T 1E2Canada
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Pope CE, Vo AT, Hayden HS, Weiss EJ, Durfey S, McNamara S, Ratjen A, Grogan B, Carter S, Nay L, Parsek MR, Singh PK, McKone EF, Aitken ML, Rosenfeld MR, Hoffman LR. Changes in fecal microbiota with CFTR modulator therapy: A pilot study. J Cyst Fibros 2021; 20:742-746. [PMID: 33390317 DOI: 10.1016/j.jcf.2020.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Abstract
Studies have demonstrated that people with CF with pancreatic insufficiency (PI) have fecal dysbioses. Evidence suggests the causes of these dysbioses are multifactorial, and that important drivers include antibiotic exposure, dietary intake, and CF gastrointestinal tract dysfunction, including nutrient malabsorption. In this pilot study, we tested whether initiation of the CFTR modulator treatments ivacaftor (in a cohort of pancreatic sufficient (PS) people with CF and an R117H CFTR variant) or lumacaftor/ivacaftor (in a cohort of PI people with CF and an F508del variant) changed fecal measures of malabsorption or fecal microbiomes. While we identified no statistically significant fecal changes with either treatment, we detected trends in the PI cohort when initiating lumacaftor/ivacaftor towards decreased fecal fat content and towards fecal microbiomes that more closely resembled the fecal microbiota of people without PI. While these findings support a model in which nutrient malabsorption resulting from CF-induced PI drives fecal dysbiosis, they must be validated in future, larger studies of fecal microbiome and malabsorption outcomes with highly effective CFTR modulator therapies.
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Affiliation(s)
- C E Pope
- University of Washington, Seattle, USA
| | - A T Vo
- University of Washington, Seattle, USA
| | | | - E J Weiss
- University of Washington, Seattle, USA
| | - S Durfey
- University of Washington, Seattle, USA
| | | | - A Ratjen
- University of Washington, Seattle, USA
| | - B Grogan
- St. Vincent's University Hospital, Dublin, Ireland
| | - S Carter
- St. Vincent's University Hospital, Dublin, Ireland
| | - L Nay
- University of Washington, Seattle, USA
| | | | - P K Singh
- University of Washington, Seattle, USA
| | - E F McKone
- St. Vincent's University Hospital, Dublin, Ireland
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Solomon J, Moss E, Morin J, Langlois Y, Joyal D, Lachapelle K, Ma F, Cecere R, De Varennes B, Bendayan M, Piankova P, Hayman V, Ouimet M, McNamara S, Rudski L, Afilalo J. THE ESSENTIAL FRAILTY TOOLSET IN OLDER ADULTS UNDERGOING ISOLATED CABG. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.219] [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] Open
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10
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Leclair V, Landon-Cardinal O, Aggarwal R, Bansback N, Campbell C, Feldman BM, Jarry M, McNamara S, White B, Hudson M. Proceedings of the 2019 Canadian Inflammatory Myopathy Study Symposium: Clinical Trial Readiness in Myositis. J Rheumatol 2020; 47:1584-1586. [PMID: 32541080 DOI: 10.3899/jrheum.200480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The Canadian Inflammatory Myopathy Study (CIMS) is a multicenter prospective cohort recruiting in 8 centers across Canada. One of the aims of CIMS is to conduct and participate in clinical trials in autoimmune inflammatory myopathies (AIM). Conducting clinical trials in rare diseases such as AIM presents challenges. During this symposium, experts in the field presented different solutions to successfully conduct clinical trials in AIM, including the importance of collaboration and careful trial design, as well as training and mentoring of young investigators.
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Affiliation(s)
- Valérie Leclair
- V. Leclair, MD, Department of Medicine, McGill University, and Division of Rheumatology, Jewish General Hospital, Montreal, Quebec, Canada;
| | - Océane Landon-Cardinal
- O. Landon-Cardinal, MD, Department of Medicine, Université de Montréal, and Division of Rheumatology and Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Rohit Aggarwal
- R. Aggarwal, MD, MSc, Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Nick Bansback
- N. Bansback, PhD, University of British Columbia and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Craig Campbell
- C. Campbell, MD, Department of Pediatrics, London Children's Hospital, University of Western Ontario, London, Ontario, Canada
| | - Brian M Feldman
- B.M. Feldman, MD, MSc, Faculty of Medicine and IHPME Dalla Lana School of Public Health, University of Toronto, and Division of Rheumatology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Martin Jarry
- M. Jarry, Patient Advocate, S. McNamara, PhD, B. White, MD, Corbus Pharmaceutical Holdings Inc., Norwood, Massachusetts, USA
| | - Suzan McNamara
- M. Jarry, Patient Advocate, S. McNamara, PhD, B. White, MD, Corbus Pharmaceutical Holdings Inc., Norwood, Massachusetts, USA
| | - Barbara White
- M. Jarry, Patient Advocate, S. McNamara, PhD, B. White, MD, Corbus Pharmaceutical Holdings Inc., Norwood, Massachusetts, USA
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Gambaro K, Marques M, McNamara S, Couetoux du Tertre M, Hoffert C, Srivastava A, Mathieu S, schab A, Alcindor T, Langleben A, Sideris L, Adbelsalam M, Tehfe M, Batist G, Kavan P. Abstract 4325: A Phase II exploratory study to identify biomarkers prognostic of clinical response to regorafenib in patients with metastatic colorectal cancer who have failed first-line therapy. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-4325] [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
Single-agent regorafenib is approved in Canada and in the US for patients with metastatic colorectal cancer (mCRC) who have failed previous lines of therapy1. Identification of prognostic biomarkers is crucial to ensure the best therapeutic strategies for mCRC patients. The goal of this clinical study (NCT01949194) was to explore putative molecular signatures of response and resistance to regorafenib in metastatic tumors and serial blood samples. We used a multi-omics approach to profile metastatic tumor tissues and serial blood samples from 47 mCRC patients who received single-agent regorafenib as second-line therapy after failing first-line therapy with an oxaliplatin or irinotecan-containing regimen with or without bevacizumab. Whole exome sequencing was performed to assess both the mutational and copy number (CN) landscapes of metastatic tissues from 29 patients and the transcriptome was interrogated using RNA sequencing. A 14-gene panel was used to profile serial plasma samples. Molecular aberrations were then correlated with lesion-specific treatment response using RECIST 1.1 and progression free survival (PFS) to investigate potential associations.The copy number aberration (CNA) landscape of metastatic tumors was assessed using Nexus Copy Number Software and 20 significant focal aberrations were identified using Genomic Identification of Significant Target in Cancer (GISTIC) test (q-bound<0.05). We interrogated all CNA regions across the genome using the log-rank statistic test and identified 38 CNA regions associated with PFS (permutated p-value <0.05). Interestingly, CN gains targeting three genes, GPR52, PTGS2 and MYC, classified within the drug resistance gene category in the drug-interaction database (DGIdb), were associated with a shorter PFS (Kaplan Meier analysis). The mutational landscape showed typical mutation rates for the top 5 driver genes: APC, KRAS, BRAF, PIK3CA and TP53. However, KRAS mutations in exons 12 and 13 appeared enriched in intrinsically resistant lesions compared to stable and acquired resistance lesions (83% versus 41%). At the transcriptome level, three main pathways were associated with intrinsic resistance (TGF-β signaling activation and MAPK activation) and shorter PFS (adherens junction). The profiling of plasma samples showed a higher proportion of samples with non-detectable ctDNA in patients exhibiting longer PFS (PFS ≥ 9 months, 70%) compared to patients with shorter PFS (< 9 months, 18%). This study allowed the identification of several candidate genes and regions at different molecular levels that warrant further validation in order to stratify patients who will likely respond, display intrinsic resistance or develop acquired resistance to regorafenib treatment. 1- Grothey A, Van Cutsem E, Sobrero A, Siena S, Falcone A, Ychou M, et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomized, placebo-controlled, phase 3 trial. Lancet. 2013 Jan 26;381(9863):303-12.
Citation Format: Karen Gambaro, Maud Marques, Suzan McNamara, Mathilde Couetoux du Tertre, Cyrla Hoffert, Archana Srivastava, Sophie Mathieu, Anna schab, Thierry Alcindor, Adrian Langleben, Lucas Sideris, Mahmoud Adbelsalam, Mustapha Tehfe, Gerald Batist, Petr Kavan. A Phase II exploratory study to identify biomarkers prognostic of clinical response to regorafenib in patients with metastatic colorectal cancer who have failed first-line therapy [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4325.
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Affiliation(s)
| | | | | | | | | | | | | | - Anna schab
- 1Exactis Innovation, Montreal, Quebec, Canada
| | | | | | - Lucas Sideris
- 4Hôpital Maisonneuve Rosemont, Montreal, Quebec, Canada
| | | | - Mustapha Tehfe
- 6Centre hospitalier de l'Université de Montreal, Montreal, Quebec, Canada
| | - Gerald Batist
- 7Segal Cancer Centre-Jewish General Hospital, Montreal, Quebec, Canada
| | - Petr Kavan
- 7Segal Cancer Centre-Jewish General Hospital, Montreal, Quebec, Canada
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Couëtoux du Tertre M, Marques M, McNamara S, Gambaro K, Hoffert C, Tremblay L, Bouchard N, Diaconescu R, Blais N, Couture C, Pelsser V, Wang H, McIntosh L, Hindie V, Parent S, Cortes L, Breton YA, Pottiez G, Croteau P, Higenell V, Izzi L, Spatz A, Cohen V, Batist G, Agulnik J. Discovery of a putative blood-based protein signature associated with response to ALK tyrosine kinase inhibition. Clin Proteomics 2020; 17:5. [PMID: 32055239 PMCID: PMC7006423 DOI: 10.1186/s12014-020-9269-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/29/2020] [Indexed: 02/07/2023] Open
Abstract
Background ALK tyrosine kinase inhibition has become a mainstay in the clinical management of ALK fusion positive NSCLC patients. Although ALK mutations can reliably predict the likelihood of response to ALK tyrosine kinase inhibitors (TKIs) such as crizotinib, they cannot reliably predict response duration or intrinsic/extrinsic therapeutic resistance. To further refine the application of personalized medicine in this indication, this study aimed to identify prognostic proteomic biomarkers in ALK fusion positive NSCLC patients to crizotinib. Methods Twenty-four patients with advanced NSCLC harboring ALK fusion were administered crizotinib in a phase IV trial which included blood sampling prior to treatment. Targeted proteomics of 327 proteins using MRM-MS was used to measure plasma levels at baseline (including pre-treatment and early treatment blood samples) and assess potential clinical association. Results Patients were categorized by duration of response: long-term responders [PFS ≥ 24 months (n = 7)], normal responders [3 < PFS < 24 months (n = 10)] and poor responders [PFS ≤ 3 months (n = 5)]. Several proteins were identified as differentially expressed between long-term responders and poor responders, including DPP4, KIT and LUM. Next, using machine learning algorithms, we evaluated the classification potential of 40 proteins. Finally, by integrating the different analytic methods, we selected 22 proteins as potential candidates for a blood-based prognostic signature of response to crizotinib in NSCLC patients harboring ALK fusion. Conclusion In conjunction with ALK mutation, the expression of this proteomic signature may represent a liquid biopsy-based marker of long-term response to crizotinib in NSCLC. Expanding the utility of prognostic biomarkers of response duration could influence choice of therapy, therapeutic sequencing, and potentially the need for alternative or combination therapy.Trial registration ClinicalTrials.gov, NCT02041468. Registered 22 January 2014, https://clinicaltrials.gov/ct2/show/NCT02041468?term=NCT02041468&rank=1.
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Affiliation(s)
- Mathilde Couëtoux du Tertre
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada.,Exactis Innovation, Montréal, QC Canada
| | - Maud Marques
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada.,Exactis Innovation, Montréal, QC Canada
| | - Suzan McNamara
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada.,Exactis Innovation, Montréal, QC Canada
| | - Karen Gambaro
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada.,Exactis Innovation, Montréal, QC Canada
| | - Cyrla Hoffert
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada.,Exactis Innovation, Montréal, QC Canada
| | - Lise Tremblay
- 3Institut universitaire de cardiologie et pneumologie de Québec, Université de Laval, Québec, QC Canada
| | - Nicole Bouchard
- 4Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC Canada
| | | | - Normand Blais
- 6Centre hospitalier universitaire de Montréal, Montréal, QC Canada
| | - Christian Couture
- 3Institut universitaire de cardiologie et pneumologie de Québec, Université de Laval, Québec, QC Canada
| | - Vincent Pelsser
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada
| | - Hangjun Wang
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada
| | | | | | | | | | | | | | | | | | | | - Alan Spatz
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada
| | - Victor Cohen
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada
| | - Gerald Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada
| | - Jason Agulnik
- Segal Cancer Centre, Jewish General Hospital, McGill University, Jewish General Hospital, 3755, Chemin Cote Ste-Catherine, Montreal, QC H3T1E2 Canada
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Gambaro K, Marques M, McNamara S, du Tertre MC, Hoffert C, Srivastava A, Samson B, Lesperance B, Ko Y, Dalfen R, St-Hilaire E, Sideris L, Couture F, Burkes R, Harb M, Camlioglu E, Gologan A, Pelsser V, Tejpar S, Kavan P, Kleinman C, Batist G. Copy number variation in longitudinal liver metastases biopsies in colorectal cancer identifies biomarker candidates of resistance to standard chemotherapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.019] [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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14
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Couëtoux du Tertre M, Marques M, Tremblay L, Bouchard N, Diaconescu R, Blais N, Couture C, Pelsser V, Wang H, Higenell V, Izzi L, Gambaro K, Hoffert C, Srivastava A, Spatz A, Rousseau C, McNamara S, Cohen V, Batist G, Agulnik J. Analysis of the Genomic Landscape in ALK+ NSCLC Patients Identifies Novel Aberrations Associated with Clinical Outcomes. Mol Cancer Ther 2019; 18:1628-1636. [PMID: 31243098 DOI: 10.1158/1535-7163.mct-19-0105] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/26/2019] [Accepted: 06/19/2019] [Indexed: 11/16/2022]
Abstract
Rearrangements in the anaplastic lymphoma kinase (ALK) gene are found in approximately 5% of non-small cell lung carcinoma (NSCLC). Here, we present a comprehensive genomic landscape of 11 patients with ALK+ NSCLC and investigate its relationship with response to crizotinib. Using whole-exome sequencing and RNAseq data, we identified four rare ALK fusion partners (HIP1, GCC2, ERC1, and SLC16A7) and one novel partner (CEP55). At the mutation level, TP53 was the most frequently mutated gene and was only observed in patients with the shortest progression-free survival (PFS). Of note, only 4% of the genes carrying mutations are present in more than 1 patient. Analysis of somatic copy number aberrations (SCNA) demonstrated that a gain in EML4 was associated with longer PFS, and a loss of ALK or gain in EGFR was associated with shorter PFS. This study is the first to report a comprehensive view of the ALK+ NSCLC copy number landscape and to identify SCNA regions associated with clinical outcome. Our data show the presence of TP53 mutation as a strong prognostic indication of poor clinical response in ALK+ NSCLC. Furthermore, new and rare ALK fusion partners were observed in this cohort, expanding our knowledge in ALK+ NSCLC.
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Affiliation(s)
- Mathilde Couëtoux du Tertre
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Exactis Innovation, Montreal, Quebec, Canada
| | - Maud Marques
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Exactis Innovation, Montreal, Quebec, Canada
| | - Lise Tremblay
- Institut Universitaire de Cardiologie et Pneumologie de Quebec, Universite de Laval, Quebec City, Quebec, Canada
| | - Nicole Bouchard
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Normand Blais
- Centre Hospitalier Universitaire de Montreal, Montreal, Quebec, Canada
| | - Christian Couture
- Institut Universitaire de Cardiologie et Pneumologie de Quebec, Universite de Laval, Quebec City, Quebec, Canada
| | - Vincent Pelsser
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Hangjun Wang
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | | | - Luisa Izzi
- Exactis Innovation, Montreal, Quebec, Canada
| | - Karen Gambaro
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Exactis Innovation, Montreal, Quebec, Canada
| | - Cyrla Hoffert
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Exactis Innovation, Montreal, Quebec, Canada
| | - Archana Srivastava
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Exactis Innovation, Montreal, Quebec, Canada
| | - Alan Spatz
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Caroline Rousseau
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Suzan McNamara
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Exactis Innovation, Montreal, Quebec, Canada
| | - Victor Cohen
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Gerald Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
| | - Jason Agulnik
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
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Nelson M, Ratjen A, Bautista G, McNamara S, Nay L, Majors C, Vo A, Hayden H, Brittnacher M, LiPuma J, Simon R, Hoffman L. P145 Effect of cycled tobramycin on the sputum microbiome in cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30439-4] [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: 11/30/2022]
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Wolter D, Onchiri F, Emerson J, Precit M, Lee M, McNamara S, Nay L, Blackledge M, Uluer A, Mann M, Orenstein D, Hoover W, Burns J, Hoffman L. ePS6.01 Prevalence and clinical significance of Staphylococcus aureus smallcolony variants: a prospective longitudinal, multicentre study. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30287-5] [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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17
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Lee D, Amadi A, Sabater J, Ellis J, Johnson H, Kotapati S, McNamara S, Walker A, Cooper M, Patterson K, Roskell N, Meng Y. Can We Accurately Predict Cost Effectiveness Without Access to Overall Survival Data? The Case Study of Nivolumab in Combination with Ipilimumab for the Treatment of Patients with Advanced Melanoma in England. Pharmacoecon Open 2019; 3:43-54. [PMID: 29790020 PMCID: PMC6393277 DOI: 10.1007/s41669-018-0080-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Nivolumab with ipilimumab (the Regimen) is the first immuno-oncology combination treatment to demonstrate long-term clinical benefit for advanced melanoma patients. We evaluated the cost effectiveness of the Regimen in this population, with and without the availability of overall survival (OS) data. METHODS A partitioned survival model and a Markov state-transition model were developed to estimate the lifetime costs and benefits of the Regimen versus ipilimumab. These models were built with and without the availability of OS data, as only progression-free survival data were available from the head-to-head, phase III trial against ipilimumab at the time of the National Institute for Health and Care Excellence (NICE) submission. Patient utilities and resource use data were sourced from trial data or the literature. RESULTS Incremental cost-effectiveness ratios (ICERs) and absolute costs were similar between the models with and without OS data, but the model with OS data generated more than 1 additional quality-adjusted life-year (QALY) across both treatment arms. In both models, based on list prices, the Regimen was the most cost-effective treatment. CONCLUSIONS The analyses show that the Regimen is a cost-effective treatment for advanced melanoma patients in England, and methods to overcome the lack of OS can give reasonable estimates of QALYs gained and ICERs.
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Affiliation(s)
- D Lee
- BresMed Health Solutions, Sheffield, UK.
| | - A Amadi
- Bristol-Myers Squibb Pharmaceuticals, Uxbridge, UK
| | - J Sabater
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - J Ellis
- Bristol-Myers Squibb Pharmaceuticals, Uxbridge, UK
| | - H Johnson
- Helen Johnson Consulting Ltd, Welwyn Garden City, UK
| | - S Kotapati
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - S McNamara
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - M Cooper
- BresMed Health Solutions, Sheffield, UK
| | | | - N Roskell
- BresMed Health Solutions, Sheffield, UK
| | - Y Meng
- BresMed Health Solutions, Sheffield, UK
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Lee D, Amadi A, Sabater J, Ellis J, Johnson H, Kotapati S, McNamara S, Walker A, Cooper M, Patterson K, Roskell N, Meng Y. Correction to: Can We Accurately Predict Cost Effectiveness Without Access to Overall Survival Data? The Case Study of Nivolumab in Combination with Ipilimumab for the Treatment of Patients with Advanced Melanoma in England. Pharmacoecon Open 2019; 3:127. [PMID: 30206825 PMCID: PMC6393273 DOI: 10.1007/s41669-018-0096-x] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The second Key Point for Decision Makers, which reads.
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Affiliation(s)
- D Lee
- BresMed Health Solutions, Sheffield, UK.
| | - A Amadi
- Bristol-Myers Squibb Pharmaceuticals, Uxbridge, UK
| | - J Sabater
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - J Ellis
- Bristol-Myers Squibb Pharmaceuticals, Uxbridge, UK
| | - H Johnson
- Helen Johnson Consulting Ltd, Welwyn Garden City, UK
| | - S Kotapati
- Bristol-Myers Squibb, Princeton, NJ, USA
| | - S McNamara
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - M Cooper
- BresMed Health Solutions, Sheffield, UK
| | | | - N Roskell
- BresMed Health Solutions, Sheffield, UK
| | - Y Meng
- BresMed Health Solutions, Sheffield, UK
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Isaacowitz D, Newman A, Carr D, Pruchno R, Sands L, McNamara S. HOW TO PUBLISH: ROUND TABLE DISCUSSIONS WITH JOURNAL EDITORS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- D Isaacowitz
- Northeastern University, Boston, Massachusetts, United States
| | - A Newman
- University of Pittsburgh, Pittsburgh, PA, USA; Editor, The Journals of Gerontology: Medical Sciences, The Gerontological Society of America, Washington, DC, USA
| | - D Carr
- Boston University, Boston, MA, USA
| | - R Pruchno
- Rowan University, Stratford, NJ, USA
| | - L Sands
- Virginia Tech, Blacksburg, VA, USA
| | - S McNamara
- Oxford University Press, New York, NY, USA
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McNamara S. HOW TO MAXIMIZE THE REACH OF YOUR PUBLISHED WORK. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S McNamara
- Oxford University Press, New York, New York, United States
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Yaung S, Xi L, Woestmann C, McNamara S, Hinzmann B, Froehler S, Tikoo N, Ju C, Balasubramanyam A, Adams HP, Thomas M, Lasitschka F, Meister M, Schneider M, Herth F, Muley T, Wehnl B, Palma J, Ma X. Ecological diversity indices as measurements of tumor heterogeneity correlates with clinical outcomes in late stage small cell lung cancer (SCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Couetoux Du Tertre M, Marques M, Izzi L, Tremblay L, Bouchard N, Diaconescu R, Blais N, Hoffert C, Srivastava A, McNamara S, Batist G, Cohen V, Agulnik J. P2.01-23 Baseline Plasma Biomarkers Predict Long-Term Responses to ALK-TKIs in ALK+ Advanced Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1077] [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: 10/28/2022]
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Tertre MCD, Marques M, Gambaro K, Witcher M, Samson B, Lespérance B, Ko YJ, Dalfen R, St-Hilaire E, Sidéris L, Couture F, Tejpar S, Burkes R, Harb M, Camlioglu E, Gologan A, Pelsser V, Constantin A, McNamara S, Kavan P, Kleinman C, Batist G. Abstract LB-231: Genomic profiling in serial metastatic colorectal tumors identifies copy number alterations and spatio temporal intra-patient heterogeneity profiles associated with clinical response. Q-CROC-01: NCT00984048. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-lb-231] [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: Colorectal cancer (CRC) is the third leading cause of cancer related deaths primarily due to its resistance to current treatments. Studies aiming at understanding mechanisms of resistance have largely investigated the genomic landscape of primary tumors at diagnosis. However, selective pressures during therapy can lead to the expansion of resistant clones and tumor heterogeneity. This highlights the need to characterize the molecular changes of metastasis over time of treatment and response to decipher tumor evolution and therapeutic resistance mechanisms.
Methods: Metastatic liver tissue samples were collected at baseline (pre-biopsies) and at the time of resistance (post-biopsies) in responder and non-responder CRC patients undergoing the same first-line treatment. Paired pre/post biopsies were collected from 14 patients including 4 patients with multiple post-biopsies to assess temporal and spatio-temporal tumor heterogeneity following treatment exposure. Biopsies were profiled using exome and transcriptome sequencing as well as high-density Single-Nucleotide Polymorphism (SNP) array analysis to capture chromosomal anomalies, loss of heterozygosity and copy number (CN) variations.
Results: Profiling of 45 samples with both high-density SNP array and exome sequencing revealed 97.4% similarity between both technologies in the identification of genes targeted by copy number changes. Using chemo-naïve biopsies, we identified 120 CN gains and 47 CN loss that were significantly associated with patient progression free survival. Integrative analysis with transcriptome data revealed that only 10% of the genomic CN gains and 17% of the CN loss correlated with their gene expression levels. Based on CN variants comparison between paired pre/post treatment samples, we found high temporal intra-patient
heterogeneity over time of treatment. Interestingly, we observed a relationship between heterogeneity and tumor response; showing that acquired resistant tumors have the highest temporal variations.
Conclusion: This study, using a multi-omic approach to profile serial liver metastatic samples in CRC patients, highlights the genomic changes in tumor composition after treatment exposure and constitutes an innovative approach to identify clinical biomarkers and molecular signatures of resistance.
Citation Format: Mathilde Couetoux du Tertre, Maud Marques, Karen Gambaro, Michael Witcher, Benoit Samson, Bernard Lespérance, Yoo-Joung Ko, Richard Dalfen, Eve St-Hilaire, Lucas Sidéris, Félix Couture, Sabine Tejpar, Ronald Burkes, Mohammed Harb, Errol Camlioglu, Adrian Gologan, Vincent Pelsser, André Constantin, Suzan McNamara, Petr Kavan, Claudia Kleinman, Gerald Batist. Genomic profiling in serial metastatic colorectal tumors identifies copy number alterations and spatio temporal intra-patient heterogeneity profiles associated with clinical response. Q-CROC-01: NCT00984048 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr LB-231.
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Affiliation(s)
| | - Maud Marques
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Michael Witcher
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | - Benoit Samson
- 3Charles Lemoyne Hospital, Greenfield Park, Quebec, Canada
| | | | - Yoo-Joung Ko
- 5Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | | | - Eve St-Hilaire
- 7Georges Dumont Hospital, Moncton, New Brunswick, Canada
| | - Lucas Sidéris
- 8Hôpital Maisonneuve Rosemont, Montreal, Quebec, Canada
| | | | | | | | | | - Errol Camlioglu
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | - Adrian Gologan
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | - Vincent Pelsser
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | - André Constantin
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Petr Kavan
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | - Claudia Kleinman
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
| | - Gerald Batist
- 2Segal Cancer Centre - Jewish General Hospital, Montreal, Quebec, Canada
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Marques M, Gambaro K, du Tertre MC, Witcher M, Samson B, Lesperance B, Ko Y, Dalfen R, St-Hilaire E, Sideris L, Couture F, Tejpar S, Burkes R, Harb M, Alcindor T, Camlioglu E, Gologan A, Pelsser V, McNamara S, Kavan P, Kleinman C, Batist G. Characterizations of DNA copy number variations and spatio-temporal intra tumor heterogeneity in liver metastasis from colorectal cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.005] [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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Couetoux du Tertre M, Marques M, Tremblay L, Bouchard N, Diaconescu R, Blais N, Hoffert C, Srivastava A, Izzi L, McNamara S, Batist G, Cohen V, Agulnik JS. Molecular predictors of long-term response to crizotinib in ALK+ advanced non-small cell lung cancer (NSCLC) patients. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Lise Tremblay
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada
| | | | | | - Normand Blais
- Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | | | | | | | | | - Gerald Batist
- Segal Cancer Centre - Jewish General Hospital, McGill University, Montreal, QC, Canada
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Moore WR, Burr LE, McNamara S, Clark PR, Peine NA, Finstuen T, Herold DL, Brown V, Warner C, Trapp GC, Lipford MC, Olson EJ, Auger RR, St. Louis EK, Junna MR. 1080 The Collaborative Care Visit Model: A New Way to Provide Ongoing Care Targeted to Long-Term Stable Positive Airway Pressure Users. Sleep 2018. [DOI: 10.1093/sleep/zsy061.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Edwards TC, Emerson J, Genatossio A, McNamara S, Goss C, Patrick DL, Onchiri F, Rosenfeld M. Initial development and pilot testing of observer-reported outcomes (ObsROs) for children with cystic fibrosis ages 0-11years. J Cyst Fibros 2018; 17:680-686. [PMID: 29358075 DOI: 10.1016/j.jcf.2017.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 12/12/2017] [Accepted: 12/20/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE Patient-reported outcomes are important clinical trial endpoints. Young children may not be able to reliably report on how they feel or function, so observer-reported outcomes (ObsROs) may be more appropriate for them. The purpose of this study was to develop and pilot field test electronic parent-reported observational instruments for children with cystic fibrosis (CF) 0-6 and 7-11years of age. METHODS We performed concept elicitation interviews with parents of children with CF ≤11years of age to elicit the respiratory signs they could observe at baseline and during an acute respiratory illness. The resulting instruments were refined based on interviews with parents and clinicians. We conducted a pilot field test to evaluate test-retest reliability and the ability of items to distinguish well and sick periods. RESULTS The instruments consist of 17 items assessing respiratory signs and observable CF-related impacts. Test-retest reliability was acceptable for both age groups but discrimination was low for ages 7-11, likely reflecting less direct observation of older children by their parents. CONCLUSIONS An ObsRO for children with CF ages 0-6 appears promising, while self-report may be more appropriate for children >6years of age. Next steps for the 0-6year old instrument will be utilizing it as an exploratory endpoint in clinical trials to enable item reduction, scale development, and further reliability and validity testing. Ultimately, this ObsRO could be a promising endpoint for early intervention trials in young children with CF.
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Affiliation(s)
- T C Edwards
- Department of Health Services, University of Washington, 1208 NE 43rd St. - Campus Box 359455, Seattle, WA 98195-9455, United States.
| | - J Emerson
- Division of Pulmonary Medicine, Seattle Children's Hospital, United States.
| | - A Genatossio
- Division of Pulmonary Medicine, Seattle Children's Hospital, United States.
| | - S McNamara
- Division of Pulmonary Medicine, Seattle Children's Hospital, United States.
| | - C Goss
- Department of Medicine and Pediatrics, University of Washington, Division of Pulmonary and Critical Care Medicine, United States.
| | - D L Patrick
- Department of Health Services, University of Washington, 1208 NE 43rd St. - Campus Box 359455, Seattle, WA 98195-9455, United States.
| | - F Onchiri
- Center for Biomedical Statistics, Seattle Children's Research Institute, Seattle, WA, United States; Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, United States.
| | - M Rosenfeld
- Department of Pediatrics, University of Washington, Division of Pulmonary Medicine, Seattle Children's Hospital, United States.
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Alcaide M, Yu S, Davidson J, Albuquerque M, Bushell K, Fornika D, Arthur S, Grande BM, McNamara S, Tertre MCD, Batist G, Huntsman DG, Cavallone L, Aguilar A, Basik M, Johnson NA, Deyell RJ, Rassekh SR, Morin RD. Targeted error-suppressed quantification of circulating tumor DNA using semi-degenerate barcoded adapters and biotinylated baits. Sci Rep 2017; 7:10574. [PMID: 28874686 PMCID: PMC5585219 DOI: 10.1038/s41598-017-10269-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 08/02/2017] [Indexed: 12/12/2022] Open
Abstract
Ultrasensitive methods for rare allele detection are critical to leverage the full potential offered by liquid biopsies. Here, we describe a novel molecular barcoding method for the precise detection and quantification of circulating tumor DNA (ctDNA). The major benefits of our design include straightforward and cost-effective production of barcoded adapters to tag individual DNA molecules before PCR and sequencing, and better control over cross-contamination between experiments. We validated our approach in a cohort of 24 patients with a broad spectrum of cancer diagnoses by targeting and quantifying single-nucleotide variants (SNVs), indels and genomic rearrangements in plasma samples. By using personalized panels targeting a priori known mutations, we demonstrate comprehensive error-suppression capabilities for SNVs and detection thresholds for ctDNA below 0.1%. We also show that our semi-degenerate barcoded adapters hold promise for noninvasive genotyping in the absence of tumor biopsies and monitoring of minimal residual disease in longitudinal plasma samples. The benefits demonstrated here include broad applicability, flexibility, affordability and reproducibility in the research and clinical settings.
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Affiliation(s)
- Miguel Alcaide
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Stephen Yu
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Jordan Davidson
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Marco Albuquerque
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Kevin Bushell
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Daniel Fornika
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Sarah Arthur
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Bruno M Grande
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Suzan McNamara
- Quebec Clinical Research Organization in Cancer (Q-CROC), Exactis Innovation and the Segal Cancer Centre, Montreal, QC, Canada
| | - Mathilde Couetoux du Tertre
- Quebec Clinical Research Organization in Cancer (Q-CROC), Exactis Innovation and the Segal Cancer Centre, Montreal, QC, Canada
| | - Gerald Batist
- Quebec Clinical Research Organization in Cancer (Q-CROC), Exactis Innovation and the Segal Cancer Centre, Montreal, QC, Canada
| | - David G Huntsman
- Department of Molecular Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine and Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada
| | - Luca Cavallone
- Department of Medicine, Jewish General Hospital, Montreal, Quebec, Canada
| | - Adriana Aguilar
- Department of Medicine, Jewish General Hospital, Montreal, Quebec, Canada
| | - Mark Basik
- Department of Medicine, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nathalie A Johnson
- Department of Medicine, Jewish General Hospital, Montreal, Quebec, Canada
| | - Rebecca J Deyell
- Division of Oncology, Hematology and Bone Marrow Transplant, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - S Rod Rassekh
- Division of Oncology, Hematology and Bone Marrow Transplant, British Columbia Children's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Ryan D Morin
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada.
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Gambaro K, Marques M, Morin R, Kleinman C, Witcher M, Turcotte S, Samson B, Lespérance B, Ko YJ, Dalfen R, St-Hilaire E, Sideris L, Couture F, Tejpar S, Burkes R, Harb M, Aubin F, Alcindor T, Camlioglu E, Aguilar A, Tertre1 MCD, McNamara S, Gologan A, Kavan P, Batist G. Abstract 2795: Integrating multiomics discovery approaches to identify biomarkers of therapeutic resistance in metastatic colorectal cancer through analyses of multiple sequential tumor and liquid biopsies; Qcroc01: NCT00984048. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2795] [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
Colorectal cancer (CRC) is the 2nd leading cause of cancer related-death in Canada. Clinical responses of metastatic (m)CRC to first-line treatment range from 35 to 60%, but even responders inevitably develop therapeutic resistance. Studies aiming at understanding mechanisms of resistance have largely investigated primary tumors. However, selective pressures during therapy can lead to the expansion of resistant clones and tumor heterogeneity. This highlights the need to characterize the molecular changes of metastasis and plasma over time of treatment and response to decipher tumor evolution and therapeutic resistance mechanisms.
In this multicenter study, 52 tissue samples from liver metastasis were collected at baseline (pre-biopsies) and at the time of resistance (post-biopsies) in responder and non-responder mCRC patients (n=44) undergoing the same standard first-line treatments. Multiple post-biopsies also have been harvested in 4 patients, to allow the assessment of tumor heterogeneity and as well as the evolution of the genomic complexity after treatment exposure.
Analyses were carried out across multiple omic platforms to identify resistant signatures and characterize molecular changes during treatment. Biopsies were profiled using exome and transcriptome sequencing as well as high-density SNP array analysis to capture chromosomal anomalies, loss of heterozygosity (LOH) and copy number variations (CNV). Additionally, serial blood samples were collected for proteomic, ctDNA and cytokine analysis.
Our preliminary analysis of transcriptomes performed on serial biopsies from a set of 11 patients identified genes consistently overexpressed at resistance. Cytogenetics analysis showed similar genomic profiles of matched pre- and post-biopsies and allowed the establishment of LOH and CNV catalogues of liver metastasis, while exome sequencing revealed cumulative somatic mutations over time of treatment, which suggests subclonal and acquired “driver” mutations of resistance. Plasma-derived ctDNA analysis was performed to investigate the mutational status during treatment and whether they correlate with their relative levels in biopsies. Immune gene expression analysis of a test set of 27 metastases revealed strong clustering of 7 metastases due to overexpression of transcripts related to active immune response, allowing to define novel subgroups of patients based on immune response status. Our study, using a multi-omic strategy and integration of independent molecular platforms to profile liver metastasis samples of responder and non-responder mCRC patients, constitutes an innovative approach to identify clinical biomarkers and molecular signature of resistance, which may enhance individualization of cancer medicine and customized therapy.
Citation Format: Karen Gambaro, Maud Marques, Ryan Morin, Claudia Kleinman, Michael Witcher, Simon Turcotte, Benoit Samson, Bernard Lespérance, Yoo-Joung Ko, Richard Dalfen, Eve St-Hilaire, Lucas Sideris, Felix Couture, Sabine Tejpar, Ronald Burkes, Mohammed Harb, Francine Aubin, Thierry Alcindor, Errol Camlioglu, Adriana Aguilar, Mathilde Couetoux du Tertre1, Suzan McNamara, Adrian Gologan, Petr Kavan, Gerald Batist. Integrating multiomics discovery approaches to identify biomarkers of therapeutic resistance in metastatic colorectal cancer through analyses of multiple sequential tumor and liquid biopsies; Qcroc01: NCT00984048 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2795. doi:10.1158/1538-7445.AM2017-2795
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Affiliation(s)
- Karen Gambaro
- 1Quebec- Clinical Research on Cancer (Q-CROC), Montréal, Quebec, Canada
| | - Maud Marques
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | - Ryan Morin
- 3Simon Fraser University, Vancouver, British Columbia, Canada
| | - Claudia Kleinman
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | - Michael Witcher
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | - Simon Turcotte
- 4Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | | | | | - Yoo-Joung Ko
- 7Sunnybrook Health Science Centre, Toronto, Ontario, Canada
| | | | - Eve St-Hilaire
- 9Georges Dumont Hospital, Moncton, New Brunswick, Canada
| | - Lucas Sideris
- 10Hôpital Maisonneuve Rosemont, Montréal, Quebec, Canada
| | | | | | | | | | - Francine Aubin
- 4Centre Hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | | | - Errol Camlioglu
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | - Adriana Aguilar
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | | | - Suzan McNamara
- 1Quebec- Clinical Research on Cancer (Q-CROC), Montréal, Quebec, Canada
| | - Adrian Gologan
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | - Petr Kavan
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
| | - Gerald Batist
- 2Segal Cencer Centre-Jewish General Hospital, Montréal, Quebec, Canada
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Couetoux du Tertre M, Tremblay L, Bouchard N, Diaconescu R, Blais N, Camlioglu E, Constantin A, Hoffert C, Gambaro K, Srivastava A, Greenwood C, Couture C, McNamara S, Batist G, Cohen V, Agulnik JS. A phase IV study using multi-omics to identify mechanisms of response and resistance to crizotinib in ALK+ advanced non-small cell lung cancer (NSCLC) patients with distinct progression free survival outcomes. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20588 Background: Crizotinib is the current first-line standard of care for ALK+ NSCLC with response rates reaching 65% [1] . However, most patients progress within 1 or 2 years and mechanisms of resistance remain unknown for approximately 30% of patients [2] . [1] Shaw et al. Crizotinib versus chemotherapy in advanced ALK-positive lung cancer. NEJM 368: 2385-2394, 2013. [2] Doebele et al. Mechanisms of resistance to crizotinib in patients with ALK gene rearranged non-small cell lung cancer. Clin Cancer Res 2012; 18:1472-1482 Methods: Eligible patients had locally advanced or metastatic ALK+ NSCLC. Patients were asked to undergo a repeat tumor biopsy at time of progression and serial bloods and archived primary tumor were collected. Responses were assessed by RECIST 1.1. ctDNA and protein expression on serial blood will be evaluated over the course of treatment. Tumors were profiled using exome sequencing and targeted genomic analysis to identify novel mutations associated with response. Results: 24 patients with stage IV adenocarcinoma received crizotinib as first-line (n = 22) and second-line (n = 2) treatment. Mean age was 60 y (range 41-80). 4% were smokers, 33.5% were former and 62.5% were never-smokers. At data cutoff (Jan 26, 2017), 16 patients have discontinued treatment (14 due to progression and 2 withdrew). The median PFS markedly differed in non-responders (patients with immediate progression) vs responders (patients with initial response or stable disease) (1.8 vs. 27 months). Profiling was performed to identify the genomic traits in tissue and blood that correlate to treatment response. Conclusions: We identified a previously unrecognized subset of patients treated with crizotinib with an exceptionally long PFS. We also observed a subset of patients intrinsically resistant to crizotinib despite harboring ALK+. There are no known predictive biomarkers which can identify patients that will have a long-lasting response or who may not derive benefit from crizotinib. The multi-omics profiling applied to these groups may provide novel insights into mechanisms of response and resistance to crizotinib. Clinical trial information: NCT02041468.
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Affiliation(s)
| | - Lise Tremblay
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, QC, Canada
| | | | | | | | - Errol Camlioglu
- Department of Radiology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Andre Constantin
- Department of Radiology, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | | | | | | | | | | | | | - Gerald Batist
- Department of Oncology, Faculty of Medicine, McGill University and Segal Cancer Centre, Montreal, QC, Canada
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Rooney A, Zienius K, Heimans L, Woltz S, McNamara S, Grant R. PO67LEVETIRACETAM MAY BE INDEPENDENTLY ASSOCIATED WITH HIGHER FATIGUE IN ADULT GLIOMA OUTPATIENTS. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov284.60] [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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McNamara S, Stokes S, Kilduff R, Shine A. Pregabalin Abuse amongst Opioid Substitution Treatment Patients. Ir Med J 2015; 108:309-310. [PMID: 26817289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pregabalin (Lyrica®) is used in treating epilepsy, nerve pain and anxiety. Pregabalin was initially thought to have a low misuse potential however there are emerging reports of Pregabalin being abused. A study was commenced at the National Drug Treatment Centre's (NDTC) Drug Analysis Laboratory to determine the level of usage of Pregabalin within the addiction services population in Ireland. A total of 498 urine samples representing samples from 440 individual opioid substitution patients, initially screened by immunoassay for drugs of abuse, were subjected to further analysis for Pregabalin by Liquid Chromatography/Mass Spectrometry (LC/MS). Of 440 patients tested, 39 tested positive for Pregabalin (9.2%). Only 10 patients from this group were prescribed this drug to our knowledge thus giving an estimated rate of misuse of 7.0%. Other drugs detected in the Pregabalin positive patients were Opiates (31.8%), Cocaine (11.4%), Benzodiazepines (79.5%) and Cannabis (77.8%). Our study confirms that Pregabalin abuse is taking place amongst the addiction services population. We believe that misuse of this prescription drug is a serious emerging issue which should be monitored carefully.
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McNamara S, Morin R, Couëtoux du Tertre M, McCloskey R, Johnston R, Fornika D, Samson B, Lespérance B, Alcindor T, Ko YJ, Dalfen R, St-Hilaire E, Sideris L, Couture F, Prenen H, Tejpar S, Burkes R, Constantin A, Camlioglu E, Aguilar A, Gologan A, Têtu B, Greenwood CM, Hoffert C, Qureshi S, Diaz Z, Marques M, Witcher M, Gagnon-Kugler T, Kavan P, Batist G. Abstract 3888: Molecular profiling of sequential biopsies in patients with metastatic colorectal cancer identifies genomic alterations that evolve during first-line therapy and could have therapeutic implications: A prospective study to identify molecular mechanisms of clinical resistance (QCROC-01: NCT00984048). Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-3888] [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
Therapeutic resistance remains a major obstacle in metastatic colorectal cancer (mCRC) and biomarkers to guide treatment are essential to improving survival and quality of life in mCRC patients. A biopsy-driven prospective study was designed to identify biomarkers and mechanisms of resistance to a standard first-line therapy in patients with mCRC which could be useful in guiding treatment selection (QCROC-01; NCT00984048). We also hoped to recognize molecular changes over time, or resulting from the selection pressure of treatment, which could have implications for subsequent therapy.
This study is ongoing and approved at thirteen sites with one-hundred patients enrolled so far. Patients with mCRC receiving FOLFOX (5-fluorouracil, leucovorin and oxaliplatin) with bevacizumab consented to three needle core tumour biopsies at pre-treatment and at the time of resistance. The rate of both patient and physician acceptance of biopsies has steadily risen with time and experience. Serial bloods were also collected for proteomic analysis and circulating tumor DNA. Twenty-five biopsy samples were profiled using exome sequencing (tumor and germ line), RNAseq, low pass genome sequencing and miRNA analysis. Differential gene expression analysis revealed signatures associated with clinical response and resistance when comparing tumours obtained pre- and post-treatment. We detect changes in variant allele fraction including both depletion and enrichment of individual somatic mutations over the course of treatment, the latter of which may indicate subclonal and acquired “driver” mutations that confer therapeutic resistance. A small number of genes show recurrent evidence for changes in clonal enrichment at the time of relapse across multiple patients. These could also represent therapeutic targets for subsequent therapy for these patients, and as such, represent new treatment opportunities. Our findings provide insights into tumor evolution during first-line chemotherapy of mCRC that may hold clues to optimize current first-line therapeutic decision making and identifies potential target pathways for second-line stratification of patients. This study is part of the Canadian Colorectal Cancer Consortium which is a multi-site collaboration funded by the Terry Fox Research Institute and le fonds de recherche du québec - santé.
Citation Format: Suzan McNamara, Ryan Morin, Mathilde Couëtoux du Tertre, Rosemary McCloskey, Rebecca Johnston, Daniel Fornika, Benoit Samson, Bernard Lespérance, Thierry Alcindor, Yoo-Joung Ko, Richard Dalfen, Eve St-Hilaire, Lucas Sideris, Felix Couture, Hans Prenen, Sabine Tejpar, Ronald Burkes, André Constantin, Errol Camlioglu, Adriana Aguilar, Adrian Gologan, Benoit Têtu, Celia M. Greenwood, Cyrla Hoffert, Samia Qureshi, Zuanel Diaz, Maud Marques, Micheal Witcher, Thérèse Gagnon-Kugler, Petr Kavan, Gerald Batist. Molecular profiling of sequential biopsies in patients with metastatic colorectal cancer identifies genomic alterations that evolve during first-line therapy and could have therapeutic implications: A prospective study to identify molecular mechanisms of clinical resistance (QCROC-01: NCT00984048). [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3888. doi:10.1158/1538-7445.AM2015-3888
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Affiliation(s)
- Suzan McNamara
- 1Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | - Ryan Morin
- 2Simon Fraser University, Burnaby, British Columbia, Canada
| | | | | | - Rebecca Johnston
- 3University of British Columbia, Vancouver, British Columbia, Canada
| | - Daniel Fornika
- 2Simon Fraser University, Burnaby, British Columbia, Canada
| | - Benoit Samson
- 4CSSS Champlain - Charles-Le Moyne, Greenfield Park, Quebec, Canada
| | | | | | - Yoo-Joung Ko
- 7Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | - Eve St-Hilaire
- 9Hôpital Georges L. Dumont, Moncton, New Brunswick, Canada
| | - Lucas Sideris
- 10Hôpital Maisonneuve Rosemont, Montreal, Quebec, Canada
| | | | - Hans Prenen
- 12University Hospitals Leuven and KU Leuven, Leuven, Belgium
| | | | | | - André Constantin
- 15Department of Radiology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Errol Camlioglu
- 15Department of Radiology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Adriana Aguilar
- 16Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
| | - Adrian Gologan
- 16Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
| | - Benoit Têtu
- 17Hôpital du Saint-Sacrement, Quebec, Quebec, Canada
| | - Celia M. Greenwood
- 16Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
| | - Cyrla Hoffert
- 1Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | - Samia Qureshi
- 1Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | - Zuanel Diaz
- 1Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | - Maud Marques
- 16Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
| | - Micheal Witcher
- 16Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
| | | | - Petr Kavan
- 16Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
| | - Gerald Batist
- 18Quebec Clinical Research Organization in Cancer, Jewish General Hospital, Segal Cancer Center, Montreal, Quebec, Canada
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Diaz Z, Aguilar-Mahecha A, Basik M, Bachvarov D, Bélanger L, Benlimame N, Buchanan M, Camlioglu E, Chabot B, Constantin A, Courtemanche C, Gagnon-Kugler T, Gosselin L, McNamara S, Orain M, Paquet E, Przybytkowski E, Qureshi S, Rodrigue D, Rousseau C, Simard M, Spatz A, Têtu B, Batist G. Abstract 3389: Determining optimal conditions for collection and processing of metastatic liver biopsies collected for a multicenter, prospective study to identify biomarkers of clinical resistance to first-line therapy in metastatic colorectal cancer. Tumour Biol 2014. [DOI: 10.1158/1538-7445.am2012-3389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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McNamara L, McNamara S. Testing The Utility Of The Nhs's Systemic Anti-Cancer Therapy Data Set For Multi-Indication Pricing. Value Health 2014; 17:A659. [PMID: 27202396 DOI: 10.1016/j.jval.2014.08.2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- L McNamara
- Roche Products Ltd., Welwyn Garden City, UK
| | - S McNamara
- Roche Products Ltd., Welwyn Garden City, UK
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Koekkoek JAF, Dirven L, Reijneveld JC, Pasman HRW, McNamara S, Grisold W, Stockhammer G, Marosi C, Taphoorn MJB, Heimans JJ. O9.08 * END OF LIFE CARE IN HIGH-GRADE GLIOMA PATIENTS IN THREE EUROPEAN COUNTRIES: A COMPARATIVE STUDY. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.79] [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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McNamara S, Day JC, Erridge S, Peoples S, Grant R. P15.03 * CARER PERCEPTIONS OF THE END OF LIFE PHASE IN MALIGNANT GLIOMA IN SOUTH EAST SCOTLAND. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou174.282] [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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Koekkoek JAF, Dirven L, Sizoo EM, Pasman HRW, Heimans JJ, Postma TJ, Deliens L, Grant R, McNamara S, Stockhammer G, Medicus E, Taphoorn MJB, Reijneveld JC. Symptoms and medication management in the end of life phase of high-grade glioma patients. J Neurooncol 2014; 120:589-95. [DOI: 10.1007/s11060-014-1591-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 08/16/2014] [Indexed: 10/24/2022]
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Koekkoek JAF, Dirven L, Reijneveld JC, Sizoo EM, Pasman HRW, Postma TJ, Deliens L, Grant R, McNamara S, Grisold W, Medicus E, Stockhammer G, Oberndorfer S, Flechl B, Marosi C, Taphoorn MJB, Heimans JJ. End of life care in high-grade glioma patients in three European countries: a comparative study. J Neurooncol 2014; 120:303-10. [DOI: 10.1007/s11060-014-1548-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 07/06/2014] [Indexed: 11/29/2022]
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McEwen SCJ, Connolly CG, Kelly AMC, Kelleher I, O’Hanlon E, Clarke M, Blanchard M, McNamara S, Connor D, Sheehan E, Donohoe G, Cannon M, Garavan H. Resting-state connectivity deficits associated with impaired inhibitory control in non-treatment-seeking adolescents with psychotic symptoms. Acta Psychiatr Scand 2014; 129:134-42. [PMID: 23621452 PMCID: PMC3787979 DOI: 10.1111/acps.12141] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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] [Accepted: 03/27/2013] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Psychotic symptoms are common in the population and index risk for a range of severe psychopathological outcomes. We wished to investigate functional connectivity in a community sample of adolescents who reported psychotic symptoms (the extended psychosis phenotype). METHOD This study investigated intrinsic functional connectivity (iFC) during resting-state functional magnetic resonance imaging (fMRI; rs-fMRI). Following screening in schools, 11 non-treatment seeking, youth with psychotic symptoms (aged 11-13) and 14 community controls participated in the study. Seed regions of interest comprised brain regions previously shown to exhibit aberrant activation during inhibitory control in adolescents with psychotic symptoms. RESULTS Relative to controls, adolescents with psychotic symptoms exhibited reduced iFC between regions supporting inhibitory control. Specifically, they showed weaker iFC between the right inferior frontal gyrus (IFG) and the cingulate, IFG and the striatum, anterior cingulate and claustrum, and precuneus and supramarginal gyrus. Conversely, the psychotic symptoms group exhibited stronger iFC between the superior frontal gyrus and claustrum and IFG and lingual gyrus. CONCLUSION The present findings are the first to reveal aberrant functional connectivity in resting-state networks in a community sample of adolescents with psychotic symptoms and suggest that disruption in integration between distributed neural networks (particularly between prefrontal, cingulate and striatal brain regions) may be a key neurobiological feature of the extended psychosis phenotype.
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Affiliation(s)
- S. C. Jacobson McEwen
- School of Psychology, Trinity College Dublin, Dublin, Ireland,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA
| | - C. G. Connolly
- School of Psychology, Trinity College Dublin, Dublin, Ireland,Department of Psychiatry, University of California, San Francisco, CA
| | - A. M. C. Kelly
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, New York University Child Study Center, New York, NY, USA,Department of Psychiatry and Psychology, Royal College of Surgeons in Ireland, Dublin
| | - I. Kelleher
- Department of Psychiatry and Psychology, Royal College of Surgeons in Ireland, Dublin
| | - E. O’Hanlon
- Department of Psychiatry and Psychology, Royal College of Surgeons in Ireland, Dublin
| | - M. Clarke
- Department of Psychiatry and Psychology, Royal College of Surgeons in Ireland, Dublin
| | - M. Blanchard
- Department of Psychiatry and Psychology, Royal College of Surgeons in Ireland, Dublin
| | - S. McNamara
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - D. Connor
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - E. Sheehan
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - G. Donohoe
- Department of Psychiatry & Neuropsychiatric Genetics Research Group, School of Medicine and Trinity College Institute of Neuroscience, Trinity College, Dublin
| | - M. Cannon
- Department of Psychiatry and Psychology, Royal College of Surgeons in Ireland, Dublin,Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - H. Garavan
- School of Psychology, Trinity College Dublin, Dublin, Ireland,Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
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Diaz Z, Przybytkowski E, Lan C, McNamara S, Aguilar-Mahecha A, Camlioglu E, Gologan A, Batist G, Basik M. MC13-0077 Array CGH analysis of paired metastatic biopsies obtained pre-treatment and at resistance to FOLFOX-bevacizumab in metastatic CRC patients. Eur J Cancer 2013. [DOI: 10.1016/s0959-8049(13)70183-7] [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: 11/25/2022]
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Acquaye AA, Vera-Bolanos E, Gilbert MR, Armstrong TS, Lin L, Amidei C, Lovely M, Arzbaecher J, Page M, Mogensen K, Lupica K, Maher ME, Armstrong TS, Won M, Wefel JS, Gilbert MR, Pugh S, Wendland MM, Brachman DG, Brown PD, Crocker IR, Robins HI, Lee RJ, Mehta M, Arvold N, Wang Y, Zigler C, Schrag D, Dominici F, Boele F, Douw L, de Groot M, van Thuijl H, Cleijne W, Heimans J, Taphoorn M, Reijneveld J, Klein M, Bunevicius A, Tamasauskas S, Tamasauskas A, Deltuva V, Bunevicius R, Cahill J, Lin L, Armstrong T, Acquaye A, Vera-Bolanos E, Gilbert M, Padhye N, Chan J, Clarke J, Lawton K, Rabbitt J, DeSilva A, Prados M, Rosen M, Cher L, Diamond E, Applebaum A, Corner G, DeRosa A, Breitbart W, DeAngelis L, Hoogendoorn P, Ikuta S, Muragaki Y, Maruyama T, Nitta M, Tamura M, Okamoto S, Iseki H, Okada Y, Lacouture M, Davis ME, Elzinga G, Butowski N, Tran D, Villano J, Wong E, Legge D, Cher L, Legge D, Cher L, Mills K, Lin L, Acquaye A, Vera-Bolanos E, Gilbert M, Armstrong T, Lovely M, Sullivan D, Mueller S, Fullerton H, Stratton K, Leisenring W, Armstrong G, Weathers R, Stovall M, Goldsby R, Sklar C, Robison L, Krull K, Pace A, Villani V, Focarelli S, Benincasa D, Benincasa A, Carapella CM, Pompili A, Peiffer AM, Burke A, Leyer CM, Shing E, Kearns WT, Hinson WH, Case D, Rapp SR, Shaw EG, Chan MD, Porensky E, Cavaliere R, Newton H, Shilds A, Burgess S, Ravelo A, Taylor F, Mazar I, Abrey L, Rooney A, Graham C, McKenzie H, Fraser M, MacKinnon M, McNamara S, Rampling R, Carson A, Grant R, Rooney A, Heimans L, Woltz S, Kerrigan S, McNamara S, Grant R, Seibl-Leven M, Wittenstein K, Rohn G, Goldbrunner R, Timmer M, Kennedy J, Sherman W, Sen-Gupta I, Garic I, Macken M, Gerard E, Raizer J, Schuele S, Grontoft M, Stragliotto G, Taphoorn MJ, Henriksson R, Bottomley A, Cloughesy T, Wick W, Mason W, Saran F, Nishikawa R, Ravelo A, Hilton M, Chinot OL, Trad W, Simpson T, Wright K, Tran T, Choong C, Barton M, Hovey E, Robinson K, Koh ES, Vera-Bolanos E, Acquaye AA, Brown PD, Chung C, Gilbert MR, Vardy J, Armstrong TS, Walbert T, Mendoza T, Vera-Bolanos E, Gilbert M, Acquaye A, Armstrong T, Walbert T, Glantz M, Schultz L, Puduvalli VK, Oudenhoven M, Farin C, Hoffman R, Armstrong T, Ewend M, Wu J. SYMPTOM MANAGEMENT/QUALITY OF LIFE. Neuro Oncol 2013; 15:iii226-iii234. [PMCID: PMC3823907 DOI: 10.1093/neuonc/not192] [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: 01/19/2024] Open
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Diaz Z, McNamara S, Holter S, Gallinger S, Batist G. The Canadian Colorectal Cancer Consortium: the First Large-Scale Molecular Based Approach to Translational Cancer Care in Canada. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt202.33] [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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Wang T, Fontenla S, McCann P, Young R, McNamara S, Mechalakos J, Lee N. Correlation of Planned Dose to Area Postrema and Dorsal Vagal Complex With Clinical Symptoms of Nausea and Vomiting in a Series of Oropharyngeal Cancer (OPC) Patients Treated With Radiation Alone Using IMRT. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pefani E, Panoskaltsis N, Mantalaris A, Georgiadis MC, Pistikopoulos EN, Aguilar-Mahecha A, Lafleur J, Seguin C, Rosenbloom M, Przybytkowski E, Pelmus M, Diaz Z, Batist G, Basik M, Tavernier J, Brunet L, Bazot J, Chemelle M, Dalban C, Guiu S, di Martino C, Lehtio J, Branca M, Johansson H, Orre M, Granholm V, Forshed J, Perez-Bercoff M, Kall L, Nielsen KV, Andresen L, Muller S, Matthiesen S, Schonau A, Oktriani R, Wahyono A, Haryono S, Utomo A, Aryandono T, Diaz Z, Gagnon-Kugler T, Rousseau C, Aguilar-Mahecha A, Alcindor T, Aloyz R, Assouline S, Basik M, Bachvarov D, Belanger L, Camlioglu E, Cartillone M, Chabot B, Christodoulopoulos R, Courtemanche C, Constantin A, Benlimame N, Dao I, Dalfen R, Gosselin L, Habbab F, Hains M, Haliotis T, Nielsen TH, Joncas M, Kavan P, Klink R, Langlaben A, Lebel M, Lesperance B, Mann K, Masson J, Metrakos P, McNamara S, Miller WH, Orain M, Panasci L, Paquet E, Phillie M, Qureshi S, Rodrigue D, Salman A, Spatz A, Tetu B, Tosikyan A, Tsatoumas M, Vuong T, Batist G, Ruijtenbeek R, Houtman R, de Wijn R, Boender P, Hilhorst R, Cohen Y, Onn A, Lax A, Yosepovich A, Litz S, Kalish S, Felemovicius R, Hout-Silony G, Gutman M, Shabtai M, Rosin D, Valeanu A, Winkler E, Sklair-Levy M, Kaufman B, Barshack I, Canu V, Sacconi A, Biagioni F, Mori F, di Benedetto A, Lorenzon L, di Agostino S, Cambria A, Germoni S, Grasso G, Blandino R, Panebianco V, Ziparo V, Federici O, Muti P, Strano S, Carboni F, Mottolese M, Diodoro MG, Pescarmona E, Garofalo A, Blandino G, Ho T, Feng L, Lintula S, Orpana KA, Stenman J, El Messaoudi S, Mouliere F, del Rio M, Guedj AS, Gongora C, Molina FM, Lamy PJ, Lopez-Crapez E, Rolet F, Mathonnet M, Ychou M, Pezet D, Thierry AR, Manuarii M, Tredan O, Bachelot T, Clapisson G, Courtier A, Parmentier G, Rabeony T, Grives A, Perez S, Mouret JF, Perol D, Chabaud S, Ray-Coquard I, Labidi-Galy I, Heudel P, Pierga JY, Caux C, Blay JY, Pasqual N, Menetrier-Caux C. Technology & tools development. Ann Oncol 2012. [DOI: 10.1093/annonc/mds163] [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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Diaz Z, Gagnon-Kugler T, Rousseau C, Aguilar-Mahecha A, Alcindor T, Aloyz R, Assouline S, Basik M, Bachvarov D, Bélanger L, Camlioglu E, Cartillone M, Chabot B, Christodoulopoulos R, Courtemanche C, Constantin A, Benlimame N, Dao I, Dalfen R, Gosselin L, Habbab F, Hains M, Haliotis T, Nielsen T, Joncas M, Kavan P, Klink R, Langlaben A, Lebel M, Lespérance B, Mann K, Masson J, Metrakos P, McNamara S, Miller W, Orain M, Panasci L, Paquet E, Phillie M, Qureshi S, Rodrigue D, Salman A, Spatz A, Têtu B, Tosikyan A, Tsatoumas M, Vuong T, Batist G. P3.07 Building the Organization Framework for Biopsy-Driven Translational Research: The Quebec Clinical Research Organization in Cancer (Q-Croc) Experience. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)31360-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Aloyz R, Rousseau C, Diaz Z, Aguilar-Mahecha A, Basik M, Bélanger L, Buchanan M, Camlioglu E, Constantin A, Benlimame N, McNamara S, Diaz Z, Orain M, Przybytkowski E, Spatz A, Têtu B, Panasci L, Batist G, Lebel M, Masson JY, Davidson D, Paquet ER, Houssein HH, Maltais A, Gagnon-Kugler T. Abstract B24: De novo and acquired resistance to first-line standard therapy in colorectal cancer: from cell lines to metastatic tumors. Clin Cancer Res 2012. [DOI: 10.1158/1078-0432.mechres-b24] [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: Personalized medicine (PM) is a concept that has raised high expectations amongst scientists, clinicians, and patients. An emerging approach is to examine tumor biopsy material for genomic changes that are known targets of currently available therapeutic agents, with the assumption that a clinical benefit will be observed if the target is inhibited. While striking anecdotal reports are predictable from this approach, the clinical impact of these agents is limited by the inevitable development of therapeutic resistance. Our focus is on the design of parallel research programs using both in vitro and in vivo strategies, in an effort to delay or inhibit resistance. We present here preliminary data for a signature of resistance to standard first-line treatment - fluorouracil, folinic acid, oxaliplatin and bevacizumab (FOLFOX/B) using cell line models of resistance to this regimen. In parallel, we are conducting a prospective study to identify biomarkers of clinical resistance to first-line therapy in patients with metastatic colorectal cancer (CRC) (NCT00984048).
Methods: Ten established CRC cell lines were treated with FOLFOX/B and categorized as resistant or sensitive based on IC50 values. In parallel, patients who consented to an initial biopsy and one at disease progression following an initial response were identified as intrinsically resistant or as having acquired resistance during treatment. CRC cell lines that were initially sensitive were rendered resistant to mimic the acquired resistance in patients, by serial passages with gradual increases in concentration of the combination regimen. We compared microarray data from three sensitive and three resistant cell lines.
Results: We found a different expression pattern from microarray data comparing sensitive and resistant cell lines, thereby indicating a potential signature of resistance to FOLFOX/B. Interestingly, we found that the Src family kinase Lyn was overexpressed in resistant cells lines. Treating cells with non-cytotoxic concentration of dasatinib, a dual Src family kinase and Abl inhibitor, sensitized both the parental sensitive cells and the cells with acquired resistance to FOLFOX/B, thereby suggesting that combination treatment with dasatinib may be effective in delaying or inhibiting resistance. We have thus far collected needle core biopsies from liver metastases from forty patients who agreed to partake in this multi-center trial. Eligible patients have confirmed metastatic CRC, measurable disease, and consent to three needle-core biopsies (NCBs) of a non-resectable liver metastasis before treatment and at resistance, as well as serial blood collection throughout the study. Using standard operating procedures developed for this trial, we were able to both preserve morphology and obtain high-quality genomic material from biopsy tissue. We will determine if the resistance signature and overexpression of Lyn observed in the resistant CRC cell lines are similarly demonstrated in patients that were intrinsically resistant to FOLFOX/B.
Conclusions: We have designed parallel in vitro and in vivo experiments to study resistance to standard first-line treatment for mCRC. These studies provide insight on metastatic signatures of resistance and suggest combination therapies to delay or inhibit therapeutic resistance in patients.
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Affiliation(s)
- Raquel Aloyz
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Caroline Rousseau
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Zuanel Diaz
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Adriana Aguilar-Mahecha
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Mark Basik
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Luc Bélanger
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Marguerite Buchanan
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Errol Camlioglu
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Andre Constantin
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Naciba Benlimame
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Suzan McNamara
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Zuanel Diaz
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Michèle Orain
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Ewa Przybytkowski
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Alan Spatz
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Bernard Têtu
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Lawrence Panasci
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Gerald Batist
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Michel Lebel
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Jean-Yves Masson
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - David Davidson
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Eric R. Paquet
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Haji Hassan Houssein
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Annie Maltais
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
| | - Therese Gagnon-Kugler
- 1Jewish General Hospital, Montreal, QC, Canada, 2Quebec Clinical Research Organization in Cancer, Montreal, QC, Canada, 3Laval University, Quebec, QC, Canada
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Gagnon-Kugler T, Diaz Z, Rousseau C, Aguilar-Mahecha A, Alcindor T, Aloyz R, Assouline S, Basik M, Bachvarov D, Bélanger L, Benlimame N, Camlioglu E, Chabot B, Christodoulopoulos R, Constantin A, Courtemanche C, Dao I, Gosselin L, Guillemette C, Hains MC, Haliotis T, Nielsen TH, Joncas MC, Kavan P, Klinck R, Lebel M, Lespérance B, Mann K, Masson JY, Metrakos P, McNamara S, Miller WH, Orain M, Panasci L, Paquet E, Philie M, Qureshi S, Rodrigue D, Salman A, Simard M, Spatz A, Têtu B, Tosikyan A, Tsatoumas M, Vuong T, Batist G. Abstract 5534: Building the organization framework for biopsy-driven translational research: The Quebec Clinical Research Organization in Cancer (Q-CROC) experience. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-5534] [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: The success of personalized medicine in oncology relies on translational research efforts to identify biomarkers that will influence clinical management. The discovery and validation of biomarkers is a concerted effort requiring an organizational framework that is often underestimated. The Quebec Clinical Research Organization in Cancer (Q-CROC) consortium is a multi-disciplinary and multi-institutional group of scientists and clinicians devoted to integrating and enhancing translational and clinical research capacity in Quebec. We describe here the organizational framework driving a multicenter, prospective study to identify biomarkers of clinical resistance to first-line therapy in metastatic colorectal cancer (NCT00984048, Q-CROC-01). Results: The Q-CROC consortium has put in place an organizational infrastructure to support the activities and operations of its translational projects. We identified and addressed several critical issues during the course of the Q-CROC-01 translational project that were also common to our subsequent biomarker-driven trial in lymphoma (Q-CROC-02, NCT01238692) and breast cancer (Q-CROC-03, NCT01276899). Examples of these issues include: (i) feasibility and burden of tissue collection at participating sites, (ii) limiting pre-analytical variability in blood and tissue specimens for functional downstream applications, (iii) verification of tumor content on biopsy specimens, (iv) tracking sample flow, (v) integration of clinical data with discovery platforms, and (vi) engaging participation throughout all steps of the project. In part to address the above issues, we established five operational Cores: clinical, biobank, biospecimen processing, bioanalytical and bioinformatic. A further challenge was the integration between these Cores, who for the most part operated in silos. We observed that a critical element to unify all components of the consortium was a scientific project management team, consisting of dedicated individuals regularly interacting with each Core to ensure that objectives were aligned and deliverables were met. This academic framework for translational research may be comparable to that of multicenter clinical trials undertaken by industry, but some challenges, including financial and time constraints, data sharing and IP agreements, and engagement of its members, may be more palpable in the academic setting. Conclusion: Infrastructure science is underestimated and under-reported in translational cancer research and is crucial to the success of any large-scale biomarker discovery effort. Our experience with three multi-institutional biomarker-driven trials is that progress hinges upon the availability of an infrastructure that is not only the sum of its parts but that provides a concrete link between each component.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5534. doi:1538-7445.AM2012-5534
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Affiliation(s)
| | - Zuanel Diaz
- 2Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | - Caroline Rousseau
- 2Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | | | | | - Raquel Aloyz
- 5Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
| | | | - Mark Basik
- 3Jewish General Hospital, Montreal, Quebec, Canada
| | - Dimcho Bachvarov
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | - Luc Bélanger
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | | | | | - Benoit Chabot
- 7Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | | | - Chantal Courtemanche
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | - Isabel Dao
- 3Jewish General Hospital, Montreal, Quebec, Canada
| | - Lise Gosselin
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | | | | | | | | | | | - Petr Kavan
- 4McGill University Health Centre, Montreal, Quebec, Canada
| | - Roscoe Klinck
- 7Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michel Lebel
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | | | - Koren Mann
- 3Jewish General Hospital, Montreal, Quebec, Canada
| | - Jean-Yves Masson
- 10Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Montreal, Quebec, Canada
| | - Peter Metrakos
- 4McGill University Health Centre, Montreal, Quebec, Canada
| | - Suzan McNamara
- 2Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | | | - Michèle Orain
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | | | - Eric Paquet
- 6Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Québec, Quebec, Canada
| | - Michel Philie
- 1Quebec Clinical Research Organization in Cancer, Québec, Quebec, Canada
| | - Samie Qureshi
- 2Quebec Clinical Research Organization in Cancer, Montreal, Quebec, Canada
| | | | - Ayat Salman
- 4McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin Simard
- 10Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Montreal, Quebec, Canada
| | - Alan Spatz
- 3Jewish General Hospital, Montreal, Quebec, Canada
| | - Bernard Têtu
- 10Centre hospitalier Hôtel-Dieu de Québec, Centre de recherche évaluative en oncologie clinique, Montreal, Quebec, Canada
| | - Axel Tosikyan
- 9Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | | | - Te Vuong
- 3Jewish General Hospital, Montreal, Quebec, Canada
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Ammoun S, Zhou L, Barczyk M, Hilton D, Hafizi S, Hanemann C, Lehnus KS, Donovan LK, Pilkington GJ, An Q, Anderson IA, Thomson S, Bailey M, Lekka E, Law J, Davis C, Banfill K, Loughrey C, Hatfield P, Bax D, Elliott R, Bishop R, Taylor K, Marshall L, Gaspar N, Viana-Pereira M, Reis R, Renshaw J, Ashworth A, Lord C, Jones C, Bellamy C, Shaw L, Alder J, Shorrocks A, Lea R, Birks S, Burnet M, Pilkington G, Bruch JD, Ho J, Watts C, Price SJ, Camp S, Apostolopoulos V, Mehta A, Roncaroli F, Nandi D, Clark B, Mackinnon M, MacLeod N, Stewart W, Chalmers A, Cole A, Hanna G, Bailie K, Conkey D, Harney J, Darlow C, Chapman S, Mohsen L, Price S, Donovan L, Birks S, Pilkington G, Dyer H, Lord H, Fletcher K, das Nair R, MacNiven J, Basu S, Byrne P, Glancz L, Critchley G, Grech-Sollars M, Saunders D, Phipps K, Clayden J, Clark C, Greco A, Acquati S, Marino S, Hammouche S, Wilkins SP, Smith T, Brodbelt A, Hammouche S, Clark S, Wong AHL, Eldridge P, Farah JO, Ho J, Bruch J, Watts C, Price S, Lamb G, Smith S, James A, Glegg M, Jeffcote T, Boulos S, Robbins P, Knuckey N, Banigo A, Brodbelt AR, Jenkinson MD, Jeyapalan JN, Mumin MA, Forshew T, Lawson AR, Tatevossian RG, Jacques TS, Sheer D, Kilday J, Wright K, Leavy S, Lowe J, Schwalbe E, Clifford S, Gilbertson R, Coyle B, Grundy R, Kinsella P, Clynes M, Amberger-Murphy V, Barron N, Lambert SR, Jones D, Pearson D, Ichimura I, Collins V, Steele L, Sinha P, Chumas P, Tyler J, Ogawa D, Chiocca E, DeLay M, Bronisz A, Nowicki M, Godlewski J, Lawler S, Lee MK, Javadpour M, Jenkinson MD, Lekka E, Abel P, Dawson T, Lea B, Davis C, Lim CSK, Grundy PL, Pendleton M, Lord H, Mackinnon M, Williamson A, James A, Stewart W, Clark B, Chalmers A, Merve A, Zhang X, Marino S, Miller S, Rogers HA, Lyon P, Rand V, Adamowicz-Brice M, Clifford SC, Hayden JT, Dyer S, Pfister S, Korshunov A, Brundler MA, Lowe J, Coyle B, Grundy RG, Nankivell M, Mulvenna P, Barton R, Wilson P, Faivre-Finn C, Pugh C, Langley R, Ngoga D, Tennant D, Williams A, Moss P, Cruickshank G, Owusu-Agyemang K, Bell S, Stewart W, St.George J, Piccirillo SG, Watts C, Qadri S, Pirola E, Jenkinson M, Brodbelt A, Rahman R, Rahman C, Smith S, MacArthur D, Rose F, Shakesheff K, Grundy R, Carroll C, Watson P, Hawkins M, Spoudeas H, Walker D, Holland T, Ring H, Rooney A, McNamara S, Mackinnon M, Fraser M, Rampling R, Carson A, Grant R, Royds J, Al Nadaf S, Ahn A, Chen YJ, Wiles A, Jellinek D, Braithwaite A, Baguley B, MacFarlane M, Hung N, Slatter T, Rusbridge S, Walmsley N, Griffiths S, Wilford P, Rees J, Ryan D, Watts C, Liu P, Galavotti S, Shaked-Rabi M, Tulchinsky E, Brandner S, Jones C, Salomoni P, Schulte A, Gunther HS, Zapf S, Riethdorf S, Westphal M, Lamszus K, Selvanathan SK, Hammouche S, Salminen HJ, Jenkinson MD, Setua S, Watts C, Welland ME, Shevtsov M, Khachatryan W, Kim A, Samochernych K, Pozdnyakov A, Guzhova IV, Romanova IV, Margulis B, Smith S, Rahman R, Rahman C, Barrow J, Macarthur D, Rose F, Grundy R, Smith S, Long A, Barrow J, Macarthur D, Coyle B, Grundy R, Maherally Z, Smith JR, Dickson L, Pilkington GJ, Prabhu S, Harris F, Lea R, Snape TJ, Sussman M, Wilne S, Whitehouse W, Chow G, Liu JF, Walker D, Snape T, Karakoula A, Rowther F, Warr T, Williamson A, Mackinnon M, Zisakis A, Varsos V, Panteli A, Karypidou O, Zampethanis A, Fotovati A, Abu-Ali S, Wang PS, Deleyrolle L, Lee C, Triscott J, Chen JY, Franciosi S, Nakamura Y, Sugita Y, Uchiumi T, Kuwano M, Leavitt BR, Singh SK, Jury A, Jones C, Wakimoto H, Reynolds BA, Pallen CJ, Dunn SE, Shepherd S, Scott S, Bowyer D, Wallace L, Hacking B, Mohsen L, Jena R, Gillard J, Price S, Lee C, Fotovati A, Verraeult M, Wakimoto H, Reynolds B, Dunham C, Bally M, Hukin J, Singhal S, Singh S, Dunn S. Abstracts from the 2011 BNOS Conference, June 29 - July 1, 2011, Homerton College, Cambridge. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor144] [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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Erridge SC, Hart MG, Kerr GR, Smith C, McNamara S, Grant R, Gregor A, Whittle IR. Trends in classification, referral and treatment and the effect on outcome of patients with glioma: a 20 year cohort. J Neurooncol 2011; 104:789-800. [PMID: 21384218 DOI: 10.1007/s11060-011-0546-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Accepted: 02/18/2011] [Indexed: 10/18/2022]
Abstract
This retrospective audit was conducted to examine the changes in patient characteristics, referral, treatment and outcome over a 20-year period in a large regional neuro-oncology centre, focusing on the impact of the changes in pathological classification of gliomas. Using the Edinburgh Cancer Centre (ECC) database all cases of glioma were identified and patient, tumour and treatment characteristics noted. Survival was calculated from date of surgery or, if no operation was performed, the date of referral. Comparison was made between four periods 1988-1992 (c1), 1993-1997(c2), 1998-2002(c3) and 2003-2007 (c4). During the 20 years, 1175 patients with a glioma were referred to ECC. The median age increased from 53 years to 57 years (p < 0.001) but the proportion without pathology remained unchanged (10%). The distribution of pathological grades changed over time Grade I-II: 24, 6, 6, and 6%, Grade III: 42, 27, 17, and 13% and Grade IV: 24, 61, 68, and 68% in c1, c2, c3 and c4, respectively (p < 0.001). Immediate RT was given to 68% (c1), 70% (c2), 78% (c3) and 79% (c4). Median interval from resection to RT reduced from 43 days (c1) to 36 days (c4) (p < 0.001). 5-year overall survival for patients with Grade III lesions increased: 21% (c1), 35% (c2), 37% (c3), 33% (c4) as did 1-year overall survival for Grade IV lesions: 18% (c1), 26% (c2), 29% (c3), 27% (c4)). This improvement probably reflects the change in pathological classification rather than a change in management. Proportional hazards analysis of grade IV 1993-2007 only (to reduce pathological variation) showed that younger age, frontal lesions, excision, higher RT dose had reduced hazard of death. Interval from surgery to RT had no impact on survival in this series.
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Affiliation(s)
- S C Erridge
- Edinburgh Centre for Neuro-Oncology, University of Edinburgh, Western General Hospital, Edinburgh, EH4 1EU, UK.
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