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Song JY, Kim BH, Kang MK, Jeong JU, Kim JH, Moon SH, Suh YG, Kim JH, Kim HJ, Kim YS, Park WY, Kim HJ. Definitive Radiotherapy in Patients with Clinical T1N0M0 Esophageal Squamous Cell Carcinoma: A Multicenter Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e340. [PMID: 37785190 DOI: 10.1016/j.ijrobp.2023.06.2400] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In this study, we aimed to assess the failure pattern and survival outcomes and to analyze the optimal treatment field of definitive RT for T1N0M0 esophageal squamous cell carcinoma (ESCC). MATERIALS/METHODS We performed a retrospective analysis in a multi-institutional cohort of patients with histologically confirmed T1N0M0 ESCC. We included patients who underwent RT with definitive aim from 2010 to 2019. Patterns of failure were demonstrated as in-field locoregional, out-field locoregional and distant metastasis. In the survival analysis, freedom from locoregional recurrence and their association with clinicopathologic risk factors were analyzed. We performed a propensity score matching in the cT1b patients to adjust for the heterogeneity of radiation technique, radiation dose and the use of concurrent chemotherapy. RESULTS A total of 168 patients were included with a median follow-up of 34.0 months, and there were 20 cT1a, 94 cT1b and 24 cT1x, (cT1, not otherwise specified) patients. The rates of all and locoregional failure were 26.9% and 23.1% for cT1a and 25.0% and 22.4% for cT1b patients. 10 (10.6%) patients experienced grade ≥ 3 adverse events. Among 116 cT1b patients, 69 patients received elective nodal irradiation (ENI) and 47 patients received involved field irradiation (IFI). After propensity score matching, the 3-year FFLRR rate was 84.5% (95% Confidence Interval, 71.0 - 92.1%). There was no significant difference between the ENI and IFI patients in FFLRR (Log-rank P = 0.831). In the multivariate analysis, the use of concurrent chemotherapy was the only factor marginally associated with FFLRR (Hazard ratio, 0.17; 95% CI, 0.02 - 1.13; P = 0.067). CONCLUSION cT1a patients who cannot receive endoscopic resection, showed similar rates of failure compared with cT1b patients, which questioned the accuracy of the staging and raised the need for through treatment such as chemoradiotherapy. In cT1b patients, IFI using dose of 50 to 60 Gy with concurrent chemotherapy could be a reasonable treatment option.
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Affiliation(s)
- J Y Song
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea, Republic of (South) Korea
| | - B H Kim
- Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea, Republic of (South) Korea
| | - M K Kang
- Department of Radiation Oncology, Kyungpook National University Medical Center, Daegu, Korea, Republic of (South) Korea
| | - J U Jeong
- Jeonnam National University Hwasun Hospital, Jeollanam-do, Korea, Republic of (South) Korea
| | - J H Kim
- Department of Radiation Oncology, Asan Medical Center, Seoul, Korea, Republic of (South) Korea
| | - S H Moon
- Proton Therapy Center, National Cancer Center, Goyang-si, Korea, Republic of (South) Korea
| | - Y G Suh
- Proton Therapy Center, National Cancer Center, Goyang-si, Korea, Republic of (South) Korea
| | - J H Kim
- Department of Radiation Oncology, Keimyung University Dongsan Hospital, Daegu, Korea, Republic of (South) Korea
| | - H J Kim
- Inha University Hospital, Inchon, Korea, Republic of (South) Korea
| | - Y S Kim
- Department of Radiation Oncology, Jeju National University School of Medicine, Jeju, Korea, Republic of (South) Korea
| | - W Y Park
- Chungbuk National University and Chungbuk National University Hospital, Cheongju, Korea, Republic of (South) Korea
| | - H J Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea, Republic of (South) Korea
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Kim R, Kwon M, An M, Kim ST, Smith SA, Loembé AB, Mortimer PGS, Armenia J, Lukashchuk N, Shah N, Dean E, Park WY, Lee J. Phase II study of ceralasertib (AZD6738) in combination with durvalumab in patients with advanced/metastatic melanoma who have failed prior anti-PD-1 therapy. Ann Oncol 2021; 33:193-203. [PMID: 34710570 DOI: 10.1016/j.annonc.2021.10.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Modulating the DNA damage response and repair (DDR) pathways is a promising strategy for boosting cancer immunotherapy. Ceralasertib (AZD6738) is an oral inhibitor of the serine/threonine protein kinase ataxia telangiectasia and Rad3-related protein, which is crucial for DDR. PATIENTS AND METHODS This phase II trial evaluated ceralasertib plus durvalumab for the treatment of patients with metastatic melanoma who had failed anti-programmed cell death protein 1 therapy. RESULTS Among the 30 patients, we observed an overall response rate of 31.0% and a disease control rate of 63.3%. Responses were evident across patients with acral, mucosal, and cutaneous melanoma. The median duration of response was 8.8 months (range, 3.8-11.7 months). The median progression-free survival was 7.1 months (95% confidence interval, 3.6-10.6 months), and the median overall survival was 14.2 months (95% confidence interval, 9.3-19.1 months). Common adverse events were largely hematologic and manageable with dose interruptions and reductions. Exploratory biomarker analysis suggested that tumors with an immune-enriched microenvironment or alterations in the DDR pathway were more likely to respond to the study treatment. CONCLUSION We conclude that ceralasertib in combination with durvalumab has promising antitumor activity among patients with metastatic melanoma who have failed anti-programmed cell death protein 1 therapy, and constitute a population with unmet needs.
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Affiliation(s)
- R Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - M Kwon
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | - M An
- Samsung Advanced Institute of Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S A Smith
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - A B Loembé
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - J Armenia
- Oncology R&D, AstraZeneca, Cambridge, UK
| | | | - N Shah
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - E Dean
- Oncology R&D, AstraZeneca, Cambridge, UK
| | - W-Y Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Korea; Geninus Inc., Seoul, Korea
| | - J Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Korea.
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Kim JY, Park KH, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im YH, Park YH. Abstract P1-09-11: Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Genetic alteration of Estrogen Receptor 1(ESR1) gene have been associated with acquired endocrine resistance and occurred in about 20% of endocrine resistant estrogen receptor(ER)-positive metastatic breast cancer(MBC). Mutations in ligand binding domain of ESR1 lead to constitutive activity of the ER without ligand estrogen and stimulated down stream cell growth signal. Therefore, ESR1 ligand binding domain alteration is known resistant mechanism of aromatase inhibitor. Among these ESR1 mutations, Y537S, one of the ligand binding domain mutations, caused ER antagonist, fulvestrant resistance. Therefore, assessment of ESR1 mutation in ER-positive MBC had significant benefit to further precision medicine for MBCs. In this study, we explored to identify the frequency and type of ESR1 genetic alterations of ER-positive MBC.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 990 BC tissues. Of 990 tissue samples, 341(34.5%) were MBCs. Of MBCs, 112(11.3%) were ER-positive and human epidermal growth factor receptor 2(HER2)-negative BCs. In ER-positive HER2-negative MBCs (N=112), 21 ESR1 genetic alterations were identified in 19 BCs (17.0%). Nineteen were single nucleotide variats (SNVs) and three were copy number (CN) amplification. Most commonly detected single nucleotide variant (SNV) was D538G (6 of 19, 31.6%) followed by Y537N, Y537S, V382I (4, 2 and 2 cases, respectively). Three mutations occurred in non-ligand binding domain (G415V, V392I and P79A). Two BC samples harbored two ESR1 mutations, respectively (Y537S and D538G, L536P and Y537N). In terms of treatment, 11 of 12 patients with ER-positive MBC harboring ESR1 mutation received palliative endocrine therapies. Eight patients received aromatase inhibitor and two patients received tamoxifen. One patient received letrozole plus palbociclib. In 2 MBCs with Y537S mutation, progression free survival (PFS) of endocrine therapy was 1.4 and 5.3 months. MBCs with D538G had 12.3months of PFS (range, 5.3-23.7(months)) and BCs harboring another ligand binding domain mutations (Y537N, L536H and L536P) had 15.7months of PFS of endocrine therapy (range, 8.4-17.3(months)). BC with mutation observed in non-lignand binding domain had short PFS (1.8 (V392I) and 2.7 (P79A) months, respectively). In terms of ESR1 CN amplification, patients could not receive endocrine therapy because their BCs rapidly progressed and extensive distant metastases were occurred within 3 months after curative surgery.
Conclusion: In this exploratory study, ESR1 genetic alterations were detected in about 20% of ER-positive MBC. The type of genetic alterations varied including SNVs, CNAs. Each locus of ESR1 mutation predicted endocrine resistance. In addition, we might suggest that ESR1 CN amplification is prognostic marker of ER-positive BCs.
Citation Format: Kim J-Y, Park KH, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Yu JH, Ahn JS, Im Y-H, Park YH. Prognostication of genetic alterations of ESR 1 in estrogen receptor positive metastatic breast cancers using targeted ultra-deep sequencing data analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-09-11.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - KH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Samsung Genome Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kan Z, Lal S, Ding Y, Lee JE, Lee SH, Lee SK, Yu JH, Choi YL, Kim SW, Nam SJ, Kim JY, Ram S, Powell E, Ching K, Cho SY, Bonato V, Deng S, Park WY, Rejto P, Bienkowska J, Park YH. Abstract PD5-08: Neoadjuvant chemotherapy alters the genomic landscape and immune microenvironment of breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-pd5-08] [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
Understanding how standard-of-care drug treatments affect tumor intrinsic biology and microenvironment is critical for elucidating drug resistance mechanisms and developing better combination therapies as well as new therapies. To characterize the effects of neoadjuvant chemotherapy (NAC) on the genome, transcriptome and tumor infiltrating leukocytes (TILs), we have conducted whole exome and whole transcriptome sequencing of a large longitudinal breast cancer cohort consisting of 146 cases and 281 paired tumor samples. In total, 52 (38%) patients achieved pathologic complete response (pCR) while 85 patients (62%) had residual disease with standard chemotherapy regimen. Tumor biopsies were collected for each patient at three time points – pre-treatment, three weeks after the first cycle of anthracycline and cyclophosphamide (AC) and at the time of surgery after 3 more cycles of AC followed by 4 cycles of taxane or taxane plus Herceptin in case of HER2+ subtype. We detected 5,955 protein-altering somatic mutations affecting 4,414 genes in pretreatment samples and 502 acquired mutations in surgery samples affecting 477 genes including 19recurrently mutated genes such as TP53 and NOTCH1. Across all subtypes, 4,346 genes were differentially expressed (DE) following NAC treatment and significantly enriched in pathways such as cell cycle, ER signaling, PI3K/mTOR, immune and metabolism. Expression-based virtual microdissection analysis indicated that NAC treatment induced an increase in the fractions of stromal and adjacent normal tissue compartment, consistent with observed reduction in tumor cellularity. To assess the NAC induced changes in the molecular landscape of these tumors, we compared molecular features including gene expression signatures, mutation prevalence and copy number alteration between three time points while adjusting for confounding effects of molecular subtype and tumor cellularity. We found that NAC induced dynamic changes in gene expression signatures associated with proliferation and immunomodulatory treatment response. We further validated the observed pattern of change in TILs through histopathology and digital imaging analyses. In pretreatment tumors, 116 genes were DE between patients with pCR vs. those with residual disease with significant enrichment in immune/inflammatory pathways. Further, pre-treatment TIL levels were found to be significantly associated with pCR, echoing previous reports in breast cancers that implicated anti-tumor immunity in mediating the efficacy of chemotherapies. Our analyses also revealed associations between NAC response and baseline genomic attributes such as genomic alterations that affect DNA damage repair pathways. Taken together, these results suggest that NAC induced a multitude of changes on the genomic landscape and immune microenvironment of breast cancers, some of which point to combination strategies with immunomodulatory therapies and therapies that target DNA damage repair.
Citation Format: Kan Z, Lal S, Ding Y, Lee JE, Lee S-H, Lee SK, Yu JH, Choi Y-l, Kim SW, Nam SJ, Kim J-Y, Ram S, Powell E, Ching K, Cho SY, Bonato V, Deng S, Park W-Y, Rejto P, Bienkowska J, Park Y-H. Neoadjuvant chemotherapy alters the genomic landscape and immune microenvironment of breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr PD5-08.
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Affiliation(s)
- Z Kan
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Lal
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y Ding
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S-H Lee
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JH Yu
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-l Choi
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J-Y Kim
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Ram
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - E Powell
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - K Ching
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SY Cho
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - V Bonato
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Deng
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - W-Y Park
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - P Rejto
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J Bienkowska
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-H Park
- Pfizer, San Diego, CA; Samsung Medical Center, Seoul, Korea
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Park WY, Kang SS, Jin K, Park SB, Han S. Is the Clinical Outcome Good or Bad in Patients Hospitalized Within 1 Year After Kidney Transplantation? Transplant Proc 2018; 50:1001-1004. [PMID: 29731055 DOI: 10.1016/j.transproceed.2018.01.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although the hospitalization rate at early period of kidney transplantation (KT) is still high, the association between the hospitalization within 1 year after KT and graft survival is unclear. We investigated the incidence and causes of hospitalization and clinical outcome of the patients hospitalized within 1 year after KT. METHODS We retrospectively analyzed 174 KT recipients (KTRs) hospitalized within 1 year after KT between 2013 and 2015. RESULTS Among them, 84 (48%) KTRs were admitted within 1 year after KT, and the number of hospitalizations was 116. The mean time from KT to first hospitalization was 4.2 months. Seventy-eight percent of the patients were hospitalized for medical causes and 22% for surgical causes. The most common cause was cytomegalovirus infection (CMV) (23.3%), followed by acute rejection (11.2%) and urinary tract infection (10.3%). Recipients and donors in the hospitalized group were significantly older than the nonhospitalized group. The proportions of deceased donor KT, acute rejection, more than 50% panel-reactive antibody, and positive donor-specific antibody were significantly higher in the hospitalized group than in the nonhospitalized group. Graft and patient survivals were lower in the hospitalized group than in the nonhospitalized group. Deceased donor KT and acute rejection were independent risk factors for hospitalization. CONCLUSION The incidence of KTRs hospitalized within 1 year after KT was high. Most causes of hospitalization were CMV infection, acute rejection, and urinary tract infection. Therefore, the immunosuppression status of these patients should be closely monitored to reduce the hospitalization rate.
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Affiliation(s)
- W Y Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - S S Kang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - K Jin
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - S B Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - S Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea.
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Kim JY, Park K, Park WY, Nam SJ, Kim SW, Lee JE, Lee SK, Jung HH, Yu JH, Ahn JS, Im YH, Park YH. Abstract P6-09-08: Identification of ESR1 mutation in breast cancers using targeted ultra-deep sequencing data analysis. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-09-08] [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: Estrogen Receptor 1 (ESR1) gene encodes an estrogen receptor, which regulates cell proliferation and promotes tumor progression in estrogen receptor(ER)-positive breast cancer (BC). Therefore, endocrine therapy that inhibiting ER downstream signal, is the most effective treatment strategy in ER-positive BC. However, about 25% of patients with primary disease and almost all patients with metastases will present with or eventually develop endocrine resistance. And genetic alteration of ESR1 is now identified as the endocrine resistance mechanism. However, a few data from clinical trials or public data base exists and could not reflect real world clinic. Therefore, we aimed to identify the frequency and type of ESR1 genetic alterations in BCs through this large scaled study.
Methods: We performed targeted ultra-deep sequencing (CancerSCAN™) using BC tissue specimens. This sequencing was covered entire coding area of ESR1 gene and also detected copy number alteration and translocation of ESR1.
Results: Targeted ultra-deep sequencing of ESR1 was performed using 618 BC tissues. Of 618 tissue samples, 253(40.9%) were MBCs, 362(58.6%) were early BCs (EBCs) and 3 were not identified. In terms of subtypes, 220 ER-positive BCs, 122 ER-positive and HER2-positive BCs, 119 HER2-positive and 153 triple-negative BCs (TNBCs) were included. BCs from patients under 40 year-old were 277(44.8%)(Median: 43.0, range: 23.5 -75.6). ESR1 genetic alterations were identified in 21 BCs (5 EBCs and 16 MBCs). In EBCs, 3 cases were observed in TNBCs and 2 cases were in ER-positive BCs (2.6% and 1.2%, respectively). All five EBC were treatment naïve status. Of 16 cases of ESR1 alterations in MBCs, 10 cases of ESR1 alterations were detected in ER-positive BCs (17.6%), 5cases in ER and HER2-positive BCs(6.7%) and 1 in HER2-positive BCs (1.2%). All ER-positive MBCs were treated with more than one line of endocrine therapy. Most commonly detected genetic alteration was single nucleotide variant (SNV) (15 of 21, 71.4%). Thirteen were in ligand binding domain and two cases occurred in activation function-1 (AF-1) domain (P79A and G145S). D538G and V392I were most frequently mutated loci followed by Y537N (3, 3 and 2 cases, respectively) and only metastatic ER-positive BCs harbored ESR1 activating mutation. Four copy number (CN) amplification in 2 ER-positive and 2 ER and HER2-positive BCs, one CN deletion in TNBC and one ESR1 fusion in ER and HER2-positive BC were also detected (19.0%, 4.8% and 4.8%, respectively). In frame ESR1 fusion was occurred between ESR1 and NPHS1 genes.
Conclusion: In this experimental study, ESR1 genetic alterations were frequently detected in ER-positive MBC but ER-negative or EBC also harbored. The type of genetic alterations varied including SNVs, CN alterations and translocation and ESR1-NPHS1 fusion is the novel genetic alteration that has not been reported. To identify the role of ESR1 genetic alteration in ER-negative BCs and novel translocation, further functional validation would be warranted (Clinical trials.gov Number :NCT02591966).
Citation Format: Kim J-Y, Park K, Park W-Y, Nam SJ, Kim SW, Lee JE, Lee SK, Jung HH, Yu JH, Ahn JS, Im Y-H, Park YH. Identification of ESR1 mutation in breast cancers using targeted ultra-deep sequencing data analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-09-08.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SJ Nam
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SW Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JE Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - SK Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JH Yu
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - JS Ahn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - Y-H Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea
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Kim JY, Lee E, Park K, Jung HH, Park WY, Lee KH, Sohn JH, Lee KS, Jung KH, Kim JH, Lee KH, Im SA, Park YH. Abstract P2-09-21: Molecular alterations and poziotinib, a pan-HER inhibitor efficacy in human epidermal growth factor receptor 2(HER2) positive breast cancers: Combined exploratory biomarker analysis from phase II clinical trial of poziotinib for refractory HER2 positive breast cancer(BC) patients. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-09-21] [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: Poziotinib is a novel, pan-HER kinase inhibitor which showed potent anti-tumor activities through irreversible inhibition of HER family tyrosine kinases in preclinical and early clinical studies. Recent the open-label, multicenter phase II trial of poziotinib monotherapy evaluated that poziotinib is a new promising option for patients with HER2-positive metastatic BC who have failed more than two HER2 targeted therapy (NCT02418689). We evaluated genetic profiles of HER2-positive metastatic BC and investigated potential biomarkers of poziotinib for HER2-positive metastatic BC (MBC). Methods: All participants were diagnosed as HER2-positive BCs according to American Society of Clinical Oncology/College of American Pathologists HER2 guideline and provided tissue specimens that would be possible to extract DNA and RNA for next generation sequencing. We performed targeted deep sequencing with a customized 381 cancer gene panel (CancerSCAN™) and analyzed the relationship among the sequencing data, immunohistochemistry and clinical outcome.
Results: From Apr 2015 to Feb 2016, 106 patients were enrolled in the trial from 7 institutes in Korea. Of 106 patients, biomarker data were available for 79 patients. TP53 was the most frequently mutated gene (70.8%) followed by PIK3CA (45.6%). HER2 single nucleotide variant (SNV) was detected in 13 BCs (16.5%) and HER3 SNV was in 9 (11.4%). The score of HER2 immunohistochemistry (IHC) was 3+ in 68 BCs and 2+ with positive in situ hybridization in 11 BCs. In copy number variant (CNV) analysis, HER2 amplification (86.1%) was most frequently observed and followed by CDK12 amplification (58.2%) and APOBEC3B deletion (30.4%). IHC score of HER2 was positively correlated to copy number (CN) of HER2 (P=0.001) but 11 breast cancer tissue did not have copy number amplification of HER2 (13.9%) (Six of HER2 IHC score 2+ and 5 of 3+). The median progression free survival (PFS) was 4.04 months (95% CI, 2.96 - 4.40) for patients who treated with poziotinib in this study. PIK3CA activating mutations were associated with short PFS compared to wild type (WT) and other SNVs (Median PFS of activating mutations vs. WT and others: 2.66 vs. 4.40 (months), P=0.009). HER2 CN amplification was positively correlated to duration of PFS (Median PFS of no amplification vs. 4 ≤ CN < 16 vs. 16 ≤ CN: 2.56 vs. 3.02 vs. 4.86 (months), P=0.032). HER2 SNVs prolonged duration of PFS without statistical significance (Median PFS of HER2 SNVs vs. WT: 4.24 vs. 3.19 (months), P=0.114), but 10 of 13 BCs with HER2 SNV (76.9%) had clinical benefit from poziotinib and 5 BCs (38.5%) had durable response more than 6 months. Conclusion: In this biomarker analysis, SNV of HER2 was frequently observed in HER2 positive MBCs and HER2 CN amplification was detected not in all. High CN amplification of HER2 derived longer PFS than those with low CN. To contrary to this, activating PIK3CA mutations shorten PFS compared to those with WT. In addition, HER2 SNVs might be a potential biomarker of poziotinib in HER2-positive MBC. Further functional study would be warranted.
Citation Format: Kim J-Y, Lee E, Park K, Jung HH, Park W-Y, Lee K-H, Sohn JH, Lee KS, Jung KH, Kim J-H, Lee KH, Im S-A, Park YH. Molecular alterations and poziotinib, a pan-HER inhibitor efficacy in human epidermal growth factor receptor 2(HER2) positive breast cancers: Combined exploratory biomarker analysis from phase II clinical trial of poziotinib for refractory HER2 positive breast cancer(BC) patients [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-09-21.
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Affiliation(s)
- J-Y Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - E Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - K Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - HH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - K-H Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - JH Sohn
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KS Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KH Jung
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - J-H Kim
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - KH Lee
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - S-A Im
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
| | - YH Park
- Samsung Medical Center, Seoul, Korea; Samsung Genome Institute, Seoul, Korea; Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea; Seoul National University Hospital, Seoul, Korea; Yonsei Cancer Center, Seoul, Korea; National Cancer Center Hospital, Goyang, Korea; Asan Medical Center, Seoul, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; Chungbuk National University Hospital, Cheongju, Korea
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Park WY, Han S, Choi BS, Park CW, Yang CW, Kim YS, Kim JI, Moon IS, Chung BH. Progression of Osteoporosis After Kidney Transplantation in Patients With End-Stage Renal Disease. Transplant Proc 2018; 49:1033-1037. [PMID: 28583521 DOI: 10.1016/j.transproceed.2017.03.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study investigated the prevalence of osteoporosis and the risk factors for its progression in kidney transplant recipients (KTRs). METHODS Dual energy X-ray absorptiometry was used to prospectively measure changes in bone mineral density (BMD) before kidney transplantation (KT) and 1 year after transplantation in 207 individuals. We also analyzed the risk factors of osteoporosis progression during this period. RESULTS Prior to KT, the mean BMD score (T-score of the femur neck area) was -2.1 ± 1.2, and the prevalence of osteoporosis was 41.5% (86/207). At 1 year post-transplantation, the mean BMD score significantly decreased to -2.3 ± 1.1 (P < .001), and the prevalence of osteoporosis increased to 47.3% (98/207; P = .277). The BMD score worsened over the study period in 69.1% (143/207) of patients, improved in 24.1% (50/207), and showed no change in 6.8% (14/207). Minimal intact parathyroid hormone (iPTH) improvement after KT was found to be an independent risk factor of osteoporosis progression. CONCLUSIONS This study demonstrates progressive loss of BMD after KT and sustained secondary hyperparathyroidism might influence the progression of osteoporosis.
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Affiliation(s)
- W Y Park
- Kidney Institute, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - S Han
- Kidney Institute, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - B S Choi
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C W Park
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - C W Yang
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Y-S Kim
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J I Kim
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Vascular and Transplant Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - I S Moon
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Vascular and Transplant Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - B H Chung
- Transplant Research Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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Kang SS, Park WY, Jin K, Park SB, Han S. Kidney Transplantation in Korean Patients With End-Stage Renal Disease Aged 65 and Older: A Single-Center Experience. Transplant Proc 2018; 49:987-991. [PMID: 28583573 DOI: 10.1016/j.transproceed.2017.03.060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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
BACKGROUND The mean age of patients starting dialysis in Korea has increased to older than 60 years and the proportion of patients aged 65 and older exceeded 40% in 2014. Although the number of elderly dialysis patients is increasing rapidly, percentages of elderly patients undergoing kidney transplantation (KT) are very low. METHODS We retrospectively reviewed the medical records of patients who underwent KT at Keimyung University Dongsan Medical Center between 1982 and 2016. Elderly patients (≥65 years old) were compared with the control group of patients in their early sixties (60-64 years old). RESULTS Among a total of 1209 KT patients, those in their early sixties totaled 34 (2.8%) and the elderly totaled only 18 (1.5%). Patient and allograft survival rate showed no significant differences between the elderly and those in their early sixties. Death with a functioning graft accounted for 50% in both groups. However, occurrences of bacterial infection and tuberculosis were higher in the elderly (P = .011 and .047, respectively). In a multivariate analysis, longer duration of renal replacement therapy before KT and the occurrence of malignancy were independent risk factors for patient death (hazard ratio [HR], 1.027; P = .014; HR, 31.934; P = .016, respectively). Also, albuminuria at 6 months after KT was an independent risk factor for allograft loss (HR, 51.155; P = .016). CONCLUSION The overall survival rate of the elderly was not significantly lower than those in their early sixties. Even in the elderly, KT should not be delayed. In addition, careful surveillance for malignancy and measures to decrease the risk of infection are necessary.
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Affiliation(s)
- S S Kang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - W Y Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - K Jin
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - S B Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea
| | - S Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea.
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10
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Abstract
BACKGROUND Kidney re-transplantation is commonly considered to have a higher immunological risk than first kidney transplantation. Because of the organ shortage and increasing waiting lists, long-term outcomes of kidney re-transplantation are being studied. However, reports of re-transplantation outcomes are not common. We have reported our 30 years of experience with second kidney transplantations. METHODS Of 1210 kidney transplantations between November 1982 and August 2016 performed in our hospital, 105 were second kidney transplantations (2nd KT). Living donor KT was 44; deceased donor KT was 61. RESULTS Patient survival rates at 1, 5, and 10 years were 100%, 97.2%, and 90.7%, and graft survival rates were 97.0%, 94.6%, and 71.5%, respectively. The leading cause of graft failure in the 2nd KT was chronic rejection (60%). In addition, induction immunosuppressant, maintenance immunosuppressant, delayed graft function, and graft survival time at the 1st KT had a significant impact on graft survival time at the 2nd KT. CONCLUSIONS Reasonable results in both patient survival and graft survival rates were found in the 2nd KT. Careful monitoring of immunologic risk is needed.
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Affiliation(s)
- S M Yeo
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Y Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - S S Kang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - W Y Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - K Jin
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - S B Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - U J Park
- Vascular Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - H T Kim
- Vascular Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - W H Cho
- Vascular Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea
| | - S Han
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea; Keimyung University Kidney Institute, Daegu, Republic of Korea.
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Kan Z, Ding Y, Cho S, Lee SH, Powell E, Jung HH, Chung W, Deng S, Choi YL, Kim J, Park WY, Vizcarra P, Fernandez-Banet J, Nichols T, Ram S, Lee SK, Kim SW, Lee JE, Ching KA, Kim JY, Ahn JS, Im YH, Nam SJ, Park YH. Abstract P1-05-15: Multi-omics and immuno-oncology profiling reveal distinct molecular signatures of young Asian breast cancers. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-15] [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
Breast cancers (BC) in younger, premenopausal patients (YBC) tend to be more aggressive with worse prognosis, higher chance of relapse and poorer response to endocrine therapies compared to breast cancers in older patients. The proportion of YBC (age ≤ 40) among BC in East Asia is estimated to be 16-32%, significantly higher than the 7% reported in Western countries. To characterize the molecular bases of Asian YBC, we have performed whole-exome sequencing (WES) and whole-transcriptome sequencing (WTS) on tumor and matched normal samples from 134 Korean BC patients consisting of 74 YBC cases (age ≤ 40) and 60 OBC cases (age > 40). We then performed comparison analyses and integrative analyses with the TCGA BC cohort consisting of 1,116 tumors from primarily Caucasian patients, also grouped by age into YBC (age ≤ 40), IBC (40 < age ≤ 60) and OBC (age > 60).
Somatic mutation prevalence analysis identified 7 significantly mutated genes and the same top three genes – TP53, GATA3 and PIK3CA – were reported by the TCGA BC study. To identify differentially expressed (DE) genes and pathways in YBCs vs. OBCs, we performed logistic regression analyses while controlling for the confounding effects of tumor purity and stage. We were surprised to see a significant overlap in DE pathways between a comparison of adjacent normal tissues in younger vs. older TCGA cohorts and a comparison of YBC vs. OBC tumors, indicating that normal tissue compartment could contribute to observed differences between bulk tumors. To separately examine molecular signatures from tumor, stroma and normal compartments, we used non-negative matrix factorization (NMF) analyses to virtually dissect bulk tumor expression data and identified 14 factors including 3 factors associated with normal tissues, 1 factor associated with stroma and 1 factor associated with tumor infiltrating lymphocytes (TIL). Integrative analyses of tumor associated factors and DE pathways revealed that estrogen response, endocrine therapy resistance, and oxidative phosphorylation pathways are up-regulated in YBCs compared to OBCs while cell cycle and proliferation pathways are up-regulated in Asian OBCs. Interestingly, many immune and inflammation pathways correlated with the TIL factor were significantly upregulated in OBCs vs. YBCs. Using gene expression signatures representing distinct immune cell types, we classified our cohort into four subtypes of varying TIL activities and observed significant enrichment of the TIL-high subtype in OBCs compared to YBCs. These observations were confirmed by IHC analyses of four TIL markers (CD45, CD4, CD8 and CD163) in 120 tumors.
To our knowledge, this is the first large-scale multi-omics study of Asian breast cancer and would significantly contribute to the compendium of molecular data available for studying young breast cancers. The major landmarks in the molecular landscape looked similar across BCs of different ethnicities and ages, however, we have identified a number of distinguishing molecular characteristics associated with Asian YBC. The sources for some signatures were further traced to non-tumor intrinsic compartments, indicating that tumor microenvironment may play potentially important roles in driving the carcinogenesis of young breast cancers.
Citation Format: Kan Z, Ding Y, Cho S, Lee S-H, Powell E, Jung HH, Chung W, Deng S, Choi Y-l, Kim J, Park W-Y, Vizcarra P, Fernandez-Banet J, Nichols T, Ram S, Lee SK, Kim SW, Lee JE, Ching KA, Kim J-Y, Ahn JS, Im Y-H, Nam SJ, Park YH. Multi-omics and immuno-oncology profiling reveal distinct molecular signatures of young Asian breast cancers [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-05-15.
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Affiliation(s)
- Z Kan
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y Ding
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Cho
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S-H Lee
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - E Powell
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - HH Jung
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - W Chung
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Deng
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-l Choi
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J Kim
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - W-Y Park
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - P Vizcarra
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | | | - T Nichols
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - S Ram
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SK Lee
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SW Kim
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JE Lee
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - KA Ching
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - J-Y Kim
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - JS Ahn
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - Y-H Im
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - SJ Nam
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
| | - YH Park
- Pfizer Inc., San Diego, CA; Samsung Medical Center, Seoul, Korea
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Hwang JY, Lee J, Oh CK, Kang HW, Hwang IY, Um JW, Park HC, Kim S, Shin JH, Park WY, Darnell RB, Um HD, Chung KC, Kim K, Oh YJ. Proteolytic degradation and potential role of onconeural protein cdr2 in neurodegeneration. Cell Death Dis 2016; 7:e2240. [PMID: 27253404 PMCID: PMC5143381 DOI: 10.1038/cddis.2016.151] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 02/25/2016] [Revised: 04/21/2016] [Accepted: 05/05/2016] [Indexed: 12/11/2022]
Abstract
Cerebellar degeneration-related protein 2 (cdr2) is expressed in the central nervous system, and its ectopic expression in tumor cells of patients with gynecological malignancies elicits immune responses by cdr2-specific autoantibodies and T lymphocytes, leading to neurological symptoms. However, little is known about the regulation and function of cdr2 in neurodegenerative diseases. Because we found that cdr2 is highly expressed in the midbrain, we investigated the role of cdr2 in experimental models of Parkinson's disease (PD). We found that cdr2 levels were significantly reduced after stereotaxic injection of 1-methyl-4-phenylpyridinium (MPP(+)) into the striatum. cdr2 levels were also decreased in the brains of post-mortem PD patients. Using primary cultures of mesencephalic neurons and MN9D cells, we confirmed that MPP(+) reduces cdr2 in tyrosine hydroxylase-positive dopaminergic neuronal cells. The MPP(+)-induced decrease of cdr2 was primarily caused by calpain- and ubiquitin proteasome system-mediated degradation, and cotreatment with pharmacological inhibitors of these enzymes or overexpression of calcium-binding protein rendered cells less vulnerable to MPP(+)-mediated cytotoxicity. Consequently, overexpression of cdr2 rescued cells from MPP(+)-induced cytotoxicity, whereas knockdown of cdr2 accelerated toxicity. Collectively, our findings provide insights into the novel regulatory mechanism and potentially protective role of onconeural protein during dopaminergic neurodegeneration.
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Affiliation(s)
- J-Y Hwang
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea.,Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - J Lee
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
| | - C-K Oh
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
| | - H W Kang
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
| | - I-Y Hwang
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
| | - J W Um
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
| | - H C Park
- Graduate School of Medicine, Korea University, Ansan 425-707, Gyeonggi-do, Korea
| | - S Kim
- Graduate School of Medicine, Korea University, Ansan 425-707, Gyeonggi-do, Korea
| | - J-H Shin
- Division of Pharmacology, Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon 440-746, Gyeonggi-do, Korea
| | - W-Y Park
- Division of Pharmacology, Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon 440-746, Gyeonggi-do, Korea
| | - R B Darnell
- Laboratory of Molecular Neuro-Oncology, Howard Hughes Medical Institute, The Rockefeller University, New York, NY 10065, USA
| | - H-D Um
- Division of Radiation Cancer Biology, Korean Institute of Radiological & Medical Sciences, Seoul 01812, Korea
| | - K C Chung
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
| | - K Kim
- Department of Brain and Cognitive Sciences, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu 711-873, Korea
| | - Y J Oh
- Department of Systems Biology, Yonsei University College of Life Science and Biotechnology, Seoul 120-749, Korea
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Lee HB, Eum HH, Chung W, Lee HO, Lee KM, Kim KT, Moon HG, Noh DY, Han W, Park WY. Abstract P6-04-01: Single cell RNA sequencing reveals key expression signatures of primary breast cancer cells and immune infiltrates. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-04-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Cancers display intratumoral heterogeneity which interferes with the precise analyses of the tumor entity, and which may affect therapeutic outcomes of targeted treatments. The aim of this study was to evaluate the feasibility of single cell RNA sequencing on primary breast cancer cells and to demonstrate the key gene expression signatures and transcriptome heterogeneity of breast cancer subtypes.
Methods: We performed RNA sequencing on 246 individual cells from 4 primary breast tumors and 2 metastatic lymph nodes from 4 patients, using C1™Single-Cell Auto Prep System (Fluidigm, South San Francisco, CA). RNA sequencing reads were aligned to the human genome reference (hg19) using the 2-pass default mode of STAR_2.4.0d, and gene expression was quantified by RSEM v1.2.18 as the sum of isoform expression.
Results: Pathologic characteristics of the 4 patients is summarized in Table 1.
Table 1. Pathologic characteristics of patients BC01BC02BC03BC04pathologic stagepT1N0 (IA)pT2N0 (IIA)pT1N3 (IIIC)pT2N1 (IIB)Immunohistochemistry estrogen receptorpositivenegativenegativepositiveprogesterone receptornegativenegativenegativepositiveHER2 (FISH)2+/3 (negative)3+/3 (positive)1+/3 (negative)3+/3 (positive)No. of single cells tumor (lymph node)214947(50)28(51)HER2, human epidermal growth factor receptor 2; FISH, fluorescence in situ hybridization
To distinguish tumor cells, we chose epithelial cell adhesion molecule (EpCAM) as an archetypal epithelial tumor marker and performed gene signature enrichment analysis for the EpCAM-positive cells. A total of 673 genes with enrichment score > |0.5| were selected and used as an "epithelial breast cancer" signature. Consensus clustering with the epithelial breast cancer signature separated 246 cells into 145 epithelial tumor and 101 non-tumor cell groups. Gene expression profiling in the tumor cells revealed many co-regulated genes in the estrogen receptor (ER)-positive tumor at a single cell resolution, which represent previously known ER-associated genes including MYC, BCL-2, and GATA3. Individual tumor cells from the two human epidermal growth factor receptor 2 (HER2)-amplified tumors demonstrated drastically different degree of HER2 signaling pathway activation, indicating the necessity of molecular subtyping for the identification of HER2-activated tumors. TNBC tumor cells showed an overall upregulation of activator protein 1 transcriptional pathway and strong activation of epithelial-mesenchymal transition signatures in a small sub-population. Immune cells comprised all the non-epithelial population, with mostly T lymphocytes in the primary tumor samples and B lymphocytes in the lymph nodes. The tumor-infiltrating T cells expressed an activated phenotype and many cytotoxic components. Altogether, the single cell RNA sequencing revealed the true identity of the tumor cells and the tumor-associated immune cells.
Conclusion: Single cell RNA sequencing of breast cancer was used to reveal the true gene expression characteristics of the tumor cells and tumor-associated non-tumor compartments. The results showed key gene expression signatures of specific tumor subtypes and a wide range of transcriptome heterogeneity which is shaped by the tumor and microenvironments.
Citation Format: Lee H-B, Eum HH, Chung W, Lee H-O, Lee K-M, Kim K-T, Moon H-G, Noh D-Y, Han W, Park W-Y. Single cell RNA sequencing reveals key expression signatures of primary breast cancer cells and immune infiltrates. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-04-01.
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Affiliation(s)
- H-B Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - HH Eum
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - W Chung
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-O Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K-M Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K-T Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-G Moon
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D-Y Noh
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - W Han
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - W-Y Park
- Seoul National University College of Medicine, Seoul, Republic of Korea; Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Park YH, Jung KH, Sohn JH, Lee KS, Lee KH, Kim JH, Kim JY, Jung J, Han H, Park WY, Im SA. Abstract OT3-01-10: A prospective, open-label, single-arm, multi-center, phase II exploratory study to evaluate the efficacy and safety of poziotinib (NOV120101) in patients with HER2-positive metastatic breast cancer who have received at least two prior HER2-directed regimens. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-ot3-01-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Poziotinib is a novel, oral, irreversible pan-HER inhibitor that has shown promising clinical activity in Phase 1 studies of patients (pts) with advance HER2 positive breast cancer who have failed at least 2 prior lines of HER2-directed therapy. A Phase 2 study of poziotinib was initiated in Korea in March 2015 in pts with HER2+ metastatic breast cancer. This phase 2 study is designed to seek accelerated approval for poziotinib for the treatment of metastatic breast cancer in Korea.
Trial Design: Prospective Phase 2, open-label, single-arm, multi-center study in pts with recurrent, Stage IV breast cancer with HER2-overexpression who had received at least 2 prior HER2-directed regimens
Eligibility Criteria: Histologically confirmed breast cancer patients, at least 19 years of age, with confirmed HER2 positive evaluable tumors (per RECIST, 1.1) who have adequate hematologic, renal, and hepatic function and have failed at least two HER2-directed regimens that included a taxane-containing anticancer chemotherapy, with a life expectancy of at least 12 weeks.
Specific Aims: The Primary Efficacy Endpoint of the study was Progression-Free Survival (PFS). The Secondary Efficacy Endpoints included: PFS rate at 12 weeks post-dose; Objective Response Rate (ORR) including Complete Response (CR) and Partial Response (PR) rates; Disease Control Rate (DCR) including CR, PR, and Stable Disease (SD); Duration of Disease Control; Overall Survival (OS); Time to Progression (TTP); Time to Objective Response and Duration of Objective Response. The Exploratory Endpoints included: Population Pharmacokinetic (PK) Profile and Exploratory Genomic and Biomarker Analyses.
Statistical Methods: In the randomized, multicenter, 2-arm, open-label study of trastuzumab emtansine (TH3RESA18), the median PFS was shown to be 3.3 months in subjects with optimal treatment per Investigator's Choice. This ongoing study with poziotinib expects a median PFS of 4.5 months based on data from a previous Phase 1 study of poziotinib (NOV120101). Based on the following assumptions, a 5% one-sided significance level, and 80% power, and 2 months of accrual and 12 months of follow-up, 66 subjects will be required. Accounting for a 10% drop-out rate, a total of 74 subjects will be recruited into this ongoing Phase 2 study.
Present Accrual and Target Accrual: 17 patients enrolled as of May 20, 2015 with a total target enrollment of 74 patients
Contact information:
ClinicalTrials.gov Identifier: NCT02418689.
Citation Format: Park Y-H, Jung KH, Sohn JH, Lee KS, Lee KH, Kim J-H, Kim J-Y, Jung J, Han H, Park W-Y, Im S-A. A prospective, open-label, single-arm, multi-center, phase II exploratory study to evaluate the efficacy and safety of poziotinib (NOV120101) in patients with HER2-positive metastatic breast cancer who have received at least two prior HER2-directed regimens. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-01-10.
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Affiliation(s)
- Y-H Park
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - KH Jung
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - JH Sohn
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - KS Lee
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - KH Lee
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - J-H Kim
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - J-Y Kim
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - J Jung
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - H Han
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - W-Y Park
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
| | - S-A Im
- Samsung Medical Center, Seoul, Korea; Asan Medical Center, Seoul, Korea; Yonsei Medical Center, Seoul, Korea; National Cancer Center, Goyang, Korea; Chungbuk National University Hospital, Cheongju, Korea; Seoul National University Bundang Hospital, Soengnam, Korea; National OncoVenture, Goyang, Korea; Hanmi Pharmaceutical Co., Ltd., Seoul, Korea; Seoul National University Hospital, Seoul, Korea
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15
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Kim YJ, Park WY, Choi IH. Effects of dietary alpha-tocopherol, selenium, and their different combinations on growth performance and meat quality of broiler chickens. Poult Sci 2010; 89:603-8. [PMID: 20181880 DOI: 10.3382/ps.2009-00280] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study investigated the effect of different levels of dietary supplementation with alpha-tocopherol or Se, or both, on growth performance and meat quality of broiler chickens. A total of 270 broiler chickens were assigned to 6 dietary treatments (0, 50, 100, or 200 IU of supplemental alpha-tocopherol; 0.3 ppm supplemental Se; or 100 IU of alpha-tocopherol plus 0.3 ppm Se) with 3 replicates of 15 chickens per pen. Growth performance was recorded at 1 and 35 d. At the end of this experiment, 10 broilers per pen were slaughtered, and thigh muscle was dissected from each carcass and stored at 4 degrees C for 1, 3, 7, and 10 d. During the experimental period, none of the experimental treatments significantly influenced the growth performance of broilers. Thigh muscle pH values of all treatments decreased over time. The pH values for 1, 3, and 10 d were not affected by all treatments, but a statistical difference among treatments was observed at 7 d. Thiobarbituric acid reactive substances and total plate counts in all treatments increased with increasing storage time. In TBA reactive substances values, there were significant differences (P < 0.05) among treatments during the storage period. Differences among treatments in total plate count were found at d 7 and 10. In all treatments, L* (lightness) and b* (yellowness) values decreased over time, and a* (redness) values increased with storage time. Significant differences in all treatments were found for L* values at 3 d and a* values at 7 and 10 d of storage. Overall, these data indicate that compared with other treatments, supplementation with 200 IU of alpha-tocopherol or 100 IU of alpha-tocopherol plus 0.3 ppm Se were most effective in increasing lipid oxidative stability and delaying microbial growth and these activities were not associated with pH.
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Affiliation(s)
- Y J Kim
- Division of Life Resources, Daegu University, Gyong San, 712-714, South Korea
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16
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Abstract
Cryptosporidium parvum is 1 of the major causative organisms in waterborne diarrheal illness. Not only does C. parvum spread ubiquitously in our environment, it is also highly resistant to harsh environmental conditions and disinfectants. Therefore, a control measure for this protozoon is urgently required. This study investigated the effect of gamma-irradiation, in the range of 1,000-50,000 Gy, on the viability of C. parvum oocysts. Oocyst viability was determined by a combined indirect immunofluorescence and nucleic acid staining and animal infectivity study. The proportion of viable oocysts estimated by nucleic acid staining ranged from 94.2 to 89.4% in the 0- to 10,000-Gy groups, whereas it was reduced significantly to 58.6 or 45.7% in the 25,000- or 50,000-Gy group, respectively, at 24 hr postirradiation. In an animal infectivity study, oocysts irradiated with less than 10,000 Gy induced infections in mice wherein there were low numbers of oocysts per gram of feces amounting to 8-10.8% of the values in control mice, whereas with 50,000 Gy-irradiated oocysts, no oocysts were produced in the mice. This study suggests that at least 50,000 Gy of gamma-irradiation is necessary for the complete elimination of oocyst infectivity in mice.
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Affiliation(s)
- J R Yu
- Department of Parasitology, College of Medicine, Konkuk University, Chungju 380-701, South Korea
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17
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Lee KM, Abel J, Ko Y, Harth V, Park WY, Seo JS, Yoo KY, Choi JY, Shin A, Ahn SH, Noh DY, Hirvonen A, Kang D. Genetic polymorphisms of cytochrome P450 19 and 1B1, alcohol use, and breast cancer risk in Korean women. Br J Cancer 2003; 88:675-8. [PMID: 12618873 PMCID: PMC2376333 DOI: 10.1038/sj.bjc.6600761] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [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] [Indexed: 11/09/2022] Open
Abstract
A case-control study was performed to assess the potential influence of CYP19 Arg(264)Cys and CYP1B1 Leu(432)Val polymorphisms on breast cancer risk in a series of Korean breast cancer patients and controls. The results suggest that the CYP19 Arg(264)Cys polymorphism modifies breast cancer risk (OR=1.5, 95% CI=1.1-2.2), especially in association with alcohol consumption (P for interaction=0.04), whereas the CYP1B1 Leu(432)Val polymorphism appears to play no role here.
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Affiliation(s)
- K-M Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - J Abel
- Department of Experimental Toxicology, Research Institute of Environmental Health, Heinrich-Heine-University, Auf'm Hennekamp 50, 40225 Düsseldorf, Germany
| | - Y Ko
- Department of Internal Medicine, University of Bonn, Wilhelmstreet 35-37, 53111 Bonn, Germany
| | - V Harth
- Department of Internal Medicine, University of Bonn, Wilhelmstreet 35-37, 53111 Bonn, Germany
| | - W-Y Park
- Department of Biochemistry, Seoul National University College of Medicine, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - J-S Seo
- Department of Biochemistry, Seoul National University College of Medicine, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - K-Y Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - J-Y Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - A Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - S-H Ahn
- Department of Surgery, Ulsan University College of Medicine, 388-1 Pungnab-Dong Songpa-Gu, Seoul, Korea
| | - D-Y Noh
- Department of Surgery, Seoul National University College of Medicine, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
| | - A Hirvonen
- Finnish Institute of Occupational Health, FIN-00250 Helsinki, Finland
| | - D Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Cancer Research Institute, 28 Yongon-Dong Chongno-Gu, Seoul 110-799, Korea. E-mail:
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18
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Park WY, Goodman RB, Steinberg KP, Ruzinski JT, Radella F, Park DR, Pugin J, Skerrett SJ, Hudson LD, Martin TR. Cytokine balance in the lungs of patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2001; 164:1896-903. [PMID: 11734443 DOI: 10.1164/ajrccm.164.10.2104013] [Citation(s) in RCA: 416] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute respiratory distress syndrome (ARDS) involves an intense inflammatory response in the lungs, with accumulation of both pro- and antiinflammatory cytokines in bronchoalveolar lavage fluid (BALF). Our goal was to determine how the balance between pro- and antiinflammatory mediators in the lungs changes before and after the onset of ARDS. We identified 23 patients at risk for ARDS and 46 with established ARDS and performed serial bronchoalveolar lavage (BAL). We used immunoassays to measure tumor necrosis factor alpha (TNF-alpha) and soluble TNF-alpha receptors I and II; interleukin 1 beta (IL-1 beta), IL-1 beta receptor antagonist, and soluble IL-1 receptor II; IL-6 and soluble IL-6 receptor; and IL-10. We used sensitive bioassays to measure net TNF-alpha, IL-1 beta, and IL-6 activity. Although individual cytokines increased before and after onset of ARDS, greater increases occurred in cognate receptors and/or antagonists, so that molar ratios of agonists/antagonists declined dramatically at the onset of ARDS. The molar ratios remained low for 7 d or longer, limiting the activity of soluble IL-1 beta and TNF-alpha in the lungs at the onset of ARDS. This significant antiinflammatory response early in ARDS may provide a key mechanism for limiting the net inflammatory response in the lungs.
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MESH Headings
- Adult
- Antigens, CD/analysis
- Antigens, CD/immunology
- Biological Assay
- Bronchoalveolar Lavage Fluid/cytology
- Bronchoalveolar Lavage Fluid/immunology
- Case-Control Studies
- Cytokines/analysis
- Cytokines/immunology
- Female
- Humans
- Immunoassay
- Inflammation
- Inflammation Mediators/analysis
- Inflammation Mediators/immunology
- Interleukin-1/analysis
- Interleukin-1/immunology
- Interleukin-10/analysis
- Interleukin-10/immunology
- Interleukin-6/analysis
- Interleukin-6/immunology
- Lung/chemistry
- Lung/immunology
- Male
- Middle Aged
- Prospective Studies
- Receptors, Interleukin-1/analysis
- Receptors, Interleukin-1/immunology
- Receptors, Interleukin-6/analysis
- Receptors, Interleukin-6/immunology
- Receptors, Tumor Necrosis Factor/analysis
- Receptors, Tumor Necrosis Factor/immunology
- Receptors, Tumor Necrosis Factor, Type I
- Receptors, Tumor Necrosis Factor, Type II
- Respiratory Distress Syndrome/etiology
- Respiratory Distress Syndrome/immunology
- Respiratory Distress Syndrome/mortality
- Respiratory Distress Syndrome/pathology
- Risk Factors
- Time Factors
- Tumor Necrosis Factor-alpha/analysis
- Tumor Necrosis Factor-alpha/immunology
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Affiliation(s)
- W Y Park
- Section of Pulmonary/Critical Care Medicine, Harborview Medical Center, Medical Research Service of the VA Puget Sound Health Care System, Seattle, Washington, USA
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19
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Park WY, Thompson JS, Lee KK. Effect of epidural anesthesia and analgesia on perioperative outcome: a randomized, controlled Veterans Affairs cooperative study. Ann Surg 2001; 234:560-9; discussion 569-71. [PMID: 11573049 PMCID: PMC1422079 DOI: 10.1097/00000658-200110000-00015] [Citation(s) in RCA: 257] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To test the hypothesis that epidural anesthesia and postoperative epidural analgesia decrease the incidence of death and major complications during and after four types of intraabdominal surgical procedures. SUMMARY BACKGROUND DATA Even though many beneficial aspects of epidural anesthesia have been reported, clinical trials of epidural anesthesia for outcome of surgical patients have shown conflicting results. METHODS The authors studied 1,021 patients who required anesthesia for one of the intraabdominal aortic, gastric, biliary, or colon operations. They were assigned randomly to receive either general anesthesia and postoperative analgesia with parenteral opioids (group 1) or epidural plus light general anesthesia and postoperative epidural morphine (group 2). The patients were monitored for death and major complications during and for 30 days after surgery, as well as for postoperative pain, time of ambulation, and length of hospital stay. RESULTS Overall, there was no significant difference in the incidence of death and major complications between the two groups. For abdominal aortic surgical patients, unlike the other three types of surgical patients, the overall incidence of death and major complications was significantly lower in group 2 patients (22%) than in group 1 patients (37%), stemming from differences in the incidence of new myocardial infarction, stroke, and respiratory failure between the two groups. Overall, group 2 patients received significantly less analgesic medication but had better pain relief than group 1 patients. In group 2 aortic patients, endotracheal intubation time was 13 hours shorter and surgical intensive care stay was 3.5 hours shorter. CONCLUSIONS The effect of anesthetic and postoperative analgesic techniques on perioperative outcome varies with the type of operation performed. Overall, epidural analgesia provides better postoperative pain relief. Epidural anesthesia and epidural analgesia improve the overall outcome and shorten the intubation time and intensive care stay in patients undergoing abdominal aortic operations.
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Affiliation(s)
- W Y Park
- Department of Anesthesia, Veterans Affairs Medical Center, Washington, DC, USA
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Park JS, Park WY, Cho KA, Kim DI, Jhun BH, Kim SR, Park SC. Down-regulation of amphiphysin-1 is responsible for reduced receptor-mediated endocytosis in the senescent cells. FASEB J 2001; 15:1625-7. [PMID: 11427507 DOI: 10.1096/fj.00-0723fje] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J S Park
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, South Korea
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21
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Park WY, Hwang CI, Kang MJ, Seo JY, Chung JH, Kim YS, Lee JH, Kim H, Kim KA, Yoo HJ, Seo JS. Gene profile of replicative senescence is different from progeria or elderly donor. Biochem Biophys Res Commun 2001; 282:934-9. [PMID: 11352641 DOI: 10.1006/bbrc.2001.4632] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
In vitro cellular senescence of human diploid fibroblast has been a good model for aging research, which shows similar phenotypes to in vivo aging. Gene expression profiling would provide an insight to understand the mechanism of senescence. Using cDNA microarray containing 384 known genes, we compared the expression profiles of three different types of aging models: replicative senescence, fibroblasts from progeria or from elderly donor. Although all of them showed senescence phenotypes, distinct sets of genes were altered in each group. Pairwise plots or cluster analysis of activation fold of gene expression revealed closer relationships between fibroblasts from progeria or from old individual, but not between replicative senescence fibroblasts and either models. Differential expression pattern of several genes were confirmed by RT-PCR. We suggest that the replicative senescence model might behave differently to other types of aging models due to the distinct gene expression.
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Affiliation(s)
- W Y Park
- Department of Biochemistry and Molecular Biology, Seoul National University, Seoul, Korea
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22
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Kim YS, Kang D, Kwon DY, Park WY, Kim H, Lee DS, Lim CS, Han JS, Kim S, Lee JS. Uteroglobin gene polymorphisms affect the progression of immunoglobulin A nephropathy by modulating the level of uteroglobin expression. Pharmacogenetics 2001; 11:299-305. [PMID: 11434507 DOI: 10.1097/00008571-200106000-00004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Uteroglobin (UG) is an anti-inflammatory/immunomodulatory protein. Targeted disruption of UG rendered mouse glomerulonephritis resembling immunoglobulin (Ig)A nephropathy (IgAN). Sequence analysis on exon 1 of UG showed several putative binding sites for transcription factors, and polymorphisms in this site might influence the expression level of UG as a competitive protein. We speculated that the single nucleotide polymorphism at the 38th nucleotide (A to G) from the transcription initiation site of UG exon 1 would impact the progression of IgA nephropathy (IgAN). Polymerase chain reaction-restriction fragment length polymorphism and single-strand conformation polymorphism were instituted to determine the genetic polymorphism. Luciferase assay was performed using the gene constructs containing a region 404-bp long located upstream of UG exon 1 initiation site to analyse whether this polymorphism would affect the expression level. UG polymorphism was distributed no differently in patients with IgAN (n = 111) compared to 60 healthy control subjects. An excess of A genotype was found in one patient having progressive disease (P = 0.03) and the risk for the disease progression increased as the number of A alleles increased (P for trend = 0.03) after follow-up for 116 months. The odds ratio for progression with the AA genotype was 4.9 (95% Cl = 1.0-23.9) compared to patients having the GG genotype. Significant interactive effects of hypertension and genetic polymorphisms of UG on the disease progression were observed (P for interaction = 0.001). In the luciferase assay, the gene construct with A at the 38th site showed a decreased activity of 74 +/- 8.4% compared to that showed by G gene construct. Our results suggest that polymorphism at the 5' UTR region of UG exon 1 is an important marker for the progression of IgAN and may modulate the level of protein expression.
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Affiliation(s)
- Y S Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Clinical Research Institute Seoul National University Hospital, Chongno-gu, South Korea
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Park WY. [Application of DNA chip technology to biomedical research]. Exp Mol Med 2001; 33:113-24. [PMID: 11708319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
The completion of Human Genome Project enabled us to access to the information on nucleotide sequences of whole human genome. One of the most valuable information on human genome would be the list of approximately 35,000 genes. Although 35% of them are still needed to annotate their functions, we can genome-widely approach to various conditions including disease states. To analyze bunch of information at once, we need high-throughput technology containing most of genes. DNA chip successfully provide a stable platform technology for the massive screening of genomes. Microarrays can be used to obtain genome-wide fingerprint on transcriptional changes in various physiological and pathological conditions, leading to the mining novel genes related to those specific states. We can check the multiple molecular markers for diagnosis, prediction or prognosis of specific diseases. Data from microarray will provide huge amounts of experssion profile, which might induce the transformation of biomedical research.
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Affiliation(s)
- W Y Park
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Korea
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Abstract
One of the characteristics of senescent cells is unresponsiveness to external stimuli like EGF. Although they have a normal level of receptors and downstream signaling molecules, EGF cannot induce the activation of Erk kinases and DNA synthesis in senescent cells as much as in young cells. Caveolin proteins directly interact with signaling molecules including EGF receptor and suppress the activation of EGFR upon EGF stimulation. We found that Erk activation after EGF stimulation in senescent human diploid fibroblasts was down-regulated. Those senescent cells showed an increased level of three isoforms of caveolin proteins. This change seems to lie in transcriptional control in senescent cells. We also demonstrated up-regulated caveolin proteins were co-localized with EGFR proteins in detergent-insoluble fractions. From these results, we suggest that the up-regulated expression of caveolin might explain the unresponsiveness of senescent fibroblasts to EGF stimulation.
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Affiliation(s)
- W Y Park
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Korea
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25
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Kwon HC, Kim SK, Chung WK, Cho MJ, Kim JS, Kim JS, Moon SR, Park WY, Ahn SJ, Oh YK, Yun HG, Na BS. Effect of pentoxifylline on radiation response of non-small cell lung cancer: a phase III randomized multicenter trial. Radiother Oncol 2000; 56:175-9. [PMID: 10927136 DOI: 10.1016/s0167-8140(00)00221-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSES The objectives of this prospective clinical trial were to determine whether pentoxifylline improves the radiation response and survival in patients with non-small cell lung cancer. MATERIALS AND METHODS From July 1993 through October 1994, 64 patients with histologically confirmed Stage I, II and III non-small cell lung cancer were randomly divided into pentoxifylline (Pento)+Radiotherapy (RT) group and RT alone group. Out of the 64 patients, only 47 patients who had measurable tumors on chest X-ray views were analyzed and divided into Pento+RT group (n=27) and RT alone group (n=20). Total tumor dose of 65-70 Gy was delivered as conventional fractionated radiation schedules. Pento was given to the patients 3 x 400 mg/day with a daily dose of 1200 mg during RT. RESULTS Complete response (CR), partial response (PR), and stable in Pento+RT group were three (11%), 13 (48%), and 11 (41%), respectively, as compared with corresponding values of three (15%), 13 (65%), and four (20%) in the RT alone group. The median time to relapse in the Pento+RT group was 11 months which was 2 months longer than for the RT alone group (P>0.05). All the patients in both groups showed lower than or equal to grade 2 dysphagia, odynophagia, pulmonary fibrosis, and pneumonitis. The median survival was 18 months in the Pento+RT group and 7 months in the RT alone group. The 1-year survival rate was 60% in the Pento+RT group and 35% in the RT alone group, the 2-year survival rate was 18% in the Pento+RT group and 12% in the RT alone group. But these differences were not statistically significant (P>0.05). CONCLUSION We concluded that Pento is a modestly effective radiation response modifier and provide benefit in the treatment of non-small cell lung cancer.
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Affiliation(s)
- H C Kwon
- Chon-buk National University Hospital and Institute for Medical Sciences, Chon-Ju, South Korea
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Yeo EJ, Hwang YC, Kang CM, Kim IH, Kim DI, Parka JS, Choy HE, Park WY, Park SC. Senescence-like changes induced by hydroxyurea in human diploid fibroblasts. Exp Gerontol 2000; 35:553-71. [PMID: 10978678 DOI: 10.1016/s0531-5565(00)00108-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Hydroxyurea was found to inhibit the growth of human diploid fibroblasts, which resulted in senescence-like changes both in morphology and replicative potential similar to the replicative senescence. SA-beta-gal activity, a typical characteristic of the replicative senescence was also induced through a long-term treatment of the presenescent cells with 400-800 microgM of hydroxyurea for about 3 weeks. In addition, we determined the levels of cyclin-dependent kinase inhibitors, p21(Waf1) and p16(INK4a), and the p53 tumor suppressor in order to monitor its effect on cell cycle and stress responses. We observed a great induction of both p53 and p21(Waf1), but not of p16(INK4a) in the premature senescent cells. UV-irradiation of the premature senescent cells showed a decreased level of DNA fragmentation presumably ascribed to the reduced activation of stress-activated protein kinases. These results suggest that a chronic hydroxyurea treatment induces the cellular senescence in association with the induction of p53 and p21(Waf1).
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Affiliation(s)
- E J Yeo
- Department of Biochemistry, Cheju National University Colege of Medicine, Cheju, South Korea
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27
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Park WY, Park JS, Cho KA, Kim DI, Ko YG, Seo JS, Park SC. Up-regulation of caveolin attenuates epidermal growth factor signaling in senescent cells. J Biol Chem 2000; 275:20847-52. [PMID: 10781609 DOI: 10.1074/jbc.m908162199] [Citation(s) in RCA: 183] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Senescent human diploid fibroblasts do not respond to growth factors like epidermal growth factor (EGF), although they have a normal level of receptors and downstream signaling molecules. To examine the mechanism of signaling attenuation, we investigated Erk activation after EGF stimulation in senescent cells. Senescent cells did not phosphorylate Erk-1/2 after EGF stimulation, whereas young cells did. In those senescent cells, we found an increased level of caveolin proteins and strong interactions between caveolin-1 and EGF receptor. Electron microscopic analysis demonstrated an increased number of caveolae structures in senescent cells. More interestingly, brain, spleen, and lung from 26-month-old rats showed substantial increases of caveolin proteins. However, in the case of p53-induced senescence, caveolin-1 was not induced, and EGF stimulation phosphorylated Erk-1/2 as much as young control cells. Finally, we overexpressed caveolin-1 in young human diploid fibroblasts in which the activation of Erk-1/2 upon EGF stimulation was significantly suppressed. These results suggest that the unresponsiveness of senescent fibroblasts to EGF stimulation may be due to the overexpression of caveolins, which seems to be independent of growth arrest and other aging phenotypes.
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Affiliation(s)
- W Y Park
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul 110-799, Korea
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Okano HJ, Park WY, Corradi JP, Darnell RB. The cytoplasmic Purkinje onconeural antigen cdr2 down-regulates c-Myc function: implications for neuronal and tumor cell survival. Genes Dev 1999; 13:2087-97. [PMID: 10465786 PMCID: PMC316965 DOI: 10.1101/gad.13.16.2087] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Paraneoplastic cerebellar degeneration (PCD) is a disorder in which breast or ovarian tumors express an onconeural antigen termed cdr2, which normally is expressed in cerebellar Purkinje neurons. This leads to an immune response to cdr2 that is associated with tumor immunity and autoimmune cerebellar degeneration. We have found that cdr2, a cytoplasmic protein harboring a helix-leucine zipper (HLZ) motif, interacts specifically with the HLZ motif of c-Myc. Both proteins colocalize in the cytoplasm of adult cerebellar Purkinje neurons, and coimmunoprecipitate from tumor cell lines and cerebellar extracts. cdr2 down-regulates c-Myc-dependent transcription in cotransfection assays, and redistributes Myc protein in the cytoplasm. Disease antisera from six of six PCD patients specifically blocked the interaction between cdr2 and c-Myc in vitro. These data indicate that cdr2 normally sequesters c-Myc in the neuronal cytoplasm, thereby down-regulating c-Myc activity, and suggest a mechanism whereby inhibition of cdr2 function by autoantibodies in PCD may contribute to Purkinje neuronal death.
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Affiliation(s)
- H J Okano
- Laboratory of Molecular Neuro-Oncology, The Rockefeller University, New York, New York 10021 USA
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Park WY, Matsui T, Konishi C, Kim SW, Yano F, Yano H. Formaldehyde treatment suppresses ruminal degradation of phytate in soyabean meal and rapeseed meal. Br J Nutr 1999; 81:467-71. [PMID: 10615222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Most of the P in oilseed meal is in the form of phytate P, and phytate forms complexes with protein. Phytate P has been considered to be absorbed easily in ruminants because of phytate degradation in the rumen. Treatment of oilseed meals with formaldehyde improves the nutritional value of protein through suppressing its ruminal degradation. The present experiment was conducted to study the effects of formaldehyde treatment on phytate degradation in the rumen. The ruminal degradation of phytate in formaldehyde-treated soyabean meal or rapeseed meal was determined by a nylon-bag technique in sheep. Soyabean meal and rapeseed meal were treated with formaldehyde at levels of 3, 5 or 10 g/kg. Treatment with formaldehyde suppressed phytate and protein degradation in both the oilseed meals. Compared with the regular soyabean meal, the regular rapeseed meal showed lower degradability of phytate in the rumen. These results suggest that treatment with formaldehyde suppresses ruminal degradation of phytate in oilseed meal. Thus, the absorption of P from oilseed meal is probably decreased by this treatment in ruminants.
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Affiliation(s)
- W Y Park
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, Japan
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30
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Ahn JH, Ko YG, Park WY, Kang YS, Chung HY, Seo JS. Suppression of ceramide-mediated apoptosis by HSP70. Mol Cells 1999; 9:200-6. [PMID: 10340476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Ceramide has been known as an important second messenger in programmed cell death (apoptosis) which is induced by various stimuli such as the tumor necrosis factor-alpha (TNF-alpha), Fas ligand, and environmental stresses such as UV-irradiation and heat shock. Although the precise molecular mechanism of apoptosis is not fully understood, ceramide generated by sphingomyelinase (SMase) mediates the activation of several downstream molecules that are implicated in the regulation of apoptosis. Here, we show that stress-inducible heat shock protein 70 (Hsp70) prevents apoptosis induced by increased level of intracellular ceramide. In T-cell hybridoma DO11.10, we examined the effect of Hsp70 on apoptosis mediated by TNF-alpha, Fas ligation, SMase, and C2-ceramide, all of which elevate intracellular ceramide levels. Hsp70 not only markedly reduced internucleosomal DNA fragmentation, but also enhanced cell viability measured by the Trypan blue dye exclusion test. Similarly, the ceramide-induced c-jun amino-terminal kinase (JNK/SAPK) activation is impaired in cells overexpressing Hsp70. These data strongly suggest that hsp70 functions as a regulator of apoptosis downstream of ceramide.
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Affiliation(s)
- J H Ahn
- ILCHUN Institute for Molecular Medicine and Department of Biochemistry, Seoul National University College of Medicine, Korea
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31
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Lee WH, Park YM, Kim JI, Park WY, Kim SH, Jang JJ, Seo JS. Expression of heat shock protein 70 blocks thymic differentiation of T cells in transgenic mice. Immunology 1998; 95:559-65. [PMID: 9893045 PMCID: PMC1364352 DOI: 10.1046/j.1365-2567.1998.00633.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Heat shock protein 70 (HSP70) is involved not only in protein folding, but also in processes of differentiation and cell-cycle progression. Recently, HSP70 has been implicated in mediation of functions of some immunosuppressive agents. To study the role of HSP70 in differentiation of haematopoietic cells, we generated transgenic mice using the human inducible hsp70 gene fused to the mouse H-2K promoter. These mice develop a T-cell deficiency that is characterized by thymic hypoplasia and a significant reduction in peripheral T cells. The total number of thymocytes is about 100-fold less than that in normal mice. The majority of the thymocytes are immature T cells that express neither CD4 nor CD8 molecules, indicating that T cells are affected at an early stage of thymic differentiation. Expression of the transgenic HSP70 was detected both in bone marrow cells and in thymocytes. Furthermore, injection of normal bone marrow cells into the T-cell deficient mice led to the generation of mature T cells indicating that the T-cell deficiency was caused by the action of HSP70 in T cells. The blockage of differentiation occurred only in T cells, both alphabeta- and gammadelta-T-cell receptor (TCR)-bearing cells, but not in B cells, granulocytes, and monocytes. The observations suggest that HSP70 may inhibit a cellular process that is essential for the differentiation of early stage T cells. Further experiments using this model system will widen our understanding of HSP70 and its function on a molecular level.
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Affiliation(s)
- W H Lee
- Clinical Research Center, Samsung Biomedical Research Institute, Seoul, South Korea
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Abstract
Fibroblast growth factor (FGF) signaling is required for normal epithelial branching in the respiratory system of several species. Recent studies have shown that FGF-10 may be a key regulator of lung branching morphogenesis, based on its pattern of expression in the early lung and its ability to induce epithelial budding in vitro. In this study we investigate whether FGF-10 is able to direct lung epithelial buds to proper positions during development . We maintained localized high levels of FGF-10 in cultured lungs using FGF-10-soaked heparin beads. FGF-10 exerts a powerful chemoattractant effect on the distal but not on proximal lung epithelium. Epithelial buds grow toward an FGF-10 source within 24 h, and subsequently form concentric layers of epithelium around the bead. BrdU incorporation analysis suggests that FGF-10, in contrast to FGF-7, is a modest proliferation factor for the lung epithelium. In the absence of mesenchyme FGF-10 requires an associated proliferative signal to induce bud migration. This can be provided by extract from lung mesenchyme, or by FGF-7, a growth factor also present in the early embryonic lung. FGF-10 does not seem to interfere with early epithelial cell differentiation. The chemoattractant effect of FGF-10 in the lung epithelium is reminiscent of the patterning effect of the Drosophila FGF ortholog branchless in the developing tracheal epithelium, suggesting that the function of these genes has been conserved during evolution.
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Affiliation(s)
- W Y Park
- Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA
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Kwak HJ, Jun CD, Pae HO, Yoo JC, Park YC, Choi BM, Na YG, Park RK, Chung HT, Chung HY, Park WY, Seo JS. The role of inducible 70-kDa heat shock protein in cell cycle control, differentiation, and apoptotic cell death of the human myeloid leukemic HL-60 cells. Cell Immunol 1998; 187:1-12. [PMID: 9681997 DOI: 10.1006/cimm.1998.1309] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Several studies have suggested a role for heat shock proteins (hsps) during development and differentiation. However, relatively little is known about the role of hsp70 in controlling human hematopoietic cell differentiation and death. Here, we show that constitutive expression of human inducible 70-kDa heat shock protein (hsp70) promotes differentiation of HL-60 cells and prevents apoptosis that occurred after terminal differentiation or directly by apoptotic agents. After treatment with phorbol 12-myristate 13-acetate (PMA), hsp70-overexpressing cells (HL-60/hsp70) underwent rapid growth arrest and plastic adherence and expressed more CD14 than parental HL-60 or empty vector-transformed cells (HL-60/puro). HL-60/hsp70 cells also rapidly differentiated into granulocytes by addition of all-trans-retinoic acid, as assessed by phenotypic changes after staining with Wright-Giemsa. After differentiation into monocyte/macrophage-like cells or granulocytes, hsp70-overexpressing cells showed little evidence for apoptosis and had a prolonged survival, indicating that the survival-enhancing properties of hsp70 counteract programmed cell death that accompanies terminal differentiation. HL-60/hsp70 cells also showed more resistance than parental cells against apoptotic agents such as sodium nitroprusside, a NO-generating agent, or Taxol, a microtubule stabilizing agent. Further, heat shock of parental HL-60 cells at 42 degrees C for 3 h increased hsp70 levels, promoted plastic adherence (< 6 h) of the cells in respond to PMA, and protected cells from SNP or Taxol. Taken together, these studies demonstrate that hsp70 plays a crucial role in the differentiation of myeloid cells, participating in cell cycle controls and phenotypic changes, with protecting effects on apoptosis induced by different pathways.
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Affiliation(s)
- H J Kwak
- Department of Microbiology and Immunology, Wonkwang University School of Medicine, Iksan, Chonbuk, Korea
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Abstract
Granulocyte-macrophage colony stimulating factor (GM-CSF) induces proliferation and maturation of myeloid progenitor cells and also activates neutrophils. In order to investigate the pleiotropic effects of GM-CSF stimulation, we examined the signaling pathways of protein tyrosine kinases (PTKs) and signal transducers and activators of transcription (STATs) in GM-CSF-dependent proliferation of leukemia cells. Using TF-1, a GM-CSF-dependent human erythroleukemia cell line, we found that GM-CSF enhanced DNA-binding and tyrosine phosphorylation of STAT3. GM-CSF receptor (GM-CSFR) and c-Fes tyrosine kinase were also activated upon GM-CSF stimulation. Furthermore, c-Fes formed a complex with STAT3. Experiments using a c-Fes mutant that lacked tyrosine kinase activity revealed that the activation of STAT3 is kinase-dependent, but that the c-Fes-STAT3 interaction is not affected by c-Fes tyrosine kinase activity. The results suggest that STAT3 is activated by c-Fes tyrosine kinase through direct interaction during hematopoietic cell proliferation induced by GM-CSF.
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Affiliation(s)
- W Y Park
- Ilchun Institute for Molecular Medicine and Department of Biochemistry, Seoul National University College of Medicine, South Korea
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Lee SS, Park WY, Chi JG, Seo JW, Kim JI, Kim CW, Park SH, Khang SK, Cho KJ, Seo JS, Jang JJ. Thymic epithelial tumor progression in an SV40T transgenic mouse model. Cortical thymoma-thymic carcinoma sequence. Virchows Arch 1998; 432:33-42. [PMID: 9463585 DOI: 10.1007/s004280050131] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
There have been several reports that thymoma in human is a progressive disease, and that thymoma and thymic carcinoma form a continuum. We established a stable line of SV40T transgenic mice, which consistently produced thymic epithelial tumours progressing to thymic carcinoma within a predictable time span. Using this animal model and a morphological approach, thymic epithelial tumour progression was studied with reference to sequential changes at different time points in animals aged from 3 to 32 weeks. At all ages, SV40T was expressed in the nuclei of thymic epithelial cells; in these transgenic mice we observed the entire spectrum from cortical type thymoma to thymic carcinoma. Thymic size tended to increase with ageing in SV40T TG mice. While younger mice had predominantly cortical (organoid) or cortical thymoma, older mice had well-differentiated thymic carcinoma (WDTC) or poorly differentiated thymic carcinoma. When SV40T TG mice (248 line) reached a certain age, carcinoma of the thymus was present in all of them. Cortical-type thymoma became malignant within a predictable time span, suggesting a cortical thymoma-carcinoma sequence. When the mice were 9 weeks of age, the thymuses formed gross masses compatible with cortical thymoma. At 14 weeks of age, WDTC appeared against the background of cortical thymoma. Poorly differentiated thymic carcinoma was found after 15 weeks and affected all animals over 23 weeks of age. Most thymic carcinomas coexisted in varying proportions with cortical-type thymoma. Medullary thymomas did not develop in the mice, and no transition from medullary-type thymomas to thymic carcinomas was observed. In this SV40T transgenic mouse model, thymic carcinoma is clearly preceded by cortical-type thymoma. These transgenic mice may provide an interesting model for the progression from cortical thymoma to WDTC and/or high-grade carcinoma.
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Affiliation(s)
- S S Lee
- Department of Pathology, Seoul National University College of Medicine, Chongno-gu, Korea.
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36
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Abstract
We produced transgenic mice using SV40 Tag gene under the control of its own enhancer and promoter. Three transgenic lines (SNU-SVT125, 127, 248) consistently developed thymic carcinoma as well as choroid plexus carcinoma and dysplastic renal tubule. In SNU-SVT248 line, SV40 Tag transgene was expressed at thymus, spleen and kidney. Thymic epithelium showed high level expression of SV40 Tag in immunohistochemistry. Histopathological and electron microscopic analysis revealed that poorly differentiated carcinoma was derived from type 2 to 4 thymic epithelial cell. Our transgenic mice would provide a model for studies on the pathogenesis of thymic carcinoma and on the regulation of thymopoiesis by epithelial cells.
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Affiliation(s)
- W Y Park
- Transgenic Mice Center, Seoul National University College of Medicine, Korea
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Abstract
P130gag-fps, the product of Fujinami sarcoma virus, has a leucine zipper (LZ) motif located in 729-756 amino acid residues. To explore the role of LZ-like domain in the transformation by P130gag-fps, we made a deletion (delta FpsLZ/SH2) and a site-directed substitution mutation (L746P). Deletion mutant did not transform the 3Y1 cells and the resulting protein did not show kinase activity. Substitution of Leu746 with Pro (L746P) reduced the transforming activity by 6-fold. Although the L746P mutant retained intact catalytic activity in vitro, it did not phosphorylate cellular proteins in vivo. We concluded that LZ-like domain might mediate the trans-activation of P130gag-fps tyrosine kinase by autophosphorylation, which is prerequisite for the transforming activity.
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Affiliation(s)
- W Y Park
- Transgenic Mice Center, Cancer Research Institute, Seoul, Korea
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Abstract
The purpose of this study was to evaluate the feasibility and advantages or disadvantages, if any, of patient-controlled sedation compared with sedation administered by the anesthesiologist during surgical epidural anesthesia. Forty patients were divided at random into two groups with 20 patients in each group. Patients in group 1 received 0.5-1.0 mg intravenous midazolam and 25-50 micrograms intravenous fentanyl in increments administered by the anesthesiologist to achieve intraoperative sedation; patients in group 2 self-administered a mixture of midazolam (0.5 mg) and fentanyl (25 micrograms) in increments using an Abbott Lifecare PCA infuser to achieve sedation. Demographics of the patients, the types of surgery performed, doses of midazolam and fentanyl administered in a given period of time, and the level of sedation maintained during epidural anesthesia and surgery were similar in both groups. Patients in the self-administered group, however, rated their level of comfort during anesthesia and surgery higher than did those in the anesthesiologist-controlled sedation group. This could have been due to a positive psychological effect produced by allowing patient to feel that they have some control over their situation. The findings of this study indicate that patient-controlled sedation using a combination of midazolam and fentanyl is a safe and effective technique that provides intraoperative sedation ranked better by patients than that provided by anesthesiologists using the same drugs. More studies are, however, needed to determine the best choice of drug(s), the doses, the lock-out intervals, and the possible use of continuous infusion with patient-controlled sedation.
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Affiliation(s)
- W Y Park
- V.A. Medical Center, Washington, DC 20422
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39
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Abstract
Epidural anesthesia has been reported to exert beneficial effects in surgical procedures. Over the past 3 years at the Veterans Administration Medical Center in Washington, DC, thoracic surgical procedures have been done using a combined technique of epidural anesthesia with light general anesthesia. A retrospective review of this experience from January 1984 to November 1987 was done in 90 consecutive patients. Postoperative extubation of patients was accomplished immediately in 32%, within 1 hour in 34%, within 3 hours in 28%, within 18 hours in 4%, and was prolonged in only 1% of patients. Mortality was 2% and morbidity was 3%. This analysis indicates that the technique of epidural anesthesia with light general anesthesia provided satisfactory anesthesia with low mortality and morbidity in a high-risk group of patients undergoing surgery.
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Affiliation(s)
- B K Temeck
- Department of Surgery, Veterans Adminstration Medical Center, Washington, DC 20422
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Gottdiener JS, Papademetriou V, Notargiacomo A, Park WY, Cutler DJ. Incidence and cardiac effects of systemic venous air embolism. Echocardiographic evidence of arterial embolization via noncardiac shunt. Arch Intern Med 1988; 148:795-800. [PMID: 3355298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Central nervous system dysfunction in venous air embolism may result from air entering the arterial circulation. Using two-dimensional and pulsed-wave Doppler echocardiography, this study not only documented the frequent presence of air in the right heart chambers of patients undergoing upright neurosurgery or pacemaker insertion, but also documented the presence of air in the left atrium and left ventricle of one patient via noncardiac shunt. Studies in dogs confirmed paradoxical air embolism in the absence of anatomic communications between right and left heart chambers. Systemic venous air also produced a dose-dependent increase in pulmonary artery pressure and diastolic flattening of the ventricular septum with increase in left ventricular filling pressure despite preserved systolic function.
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Affiliation(s)
- J S Gottdiener
- Medical Service, Veterans Administration Medical Center, Washington, DC
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Park WY, Hagins FM, Massengale MD, Macnamara TE. The sitting position and anesthetic spread in the epidural space. Anesth Analg 1984; 63:863-4. [PMID: 6465584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Park WY, Massengale M, Kim SI, Poon KC, Macnamara TE. Age and the spread of local anesthetic solutions in the epidural space. Anesth Analg 1980; 59:768-71. [PMID: 7191650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Sensory level of anesthesia following the injection of 20 ml of 1.5% lidocaine with epinephrine (1:200,000) in 238 adult males averaged T7.7, T5.6, and T5.1 at 10, 20, and 30 minutes, respectively. Patient age had no significant effect on local anesthetic requirements per spinal segment per unit height until age 40 years, which age the calculated amount of local anesthetic decreased significantly to 0.62 ml from 0.69 ml/segment/meter of height. Above age 40 there was no further decrease in epidural anesthetic requirement with advancing age. Patient height was inversely related to sensory level (p < 0.001). Time required for anesthesia ro recede to T12 averaged 164 minutes and was slightly but significantly (p < 0.05) prolonged with advancing age.
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Park WY, Massengale M, Macnamara TE. Age, height, and speed of injection as factors determining caudal anesthetic level, and occurrence of severe hypertension. Anesthesiology 1979; 51:81-4. [PMID: 453598 DOI: 10.1097/00000542-197907000-00019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Park WY, Balingit PE, Macnamara TE. Effects of patient age, pH of cerebrospinal fluid, and vasopressors on onset and duration of spinal anesthesia. Anesth Analg 1975; 54:455-8. [PMID: 238430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Two hundred twenty-two spinal anesthesias were administered with 10 mg. of tetracaine and 1 ml. of 10 percent dextrose to investigate the effects of vasopressors, patients age, and pH of cerebrospinal fluid on the onset and duration of spinal anesthesia. Neither the differences in overall age, cerebrospinal fluid pH, nor the addition of vasopressors had any significant effect on onset. Duration, however, was significantly prolonged by the addition of vasopressors, 53 percent prolongation by 0.2 mg. of epinephrine and 72 percent prolongation by 2 mg. of phenylephrine.
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Kenmore PI, Park WY. Effect of poly (methy methacrylate) on arterial PO2 in total hip operation. J Biomed Mater Res 1975; 9:381-2. [PMID: 1176494 DOI: 10.1002/jbm.820090314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Park WY, Balingit PE, Macnamara TE. Interactions of gallamine and pancuronium with tubocurarine under morphine-nitrous oxide-oxygen anesthesia in man. Anesth Analg 1974; 53:723-9. [PMID: 4472154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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